January 31, 2025 • 28 mins
This two part episode discusses the effects of obesity on the cost of healthcare as well as doctor burnout. While itself now being considered a chronic condition, obesity in America also increases the risk of developing other chronic conditions including diabetes, cardiovascular disease, and many cancers. We're talking to Emory University Professor and Chairman of the PFCD Dr. Kenneth Thorpe about a new study that highlights the potential financial savings resulting from modest to moderate weight loss by obese adults. Then we'll talk about how many doctors ‘feel your pain’ when it comes to long waits and rushed visits. Dr. Andrea Klemes, Chief Medical Officer, MDVIP gives us more information about a new survey showing doctor burnout with 9 in 10 physicians wishing they could do more to help patients stay well.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:06):
Welcome to Virginia Focus. I'm Rebecca Hughes of the Virginia
News Network. This two part episode discusses the effects of
obesity on the cost of healthcare, as well as doctor burnout.
We'll start with obesity, which is now considered a chronic
condition in America. It also increases the risk of developing
other chronic conditions, including diabetes, cardiovascular disease, and many cancers.
(00:29):
We're talking to Emory University professor and chairman of the PFCD,
doctor Kenneth Thorpe about a new study that highlights the
potential financial savings resulting from modest to moderate weight loss
by obese adults. Welcome, doctor Thorpe. I'm so glad we
could talk today. We're talking about obesity and how it
plays into healthcare costs. What can you tell me about
(00:54):
a new study that has just been.
Speaker 2 (00:56):
Done well, sheriff.
Speaker 3 (00:58):
So, we know that about seventy three percent of the
adult population is either overweight or obese, and as you
increase in your body mass, the number of chronic health
care conditions like heart failure and type two diabetes and
high blood pressure and bad cholesterol increases, and that increases
(01:19):
health care spending. And so what the study did is
just look at what would happen for overweight and obese
people if they lost weight, how much would they save
in terms of what is spent on health care because
the likelihood of having a stroke or a heart attack
(01:39):
or some type of blood sugar malfunction goes down. And
we found that the savings are potentially quite substantial. So
a fifteen percent reduction of body mass generates about a
twenty percent reduction in overall healthcare spending for employers and
for the Medicare program.
Speaker 1 (02:00):
Oh wow, So it's behooves not only the employee to
pay attention, but and also indirectly benefits employers to make
sure that their employees are healthy. Is that what you're saying?
Speaker 3 (02:15):
Absolutely, And it benefits employers in two waves. One is
that they'll spend the less on healthcare spending, so the
premiums to workers will be lower or they'll grow at
a lower rate. Second to the rate of worker productivity
will increase. They'll have fewer absent work days because of
(02:36):
doctor appointments or because of patient's not feeling well.
Speaker 2 (02:40):
And for the family.
Speaker 3 (02:41):
What we have found is that they save in terms
of what they spend out of pocket, but they also
save on groceries. If you reduce weight, and particularly if
you're using one of these new GLP one medications, the
amount of growth and what the research is found processed
(03:03):
foods goes down. So there's really all kinds of really
beneficial aspects associated with weight loss.
Speaker 1 (03:12):
That's awesome. And I know white loss can add to
other risk factors for other conditions, right like which ones?
Speaker 2 (03:24):
Oh?
Speaker 3 (03:24):
Absolutely, I mean, the research is going very clearly that
when you have a real effective diet, exercise, nutrition intervention,
it reduces the number of new cases of type two diabetes.
We found that it reduces the number of new cases
of diabetes in the research literature by almost sixty percent.
(03:47):
So it affects blood pressure, you're less likely to be hypertensive,
effects bad cholesterol, So it has a variety of beneficial
health aspectsarticular for cardiovascular health.
Speaker 1 (04:02):
Okay, what role does stress hormone play in this obesity
problem that we're seeing. Do you think that maybe it's
the stress that everyone is under that is leading to
that obesity or do you think it's something else.
Speaker 3 (04:22):
Well, that's something that the science is trying to look at.
It's really trying to understand what are the underlying factors
outside of genetics. You know, we know that there's a
strong link between parents and their kids in terms of
body mass, but a lot of the research now is
looking at issues around aspects of the brain that are
(04:47):
affecting eating, aspects of the brain that affects.
Speaker 2 (04:52):
Exercise.
Speaker 3 (04:54):
So there's a lot of really good scientific research and
play so that we can really understand what what are
the factors that are causing the growth and obesity as
well as what's causing the growth and related to chronic
health care.
Speaker 1 (05:08):
Conditions, right, Because that's what I was thinking is you know,
you learn all about food from the time you're an
infant from your family and whatever you grow up eating
and how you grow up eating is something that we
typically carry into our adult life. So is there a
way to scientifically study all of those factors in combination
(05:35):
at the same time. Is that something you have to
isolate and then take a best guess as to which
one is the most influential. How does that work?
Speaker 3 (05:45):
Well, yeah, there have been studies looking at consumption of
sugary drinks and processed foods and what impact that has
on the level of weight and the growth of weight,
and as you can imagine, they're both associated with overweight
and obesity. So this focus on sugar, the focus on
(06:08):
ultra process foods is a really good one for us
to get out in front of And certainly the new
administration has already been talking about food and food consumption
and chronic disease.
Speaker 2 (06:21):
That was mentioned during the swearing in, So.
