My Personal Journey and Insights

Having practiced clinical medicine in the NHS for 2 years, I have noticed a number of problems that I can no longer ignore. The undeniable one is the imbalance in demand and supply of healthcare resources — too many patients but too few healthcare professionals. This leads to an overworked workforce, poor management decisions and spiralling costs to the system. The issue is evident amongst healthcare professionals as it is a commonly voiced concern. But they choose to adhere to their duty and complete their jobs list for the day. This set of events will repeat itself day after day compounding the underlying causes of the issue. They are not to blame. Unfortunately, there is inadequate time in the day to produce innovative solutions. Clock in and clock out. What a shame! We enter the profession with the sole purpose of making a difference but very quickly realise that we’re not in control.

I decided to make time and dig deeper. This led me to the bigger problem. The NHS and every healthcare system in the world is a reactive one also known as “sick care.” That is, the system waits for one to become sick before it intervenes. It is built to diagnose and treat illness. This works extremely well in the context of acute illness; conditions that are severe and sudden in onset for example a broken bone or a chest infection. However, 70–80% of patients that I have seen in a healthcare setting have been due to chronic diseases — illnesses that last for 3 months or longer such as diabetes and heart disease. The World Health Organisation released a report stating “heart disease, stroke, cancer, diabetes and chronic lung disease, are collectively responsible for almost 70% of all deaths worldwide.” You may argue, that life expectancy has increased. True! However, those extra years are not healthy ones. In reality, we are now living fewer healthy years than we once did.

Prevention is better than cure

The good news is that chronic diseases can be prevented. Reason being, they are a result of lifestyle and environmental factors which can be controlled by the individual. Hence, I discovered Lifestyle Medicine. This type of medicine’s primary focus is to promote healthier lives through salutary environments and healthier lifestyle choices resulting in the treatment of root causes of diseases rather than superficially managing symptoms. The European Society of Lifestyle Medicine defines Lifestyle medicine (LM) as: a branch of evidence based medicine in which comprehensive lifestyle changes (including nutrition, physical activity, stress management, social support and environmental exposures) are used to prevent, treat and reverse the progression of chronic diseases by addressing their underlying causes. Interventions in LM include health risk assessment, health behaviour change counselling and clinical application of lifestyle modifications. It has the potential to reduce the burden of chronic disease to the health system leading to significant cost savings and a more productive population creating an unprecedented amount of economic value. Most importantly it will increase the quality of life in combination with longevity for the individual.

Lifestyle Medicine boils down to one simple explanation. Our bodies have a remarkable capacity in healing themselves as long as we support them with the right factors.

How should we deliver Lifestyle Medicine?

A multi-disciplinary approach can be taken:

  1. Raise awareness of LM among healthcare professionals
  2. Change university curriculums at medical schools to integrate LM modules
  3. Promote and support research of LM
  4. Create government policies to encourage the population to live healthier.

However, technology is the ultimate form of leverage. Archimedes once said “Give me a lever long enough and a fulcrum on which to place it, and I shall move the world.” In 2018 and looking ahead, I strongly believe that technology is that lever. It is fundamentally a force that takes a scarce resource and makes it abundant. Aluminium is a perfect example of this. Once considered the most valuable metal in the world due to its rarity, is affordable and ubiquitous today as a result of a breakthrough technology known as electrolysis. Other more practical examples include abundance of apples due to ladders, information through Google, knowledge through Wikipedia, communications through Facebook, and taxis through Uber. By applying this theory and taking a methodical approach, healthcare or lifestyle medicine has the potential to become abundant using data science and machine learning technology powering web and smartphone applications.

Global smartphone penetration is projected to reach 40% in 2020. This means around 3 billion people will own a smartphone by then. Applications on these devices allow the user to have a direct channel of communication or access to anything of their choice. Imagine, 3 billion people having an app or a number of apps that empowers them to take control of their health. Empowerment would take place in the form of education, smart nudges, data collection + analysis and prediction of illness. Essentially, it would support their hyper efficient bodies by facilitating the application of the principles of lifestyle medicine. Wouldn’t that be an effective way to reduce the demand and increase the supply of healthcare resources?

After all my research, experiences, and learnings the next big question I had to ask myself— which industry will build the technology to scale lifestyle medicine? I found the answer in Dr. Michael Greger’s book “there is one corporate sector that actually benefits from keeping people healthy — namely, the insurance industry.”