If I came from Mars, I would get back in the ship, turn it around, and go home.

Want to know what is wrong with our health care system in less than 300 words.  See this tragic story:

Yes Virginia, We Have a Problem in this Country

  • Public Health and Prevention.  Fail.
  • Health care access for folks in the individual market or with preexisting conditions.  Fail.
  • National food policy.  Fail.
  • Cultural norms and desensitization to preventable morbidity (Heart Attack Grill?  My god, what’s next, Strokes ‘R’ Us?).  Fail.
  • Our societal figureheads and leaders advocating free access to junk food.  I won’t say her name.  Fail.
  • Advertising industry, responsibility, and, well, good taste.  Men with risk factors will see this as a challenge, not a warning.  Trust me, I am one.  Fail.
  • A good reason for Chinese not to worry about US finding our mojo anytime soon.  (although this could be our long-term success strategy: export this franchise).  US promoting wellness for long-term corporate success.  Fail.

Hospitalist Take Home: I am certain that n=1 efforts, i.e., doctor centric action to reduce public health problems like that of good nutrition is futile (another post).  However, that does not mean I do not try damn hard.

Drop a thirty second message at the bedside as you are discharging a patient: “soda is ALL sugar and a few a week will add needless pounds, etc.”  Use a style you are comfortable with–even augmenting with visuals as they are powerful and do more in a glance than five minutes of discussion:

Also, don’t use the word calorie, diet, or other jargon–health literacy is trickier than you think.  Additionally, it is not about patient engagement in the grand scheme or initiating lifestyle modifications 24/7, but passing on some useful facts (that most folks are unaware of) that may give pause and move a patient to the contemplative phase of change.  It is our small part, and a meaningful message when we have little time and cant conscript a live at home health coach.

Finally, I am a member of the Center for Science in the Public Interest (CSPI), a great organization that works tirelessly in this realm.  Look their site over.

Brad Flansbaum

Bradley Flansbaum, DO, MPH, MHM works for Geisinger Health System in Danville, PA in both the divisions of hospital medicine and population health. He began working as a hospitalist in 1996, at the inception of the hospital medicine movement. He is a founding member of the Society of Hospital Medicine and served as a board member and officer. He speaks nationally in promoting hospital medicine and has presented at many statewide meetings and conferences. He is also actively involved in house staff education.

Currently, he serves on the SHM Public Policy Committee and has an interest in payment policy, healthcare market competition, health disparities, cost-effectiveness analysis, and pain and palliative care. He is SHM’s delegate for the AMA House of Delegates.

Dr. Flansbaum received his undergraduate degree from Union College in Schenectady, NY and attended medical school at the New York College of Osteopathic Medicine. He completed his residency and chief residency in Internal Medicine at Long Island Jewish Medical Center in New York. He received his M.P.H. in Health Policy and Management at Columbia University.

He is a political junky, and loves to cook, stay fit, read non-fiction, listen to many genres of music, and is a resident of Danville, PA.

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