Speaker 3 (06:23):
That was for somebody who studies chronic illness, was welcome
to my ears to hear a focus on really reducing
the number of people that have chronic health care conditions.
Speaker 1 (06:36):
Yeah, and I love that. So w what don't we
talk about that for just a second. What got you
into studying chronic diseases? What led you down that path?
Speaker 2 (06:45):
Well, it was.
Speaker 3 (06:46):
Actually an understudied aspect of healthcare. Most of the work
I'm interested in is what's driving the growth in healthcare spending,
and nobody had really looked at trends and obesity and
how those trends in obesity translates into higher rates of
growth in healthcare spending because it's manifest through an increase
(07:11):
in the number of people that have one or more
chronic health care conditions.
Speaker 2 (07:17):
And the study that I.
Speaker 3 (07:19):
Did the original studies showed that obesity and associated with
chronic diseases were one of the leading causes of why
healthcare spending is increasing. In the Medicare program, Over ninety
percent of what Medicare spends is linked to patients that
have one or more chronic health care conditions. So it's
(07:41):
just a critical issue if we want to get a
handle on health insurance premiums and a handle on what
we spent on the Medicare program, is really this focus.
Speaker 1 (07:53):
Yeah, I definitely agree with that. I know I've seen
a lot lately about seed oils and how some of
the more common ones, vegetable oil, canola oil, things like
that apparently are not as healthy as we originally thought,
and that we need to stick with some of the
ones that I think. The rule of time I saw
(08:14):
was if it's solid at room temperature, then those are
the more natural and more healthy oils to use for cooking.
Can you speak to that? Is that a true thing?
Is that just an Internet folklore? What do you know
about that?
Speaker 3 (08:29):
Well, not as much as a nutritionist one, but certainly
the closer you are to consuming and cooking with things
that are natural, it is going to be your safest bet.
Anything that has additives or ingredients or has some type
of alteration to it is going to be it's going
(08:53):
to be a problem. Unfortunately, most of the food you
see in the grocery store is processed for ultra processed,
and so whether or not do we start putting labels
on the food, it's going to be an interesting public
policy debate on whether or not this food it contains
(09:16):
a level of processed foods that over time could be
the danger for consumption. Then it could include these oils
as well. But I think that's a debate we're going
to have over the next couple of years.
Speaker 1 (09:29):
And if I had to ask you, are you willing
to share your opinion on where you would stand in
that debate.
Speaker 2 (09:36):
Yeah.
Speaker 3 (09:36):
I think that looking at labeling is good. I think
that we need to start with the science first. So
I think before and certainly the FDA would do this anyways,
they wouldn't make a policy change or suggest a policy
change unless they had real clear scientific evidence that links
(09:59):
consumption enough processed foods and sugary drinks to weight in
chronic disease. Now they're out there, but I think that
that would be the first step is really to generate
a science face and a fact based on this that
you can then use to develop congressional or other interests
(10:19):
in doing food labeling. But we've got to sort of
do the science part of it first.
Speaker 1 (10:26):
Right, I agree with that. So basically what we're saying
is weight, of course, like you said, influences healthcare costs.
How much of that is determined by or influenced by insurance?
Speaker 3 (10:45):
Well, I don't think it's really, you know, much influenced
by insurance. We know, if you have insurance, you spend
more in healthcare because you're more likely to go see
the physician and go get an annual up or if
you have chronic disease, going for management of it. It
really is I think a combination of lack of exercise,
(11:08):
poor diet, in genetics. I mean that those are sort
of the three components, right.
Speaker 1 (11:15):
I guess what I was saying is do you think
people kind of avoid possibly seeing the doctor even though
they know they're overweight and maybe they have other symptoms,
but they're like, you know what, regardless of this, my
insurance costs are so high and maybe I don't have it,
you know, because insurance has driven up the cost of healthcare,
(11:37):
and doctors are not getting paid what they used to
be paid, and we see less people going into the
field because of the stress and the result of I mean,
the reward, the income is not what it used to be.
I guess that was my question is how much of
an influence do you think or negative influence do you
think insurance has overall on the healthcare industry.
Speaker 3 (12:00):
Well, certainly, the design that came out of the Affordable
Care Act, for example, is that clinical clinical preventive services
don't have any cost sharing associated with it, and in
most private insurance, if you go in for your annual physical,
which you should do, there's not an out a pocket
(12:21):
component associated with that as well. I think unfortunately, though,
if you have three, four or five six chronic conditions
and you do go to the doctor, there is usually
a copay associated with it. And one of the things
that I've worked on is that had really advocated in
(12:44):
the design of health insurance for Medicare and for private insurance,
is that if you're chronically ill patient and you go
see the doctor for a clinically recommended service, an annual
eye exam for a diabetic for example, an extremity exam,
am for a diabetic to make sure that you're not
at risk of an amputation. Those visits and those trips
(13:08):
should have no cast sharing associated with it, because we
want to encourage people to use clinically important services that
physicians recommend that are going to keep patients healthy.
Speaker 2 (13:21):
So cast sharing can be a real deterrence.
Speaker 3 (13:26):
You're right in cases where chronically oh patients are seeking
care for clinically recommended services, and then the design of
insurance and call it value based insurance design, we really
should have no cast sharing for those clinically recommended services.
Speaker 1 (13:42):
Yeah, I definitely agree with that. I assume that you
do some of your own scientific research. Is that a
good assumption?
