Healthcare And Compliance
The second part of this series outlined real-world solutions to redefining and overhauling a broken healthcare system.
I suggested:
● Insurance benefit change to reflect an increase in the value of fitness reimbursements
● Key partnerships between doctors’ offices and fitness facilities
● Onsite nutrition education at the physician’s office
● Changing the current payout model for physicians and healthcare providers.
The current order of the day is that one must wait until one becomes sick before seeking care. The proof is as clear as day in the stats outlined in the first article that sick care is way too costly and draining of our resources and quality of life.
The mindset that must be developed is “fitness and nutrition ARE healthcare.” Conscious food consumption and a minimum threshold of movement should be viewed as being as valuable or as costly as a monthly prescription for blood pressure medicine. Fitness and nutrition ARE the medicine.
So, if the answer is simply proper fitness and nutrition, what is stopping the average person from implementing some form of one or both into their daily lives? The answer lies in compliance. How compliant are people in building good habits and sticking with them sustainably over time?
I will go into some depth with this concept as it relates to being compliant in caring for one’s health.
“In medicine, compliance describes the degree to which a patient correctly follows medical advice. Most commonly, it refers to medication or drug compliance, but it can also apply to medical device use, self-care, self-directed exercises, or therapy sessions.”
During the pandemic lockdown in New York City in the first half of 2020, I spent many days sitting on my building stoop seeking solace or cruising the streets on my bike observing. The first couple of months were eerie; the streets of Brooklyn were like a ghost town with minimal human activity. As the third month trended, the trainer in me began to notice:
● The majority of people outside were doing some form of exercise, power walking, jogging, or jumping rope on the sidewalk in front of their buildings
● A significant number of these people seemed to be fairly new to exercise; I could tell by their gait, stride, gear, or lack thereof.
My observations were corroborated by data from large fitness brands Fitbit and Asics as follows:
● According to 2020 Fitbit data, daily steps dropped by as much as 38% in some regions of the world in March when lockdown commenced. Though the daily step counts decreased, there was an uptick in the intensity of active minutes by users as the pandemic continued in 2020, more than the minutes for the same period the year prior in 2019, pre-Covid. This data showed these intense active minutes were primarily achieved by running, jogging, yoga, and hiking.
● Brooks Running Company recorded a 20% spike in running shoe sales. Given the fact that 90% of Brooks running shoes are sold in retail stores and that most of these retail stores were shut for months during 2020, it is a testament to the fact that running activity spiked during the pandemic.
How can we get people to recognize that movement, any movement, is lifesaving without the threat of a deadly pandemic? How can we increase compliance? How do we create and develop the habit of movement?
I think the solution is a combination of issues:
● Quality of life messaging
● Habit development and sustainability.
Quality of life messaging translates into the real-world impact of disease and should be the primary motivator. Meaning, “what does it mean to you personally if my sugar is high?” It ties the objective and medical data to the patient’s daily life. So, for example, instead of simply saying, “Hey, your blood pressure is trending into dangerous levels, you should change your diet and workout more,” it would take the form of, “Hey, your blood pressure is trending dangerously high, which means you run the risk of a coronary episode; an episode that may result in you not being present for your daughter’s High School graduation or in being semi-paralyzed and not being able to enjoy the independence of walking to your favorite coffee shop without assistance.
The messaging and the conversation need to be in a personal but yet very serious tone. Again, the motivating factor behind wanting to move more.
The pandemic conveyed that serious tone to many after weeks of sitting sedentary in their apartments. The realization that depression was setting in and was affecting their eating and sleeping habits. The lack of movement and the impact on the human mood spurred many to take to the streets to power walk, jog, skip, bike ride, etc.
So, the conversation needs to be conducted between physicians and patients. The patient secures a pair of workout shoes, the latest Fitbit, and training gear from Nike and grabs a gym membership. They show up one week, two weeks, a month — and suddenly they stop. Why is that? Taking New Year resolution data as an example:
“It has been proven time and time again that fitness compliance wanes and fades one month into each year and is practically down to single-digit compliance of about 9% by December in most studies. So, for every 100 people that start a fitness regimen in January, nine have stuck with it by December. This is a mind-blowing stat.
Do they lack willpower?
Willpower fuels habits, so how do we improve our willpower and, in turn, boost wellness habits?
Studies have proven that “willpower” is a finite resource that can be depleted and, like a muscle, can be worn out and fatigued. So many variables can come into play for individuals of all backgrounds, ages, genders, etc., but I will not go down that rabbit hole. I would like to touch on how we can improve willpower, not deplete it.
● Avoidance. Avoid instances of temptation that will test your willpower. I avoid going out to eat during the week because it will tempt me to have a sweet alcoholic drink. I avoid the snack aisle altogether when grocery shopping and, in turn, keep no unhealthy snacks in my apartment. Go straight to the gym after work. Avoid going home where you may be tempted to sit on the sofa or in front of your laptop and end up never going back out. Avoidance is a major help for me in building habits and essentially does not overly tax my willpower.
● “The Motivator” must be significant. The motivation for a recovering stroke patient to quit cigarettes is way more significant than someone wanting to quit cigarettes so they can run a faster mile. The former being literally a life or death decision. Find and define your motivator. Personally, my motivator has grown greater with age. In my twenties, my motivator was to simply look good, now in my forties, I would like to be as active, strong, and functional well into my eighties as I am now, so I can enjoy life with friends and family. This supreme and super long-term motivator is what drives my daily activity level and nutrition.
● “Implementation intention.” This is basically a fancy way of having a back-up/pivot plan for unexpected social situations or emergency situations that may come up and cheat me out of my 45-minute workout. It looks like me telling myself, “If I am to work out at 5 pm and I get caught on a long zoom meeting past 5 pm, I will go to bed earlier and do 30 minutes first thing in the morning,” or “if I go out to eat tonight with my business partners, even though I am not planning to, and I am offered a drink, I will have a cranberry juice with water.” I preemptively plan to be derailed, so that plan B is reflexive and not a spur of the moment, worst case emotional decision.
I have found these above tactics to be sustainable in my journey in building wellness habits without overly taxing my willpower. These three are my major keys to building sustainable habits as they pertain to my movement practice and nutrition. Over the course of the last 3 pieces inclusive of this one, I have outlined the healthcare issue, redefined it, and given large-scale systemic solutions. I close with this piece by providing distilled solutions and tactics that can be implemented in anyone’s day to day. Give the aforementioned a try and give yourself a better shot at boosting your compliance and in turn improving your existing and future quality of life. Your friends and family would greatly appreciate a truly healthy and functional version of you.
