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Changing the Conversation: Focusing on Health, Not Health Care

"Calling it a health care crisis is misleading. The real crisis is not in health care, but in health. If you had to choose either optimal health or great health care, which would you choose?"
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At The Global Good Fund, many of the fellow organizations that we support (such as Health for America, Charity Miles, and Splash) work to improve the health of our communities. Working with the young social entrepreneurs of these organizations has piqued my interest on the topic of health and wellness across the world. As such, it was a pleasure to meet emergency physician Anoop Kumar, M.D., who I consider to be an emerging leader in the health care industry.


Dr. Kumar completed his residency in Philadelphia, and it was there that he witnessed how broken our health care system is. He saw hospital staff jumping from emergency to emergency with repeat patients living "roller coaster lives" and receiving emergency treatment all too regularly. This reality unnerved Dr. Kumar, especially when he realized that most physicians don't speak up about these issues. Dr. Kumar decided that, as a physician, it was his responsibility to speak up -- and as long as he resisted voicing his opinion, he was unsatisfied in his work.

Dr. Kumar went on to develop the blog (and will eventually be writing a book) called The Story of Health, which captures the experiences he shares with patients in the emergency room (ER). Bigger picture, his blog offers a rich perspective on what is happening to our health in American society and why.

Upon further exploration of the man behind the writing, I discovered that documenting The Story of Health has been an incredible journey for Dr. Kumar. What started as a glance into health and health care became a deep appreciation of the relationship between our personal choices and the greater events that shape modern society.

Today, Dr. Kumar is fulfilling what he feels to be his true responsibility as a physician and has more professional and personal satisfaction than ever before. I'd like to share with you my insightful interview with Dr. Kumar on the driving forces behind his work and observations in the health care industry.

You are a successful ER physician dedicated to making health a national priority. In our most recent conversation, you mentioned that you believe that the U.S. is in a state of emergency due to our lack of focus on health. Would you please explain to readers why you take this view and how you came to develop the views you have?

I see all types of patients in the ER, including many with health insurance and many without. One of the things that strikes me is that having robust health insurance plans, getting checkups, and taking medications regularly doesn't guarantee health. So that got me thinking that health insurance and medical homes, while helpful, would not address the root issue which is one of health, not health care.

What makes it an emergency is that our health is getting worse while our minds are busy figuring out ways to fix health care, which may not address the fundamental health problem. It is important to fix health care, but not as an end unto itself. We are not focused on the real problem.

What is "The Story of Health"?

The Story of Health is the story of the factors that have led our country to its current state of health, of the trends that are defining a historic present moment, and of the steps we need to take to write the next chapter of health. In essence, it's a refreshing and compelling look at the past, present, and future of America's health in a broad sense, woven together into one story. Most importantly, it's our story -- one that we haven't heard in its entirety before, which makes it all the more important to tell.

When I started looking into our story, I thought about the different aspects of health -- physical, mental, etc. From there I moved to the idea of wellness, which I think is one of the most widely interpreted words we have now. Wellness blew the door open for me. It connected the person and the community, the unit and the whole. I couldn't help but draw the connection between the personal choices we make in our lives and the greater events shaping our society. That's really what The Story of Health is about. It's as relevant to personal well-being as it is to overall societal health.

The Story of Health is evolving. It is quite different today than when I first thought about it. And it will continue to evolve as more people share their parts of the story.


What should be the top three priorities of the U.S. to get out of our national health care crisis?

Calling it a health care crisis is misleading. The real crisis is not in health care, but in health. If you had to choose either optimal health or great health care, which would you choose? Somewhere along the way, the conversation took a detour from health and now all the talk is about health care. That needs to change. If we had great health care and our nation's health was still poor, would that be a grand success? Is that really what we aspire to?

Our No. 1 priority should be to clearly and uncompromisingly state our intention: optimal health for everyone, not just better health care. I understand that "optimal health for everyone" is hard to define and lofty, but if we don't dare to make our ideals ideal and say them out loud, we will never even get close. Incremental improvement may be the method but it should not be the vision. Let's be bold about what we want. Let's aim high and state our intention clearly.

Number two would be understanding how we got here in the first place. We are quick to want solutions to problems that we don't understand. How did our nation's health reach its current state? The answer greatly depends on how we define health, which I had a hard time doing. I ultimately recognized that health is so broad and yet so personal that each person could have a different definition.