Speaker 2 (13:52):
Yeah?
Speaker 3 (13:52):
Most of it is not the economics of it, okay,
but I do do look at the interplay of consumption
items and healthcare costs and weights and chronic disease and
really try to pull all those together.
Speaker 1 (14:06):
Okay. Well, that's definitely influenced by the more physical side
of the science, you know, where they're doing the testing
for different things. Is there a particular type of study
that you would like to see done or that you
would like to do yourself that hasn't been done already?
Speaker 2 (14:23):
Yeah. So I'm doing a study that's looking at.
Speaker 3 (14:28):
Really at a community level, the association of things like
sugary beverage consumption per capita, fast food consumption per capita
really is a good proxy for processed.
Speaker 2 (14:45):
Foods, and look at how food.
Speaker 3 (14:48):
And sugary beverages interact with weight in a community, both
for children and adults.
Speaker 2 (14:58):
So that's something that we have in progress.
Speaker 1 (15:01):
I love that. And when you do that, are you
taking into account the addictiveness, because I know they've come
out and said that processed food in general, and like
you said, sugary drinks, all these things that we're talking
about that are so bad for you, they also have
addictive qualities that once you have one or two, now
(15:21):
all of a sudden you want more and more and more,
and you kind of don't have that when it comes
to the more natural stuff. Is that part of your
research whenever you're taken that into account or is it
just numbers?
Speaker 3 (15:36):
No, certainly taking that into account because we look at
people who do and do not consume sugary beverages, for example,
and once you start, you're right, we're looking at per
person consumption per year of a sugary beverage and you know,
we find people obviously have them every day.
Speaker 2 (15:57):
Same thing with ultra processed foods.
Speaker 1 (16:01):
And are you also looking at the different income levels
when it comes to that.
Speaker 3 (16:06):
Study or okay, yeah, we're looking at all kinds of demographics.
We're looking at income, race, and ethnicity, gender, age, all
of those are part of the broader study that we're
looking at.
Speaker 1 (16:20):
I love that. And I don't know if you have
a time period now, but do you do you know
when that study will be completed so we can take
a look at it.
Speaker 2 (16:32):
Not yet.
Speaker 3 (16:34):
I think we're probably at least i'd say six to
ten months out. It's a pretty big, complicated study, so
it is going to take some time.
Speaker 1 (16:45):
Oh yeah, and how many people besides you were working
on it?
Speaker 2 (16:49):
I have two others.
Speaker 1 (16:51):
Okay, that sounds awesome. So when it's ready, where do
we go to find it?
Speaker 3 (16:58):
Well, the best website all of this information I've been
talking about on chronic disease and it's available by state,
would be under www dot Fight Chronic disease. That's one word,
fight chronicdisease dot org and it has a wealth of
information there on our website.
Speaker 1 (17:19):
Wonderful. That's awesome. We'll definitely have to check that out
while we're waiting on your stuff. Is there anything that
people who are listening anyway they could help you being involved, volunteering,
anything like that?
Speaker 3 (17:38):
Now, I think that be a good consumer of the information.
I think that's sort of the best thing that people
can do is that, you know, pay attention to the
science and understand what you're consuming and what the science
are saying, the impact it has on your body shape,
your body weight, and the impact that has in your
(17:59):
overall health. So I think that that's an important thing
that the people can do, is really understand all of
these links that oftentimes they don't pay attention to.
Speaker 1 (18:10):
Yeah, I definitely agree with that. I know we're coming
up close to the end of our time and I
need to let you go, So let me ask you
a final question this way. I'm just really curious, and
you are the expert in this realm. Is there anything
the audience needs to know about all of this that
I just didn't know to ask you about.
Speaker 2 (18:34):
No, No, not that I can think of.
Speaker 3 (18:36):
I think the good news is that there are tools
out there that people can employ that will make them healthier,
help them lose weight, save money both on groceries and
save money out of pocket. And they can look up
programs online like the diabetes prevention program. Medicare offers that
(18:59):
as a cover service, so I encourage Medicare patients who
are eligible to enroll in.
Speaker 2 (19:05):
That it works.
Speaker 3 (19:07):
Many employers have a similar program, and I encourage employees
that want to keep healthy enroll in those lifestyle programs
that many employers offer. And obviously, these new GLP one
medications have been very effective at weight laws, but there
(19:27):
also have been very effective at preventing new cases of
cardiovascular disease. So you know, combining that with a good diet,
those are all all three options that patients have.
Speaker 2 (19:44):
So there are answers.
Speaker 1 (19:45):
Here wonderful And is there a website you'd like to plug?
Speaker 3 (19:51):
Yeah, I just think, you know, if you're going to
fight conduct disease dot org, that's really the best place
for the information. So it'll have links to actually everything
I just talked about.
Speaker 1 (20:02):
Awesome. Well, I know you need to get going, so
I'm gonna let you go, But thank you so much
for your time today.
Speaker 2 (20:10):
Okay, well, thank you appreciate it.
Speaker 1 (20:12):
Now we're gonna switch gears slightly. We'll talk about how
many doctors feel your pain when it comes to long
waits and rushed doctor visits. Doctor Andrea Klemis, chief medical
officer of MDVIP, gives us more information about a new
survey showing doctor burnout, with nine and ten physicians wishing
(20:33):
they could do more to help patients stay well. Let's
jump right in. Obviously, people are frustrated with the healthcare industry.
