THE CHINESE WORD FOR crisis is comprised of two separate words, "danger" and "opportunity" -- and this describes the exact situation we face with the healthcare crisis in our country. As a nation we are at the precipice of change for our healthcare system. But if we make the wrong choices and simply provide universal coverage to an outdated 19th and 20th century model of medicine, this crisis will lead us into danger. However, there are different choices we can make now that will lead to profound opportunity -- one that may provide real solutions to our healthcare crisis. Today, I will outline a 9-point plan for real healthcare reform. This plan takes into account all of the changes we need to make -- including the fundamental shift in the type of medicine we practice -- if we are going to truly resolve the health catastrophe in this country. Hope for a Brighter Future in Medicine Despite the looming dangers we face as we work to change medicine, I have hope. I have been privileged to participate in events at the nexus of change that have all focused on fundamentally changing our disease-based healthcare system to one focused on creating health and wellness. These ideas are not yet at the center of the healthcare debate, but they must be -- and they can be. In February of this year, the Institute of Medicine held a Summit on Integrative Medicine and the Health of the Public at the National Academy of Sciences. Six hundred key leaders and stakeholders in healthcare including educators, scientists, community leaders, practitioners, lawmakers, policy makers, and insurance leaders attended it. It was a broad coalition that came together with a common purpose to change not only the way we practice medicine, but also the type of medicine we practice. I believe the medicine at the core of healthcare reform must be founded on the clinical model and framework for practice developed by the Institute for Functional Medicine, a nonprofit organization of which I am a member. The Institute's mission is to support the widespread adoption of functional medicine.

These policies and initiatives are necessary for healthcare reform that addresses the true causes of our chronic disease epidemic and exploding costs.

This new way of thinking about health and disease is the biggest secret in healthcare today, yet it is the most effective model to address the current drivers of cost and chronic disease. To spread the word, the Institute recently published a detailed white paper called "21st Century Medicine: A New Model for Medical Education and Practice." The same week the white paper was published, I testified on integrative and functional medicine before Senator Edward Kennedy’s Senate working group on healthcare reform, alongside other leaders in healthcare including Drs. Dean Ornish, Mehmet Oz, and Andrew Weil. The full testimony is available for the Committee on Health, Education, Labor, and Pensions, "Integrative Care: A Pathway to a Healthier Nation." I also met with key policy makers in the White House. and was heartened by their openness and willingness to find a way to true healthcare reform. More recently, at a retreat center on the edge of a Minnesota pond, I was privileged to be part of a think tank sponsored by the National Institutes of Health on "whole systems research." It was an international gathering of systems biologists, mathematicians, physicists, geneticists, physiologists, psychologists, researchers, and doctors from a dozen countries and diverse backgrounds—Palestinians and Jews, Chinese and Iraqis, French and Germans -- all exploring very important but neglected questions that hold the solution to our epidemic of chronic disease. In this isolated place, the thinkers with their fingers on the pulse of the future all suddenly came to the same conclusion. The way we do research doesn’t help us understand how things really work as a whole, integrated system. In other words, the current model of studying one drug, chemical pathway, or gene for one disease doesn’t give us useful answers to how we get sick and how we can get well. What everyone at the conference understood at that moment is the same truth we need to come to as a nation ... The old, conventional model of medicine and scientific research is simply outdated. It must give way to a new way of thinking about health and illness and a new method for medical practice. A 9-Point Plan for Real Healthcare Reform I believe that real healthcare reform is now possible because of a perfect storm where alignment of economic, scientific, and moral imperatives provides us an opportunity to do well as a nation by doing good, through fundamentally changing the kind of medicine we practice. But to achieve that goal will require the collective imagination, intention, focus, and action of healthcare providers, consumers, industry, and policy makers. A coordinated effort across government agencies and industry sectors focusing on health and wellness, incorporating what we already know, is urgently needed. We also need leadership at the highest levels of the White House to successfully create a culture of health and wellness and transform our healthcare system. The 9-point plan below, while not at the center of the healthcare debate, is essential to create real change and avert disaster. Just as horse-and-buggy makers gave way to the automobile, and 8-track tape manufacturers gave way to the iPod so must conventional medicine give way to a new way of practice. Yes, some industries will fade, as funds are allocated toward policies and initiatives that prevent and treat chronic disease through dietary, lifestyle, and community interventions instead of expensive drugs and medical technologies. But other industries that promote health and wellness will flourish in their place. These policies and initiatives are necessary for healthcare reform that addresses the true causes of our chronic disease epidemic and exploding costs. These are the changes that must be made if we are going to fix our broken healthcare system:

1. Change reimbursement to include payment for healthcare teams focused on lifestyle treatments for chronic disease and the use of functional medicine, not just for expensive (and often unproven) procedures.

2. Improve research by comparing existing drug- and procedure-based medicine to changes in lifestyle, diet, and other functional and integrative approaches.

3. Transform medical education by including nutrition, lifestyle, and environmental factors as core components of the education of health professionals and physicians.

4. Establish an Institute for Functional Medicine at the federal level that would develop the educational curriculum for medical schools, residencies, postgraduate education, and other health professionals.

5. Improve food policy, agriculture policy, and school and community environments to encourage health by prohibiting food that is known to promote obesity and disease and providing whole, real, fresh foods for our children. Obese teenagers have the same risk of premature death as heavy smokers. We wouldn’t feed our dogs cola, burgers, and fries -- so why do we feed them to our children?

6. Conduct projects in community health centers that demonstrate how offering inexpensive, nutritious meals (including takeout), recreational facilities, lifestyle counseling/education (like cooking classes), and healthcare based on functional medicine at one location can dramatically improve health outcomes.

7. Impose limits on pharmaceutical and unhealthful food advertising. More than $30 billion is spent on marketing junk and fast food to consumers, including $13 billion targeted at children, and more than $30 billion is spent by the pharmaceutical industry on marketing drugs to physicians (about $30,000 annually per physician). Direct-to-consumer drug advertising also drives prescribing practices based on preferences induced by commercials rather than science.

8. Develop a system of electronic medical records that facilitates 21st-century, systems-based, functional medicine. We shouldn’t simply transfer 19th- and 20th-century medical records-keeping systems to an electronic format.

9. Create a White House Office on Wellness, Health Promotion, and Integrative Health as a way to develop an ongoing vehicle for coordination of strategy and policy. It should focus specifically on coordinating and developing policies and programs for lifestyle-based chronic disease prevention and management, integrative health care practices, and health promotion.

These changes won’t take place overnight, and they won’t be easy. But they can happen. However, the only way they will happen is if the average person—that means you—gets involved and votes for change every day with your fork, with your feet, and with your voice. We are facing a watershed moment in the history of medicine, one where changing the very way we understand and treat disease is finally possible. But we all must work together to effect such a tremendous change in our medical system. As Margaret Mead said, "Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has." We now have all the information we need to cure or dramatically improve chronic problems that are poorly addressed by conventional medicine and to discover vital, vibrant, good health at any age. And we can finally transform our "sick care" system into a healthcare system that promises vibrant health and vitality to every man, woman, and child in this country. The answer lies in functional medicine –- the future of medicine, available now. Now I’d like to hear from you ... What do you think of my 9 point plan? Do you have any other suggestions? How do you think functional medicine can help improve healthcare? Please share your thoughts by leaving a comment below. To your good health, Mark Hyman, MD