The Institute, financed by private foundations, uses “the
latest biological tests, including measures of body fat, bone density,
circulatory function, physical fitness, and brain function.” Four ‘biomarkers’ are thought to be
especially significant in predicting future health: inflammation, oxidative stress, immunity, and
regenerative capacity. After data on
each patient has been collected she or he works with a health coach on an
individualized plan that involves diet, exercise, and medical care.
I wanted to know more about the program so I went into
the Emory website and found an interview with Kenneth Brigham, director of the Institute. Brigham describes America as
having a “disease care non-system” with a vertical
relationship between doctor and patient that doesn’t work. He cites studies showing that “half of the
people who see doctors don’t do what the doctors tell them to do.” At the Institute, health partners (health
coaches) engage in a horizontal relationship
with patients; they seek to inform patients and to encourage
them as they work toward their individual goals. Of course, the bottom line is money. We all know that the present system is unsustainable,
but will the PHI program save money in the long run? The Institute hopes to
collect data to show that the approach is cost effective so that it can be
adopted on a larger scale.
Health coaches could play an important role in enhancing
quality of life and preventing illness. Under
our current system doctors see so many patients per day that it is impossible
for them to know each person well. The
emphasis now is on ordering tests and prescribing medications rather than
attaining a holistic view of the individual.
By contrast, health coaches could get to know patients personally and
follow their progress on a regular basis.
Doctors primarily seek to identify and treat disease. Health coaches could observe characteristics
like balance, posture, muscle tone, and flexibility that can contribute to
later health problems. They could then
pass along valuable insights to doctors in order give them a more complete
picture of each patient. They could also help patients understand more about their own bodies and participate directly in their own health care.
Here in Indiana we currently have an ideal opportunity to
try out this new approach. Indiana
University is about to establish two Schools of Public Health, one in
Bloomington, the other in Indianapolis.
The Bloomington School will be the successor to the current School of
Health, Physical Education, and Recreation, which has a well-regarded program
in kinesiology. Why not use this
occasion to try a cooperative program between the Department of Kinesiology and
the IU Med School to train health coaches?
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