There's a big movement towards holistic care, treating the whole
body instead of individual symptoms and individual pieces of the body. Obviously,
doctors are a little upset about it too. What can
(20:56):
you tell me about the doctor side of things?
Speaker 4 (21:01):
Sure, so we all know the healthcare system's broken. Doctors
are doing their best. Primary care physicians have over two
thousand patients in their practice. They're working fifty sixty hour
work weeks to just try and get everybody in and
you know they're all vying for those same appointments. Doctors
are seeing twenty twenty five patients a day. The MDVIP
(21:25):
survey showed that fifty seven percent say that they have
written a prescription or refer to a specialists because it's
faster than diving deeper into the problem or coaching on
things like lifestyle, sleep habits, or exercise. So we really
need to come up with some better models for the
healthcare experience.
Speaker 1 (21:47):
Definitely agree with that. How does or what effect does
it have where we see fewer people going into the
medical industry. Is there a way to remedy that, do
you think, because I'm sure that's part of the problem.
Speaker 4 (22:06):
Yeah, it is. In the survey, many physicians said that
they wouldn't want their children going into primary care and
they wouldn't even go into it again if they had
the choice. So I think we really need to find
alternative ways to take care of patients, things like the
MDVIP model where you have a maximum of six hundred
(22:30):
patients in your practice, but you get to give them
an executive style physical every year and really focus on
them creating a wellness plan, you know, an action plan
to keep you healthier longer, you know, improve your health span,
not just your lifespan.
Speaker 1 (22:50):
Definitely. My mother was an X ray tech, so I'll
tell you that as a preference to this question. She
absolutely hates insurance companies. And I see that as a
growing trend with not only people you know, layman, people
like myself who are not in the industry but have
(23:10):
to deal with it, but also people in the medical industry.
Do you think that is the largest part of the
problem or just part of the problem in general.
Speaker 4 (23:23):
It's a very large part of the problem.
Speaker 3 (23:25):
You know.
Speaker 4 (23:26):
Well, the administrative task physicians have to do jump through hoops.
You know, when I went into practice, I won't tell
you how many years ago I could just prescribe a
medicine if I thought a patient wanted it. I didn't
have to, you know, ask an insurance company and then
them tell me, no, you have to use this, this,
and this. First I was picking the right thing for
(23:49):
the patient. So there are a lot of hoops to
jump through. It's also what has raised all the you know,
healthcare price index and costs keep going up because as
they you know, have their contracted rates and all, you know,
(24:09):
physicians are sort of at their mercy, hospitals are at
their mercy, and it really is kind of a vicious cycle, right.
Speaker 1 (24:18):
And I see the healthcare industry a lot like I
see the body. It is a whole system. If you
were to take a guess, how much of the entire
system would you attribute The problems are insurance.
Speaker 4 (24:37):
Oh, I don't know about a guess. I mean, I
think it's a lot. I think that's what started getting
us down this path. Part of it is also that
there are more and more patients that are sicker right now,
you know, as obesity rates, sore and diabetes and heart disease,
and you know the SAD diet, the standard of American diet.
(25:01):
It just overloads the system even more so when you
add the two together, it really creates a problem.
Speaker 1 (25:10):
I agree with that for sure. Why don't you tell
me about the MDVIP model that you have.
Speaker 2 (25:18):
Sure?
Speaker 4 (25:18):
So, MDVIP is a national network of primary care physicians.
We practice membership based personalized care. You get half an
hour follow ups with the doctor one to two hours
yearly for an executive style physical and they can really
get to know you and your family so that they
(25:39):
can do the best for you.
Speaker 1 (25:41):
Coach you.
Speaker 4 (25:43):
They love to coach on diet and exercise and really
help prevent disease.
Speaker 1 (25:52):
And what allows them to do that versus the rest
of the industry that's kind of struggling.
Speaker 4 (26:01):
Yeah, So, patients will pay a membership fee that you
know ranges across the country, and then that lets doctors
cut down their panel. What the fee is going towards
is that executive style physical and then the doctors just
can take the time during the year because they have
(26:21):
less patients and they have the time to focus on them.
Speaker 1 (26:25):
And is this in place of insurance.
Speaker 4 (26:28):
No, we work with insurance. Medicare commercial insurance is all
compatible and so patients can still have their insurance go
in and be seen for their sinus infection, their insurance
will be builled.
Speaker 1 (26:41):
But this is over and above, okay. And if I
was looking for a doctor that is part of this,
how would I do that?
Speaker 4 (26:51):
You can go to mdvp dot com. If you go
to backslash doctor health, you can learn more about the
survey and patients can even take a patient burnout survey
and see if they're burned out. But then you can
look for a doctor in whatever town you're in across
the country.
Speaker 1 (27:10):
Love it. And a final question, I am just the
most curious cat in the world, and you are obviously
the expert. So is there anything the audience needs to
know that I just didn't realize I needed to ask
you about it.
Speaker 4 (27:29):
You know, I think patients really just need to trust
their physicians and stand up for themselves, so that if
you go in and you're not getting what you need,
you need to talk about that, you need to ask
more questions, be an advocate for yourself, but respectfully, not
with a whole list of things that you got from
(27:50):
the internet saying that you must have this disease or
this disease. But just partner with your physician and they
will be more than happy to partner with you, and
you know, take the time to focus and help you
stay healthy.
