Education Before Prescription: Informed Healthcare

Topics: Diabetes, Education, Media, Recipes, Refuel, Wellness and Health

 

I participated in a diabetes twitter chat with Dr Sanjay Gupta and Everyday Health earlier this week, and the phrase that seemed to strike a RT chord was “Education Before Prescription.”  Since I spend much of my time teaching

Dr La Puma teaching men to cook

*patients and families how to make the best personal nutritional choices in their busy lives

*clients and cooks a chef’s ways to make a recipe simpler, easier, more flavorful and nutritionally powerful; and
*clinician and executives how to ask the right questions, on subjects from insomnia and sexual function to leadership and product innovation

…I’m baffled that I didn’t see this “Education Before Prescription” as the emerging health care meme that it is before now.

But at least I’m able to recognize it in a twitterstream, and now with you.

Top 10 Health Websites, 08.13 from ebizmba.com

This is a game-changer for companies who care about their employees’ health, and for individuals who are want to look and feel better, and are not getting the help they need from their physician or her office.

The first thing that many people do when they need medical help is search (free) for it…and they find the 3 Ks (Kim, Kanye and Khloe, I think) on Yahoo Health; scientific medicalese on NIH.gov; intermixed sponsor content and medical content on WebMD; very good, albeit hard-to-dig-in medical analyses on Medicinenet.com (owned by WebMD); and largely conventional though accessible advice from MayoClinic.com.

So, people find edutainment and peer-reviewed science…but the sites that provide a physician’s answers to questions, like HealthTap and ShareCare don’t make the top 15. The top sites are very good at providing information but not educating about health care. Specifically, your health care.

Clinicians who can take the information that patients find on the web, integrate it into an office (or Skype) discussion, and help to confirm it or suggest the most credible sites and apps for that patient’s conditions will be delivering a service as powerful as a prescription.  They’ll curate this info in the office, and that’s valuable.

As I write recipes on prescription slips, for example, so do I write for condition-specific sites and apps. Yes, it takes more time. And yes, people then really learn about touchy subjects, on their own time, explained better than I could.

For example, look at how many men and women are confused about having a healthy sex life after one has had a heart attack!  Now there’s a AHA/ESC consensus document (very good Medical Daily report; and original Circulation paper) addressing it.  20 percent of men with heart disease have erectile dysfunction (minimum), and 20 percent of women with heart disease have sexual dysfunction too: both coincide with depression.

Most people just want to look and feel better. Before anything else. They care about sex, mood, quality of life, their families, their energy levels, their capabilities, caring for others, and being engaged in a life with meaning.

Few people care about the blood pressure, sugar, lipid and other numbers as much as or in the same way as do physicians.  People can’t feel their numbers, so they don’t have as much meaning as what they can feel.

It’s not easy for a doctor to value prevention and education over prescription and pharmacologic intervention. Many patients *expect* a prescription, an expectation heightened by the time pressure on clinicians; intensive advertising; and by voice search on any smartphone or tablet (now bumped up a level by Google’s Moto X, which awakens when you address it).

To reach people where they are, we must become more adept at asking questions about people care about, and better at directing them towards answers. We can use the pen, stylus and swype to write first for educational and lifestyle interventions, instead of pharmaceuticals.