The topics of this blog are two:
- Changing behaviors to lead a healthier lifestyle
- Learning how to navigate the healthcare system
A little about me will explain why I chose them. I am a Board Certified Internist and practiced Internal Medicine for about 13 years. Throughout those years I especially enjoyed building relationships with my patients and their families. This was during the early days of what has been referred to as “managed care.” Over the years it became clear to me that this new approach to the delivery of health care needed strong physician involvement at a managerial level to prevent the non-clinical, financially focused managers from cutting quality from health care while they attempted to cut costs. This led me to leave private practice and begin a career in medical management. Throughout my career in medical management I have never forgotten to put the patient first.
In the role of medical director for a variety of organizations, I focused on areas such as case and utilization management, physician credentialing, quality improvement and, my favorite, disease management. I won’t take time here to explain each of these, though during the course of this blog, I’ll refer to this background as appropriate. I do want to spend a few moments explaining disease management since that experience has shaped much of my thoughts about behavior change.
Disease management, now often referred to as chronic care management, attempts to help people with some of the more common chronic conditions such as, asthma, heart failure, coronary heart disease or diabetes learn about their conditions and better manage them. The thinking behind this is simple really – a patient who better manages his condition will be healthier and use less health care resources than one who doesn’t. Everyone wins, the health plan and the patient. The challenge is that in order to better self-manage requires learning new behaviors and replacing old ones with healthier ones. As anyone who has ever tried to stop smoking or lose weight can tell you, these changes are not easy. Over the years I have seen strategies that help people make these changes successfully, and that’s what a portion of this blog will deal with. Also, since I have personally had to make behavior changes after I survived a heart attack and cardiac arrest, I bring the perspective of a patient to the discussion as well.
Right now professionally, I coach nurses who coach individuals on learning the skills and making the changes to optimize their health and well-being. Over the years I have often heard conversations between the nurse and the health plan member at a decision point in that individual’s life. The member may be experiencing worsening symptoms or new symptoms and they are about to make or have made a decision about how to deal with it – whether to seek care or not and where they will go for that care. I am astounded by the poor health care decisions these individuals are about to make. Luckily, our nurses are able to explain to the member the better choice that they should make and convince them to make it. Having heard this many times over the years, I know that thousands of times a day these decision points are faced by people, many of whom make a poor choice from the perspective of their health. This results in unnecessary complications, health impacts and costs. Others are trying to address this health literacy issue, and the other topic of my blog will add to this conversation.
Thanks,
Robert Kolock, MD aka Dr. Bob