Speaker 1 (28:05):
I hope you've enjoyed today's show. Thanks for tuning in
to the show on your favorite local radio station. You
can now listen to this show or past shows through
the iheartapp or on iHeart dot com. Just search for
Virginia Focus under podcasts. I'm Rebacca Hughes with a Virginia
news network, and I'll be here next week on Virginia Focus.
Welcome to Virginia Focus. I'm Rebecca Hughes of the Virginia
News Network. This two part episode discusses the effects of
obesity on the cost of healthcare, as well as doctor burnout.
We'll start with obesity, which is now considered a chronic
condition in America. It also increases the risk of developing
other chronic conditions, including diabetes, cardiovascular disease, and many cancers.
(00:29):
We're talking to Emory University professor and chairman of the PFCD,
doctor Kenneth Thorpe about a new study that highlights the
potential financial savings resulting from modest to moderate weight loss
by obese adults. Welcome, doctor Thorpe. I'm so glad we
could talk today. We're talking about obesity and how it
plays into healthcare costs. What can you tell me about
(00:54):
a new study that has just been.
Speaker 2 (00:56):
Done well, sheriff.
Speaker 3 (00:58):
So, we know that about seventy three percent of the
adult population is either overweight or obese, and as you
increase in your body mass, the number of chronic health
care conditions like heart failure and type two diabetes and
high blood pressure and bad cholesterol increases, and that increases
(01:19):
health care spending. And so what the study did is
just look at what would happen for overweight and obese
people if they lost weight, how much would they save
in terms of what is spent on health care because
the likelihood of having a stroke or a heart attack
(01:39):
or some type of blood sugar malfunction goes down. And
we found that the savings are potentially quite substantial. So
a fifteen percent reduction of body mass generates about a
twenty percent reduction in overall healthcare spending for employers and
for the Medicare program.
Speaker 1 (02:00):
Oh wow, So it's behooves not only the employee to
pay attention, but and also indirectly benefits employers to make
sure that their employees are healthy. Is that what you're saying?
Speaker 3 (02:15):
Absolutely, And it benefits employers in two waves. One is
that they'll spend the less on healthcare spending, so the
premiums to workers will be lower or they'll grow at
a lower rate. Second to the rate of worker productivity
will increase. They'll have fewer absent work days because of
(02:36):
doctor appointments or because of patient's not feeling well.
Speaker 2 (02:40):
And for the family.
Speaker 3 (02:41):
What we have found is that they save in terms
of what they spend out of pocket, but they also
save on groceries. If you reduce weight, and particularly if
you're using one of these new GLP one medications, the
amount of growth and what the research is found processed
(03:03):
foods goes down. So there's really all kinds of really
beneficial aspects associated with weight loss.
Speaker 1 (03:12):
That's awesome. And I know white loss can add to
other risk factors for other conditions, right like which ones?
Speaker 2 (03:24):
Oh?
Speaker 3 (03:24):
Absolutely, I mean, the research is going very clearly that
when you have a real effective diet, exercise, nutrition intervention,
it reduces the number of new cases of type two diabetes.
We found that it reduces the number of new cases
of diabetes in the research literature by almost sixty percent.
(03:47):
So it affects blood pressure, you're less likely to be hypertensive,
effects bad cholesterol, So it has a variety of beneficial
health aspectsarticular for cardiovascular health.
Speaker 1 (04:02):
Okay, what role does stress hormone play in this obesity
problem that we're seeing. Do you think that maybe it's
the stress that everyone is under that is leading to
that obesity or do you think it's something else.
Speaker 3 (04:22):
Well, that's something that the science is trying to look at.
It's really trying to understand what are the underlying factors
outside of genetics. You know, we know that there's a
strong link between parents and their kids in terms of
body mass, but a lot of the research now is
looking at issues around aspects of the brain that are
(04:47):
affecting eating, aspects of the brain that affects.
Speaker 2 (04:52):
Exercise.
Speaker 3 (04:54):
So there's a lot of really good scientific research and
play so that we can really understand what what are
the factors that are causing the growth and obesity as
well as what's causing the growth and related to chronic
health care.
Speaker 1 (05:08):
Conditions, right, Because that's what I was thinking is you know,
you learn all about food from the time you're an
infant from your family and whatever you grow up eating
and how you grow up eating is something that we
typically carry into our adult life. So is there a
way to scientifically study all of those factors in combination
(05:35):
at the same time. Is that something you have to
isolate and then take a best guess as to which
one is the most influential. How does that work?
Speaker 3 (05:45):
Well, yeah, there have been studies looking at consumption of
sugary drinks and processed foods and what impact that has
on the level of weight and the growth of weight,
and as you can imagine, they're both associated with overweight
and obesity. So this focus on sugar, the focus on
(06:08):
ultra process foods is a really good one for us
to get out in front of And certainly the new
administration has already been talking about food and food consumption
and chronic disease.
Speaker 2 (06:21):
That was mentioned during the swearing in, So.
Speaker 3 (06:23):
That was for somebody who studies chronic illness, was welcome
to my ears to hear a focus on really reducing
the number of people that have chronic health care conditions.
Speaker 1 (06:36):
Yeah, and I love that. So w what don't we
talk about that for just a second. What got you
into studying chronic diseases? What led you down that path?
Speaker 2 (06:45):
Well, it was.
