Prevention Before Cure
Our health system is good at fixing up sickness, if we have an accident or get an infectious disease, get ear ache or a sore tooth, then it’s good to know that we have world class medical professionals and a system to deal with all of that.
But, let’s face it, our health system is not so awesome at preventing us from getting sick, and providing us with the tools to have a great life where our health allows us to flourish and reach our full potential.
We’re adequate at producing the ambulance at the bottom of the cliff.
But what of the preventative vehicle to stop us falling ill in the first place?
At PreKure™ we are big fans of what has been achieved in medicine. As part of the health profession, we all stand on the shoulders of giants in so many ways – Louis Pasteur, Florence Nightingale, Marie Curie, Joseph Lister, Otto Warburg, Watson and Cricks….thank goodness for their curiosity, bravery and tenacity in the face of what would have no doubt been severe opposition from the medical minds of the day.
Yes, we’ve come a long way, but each change has been painful and slow.
In 1846, Hungarian doctor Ignaz Semmelweis found that if doctors washed their hands after the autopsy of dead mothers then this reduced neonatal death from sepsis 9-fold. Yes… 9-fold! Unfortunately, this doctor’s findings were not adopted by the medical fraternity who refused to accept that they themselves could have been a cause of death.
He never got to see his breakthrough as he was ostracised then institutionalised for a mental breakdown. In a terrible twist of fate, he died himself of sepsis in the mental institution.
Let’s face it, when it comes to accepting new evidence for changes in medicine, history tells us we’re cynical and we’re slow, even when the evidence and the need is overwhelming.
Citrus on boats to prevent scurvy.
It took more than 50 years to move on the evidence that smoking kills to doing something about it.
It took about the same time from learning of the evidence that asbestos caused lung cancer to doing something about that.
“Human health is defined as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
World Health Organization (WHO), 1948
The World Health Organization (WHO) defined human health in its 1948 constitution as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” And they were right. Yet today, 70 years later, most countries in the developed world spend very little on prevention. These countries spend approx. 10% of GDP on “health”. By way of example, this equates to 18 Billion dollars that the New Zealand Government spends on healthcare each year, yet it is estimated that < 1.0%, of this is spent on prevention of chronic disease through supporting healthy lifestyles and other activities such as preventing smoking, alcohol moderation, physical activity, healthy diet, and reducing overweight/obesity.
The large majority of that 18 billion dollars goes on treatment of chronic conditions and over spending on end of life care which often provides very little extra quality or quantity of life.
Let’s face it, we spend billions on sickness and very little on health. It is time to tip the balance. We simply cannot out-treat these diseases, we need to prevent them from occurring in the first place.
Currently we are unable to achieve the WHO wholistic goal of health as every ‘health system’ in the world is being crushed by the burden of lifestyle disease. Our hospitals are full of patients who are overfed yet undernourished. Our hospitals are full of patients in need of curing. Average Life Expectancy for males in the world’s developed countries is approx. 80 years and some 83 years for females. However, ‘Healthy Life Expectancy’ is more like 65 and 67 years respectively.
What of these 15 or so missing years? Today, some 20% of our lives will on average be spent with a disability – a functional limitation that requires assistance. Although we are living longer than our predecessors we are unfortunately spending proportionally less of our lives in good health. This is also known as the disability transition… the worldwide trend away from communicable to non-communicable diseases.
The stark reality is that we now have systemic failure in our health systems. The financial dominance of Big Pharma and to an extent Big Food in modern medicine has conned the system into massive spending on pharmaceuticals and one-off treatments. The poor cousin is lifestyle medicine.
What is Lifestyle Medicine?
In scientific terms it is a blend of complex physiology and behavioural sciences that prevents preventable diseases and treats modifiable illness. It is estimated that 50% of all cancer could be prevented by not smoking and maintaining a healthy weight. Eliminating cancer is not a moon-shot but rather an earth shot. It is achievable.
We define Lifestyle Medicine as a personalised prescription of behavioural sciences and psychology, nutrition, sleep and movement.
Something in here about mental health from Dr Julia ### Tedx
Lifestyle medicine is the medicine of the future. It is clinically sound and evidence-based. It is the answer to increasing not just the human lifespan but more importantly the human healthspan.
