A main reason that the U.S. health care system is in crisis is its lopsided focus on disease management rather than on prevention and health promotion. Sadly, conventional medicine does not manage well the most prevalent chronic diseases, most of which result from poor lifestyle choices. They drain much of the money we spend on health care and could be prevented if we would teach and incentivize people to improve habits of eating and exercise, get adequate rest and sleep, neutralize harmful effects of stress, attend to mental and emotional wellness, and practice self- care.
Given that we now spend upwards of 18 percent of our gross domestic product (GDP) on health care – more than any other country – yet have the poorest health outcomes of all developed nations, one would think the U.S. would try to do better at preventing disease and promoting health. We don’t for the simple reason that prevention doesn’t pay. As dysfunctional as our health care system is, it generates rivers of money – money that flows into few pockets: those of Big Pharma, the manufacturers of medical devices, and insurers. We happily pay for medications and procedures; we do not reimburse physicians for counseling patients about nutrition or exercise or teaching them how to breathe. Until our priorities of reimbursement change, health care providers trained to practice integrative medicine are at a great disadvantage.
In the past, preventive medicine has concerned itself with sanitation, immunization, and disease screening – all worthy enterprises but not what I consider the most important aspects of prevention and health promotion: the influence of lifestyle choices on health and risks of disease and the ways health professionals and society can encourage people to change them for the better. A new field of lifestyle medicine is coming into being. Integrative practitioners are trained in it, and preventive medicine must embrace it.
The effectiveness of preventive medicine has also been limited by the same deficiencies that weaken conventional medicine in general – namely, attending only to the physical body and not to the whole person (including mind and spirit), undervaluing the intrinsic healing potential of human beings, ignoring the useful ideas and practices of other systems of treatment (like traditional Chinese medicine), and not doing enough to improve the health of communities and the environment.
This volume is a milestone in the development of a new paradigm of preventive medicine. My longtime friend and colleague, Dr. Richard Carmona, has assembled a stellar roster of contributors from diverse fields of expertise to give readers a sense of what is possible. The alliance of integrative medicine and preventive medicine is logical and natural. Each can learn from and enrich the other. I am confident that Integrative Preventive Medicine will help strengthen that alliance and lead to better health outcomes in our society.