Speaker 3 (06:46):
Actually an understudied aspect of healthcare. Most of the work
I'm interested in is what's driving the growth in healthcare spending,
and nobody had really looked at trends and obesity and
how those trends in obesity translates into higher rates of
growth in healthcare spending because it's manifest through an increase
(07:11):
in the number of people that have one or more
chronic health care conditions.
Speaker 2 (07:17):
And the study that I.
Speaker 3 (07:19):
Did the original studies showed that obesity and associated with
chronic diseases were one of the leading causes of why
healthcare spending is increasing. In the Medicare program, Over ninety
percent of what Medicare spends is linked to patients that
have one or more chronic health care conditions. So it's
(07:41):
just a critical issue if we want to get a
handle on health insurance premiums and a handle on what
we spent on the Medicare program, is really this focus.
Speaker 1 (07:53):
Yeah, I definitely agree with that. I know I've seen
a lot lately about seed oils and how some of
the more common ones, vegetable oil, canola oil, things like
that apparently are not as healthy as we originally thought,
and that we need to stick with some of the
ones that I think. The rule of time I saw
(08:14):
was if it's solid at room temperature, then those are
the more natural and more healthy oils to use for cooking.
Can you speak to that? Is that a true thing?
Is that just an Internet folklore? What do you know
about that?
Speaker 3 (08:29):
Well, not as much as a nutritionist one, but certainly
the closer you are to consuming and cooking with things
that are natural, it is going to be your safest bet.
Anything that has additives or ingredients or has some type
of alteration to it is going to be it's going
(08:53):
to be a problem. Unfortunately, most of the food you
see in the grocery store is processed for ultra processed,
and so whether or not do we start putting labels
on the food, it's going to be an interesting public
policy debate on whether or not this food it contains
(09:16):
a level of processed foods that over time could be
the danger for consumption. Then it could include these oils
as well. But I think that's a debate we're going
to have over the next couple of years.
Speaker 1 (09:29):
And if I had to ask you, are you willing
to share your opinion on where you would stand in
that debate.
Speaker 2 (09:36):
Yeah.
Speaker 3 (09:36):
I think that looking at labeling is good. I think
that we need to start with the science first. So
I think before and certainly the FDA would do this anyways,
they wouldn't make a policy change or suggest a policy
change unless they had real clear scientific evidence that links
(09:59):
consumption enough processed foods and sugary drinks to weight in
chronic disease. Now they're out there, but I think that
that would be the first step is really to generate
a science face and a fact based on this that
you can then use to develop congressional or other interests
(10:19):
in doing food labeling. But we've got to sort of
do the science part of it first.
Speaker 1 (10:26):
Right, I agree with that. So basically what we're saying
is weight, of course, like you said, influences healthcare costs.
How much of that is determined by or influenced by insurance?
Speaker 3 (10:45):
Well, I don't think it's really, you know, much influenced
by insurance. We know, if you have insurance, you spend
more in healthcare because you're more likely to go see
the physician and go get an annual up or if
you have chronic disease, going for management of it. It
really is I think a combination of lack of exercise,
(11:08):
poor diet, in genetics. I mean that those are sort
of the three components, right.
Speaker 1 (11:15):
I guess what I was saying is do you think
people kind of avoid possibly seeing the doctor even though
they know they're overweight and maybe they have other symptoms,
but they're like, you know what, regardless of this, my
insurance costs are so high and maybe I don't have it,
you know, because insurance has driven up the cost of healthcare,
(11:37):
and doctors are not getting paid what they used to
be paid, and we see less people going into the
field because of the stress and the result of I mean,
the reward, the income is not what it used to be.
I guess that was my question is how much of
an influence do you think or negative influence do you
think insurance has overall on the healthcare industry.
Speaker 3 (12:00):
Well, certainly, the design that came out of the Affordable
Care Act, for example, is that clinical clinical preventive services
don't have any cost sharing associated with it, and in
most private insurance, if you go in for your annual physical,
which you should do, there's not an out a pocket
(12:21):
component associated with that as well. I think unfortunately, though,
if you have three, four or five six chronic conditions
and you do go to the doctor, there is usually
a copay associated with it. And one of the things
that I've worked on is that had really advocated in
(12:44):
the design of health insurance for Medicare and for private insurance,
is that if you're chronically ill patient and you go
see the doctor for a clinically recommended service, an annual
eye exam for a diabetic for example, an extremity exam,
am for a diabetic to make sure that you're not
at risk of an amputation. Those visits and those trips
(13:08):
should have no cast sharing associated with it, because we
want to encourage people to use clinically important services that
physicians recommend that are going to keep patients healthy.
Speaker 2 (13:21):
So cast sharing can be a real deterrence.
Speaker 3 (13:26):
You're right in cases where chronically oh patients are seeking
care for clinically recommended services, and then the design of
insurance and call it value based insurance design, we really
should have no cast sharing for those clinically recommended services.
Speaker 1 (13:42):
Yeah, I definitely agree with that. I assume that you
do some of your own scientific research. Is that a
good assumption?
Speaker 2 (13:52):
Yeah?
Speaker 3 (13:52):
Most of it is not the economics of it, okay,
but I do do look at the interplay of consumption
items and healthcare costs and weights and chronic disease and
really try to pull all those together.
Speaker 1 (14:06):
Okay. Well, that's definitely influenced by the more physical side
of the science, you know, where they're doing the testing
for different things. Is there a particular type of study
that you would like to see done or that you
would like to do yourself that hasn't been done already?
