When was the last time you went to the hospital for yoga?
Though the hospital setting tends to go hand in hand more with illness, surgery and trauma care, recent developments in the healthcare industry signal a dramatic shift in the way that hospitals and healthcare clinics approach the treatment of chronic disease. Namely, moving increasingly toward prevention and wellness—including programs for acupuncture, dance classes, tai chi and, yes, yoga.
Such a shift couldn't come at a better time for the United States. According to new report by the National Research Council and the Institute of Medicine, Americans live shorter lives and experience more injuries and illnesses than those in comparable high-income nations. In terms of life expectancy, the United States ranks at or near the bottom of a list of 17 countries.
"If we're able to educate people and the public, we're going to have a healthier community, and that's best for everyone," explains Dr. Marko Bodor, medical director at the Synergy Medical-Fitness Center in Napa. Located on the campus of the Queen of the Valley Medical Center, Synergy opened its doors in 2006. Utilized by both patients and fee-paying members of the public, the facility emphasizes the five aspects of wellness: exercise, nutrition, sleep, psycho-social and spiritual well-being and, of course, prevention, says Bodor.
With its pool, dance classes, nutritionists, cardio and strength-training equipment, Synergy may look like a gym, but it goes beyond your standard 24 Hour Fitness, offering a breast and mammography center, a cardiac rehab facility, public talks on health and nutrition and an integrative health center.
"Medicine for centuries was pretty much acute or terminal care. When you absolutely needed to see a doctor, you saw one," says Bodor. "We're definitely seeing a transformation in the way we treat things." Because of healthcare reform, organizations will be more accountable for their outcomes, and prevention will become much more essential, he adds.
By 2015, Santa Rosa may get its own medical-fitness center. A zoning amendment approved on Dec. 4 by the Santa Rosa City Council has opened the doors for the construction of a facility to be integrated with Santa Rosa Memorial Hospital. It's part of an overarching goal of promoting wellness, preventative care and physical activity, says Katy Hillenmeyer, a spokesperson for the St. Joseph Health System.
"Healthcare reform has provisions in it to minimize readmissions to the hospital for people with chronic illness," she adds. "Anything we can do for the health of our neighbors outside of the hospital helps in combating chronic disease, and helps keep people healthy so that they don't necessarily end up in an acute care hospital."
The shift toward a preventative model can be traced to two sources. The first is a change in public health needs. Infectious diseases, a cause for concern a hundred years ago, have been replaced with chronic disease from poor lifestyle choices. The second is the passing of the Affordable Care Act in 2010, which allows for the creation of a prevention and public health fund, along with the issuance of community transformation grants to help promote healthy lifestyle choices in every community.
A switch in focus to outcome-based reimbursement, something that's already in place at for-profit Kaiser Permanente—a company that, according to Bodor, stays profitable by keeping people out of the intensive care unit—is another Affordable Care Act goal. According to a report by Trust in America's Health, for every dollar spent on prevention, approximately $6 are saved in healthcare costs.
"The reality is that every time we keep someone out of the emergency room, it saves the public a lot of money," says Michael DiRosario, clinic manager at the Forestville Wellness Center, which was opened in 2011 by West County Health Centers.
Geared specifically toward the uninsured and low-income populations that don't normally have access to alternative medical services and preventative health education, the wellness center offers acupuncture, nutrition for diabetes and smoking cessation group meetings, cooking demos, and Zumba and yoga classes.
"What lots of places are starting to focus on is how we can get people to think about wellness and lifestyle changes," says doctor of osteopathy Connie Earl, who's practiced integrative medicine at the Forestville Wellness Center since November 2011. Though most people dread entering clinical settings, creating community by focusing on healthy lifestyles has made a marked difference.
"People love coming here," says Earl. "They say they love the feel of the place. It shifts the feel since they're actually getting treatment for chronic medical conditions, and feel more empowered in their own healthcare."
The Petaluma Health Center is a federally qualified health center that serves approximately 18,000 patients. After moving to a 6,000-square-foot building in November 2011, the facility was able to expand the services in its Center of Good Health. Now, the primary care clinic—which serves low-income individuals along with those with private insurance—is taking prevention to a level not often seen in healthcare settings. The center sees on average 200 wellness group visits a month, for sessions on smoking cessation, child obesity (an issue of serious concern in the United States) and chronic pain. The facility offers medical acupuncture (getting an average of 100 visits a month), yoga, Zumba, tai chi, meditation and hour-long integrative medicine consultations with Dr. Fasih Hameed, a doctor who recently spearheaded a conference in Santa Rosa focusing on "Integrative Medicine for the Underserved."
The crux is getting out of chronic-disease cycle, says Luke Entrop, wellness program manager.
"Tobacco use, poor diet and lack of exercise lead to heart disease, type 2 diabetes, lung disease and cancer, which account for 50 percent of U.S. deaths per year," he adds. "If we can get on the prevention end of things, we're getting to the heart of these chronic conditions of our time."
Entrop sees the Center of Good Health and the preventative approach as a way to promote healthy living for people of all backgrounds.
"With more affordable healthcare coverage, we're able to reduce the cost of acute emergent health conditions by working on some basic behavior change and nutrition education," he says. "These are some of the driving factors of more expensive healthcare costs. By investing in prevention, we're able to reduce costs in the long run."