Our healthcare system fails patients in preventing and managing chronic diseases such as diabetes, heart disease and obesity. I see the consequences every day. When they don’t have time or financial resources, we tell our patients to eat and exercise. Once the patient has a heart attack or stroke, our system will provide excellent care, but then we leave our recovery to troubled family members.
As our new health secretary, Robert F. Kennedy Jr. I scan my patient list at a long-term care hospital. On a given day, I cared for a woman whose years of smoking caused a lung transplant, a relatively young man whose severe obesity required a tracheostomy tube to help him breathe, while in a low-income man with heart disease in his 60s. The man is now ventilating and dialyzing after a dangerous surgery to open up his blocked artery. He just wanted to go home, but he was frustrated with medical interventions, which made him feel worse than better.
One recent morning, curiosity led me to create a video that promoted Mr. Kennedy's American health exercise again. With the sound of the ventilator and heart rate monitor in the backstage, I watched Mr. Kennedy stand on the grass and promised to find and target the root cause of the chronic disease – with few practical details.
I thought of my patient on the ventilator. He worked as a bus driver for a long time. Probably his primary care doctor told him to exercise or change his diet, but when should he do it? He knows he is overweight and has diabetes, but he doesn’t have the time or money to make healthy home-cooked meals. How does he combat the effects of stress and poor sleep? Then, when he starts to feel breathing, how should he know that it is a symptom of his heart failure, not just the consequence of being overweight?
There is no factor that can reverse his fate. The poorest of us bear the highest burden of disease. Mr. Kennedy will find that the root cause of chronic disease is not the vaccination model, but in the reality of poverty, pollution, racial disparity and access to primary care. We know that obesity is a risk factor for so many diseases, but we make effective obesity drugs economically unable to reach many diseases. Mr. Kennedy's video shows a perfect family enjoying a large salad at an outdoor picnic table. But, in reality, if we want to work for everyone, especially those who have to work seven days a week, especially those who have to work multiple times, there is an overwhelming social change.
When I see patients as intensive care physicians, it is usually so late in their illness that the best I can do is treat their symptoms rather than cure them. To truly reverse the development of chronic diseases, we must start from childhood, get healthy food, exercise, clean air, and high-quality health care. There is no reason school lunch should contain a lot of super-processed food. I don't know of any doctor who disagrees with Mr. Kennedy's claim that the American diet is severely damaged. But it is disturbing that the announcement of the Maha Movement was greatly reduced in the NIH structure as the Trump administration made massive cuts on health care workers in public health institutions. Republicans are providing huge cuts to Medicaid, which provides health care to more than 70 million low-income Americans.
Looking at the positive response to the Maha movement, it became increasingly clear that modern medicine has caused harm to damage, and once the crisis point is reached, it will reduce the focus on health and treat more diseases. Patients don't want to survive only in strokes; they want to feel themselves again. Longevity researchers are increasingly talking about the fact that health spans contrast sharply with life spans – not only the years of life, but also the years of health. These are important results for people.
Mr. Kennedy seems to have gained support from many Americans who are neglected by medical institutions. If he uses this trust to motivate people to make healthier choices and uses his stance to drive the social change needed to support those choices, he serves us. But I'm worried that all his pseudoscience, criticism of antidepressants and weight loss medications, and anti-vaccine statements will cover everything else.
Without public trust, medicine has nothing. We can order treatments, but they are useless if our patients choose not to take the treatment. We can make thoughtful suggestions, but they are only helpful if our patients listen to them and have access to the tools to follow. Those in the healthcare field are concerned that the Maha movement will inadvertently harm their patients by giving up tested traditional medicine because they do not believe in data or doctors.
But maybe we can learn something from the attraction to our patients. We need to find out what is most important to our patients and fight for it. This will require more from our government agencies than vague commitments. To make Maha a slogan, we need real social change. Only in this way can we hope for a healthier country than a disease.
