Bringing you this lovely title on this gorgeous day here in Santiago de Compostela, Spain. Why do I want to discuss the leading causes of death and suffering? Healthcare can be complex, and it’s important to remember where our value lies.
The Clinical Value I Provide
As a physician, I have to either increase the patient’s life expectancy or improve the quality of their life. Both of these aren’t all that tangible so there is value in having some proof.
- Less Suffering
- More Clarity
- Longer Life
- More Worry-Free Time
- Less Wasted Resources
Chronic pain is a classic example of suffering and opioids prescribed by our Pain Specialist colleagues have done little to ease this suffering; often trading one type of suffering for another.
Emotional suffering, however, has been very well addressed by Psychiatry and other mental health experts. Those clinicians are also really good at demonstrating to their clients how and why they are a little better off than in prior sessions.
Leading Causes of Death
Death is a little trickier; as a Family Medicine doctor, my atorvastatin prescription can be less meaningful to the patient. Even if I add an extra 5 years to their life with a statin, it’s not something that can be proven.
What I’m doing in my Heart Health Coaching practice is calculating a risk score for each client that comes to me. I then show them how each intervention can decrease their mortality or suffering risk.
It’s a very visual tool, and it’s great marketing. That’s how most humans communicate, after all, visually.
Demonstrating Clinical Value
Many of you know I also have a Digital Nomad Health brand, a virtual-first Primary Care practice. It’s a subscription-based practice, and demonstrating value to my patients is key to retaining them.
A dermatologist can demonstrate value by taking before and after skin photos for a person’s psoriasis or acne condition.
An orthopedist might measure someone’s pain index and ADL limitations.
As a Family Medicine doctor, I have to prove to my patient that I am changing their quality of life by not only increasing longevity but improving their healthspan.
Focusing on the Leading Causes
Let’s get back to the basics. I linked the CDC’s Death Table above, showing the following leading causes of death:
- Heart disease
- Malignant neoplasms
- Chronic lower respiratory diseases
- Cerebrovascular diseases
- Alzheimer disease
- Diabetes mellitus
- Influenza and pneumonia
- Kidney disease
- Chronic liver disease
Whether you’re treating patients or doing healthcare consulting, research, or health coaching focusing on just the top 3 in this list would offer immense value.
That’s step 1, offering value. Step 2 is showing, proving, or demonstrating that value to the stakeholder.
I obviously won’t get far trying to prove to a suicidal or self-sabotaging patient that my unique method with lower their risk of cancer. So, marketing to the right people is also quite important.
It’s Messy at the Top
The top 3 diseases are messy because there is a lot of competition in this space. The FDA keeps approving more and more useless chemotherapeutic agents while the AHA recommends GLP1s for weight loss and some famous online chiropractic claims it’s all about a ketogenic diet.
If the competition is intimidating or you have difficulty standing out, there are plenty of neglected conditions, especially dementia, suicide, and chronic respiratory diseases, which can become your field of expertise.
Coming up With Protocols
What I like about protocols is that it’s a consistent message which you can extrapolate to many patients and reach a far broader audience.
A protocol is useful in that it can be created into courses, visuals, and useful tools a patient can use. And it’s less useful in that it’s more general but not unique to the person.
Combining a protocol with 1:1 coaching or clinical interventions seems to be a good way to benefit from both aspects.
I can sell an online course for weight loss focusing on lifestyle factors and educate patients about available interventions. And I can also sell them an individual clinical consult for the prescription or individual assessment.
I’m jaded and so I don’t believe that suicide can be prevented as much as it is claimed. But, for those with personal experience in this space, a suicide intervention protocol for pediatric or elderly individuals might make sense.
You’ll need to demonstrate the value to the patient or the stakeholder (parents or caregivers) by showing the increased lifespan and healthspan.
Chronic Pulmonary Diseases
Pulmonary disease doesn’t get a lot of rep in social media or clinical circles. The inhalers are expensive, the patients have complex medical conditions, and PFTs don’t always correlate with how patients feel.
Demonstrating value but showing the patient how much money they saved on inhalers or how many more days they were able to spend outdoors, etc, can be powerful.
Google: pneumonia prevention … nothing.
There is no pneumonia prevention protocol. No algorithm to help someone prevent pneumonia, one of the leading causes of morbidity, mortality, hospitalization, C diff, frailty, falls, etc.
Factors to adjust for to decrease the risk of pneumonia:
- Increase exercise
- Improve pulmonary function
- Improve nutrition in the elderly
- Increase muscle mass
- Decrease alcohol and tobacco consumption
- Begin pulmonary rehab after any surgery
- Begin a pulmonary rehab when hospitalized for other causes
- Diagnose & Control underlying chronic pulmonary disease
- Assess and improve swallowing