The need for strengthening of medical education and training in the prevention of disease is now both compelling and urgent. The opportunity to do so abundant. We are living in times of great change but also of massive possibility. The triple revolution of machine, platform and the crowd will and is irrevocably changing traditional medical practise. There is now enormous amounts of human knowledge, expertise and enthusiasm distributed all over the world that is available and able to be focused online.
“The doctor of the future will give no medication, but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease.”
Thomas Edison, American Inventor, 1900s
As Thomas Edison stated “The doctor of the future will give no medication, but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease.”
The established giants of today’s industry are beginning to take notice. Amazon, Berkleyshire Hawaway and JP Morgan Chase recently formed a JV aimed at exploring healthcare tech with a specific view to preventative medicine.
We are also seeing innovative Upstarts such as Prolon – a clinically tested fasting mimicking program currently awaiting FDA approval. This product is directly aimed at Diabetes reversal and prevention.
Could we be at the tip of a tipping point?
Perhaps, yet the large majority of health professionals have little or no training in the complex physiology and behavioural sciences that constitute lifestyle medicine and that must be understood if they are to prescribe the changes their patients require. Not only that, but what training does exist is often tainted by commercial interests and science that is now well out of date.
71% of medical schools in the USA provide less than the recommended 25 hours of nutrition education, and 36% provide less than half that amount (Adams et al, 2015). A 2017 report by medical educators from Harvard Medical School proposes a major restructuring of university medical education to graduate “science-minded” and “service-minded” physicians with the capacity to advance population health.
The way we do medicine has fundamentally changed. Patients now expect their nurses, doctors, and dietitians to understand the new science of nutrition and lifestyle medicine.
We all need to learn to change medicine… as the new world needs new knowledge.
The new world is preventative, customer centric, future focused and about thriving not just surviving. This is a rapidly moving and exciting field that can and will deliver health, or as we like to call it; a PreKure, to those who need it most.
To advance population health we must PRE Cure…that is prevent ill-health in the first place and optimise for wellbeing.
“Be the change you want to see in the world.”
The old world was one of drugs, outdated nutrition guidelines and written clinician’s nutritional guides based on poor science. The old world was palliative, Big Pharma and Big food centric. Let’s change medicine.
PreKure is a Lifestyle Medicine Movement. We’re out to fuel a tipping point!
We believe that the WHO’s wholistic and broad definition of health is achievable for all of us. The prescription is three-fold
- Live with meaning and purpose
- Cultivate your social networks positively, and
- Eat well… Sleep plenty and Move every day …OR in other words nourish your body and soul.
Nourish your learning.
We believe that prescribing lifestyle medicine should be as easy as prescribing drugs. We believe that the definition of medical and/or health professional needs to be expanded to include those at the frontline of health, including personal trainers, nutritionists and health coaches. We believe that medical and allied health professionals should work together without the burden of any form of stigma for doing do.
PreKure is a medical education and training organisation. We believe that all medical professionals should have easy access to the latest research. We believe that constructive and open debate is the way forward and will ultimately lead to less confusion, not more. So we provide continuing medical education courses that are based in the irrefutable evidence that Lifestyle Medicine works to PreKure disease.
PreKure is also a provider of curative and preventative health-change programs. We believe that both patients and health professionals should be empowered and encouraged to try N=1 self-experiments, enabling a deeper appreciation of new treatment approaches. We believe in learning by doing. The way we interact with patients has fundamentally changed. Patients now expect their nurses, doctors, and dietitians to have a deep empathy with their personal plight.
Together we can prevent ill-health before a cure is needed. We can help create a tipping point and shift from a sickness system to a health system if we pull together.
#PreventHeartDisease #PreventDementia #PreventCancer #PreventDiabetes
At PreKure™ we use this year’s thinking and this year’s evidence. A 2018 Science Advisory just released by the American Heart Association conclude’s by stating that
“Enhancing physician education and training in nutrition, as well as increasing collaborative nutrition care delivery by 21st century health systems, will reduce the health and economic burdens from atherosclerotic cardiovascular disease to a degree not previously realized.”
Together we can eliminate the over prescribing of medication that offers little or no benefit, poor nutritional advice and programs which don’t work, and have the health community embrace nutrition as medicine. And that’s a vision we believe is worth fighting for.