I gave up trying to find the perfect definition and instead focused on the key contributors to health, which I call the four pillars of health: they are nutrition, movement, rest, and connection. How did we develop our current eating habits? What factors have led to the more sedentary life many of us have now? How much sleep and R&R (rest and relaxation) are we getting and why? Do we enjoy a sense of purpose and passion, and are we able to connect with others as part of a community? Answers like "we're lazy," "we eat too much," "we drive everywhere" are superficial and don't give us a real understanding of what's happening.

The four pillars can also be thought of a in a broader sense. Nutrition is the information we consume. Movement is allowing our thoughts, feelings, and creative expression to flow through us. Rest is allowing our minds to settle down. And connection is seeing that my well-being is bound with the well-being of everyone else.

The top two priorities I mentioned are not quick, bullet point solutions. But they are the most important steps. Without identifying our goal, stating it explicitly, and becoming aware of the situation we're in, we are likely to spin our wheels and waste resources. Once we accomplish the top two priorities, more tangible solutions that can bring us back to health will emerge.

There are a couple ideas vying for priority number three. One is reforming medical education. We are evolving past the era of pill and procedure medicine. In some cases, pills and procedures work well. In others situations, they do not. We know that many cases of hypertension, Type 2 diabetes, high cholesterol, and even heart disease can be reversed by lifestyle modification alone, which would prevent many acute emergencies. The power of nutrition, movement, rest, and connection need to come across in medical education, not only in public health. This needs to influence the minds of tomorrow's physicians so it is a significant part of every doctor's visit.

To achieve this vision, we need to ask difficult questions. Who sets the agenda for medical education? Who funds our medical schools? What are the strengths and weaknesses of allopathic medicine and other systems of medicine? We need to foster a spirit of collaboration in the hearts of tomorrow's providers so that they will do what's best for the health of the patient, even if it means acknowledging that someone else does it better.

I want to mention one more idea that should be a priority of the U.S. to shift to a future of health, not just health care. We need to get the people, organizations, companies, and movements whose work supports the goal of optimal health to raise the volume. No matter what your interest, your job, or your passion, your voice matters and it needs to be heard. I learn something from everyone I talk to about this topic because each voice is unique, including the ones who disagree with me. Out of this collective conversation will emerge a new vision of health for our country. Business and civic leaders need to step forward and support that new vision. It's time.

What do you think is the most important step in making health a national priority and why?

Calling attention to what is happening to our health right now and why is the most important step. Health care has drawn so much coverage that health is seldom talked about. When we make health the first priority, the questions we've been asking about health care will change. Let's aim for health and in the process get great health care. Aiming for great health care is settling for second best, which isn't good enough.

What do you think is the biggest innovation or movement in the health industry that is going to write our next chapter of health as we move into the future?

The biggest movement in both health and health care is the wellness movement. It's hard to pinpoint exactly what fits into the category of wellness and what doesn't. Some have adopted the word "wellness" to be relevant. What I've found common to all things "wellness" is that it comes with acceptance of responsibility for one's health. Wellness can't be given to you. It is something that comes with finding what works for you. Wellness begins with saying "I can."

McKinsey has stated that wellness is the next trillion dollar industry. I think the reason it's growing so fast is that people are looking for health outside of the established paradigm. People recognize that going to the doctor, taking pills, and exercising once a week isn't necessarily going to yield health. More and more, people are taking it upon themselves to find what works. And they're ready to pay out of pocket for it if health care doesn't offer it. I believe that the health care organizations that don't figure out how to integrate wellness into their model are endangered species.

When it comes to paying out of pocket, what areas of health would you advise people to invest their money in?

Of the four pillars of health, I would recommend investing in the "connection piece" -- and it's often free! Connection energizes the "I can" state of mind and is the catalyst for the other three pillars. Find something that moves you and make time for it regularly. Spend a few minutes everyday alone with yourself. See what comes up. Get to know silence a little better. When you're inspired, you find ways to do things. When you are not, you won't feel like eating well or moving your body much.

But it's important to note that one size doesn't fit all. For some, nutrition might be an initial focus. For others, movement. There's no wrong way to start.

If you could give millennials one piece of advice in regards to the future of national health care, what would it be?

I would say find what works for you. Take into consideration what you read, what your doctors tell you, etc., but also take the time to listen to yourself. Nobody knows more about your health than you. That means you have to speak up, and also that you have to listen.

Find your voice. Speak up about the issues that stir you, health care or otherwise. When you contribute your opinion, something unique is gained that can't be found anywhere else. This is how we raise the volume, and only this can truly change health care.

If this interview is something that resonates with you, share this story. Visit The Story of Health website and post your comments. Let's say "I can."