Speaker 2 (14:23):
Yeah. So I'm doing a study that's looking at.
Speaker 3 (14:28):
Really at a community level, the association of things like
sugary beverage consumption per capita, fast food consumption per capita
really is a good proxy for processed.
Speaker 2 (14:45):
Foods, and look at how food.
Speaker 3 (14:48):
And sugary beverages interact with weight in a community, both
for children and adults.
Speaker 2 (14:58):
So that's something that we have in progress.
Speaker 1 (15:01):
I love that. And when you do that, are you
taking into account the addictiveness, because I know they've come
out and said that processed food in general, and like
you said, sugary drinks, all these things that we're talking
about that are so bad for you, they also have
addictive qualities that once you have one or two, now
(15:21):
all of a sudden you want more and more and more,
and you kind of don't have that when it comes
to the more natural stuff. Is that part of your
research whenever you're taken that into account or is it
just numbers?
Speaker 3 (15:36):
No, certainly taking that into account because we look at
people who do and do not consume sugary beverages, for example,
and once you start, you're right, we're looking at per
person consumption per year of a sugary beverage and you know,
we find people obviously have them every day.
Speaker 2 (15:57):
Same thing with ultra processed foods.
Speaker 1 (16:01):
And are you also looking at the different income levels
when it comes to that.
Speaker 3 (16:06):
Study or okay, yeah, we're looking at all kinds of demographics.
We're looking at income, race, and ethnicity, gender, age, all
of those are part of the broader study that we're
looking at.
Speaker 1 (16:20):
I love that. And I don't know if you have
a time period now, but do you do you know
when that study will be completed so we can take
a look at it.
Speaker 2 (16:32):
Not yet.
Speaker 3 (16:34):
I think we're probably at least i'd say six to
ten months out. It's a pretty big, complicated study, so
it is going to take some time.
Speaker 1 (16:45):
Oh yeah, and how many people besides you were working
on it?
Speaker 2 (16:49):
I have two others.
Speaker 1 (16:51):
Okay, that sounds awesome. So when it's ready, where do
we go to find it?
Speaker 3 (16:58):
Well, the best website all of this information I've been
talking about on chronic disease and it's available by state,
would be under www dot Fight Chronic disease. That's one word,
fight chronicdisease dot org and it has a wealth of
information there on our website.
Speaker 1 (17:19):
Wonderful. That's awesome. We'll definitely have to check that out
while we're waiting on your stuff. Is there anything that
people who are listening anyway they could help you being involved, volunteering,
anything like that?
Speaker 3 (17:38):
Now, I think that be a good consumer of the information.
I think that's sort of the best thing that people
can do is that, you know, pay attention to the
science and understand what you're consuming and what the science
are saying, the impact it has on your body shape,
your body weight, and the impact that has in your
(17:59):
overall health. So I think that that's an important thing
that the people can do, is really understand all of
these links that oftentimes they don't pay attention to.
Speaker 1 (18:10):
Yeah, I definitely agree with that. I know we're coming
up close to the end of our time and I
need to let you go, So let me ask you
a final question this way. I'm just really curious, and
you are the expert in this realm. Is there anything
the audience needs to know about all of this that
I just didn't know to ask you about.
Speaker 2 (18:34):
No, No, not that I can think of.
Speaker 3 (18:36):
I think the good news is that there are tools
out there that people can employ that will make them healthier,
help them lose weight, save money both on groceries and
save money out of pocket. And they can look up
programs online like the diabetes prevention program. Medicare offers that
(18:59):
as a cover service, so I encourage Medicare patients who
are eligible to enroll in.
Speaker 2 (19:05):
That it works.
Speaker 3 (19:07):
Many employers have a similar program, and I encourage employees
that want to keep healthy enroll in those lifestyle programs
that many employers offer. And obviously, these new GLP one
medications have been very effective at weight laws, but there
(19:27):
also have been very effective at preventing new cases of
cardiovascular disease. So you know, combining that with a good diet,
those are all all three options that patients have.
Speaker 2 (19:44):
So there are answers.
Speaker 1 (19:45):
Here wonderful And is there a website you'd like to plug?
Speaker 3 (19:51):
Yeah, I just think, you know, if you're going to
fight conduct disease dot org, that's really the best place
for the information. So it'll have links to actually everything
I just talked about.
Speaker 1 (20:02):
Awesome. Well, I know you need to get going, so
I'm gonna let you go, But thank you so much
for your time today.
Speaker 2 (20:10):
Okay, well, thank you appreciate it.
Speaker 1 (20:12):
Now we're gonna switch gears slightly. We'll talk about how
many doctors feel your pain when it comes to long
waits and rushed doctor visits. Doctor Andrea Klemis, chief medical
officer of MDVIP, gives us more information about a new
survey showing doctor burnout, with nine and ten physicians wishing
(20:33):
they could do more to help patients stay well. Let's
jump right in. Obviously, people are frustrated with the healthcare industry.
There's a big movement towards holistic care, treating the whole
body instead of individual symptoms and individual pieces of the body. Obviously,
doctors are a little upset about it too. What can
(20:56):
you tell me about the doctor side of things?
