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In previous Conversations we examined why the U.S. ranks as the worst healthcare value in the developed world. Now we’ll focus on addressing the question, “How can the value of healthcare in the U.S. be improved”?

This quote from Peter Drucker points out today’s target:

“There is nothing quite so useless as doing with great efficiency something that should not be done at all.”

But in healthcare doing what shouldn’t be done in the first place happens all too often. Switch focuses on improving the decision making processes in order to reduce unnecessary testing, treatments, and procedures. Our goal is to skillfully and compassionately help members reach better decisions concerning their health and well-being.

Much is known about how to make better decisions.1  We follow this algorithm to expand our effectiveness:2

  1. Clarify baseline priorities,
  2. Evaluate three distinct options,
  3. Be aware of the assumptions inherent in one’s predictions, and
  4. Create distance to enhance objectivity.

As the options are systematically evaluated, we also support members with the means to successfully navigate their choices.

Here is how it might work in a hypothetical scenario:

Bob is a generally healthy 45 year-old man who is seeing his physician for a blood pressure (BP) reading of 142/89. He was advised that starting a medication to control his blood pressure would reduce his risk of a heart attack or stroke. His physician discussed the side effects of the drug and answered Bob’s questions.

As background, the routine protocol in early hypertension often overstates the benefits of medications.3 This approach squanders a valuable opportunity to improve future health by diverting the focus from the benefits of lifestyle choices that have the potential to reverse high BP and stop its progression. (To better understand why a drug is likely to be over prescribed, refer to Conversations #3 – Best Marketing Tagline of All Time).

A call with his Switch Champion helps Bob further develop his thoughts:

  1. Clarify priorities: Bob wants to avoid medications if he can, but would take a medicine if necessary. He is not that interested in modifying his diet.
  2. Evaluate his options:
    a) Take the medication or not– Given Bob’s condition, priorities and the scientific evidence, starting a drug is not indicated.
    b) Significant diet changes– Blood pressure reduction with better food choices would greatly decrease Bob’s risk of a heart attack or stroke.
    c) Several other lifestyle change improvements could also be made.
  3. Test your assumptions: Before moving ahead it is often helpful to ask, “What would have to be true for this option to be the best choice?” This question might help Bob investigate why he didn’t want to make diet changes.
  4. Get distance to create objectivity: Bob could be asked to consider his situation through his father’s eyes. What might his father have wished that he had done at age 45?  Such a question gives added perspective to decision making and might also energize enthusiasm for change.

To conclude, the decision to start a medication gives Bob the misperception that he is actually doing the best he can for his health. Stage 1 hypertension is almost always a warning signal that poor lifestyle choices have begun to cause significant cardiovascular changes. At this early stage the damage is almost always reversible.

This scenario with Bob shows how starting a medication too early can be the first domino in a series of poor decisions.

Empowering employees with targeted resources to make better health choices saves healthcare costs and improves lives. For an employer, it doesn’t get better than this.

Breakthrough To Better,

1Personal bias drives suboptimal decisions
2Best practices for quality decision-making
3Studies reveal inefficacy of early hypertension treatment


Switch Conversations is a bi-weekly blog exclusively for our potential employer partners.


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Edition 1 – Solving a Well-Entrenched Problem
Edition 2 – A Case of Dr. Jekyll and Mr. Hyde
Edition 3 – Best marketing tagline of all time?
Edition 4 – Post-Truth Killed a President
Edition 5 – What’s an employer to do?
Edition 6 – Profiting From the Opioid Epidemic
Edition 7 – The Keys to Unlocking Better Decisions
Edition 8 – When Difficult Things Need to be Done Well
Edition 9 – Fixing Healthcare
Edition 10 – Beware of a Singing Cow
Edition 11 – Wise Reflections
Edition 12 – Warning: Reader Discretion Advised
Edition 13 – Can AI save healthcare? (Part 1)
Edition 14 – Can AI save healthcare? (Part 2)
Edition 15 – Can AI save healthcare? (Part 3)
Edition 16 – Embracing Reality to Improve Healthcare
Edition 17 – Everything I Needed To Know…
Edition 18 – The Eighth Circle of Hell
Edition 19 – So… What’s Our Solution?
Edition 20 – Protecting Integrity as a Core Strategy
Edition 21 – An Unadorned Legacy
Edition 22 – Time to Grow Up
Edition 23 – Against All Odds
Edition 24 – When Everyone Has Stopped Listening
Edition 25 – Focusing on What’s Important
Edition 26 – Don’t Give Up Your Shot
Edition 27 – Join the Goodhood
Edition 28 – Fixing Healthcare (Recycled)
Edition 29 – Taming the Healthcare Beast
Edition 30 – Leadership
Edition 31 – Better Health Requires Good Sense
Edition 32 – Little Decisions With Big Consequences
Edition 33 – Transformational Courage
Edition 34 – Transformational Courage – Part 2
Guest Post – Happy Thanksgiving! By Jeff Novick, RD
Edition 35 – Transformational Courage – Part 3