A most beautiful alternative healthcare delivery system is needed.
by JP Saleeby, MD
Hard for me to say this, but the current healthcare delivery systems on planet Earth are so corrupt and dysfunctional they are beyond repair. When I started my journey towards a more holistic/integrative approach to medicine in 1998 I was hoping for a slow organized and easy transition from what was a dysfunctional healthcare delivery system back then to what I enjoy in my private practice as a very functional system now. However, that was not readily embraced and because the paradigm shift did not occur in a manner that would be safe and orderly we have the mess we are in now.
Twenty years would have been a suitable amount of time for an easy transition without too many bumps and bruises along the way. The Pandemic has triggered a rude awakening for many and a scramble for those seeking to exit the broken down system that still predominates. When viewed thru my prism I see the catastrophe that has only grown worse in the past 36-months. The resultant stubbornness of those stuck in the old system divulges the poor patient outcomes we see today. Top of mind is the disastrous outcomes in COVID inpatients who are hospitalized or do not receive proper early interventional therapies. The outlandish disregard for patient safety, the dismissiveness to at least try any alternatives in inpatient treatment has resulted in large numbers of unnecessary fatalities.
It is not just COVID. Take a hard look at the world of oncology. I have witnessed personally in my practice quite a few atrocities coming from that specialty group. I have had firsthand conversations from providers and nurses within oncology that are quite upsetting. The system that thrives in that specialty group is cemented with the insurance-bio-medical industrial complex that does not serve the cancer-stricken patient at all.
Another blatant example of poor patient advocacy is in psychiatric medicine. Those tormented soles suffering mental illness are placed on a rapidly moving conveyor belt subjecting them to polypharmacy and pharmaceutical dependance that is lifelong. For many the true diagnosis is missed and there are organic chronic illnesses often vector born that are the root cause from the mood disorders, depression and anxiety that a psychopharmaceutical cocktail will not address properly.
The first step to avert total disaster is to embrace a different paradigm in medicine. One that is sustainable both in terms of financial and in terms of protecting the healthcare providers from burnout. A system or paradigm in practice that is truly patient-based, preventive in focus (not just lip service), and based in science. Evidence based medicine in the past two decades has degraded into the religious believe that anything published in a top-notch high-powered peer reviewed medical journal was the gospel. However, it you take a deeper critical look you see a very biased reporting system, large numbers of retractions and a litany of ex-journal editors decrying the fact that large pharmaceutical companies have a very strong hand in what is published. Since the pandemic an all-time high censorship rate permeates the journals and even spills out into mainstream media. The doctors and the public are now subject to ill written, erroneous published studies. Hard to make good clinical decisions from those articles these days.
In my experiences over the past two-decades I have realized that a modified or reformed form of functional medicine is the salvation of our healthcare delivery system. Step one is to convert the existing practitioners to this form of medicine. To achieve this, we must present and convince those open to the idea and support their disembarkation from the sinking ship to the life raft of functional medicine. Supporting a national effort to establish clinics (outpatient healing centers) initially is paramount. Next would be hospitals for healing, treatment protocols that are outside of the box and not 20-year-old protocols and the freedom for providers to prescribe for the patient’s best interest. This inpatient proposition can only be achieved when we take the dependency of existing insurance companies and pharma away from them. Therefore, the third proposition would be to establish a new form of patient driven shared healthcare insurance businesses. Along with this would be direct negotiations with pharmaceutical companies (with newfound leverage) for better pricing and insistence of safety and efficacy research for existing and emerging products. Until the FDA is reformed, we can no longer rely on this agency to protect the populous.
It is not just a simple step of setting up new-paradigm clinics all throughout the USA and eventually the world, it must go further to develop an entire new system of healthcare insurance companies to serve humanity, a new system of in-patient care hospitals and finally a new system of education including medical journal reform.
We must as an organization direct our focus on the newly graduated healthcare provider to offer them opportunities to ease-into this new paradigm of medicine. It is hard to teach an old-dog new tricks and embrace something new once they have been slaves to an older corrupt system. Our influence with the young, hungry and bright providers is the target audience. Developing a new system of education is paramount and will propel a new system much more effectively. We can learn from foreign medical education systems a less laborious and time-consuming system of education and training. We can graduate medical professionals in much less time to fill the void we are witnessing now.
The healthcare insurance industry is already developing alternatives to traditional health insurance and those start ups should be nourished and supported. They will be integral in providing support for clinics and hospitals. They will be integral in our leverage in exacting change with pharma.
All these moving parts must be adopted together simultaneously for success. Organizations such as the AAPS are at the tip of the spear in making these changes. The moment in history is now, the iron is hot, let us strike.
Yusuf (JP) Saleeby, MD is a functional medicine practitioner having a 20-year previous career in urgent/emergency medicine. He is the founder and director of two South Carolina FxMed centers and founder of the Priority Health Academy. He can be reached at firstname.lastname@example.org