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How the “I Feel Fine” Syndrome™ is Costing You Millions – Part 1

By DrScott – Posted on December 26, 2013 on

How could this go on all these years without us discovering diabetes, heart disease, or cancer in your body and not acting? To understand this we just need to ask a person with pre-cancer, early cancer, metabolic syndrome, hypertension, diabetes, or heart disease how they feel. What would they tell you?

As a practicing doctor I can assure you it is almost always the same; “I Feel Fine.”

How could this be? The changes discussed in the first of the Seven Numbers Series describing the changes occurring in our bodies as we begin to develop diabetes, hypertension, heart disease, strokes, and cancer all occur without symptoms. Literally our bodies start to fail, either in the processing of food – metabolic syndrome, in the deposition of fat in the arteries – heart disease and strokes, or in the regulation of cells – cancer, without us feeling a significant difference in our bodies.

On one level this may not be a bad thing. ”Mother Nature” had to make a choice. Should I have people with early conditions “feel bad”, with milder symptoms as conditions begin, and then gradually increasing during the five to fifteen year window before the disease is fully manifest? Or should the pain and suffering be delayed as long as possible, with symptoms beginning much later in the process? Well, for diabetes, heart disease, and early cancer the choice was option B – hold off symptoms as long as possible, even though it is often too late when symptoms finally do appear to completely reverse the illness.

Until modern medicine discovered how these processes occur in our bodies, it was difficult to know where we are in this continuum. This means if we “feel fine” we may be perfectly healthy (and so as not to alarm everyone, the majority of working-age people are functionally healthy), or we may be walking around with a debilitating or terminal condition percolating in our bodies. But that is not the case today. With a few tests like blood pressure, cholesterol, blood sugar, and cancer screening (following the USPTSF recommendations) we can substantially increase the odds of knowing whether we are in this situation, though the testing is not perfect. Acting early, to reverse or remove the problem, is not only possible, but it is very likely to lead to arresting or delaying the problem for years. Even better news is that it is not necessary to do this testing daily or even monthly. Annual, bi-annual or even every decade (depending on the guideline) is enough to allow us to discover and keep these nefarious characters out of our bodies, while balancing the risk of being stressed over false-positives that can arise from over testing.

Setting up and encouraging employees to discover whether “I Feel Fine” = “I Am Healthy” or “I have not developed symptoms yet” is vital to preventing further illness and costs for your company.

Missed The Window? It Is Not Too Late

By DrScott – Posted on December 19, 2013 on

In the first three Seven Numbers posts the natural history of the most important conditions to your healthcare spend were shared. But what do you do if you have missed the primary prevention window? Is it too late to control costs? So let’s say that the disease has appeared in the body – diabetes, heart disease, or cancer. It is not too late.

With cancer, for example, one cell becomes two, then four, eight, sixteen, thirty-two, and so forth. But the cells are localized, contained in one small area. They could easily be removed by a short procedure. It is not until literally hundreds of thousands of cells have appeared that the ability to completely cure the cancer is lost for many of the common cancers. Again, it is estimated that 3 to 5 years go by during which we could act and literally save our own lives. Which cancers could be diagnosed early?

  • Breast cancer (detected with breast exam, mammography, and breast MRI),
  • Colon cancer (detected with colonoscopy, occult blood testing and exam),
  • Cervical cancer (detected with an exam and pap smear),
  • Endometrial cancer (detected with a history, exam and a simple test) and
  • Skin cancer (detected with history, exam, and a simple biopsy).

For heart disease, diabetes, or hypertension, blood sugar and blood pressure gradually rise. Fat gets deposited in our arteries (LDL cholesterol for example) and begins to accumulate. No untreatable “end organ damage” in our heart, brain, kidneys, or other organs has occurred (if they had the employee would have had a heart attack, stroke, or kidney failure). With proper treatment these complications can be prevented or delayed for decades. But the window to act is closing.

How does your company make sure this occurs? Why don’t we and our employees act? Why do the majority of us allow these changes to occur in our bodies without acting? In the next Seven Numbers Blog we will explore the answer to this question.

The Five to Fifteen Year Window to Reduce Healthcare Costs & to Save Lives

By DrScott – Posted on December 12, 2013 on

In the first installment of the Seven Number Series, we understand how three of your biggest expenses are slowly (and effectively) attacking your company. The key to stopping this epidemic? Acting early – preventing pre-disease from moving to disease. During this phase, which lasts 5 to 15 years, our bodies have the ability to undo or delay any long term damage. If we stop the lifestyle and habits, our bodies will heal the damage – return to normal functioning, and even repair body tissues that are beginning to fail (diabetes & heart disease) or grow abnormally (cancer). Perhaps the best example of pre-disease that can be reversed is metabolic syndrome.

Metabolic syndrome is defined as the appearance of any three of these five numbers on an employee’s biometrics:

1. A waist circumference of 35 inches for women, 40 inches for men

2. Triglycerides (a lab test for blood fat) of over 150 mg/dl

3. A reduction in good – HDL cholesterol to <50 in women, < 40 in men

4. A blood sugar of >100 mg/dl

5. A blood pressure of >130/85

What do you do when you know these numbers? Simple, set up programs and activities to get them down. Everything from participating in 5K walks and bike rides, changing food out in the vending machines and your café, bring in targeted programs, and so forth. These actions should be part of your health benefits design and included based on their effectiveness.

Equally important to these efforts is activating and empowering employees to get more involved in understanding, monitoring and managing their health. Focus on what really matters – getting these Seven Numbers to goal. Putting incentives and penalties in place over a series of years is vital to actually decreasing illness, disability, and costs. Having a foundation to communicate with your employees, to empower them, is necessary for success. Please feel free to request a copy of The Seven Numbers book.

Follow my blog posts and I will give examples of companies that are doing these types of changes today with outstanding results.

Proactive Providers Save Lives and Money

By DrScott – Posted on November 26, 2013 on

In my private practice in the 1990s, I often would see patients for 7 to 15 minutes, three times a year, trying to inspire them and direct them in management of high cholesterol, diabetes, high blood pressure, and other medical conditions. One particular patient I remember was a mechanic working at a large defense contractor. He had diabetes, high cholesterol, and an at-risk blood pressure. Every year he would come in for his physical because it was required by his employer. I would test his blood and consistently find that his cholesterol and other numbers were not well managed. We talked about how important it was to treat these conditions. I would offer additional medications and teach him to improve his lifestyle. He always assured me that he “felt fine” and didn’t think there was anything significantly wrong. A year later nothing changed and he continued down the same path.

Then one year, he came in with a form from his employer and asked me to fill in his numbers to then send back to his employer. Upon completing the form and handing it back to him, he said he had a new incentive program at work and was rewarded if his numbers met the goal. I asked him if he was willing to take additional medications and he said he would do “whatever it takes”. Low and behold, he saw a dietician, took additional medicine, and got his numbers to goal. Upon receiving the reward from his employer, he and his wife used that money to take a trip in their RV to the Pacific Northwest.

This continued for the next several years with him maintaining and managing his numbers to goal because his employer would reward him for his behavior. After he retired he was no longer incentivized, lost focus on his numbers, and had a significant heart attack several years later. I believe we prevented this for years through his engagement.

It was through interactions like this that it became clear to me that seeing a patient for 7 to 15 minutes, three times a year was only a portion of the solution. Having a partnership with employers that encourage and support employees engaging in proactive healthcare was equally important. Through this partnership, employees would win significantly.

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