Illness starts in the social and environmental conditions of our everyday lives. A 31-year old Sacramento physician, Dr. Charlene A. Hauser, just marked her first year of practice at Sutter Health Group in Grass Valley, near Sacramento and is featured in a new TED book, The Upstream Doctors: Medical Innovators Track Sickness to Its Source, by Dr. Rishi Manchanda.
You may wish to check out the September 9, 2013 Sacramento Bee article by Cynthia H. Craft, "Q&A: Doctor goes upstream to find root cause of patients' medical problems." TED books are electronic narratives that discuss innovative ideas and approaches. The Sacramento (Grass Valley area) Dr. Charlene A. Hauser, is part of a movement of "upstreamist" physicians – doctors who search for patients' life issues that may be triggering their health problems.
Manchanda's new TED Book, The Upstream Doctors, is available for download as an e-book on Kindle, Nook, or from the iBookstore. Also, you may want to check out Paul Farmer's compelling essay about the book as well as its afterword.
The healthiest goal is to fix the root causes of illnesses rather than put a bandage on the symptoms
It's more logical for medical professionals and hospitals to work with communities to fix the causes than to keep drugging down people (or animals) to lift them up into well-being. In the new TED Book, finding the root causes at the source of diseases and illnesses might also be the key to turning our high-cost sick-care system into a high-value health-care system. That's where preventive and personalized medicine kicks in.
The book shows how it's a health care provider¹s obligation to treat not only the symptoms, but also the social and environmental conditions of everyday life that cause disease
The goal is to train and equip more 'Upstreamists' around the country, such as upstream physicians and nurses. It's about health innovation and advocacy. Physicians need to treat people to prevent disease before it happens rather than only focusing on patching up the disasters after illness occurs. The book can be found at the TED Books website.
More money is spent on health care per person in the USA instead of putting a high value on keeping people healthy
Notice that foods, for example at restaurants as a money-making venture, focus more on rewarding the brain's pleasure area by emphasizing taste and even addiction to foods such as fat, salt, sugar, chocolate, cheese, and various types meats and seafood rather than on the healthiest of foods. Otherwise, why would we have in Sacramento, for example, fast-food eateries every two blocks on some high-traffic areas?
If the fried meat and fried potatoes diets or the chocolate fudge ice cream and doughnut sandwiches, greasy bacon and sweet and savory BBQ sauces didn't bring people back to buy more, than heavily salting foods, frying grains, or sweetening them will keep rewarding the brain's pleasure senses until the people are hooked on those foods, whether it's white flour and sugar or spicy sauces.
Even vegetables are served breaded and fried in many eateries to coax people to come in, taste the reward with the brain and the tastebuds, and come back for more. Nobody is offering fast-food raw vegan meals without adding oily dressings or butter over pasta mixed with cream and flour. Even the word 'healthy' before the word 'food' has kids frowning and adults who rarely ate salads or soups without added fats as kids avoiding or not even recognizing what some vegetables look like on supermarket produce shelves. How many people can recognize kale or parsley from cilantro without smelling it -- unless one works in a food market or farms vegetables?
The U.S. spends about $8,000 per person every year on health care, more than any other nation has ever spent. But among all nations, the U.S. ranks 37th in health status
What the new doctors are trying to do is transform the USA's high-cost sick-care system into a high-value health care system. If you read the TED Book, The Upstream Doctors, you'll see how physician and public health innovator Dr. Rishi Manchanda shows how the key to this transformation lies in embracing and supporting upstreamists doctors, nurses and other clinicians. And in Sacramento/Grass Valley, you also have physicians such as Dr. Charlene A. Hauser, who realizes that health (like sickness) is more than writing a prescription. Health is not due to a lack of prescription drugs.
It's amazing how many other physicians are trained to write conventional medicine prescriptions as the only answer because they haven't been trained to use food as medicine or even have a knowledge of which supplements have been checked out by independent labs. Health is more than finding which chemical equation is best balanced by food as medicine and which equation is best balanced with prescription drugs and surgery instead of finding the root cause downstream at the source of what ails the patient.
Disease partly originates with lifestyle and policy choices
In Sacramento, doctors ask whether asthma begins with what the mother eats or doesn't eat or whether asthma begins with local heavy air pollution and living near high traffic areas. Physicians know that heart disease partly originates in lifestyle and policy choices. But most doctors blame heart disease 80 percent on genes inherited from a family history of similar illnesses. How many doctors will prescribe a vegan reversal diet instead of procedures and surgery? And how does the reversal diet work after a year or a decade?
What other illnesses happens from depression and stress related to work or where you live, such as in a low-rent, high-crime area? Take a look at the case histories and anecdoes in the book, Upstream Doctors. What every patient wants usually will be a healthcare system that tackles illness at its roots. The goal is to have a system that works to improve health where it begins.
Rishi Manchanda is a physician and public health innovator. He is the medical director of a clinic for homeless Veterans in Los Angeles, president and founder of HealthBegins, a startup that helps healthcare deliver better care for patients and communities with social needs, and the founder of RxDemocracy, a nonpartisan healthcare coalition that supports civic engagement.
He was previously the founding Director of Social Medicine at a community clinic in South Central Los Angeles. His work focuses on systems change and innovative methods to improve primary care, the social and environmental conditions that make people sick, and health and human rights.
Finding out the source of the illnesses is what the new physician, the upstream doctor is trying to do
In Sacramento, Dr. Charlene A. Hauser told the media that doctors need to look at why people are getting sick in the first place. The key is looking at the social issues and social determinants of health – the way everything around us influences our health: our environment. Look at stress as the source. Look at the social and environmental issues that may be contributing to their problem. That's what the new upstreamist doctor can do. The new upstreamist health professional looks for the trigger that starts the disease. Is it the smoky air?
Personalized and preventive medicine
If someone talks about headaches and they don't have a tumor or aneurism, what about stress that builds up? Is there financial stress? What can the new physician do about problems that can't be fixed by pills, implants, or surgery? Sacramento needs more upstream primary care physicians because issues happen. Many patients don't have the transportation to see a doctor. People have chronic issues such as stress, depression. There's a reason why people don't take medications regularly. It's because the side effects are worse than the symptoms, the pills are habit-forming, or they don't work.
You have patients walking away from conventional medicine because their chronic conditions aren't being changed for the better. Others want to focus more on self-care with natural sources that don't have side effects and that at least are calming. That's why preventive medicine is called upstream medicine, where doctors look for the root causes of what triggers a specific disease in the first place. The old way still taught in most medical schools is to bandage or drug down the symptoms with a prescription medicine, procedures, or surgery rather than recommend a change that gets rid of the chronic stress, the polluted air, or the unhealthy food for that individual.