Speaker 4 (21:01):
Sure, so we all know the healthcare system's broken. Doctors
are doing their best. Primary care physicians have over two
thousand patients in their practice. They're working fifty sixty hour
work weeks to just try and get everybody in and
you know they're all vying for those same appointments. Doctors
are seeing twenty twenty five patients a day. The MDVIP
(21:25):
survey showed that fifty seven percent say that they have
written a prescription or refer to a specialists because it's
faster than diving deeper into the problem or coaching on
things like lifestyle, sleep habits, or exercise. So we really
need to come up with some better models for the
healthcare experience.
Speaker 1 (21:47):
Definitely agree with that. How does or what effect does
it have where we see fewer people going into the
medical industry. Is there a way to remedy that, do
you think, because I'm sure that's part of the problem.
Speaker 4 (22:06):
Yeah, it is. In the survey, many physicians said that
they wouldn't want their children going into primary care and
they wouldn't even go into it again if they had
the choice. So I think we really need to find
alternative ways to take care of patients, things like the
MDVIP model where you have a maximum of six hundred
(22:30):
patients in your practice, but you get to give them
an executive style physical every year and really focus on
them creating a wellness plan, you know, an action plan
to keep you healthier longer, you know, improve your health span,
not just your lifespan.
Speaker 1 (22:50):
Definitely. My mother was an X ray tech, so I'll
tell you that as a preference to this question. She
absolutely hates insurance companies. And I see that as a
growing trend with not only people you know, layman, people
like myself who are not in the industry but have
(23:10):
to deal with it, but also people in the medical industry.
Do you think that is the largest part of the
problem or just part of the problem in general.
Speaker 4 (23:23):
It's a very large part of the problem.
Speaker 3 (23:25):
You know.
Speaker 4 (23:26):
Well, the administrative task physicians have to do jump through hoops.
You know, when I went into practice, I won't tell
you how many years ago I could just prescribe a
medicine if I thought a patient wanted it. I didn't
have to, you know, ask an insurance company and then
them tell me, no, you have to use this, this,
and this. First I was picking the right thing for
(23:49):
the patient. So there are a lot of hoops to
jump through. It's also what has raised all the you know,
healthcare price index and costs keep going up because as
they you know, have their contracted rates and all, you know,
(24:09):
physicians are sort of at their mercy, hospitals are at
their mercy, and it really is kind of a vicious cycle, right.
Speaker 1 (24:18):
And I see the healthcare industry a lot like I
see the body. It is a whole system. If you
were to take a guess, how much of the entire
system would you attribute The problems are insurance.
Speaker 4 (24:37):
Oh, I don't know about a guess. I mean, I
think it's a lot. I think that's what started getting
us down this path. Part of it is also that
there are more and more patients that are sicker right now,
you know, as obesity rates, sore and diabetes and heart disease,
and you know the SAD diet, the standard of American diet.
(25:01):
It just overloads the system even more so when you
add the two together, it really creates a problem.
Speaker 1 (25:10):
I agree with that for sure. Why don't you tell
me about the MDVIP model that you have.
Speaker 2 (25:18):
Sure?
Speaker 4 (25:18):
So, MDVIP is a national network of primary care physicians.
We practice membership based personalized care. You get half an
hour follow ups with the doctor one to two hours
yearly for an executive style physical and they can really
get to know you and your family so that they
(25:39):
can do the best for you.
Speaker 1 (25:41):
Coach you.
Speaker 4 (25:43):
They love to coach on diet and exercise and really
help prevent disease.
Speaker 1 (25:52):
And what allows them to do that versus the rest
of the industry that's kind of struggling.
Speaker 4 (26:01):
Yeah, So, patients will pay a membership fee that you
know ranges across the country, and then that lets doctors
cut down their panel. What the fee is going towards
is that executive style physical and then the doctors just
can take the time during the year because they have
(26:21):
less patients and they have the time to focus on them.
Speaker 1 (26:25):
And is this in place of insurance.
Speaker 4 (26:28):
No, we work with insurance. Medicare commercial insurance is all
compatible and so patients can still have their insurance go
in and be seen for their sinus infection, their insurance
will be builled.
Speaker 1 (26:41):
But this is over and above, okay. And if I
was looking for a doctor that is part of this,
how would I do that?
Speaker 4 (26:51):
You can go to mdvp dot com. If you go
to backslash doctor health, you can learn more about the
survey and patients can even take a patient burnout survey
and see if they're burned out. But then you can
look for a doctor in whatever town you're in across
the country.
Speaker 1 (27:10):
Love it. And a final question, I am just the
most curious cat in the world, and you are obviously
the expert. So is there anything the audience needs to
know that I just didn't realize I needed to ask
you about it.
Speaker 4 (27:29):
You know, I think patients really just need to trust
their physicians and stand up for themselves, so that if
you go in and you're not getting what you need,
you need to talk about that, you need to ask
more questions, be an advocate for yourself, but respectfully, not
with a whole list of things that you got from
(27:50):
the internet saying that you must have this disease or
this disease. But just partner with your physician and they
will be more than happy to partner with you, and
you know, take the time to focus and help you
stay healthy.
Speaker 1 (28:05):
I hope you've enjoyed today's show. Thanks for tuning in
to the show on your favorite local radio station. You
can now listen to this show or past shows through
the iheartapp or on iHeart dot com. Just search for
Virginia Focus under podcasts. I'm Rebacca Hughes with a Virginia
news network, and I'll be here next week on Virginia Focus.
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