The New Normal is Still Unknown, on Earth as it is in Healthcare


From the vantage point of our self-quarantined shrunken universes, we cannot see even the immediate future, let alone what our personal and professional lives will look like some years from now.

Factories are closed, luxury department stores are in bankruptcy, hospitals have stopped performing elective procedures and patients are having their heart attacks at home, unattended by medical professionals. New York office workers may continue to work from home while skyscrapers stand empty and city tax revenues evaporate.

Quarantined and furloughed families are planting gardens and cooking at home. Affluent families are doing their own house cleaning and older retirees are turning their future planning away from aggregated senior housing and assisted living facilities.

In healthcare, procedure performing providers who were at the pinnacle of the pecking order sit idle while previously less-valued cognitive clinicians are continuing to serve their patients remotely, bringing in revenues that prop up hospitals and group practices.

The social experiment we stumbled into has already demonstrated the value of self-sufficiency and it has started to shake the notion that our society can continue to rely on the medical system to fix just about any medical problem we might develop. Self-care and prevention seem like more powerful pieces of our individual plans for our future wellbeing.

I believe this is an unstoppable trend and I hope it will make us a healthier people.

Thinking back very briefly at influenza, our old scourge, didn’t we rely so completely on the vaccine, which is at most 50% effective in preventing the disease, that we did less than we could of commonsensical hand washing and social distancing?

Didn’t we, because of America’s denial of the wisdom of staying home when you’re sick, as it is manifested in the lack of sick days for many workers and the much celebrated “work ethic” of our society, allow ourselves to spread even less dangerous but economically impactful diseases unnecessarily?

Didn’t we, for far too long, ignore the indisputable fact that the majority of chronic illnesses that burdened our pre-pandemic health care system are in fact preventable and reversible?

Didn’t we, as citizens and as a society, ignore personal responsibility for and stewardship of the health of our human bodies in our thinking of health and disease?

Imagine how our newfound sense of self-reliance can create a new view of preventive and restorative healthcare.

I have said it before, but consider the pathological notion that more diabetes, more cancer, more autoimmune diseases means more drug sales and pharmaceutical profits, more hospital procedures and more money processed and profited from by insurance companies.

Imagine a society with less chronic disease, more able-bodied workers, a pharmaceutical industry more ready for new viruses and more focused on advanced disease prevention, correcting genetic and non-lifestyle triggered diseases.

Imagine a working public health system, capable of disease tracking and empowered to demand a better environment and better social circumstances for all Americans.

Imagine doctors with more time to help patients avoid ill health and less need to continually escalate pharmaceutical treatment for steadily advancing lifestyle-related diseases.

Who would pay for all this?

Well, I’m just a Country Doctor who used to think Sweden’s health care system wasn’t efficient enough. I have since realized that neither is the United States’.

It is time to reimagine what kind of healthcare system we really need.

Hans Duvefelt is a Swedish-born rural Family Physician in Maine.

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8 replies »

  1. Great essay—-without any mention of the total lack of data on convid19 in the US! But we no longer listen to scientific or medical experts.

    Of the many reasons the US has for the worst health outcomes and highest costs in the developed world–the thousands or millions of corporate industry lobbyists working on the “healthcare sector” of the economy are the key cause of the destruction of medical treatment and care.

    Similarly, corporate lobbying in Congress for the “education sector” has driven costs for education sky-high while lowering the quality of education.

    It’s very hard for NGO non-profit organizations that represent the public’s democratic & human rights of individuals before Congress because we’re vastly outnumbered. US law has been perverted to allow corporations to be treated as if they were humans being who have fundamental human rights.

    The Hippocratic Oath, the ethical standard that enabled all clinicians, not just doctors, to be trusted by patients. Surveillance capitalism, which destroys our former right control over all personal information, is now the largest business model on the planet.

  2. Functional medicine is indeed what I was thinking of when I wrote this. I am a casual student with IFM.

  3. I agree! I would also add that I imagine a healthcare system in which any patient could access the healthcare they need when they get sick.

    As for who would pay for it? I think Sweden, or Canada, or most other developed country would say that we all should pay for it through a fair system of taxation. There are now so many barriers, and so much waste. Eliminate our expensive administrative barriers, and multiple insurance companies, and that would free up the necessary funds – as any of the many fiscal feasibility studies have shown.

  4. Thank you for your writing! I’m so happy to see a bit more of it. As a family physician, I felt more useful in those first weeks as the pandemic arrived than I had in years. We will see what the next year brings us!

  5. Thank you. I will share with every graduating teacher educator. Imagine if we can create new public schools that hold this value at the core of teaching children well, imagine how much good could be done. Imagine entering into a relatiohship with our doctors with this goal in mind. It is such a pleaasure to hear your written voice again.

  6. Re-imagine is a good word. To paraphrase Rahm Emanuel, let’s not let this crisis go to waste.

  7. Imagine a political system bringing us everything you have listed.

    We will go back to the same old, same old. There will be no paradigm shift in how money is accumulated and distributed in health care. The kleptocracy will survive.

  8. Brilliant piece, thank you. In the meantime, some patients are able to find this approach working with functional and integrative MDs, and with biological dentists.

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