By Ken Dychtwald
Until I was five, we lived in Newark, New Jersey, in the same house as my mom’s parents. Up the block, in a pleasant duplex, was the medical office of Dr. Victor Tepper, our family physician. If there was ever anything wrong, you went to see Dr. Tepper. If we were unable to leave the house for some reason, Dr. Tepper would show up at our front door with his medical bag to do an exam in our home. He usually checked what were then believed to be the key vital signs, so he used his stethoscope to hear how your heart was beating and how your lungs sounded. And he took your temperature and looked at your tongue. That was pretty much it.
We didn’t know better, so we thought it was first rate medicine. Dr. Tepper sure seemed like a kind and wise physician. Back then, anyone who went to medical school was usually thought to be a stand-out individual.
Although we eventually moved into our own home a few miles away, Dr. Tepper remained our family doctor until I went off to college. You may think this is unimaginable, but when I was growing up, doctors wrote prescriptions in Latin. The idea was that you, the patient, were not supposed to understand what was in a prescription: that was not your expertise or your business. You’d take the prescription to the local pharmacist, who was trained to read these Latin requests—and then you took your medicine as prescribed. In time, you got better or you didn’t.
Then, in the late 1960s, as mass media and mind-expanding education began to open the world up to us, we boomers were being taught to question authority. What emerged was an anti-authoritarian mood: it was rebellion against militarism, materialism, gas-guzzling cars, the sexual mores of our parents and grandparents’ generations, and even medicine. Women—lead by the Boston Women’s Health Collective—and then men—began to believe that people should have knowledge about and control of their own bodies.
Until recently, most people died relatively young of infectious diseases, accidents, or in childbirth. When the first US census was taken in 1790, half the population was under the age of 16 and less than 2% of the 4 million Americans were 65 and older. As a result, society rarely concerned itself about the health needs of its aging citizens. The elderly were too few to matter. However, during the past century, advances in medical diagnostics, pharmaceuticals, surgical techniques, and nutrition have eliminated many of the acute problems or infectious diseases that once caused people to die prematurely. However, although we’ve managed to lengthen the average person’s lifespan, we have done far too little to lengthen the corresponding healthspan. One century ago, the average adult spent only 1% of his or her life in a morbid or ill state; today’s average adult will spend more than 10% of his or her life sick.
In a hopeful attempt to fix this, in the early 1970s, a group of us, including Gay Luce Ph.D., Eugenia Gerrard M.A., Ken Pelletier Ph.D, M.D., Len Duhl M.D. and myself came together in Berkeley, California to form a study council in an attempt to create a new mashup of mind/body medicine – for which we made up the name “holistic health.” Around the same time, a young California physician named John Travis, trained at Tufts and Johns Hopkins, found himself taken by psychologist Abraham Maslow’s innovative suggestion that you didn’t have to be mentally ill to focus on being more mentally well. Travis applied that notion to the practice of medicine and popularized the word “wellness.” At the time the medical establishment thought Travis had totally gone off the rails! In subsequent years, some inventive and high-minded people tried to connect a number of dots in their pursuit of a new health paradigm. Dr. Dean Ornish followed up on Pritikin’s diet with a more comprehensive program of nutrition, yoga, meditation, and supportive group co-counseling sessions. Dr. Andy well conjured “integrative medicine’ and then Dr. Deepak Chopra attempted to blend an east/west approach.
Now, in this far more entrepreneurial, capitalistic era and driven by the aging of the Boomers, we’re being sold skin preparations, hormone therapies, vitamins, bio-hacks, prepared meals, pillows, mantras, brain wave supplements, self-help apps, and exercise technology along with books and seminars. Over the past 50 years, I have heard and seen a thousand different “experts” make the case that they’ve got the secret sauce or treatment that can cure almost everything.
We have reached a tipping point. To meet the needs of our longer lived population, tone down the chaos and avert the chronic disease pandemics looming in the future, it is imperative that we take bold action now. We need to create a new healthy longevity infrastructure.
Below is my recommended four-part solution. To learn more, check out my recent keynote at the NextMed Health conference where I shared my vision for a scientific grand concerto to create healthy longevity for everyone.
- Turbo-charge advances in medicine, technology, and AI to replace unhealthy aging with healthy longevity. Since now there might be literally thousands of biomarkers to measure and thousands of ways to improve one’s health, how can every individual doctor know for sure which approach or which combination of approaches will get the best results? Due to advances in artificial intelligence and machine learning, we’re going to transition relatively swiftly from this somewhat chaotic period of health diagnosis and treatment to an era of “precision medicine.” We’ll be able to ascertain a far richer understanding of the interactions between our genes, nutrients, molecular activity, and brain-body interactions. And if the AI is informed by a wide range of potential solution paths—allopathic, naturopathic, homeopathic, Ayurvedic, and others (always evolving based on outcomes research)—it could be far more effective at precisely proposing the ideal constellation of solutions for each individual at exactly the right time.
- Recruit and train health care professionals with expertise in gerontology and geriatrics. While leaders in this field disagree as to how many geriatric specialists will be needed in the future (most likely 10x the number we have now – less than 5,000, vs 50,000+ pediatricians), there is strong consensus that all health care professionals need an array of basic knowledge and skills to provide the complex care that older patients require. The projected shortage of physicians, nurses, and other health care professionals will exacerbate the problem of access to care for older adults. Watch for the ascendancy of nurse practitioners and physicians’ associates. In addition, through advances in home monitoring systems, health and medical apps, telemedicine, personal emergency response systems, virtual medicine and the AI described above, the shortfall of trained health professionals can be eased somewhat. In addition, like Google Maps, a “Health Waze” could emerge that would direct each of us the specific actions needed to produce our healthiest futures.
- Prioritize research to cure Alzheimer’s disease and assure our brainspans match our lifespans. Alzheimer’s disease and related dementias prey on older adults and Alzheimer’s disease has now become the scariest disease of later life. To make matters worse, our governmental medial research priorities are out of sync with the unprecedented age wave that is currently transforming our demography and the disease landscape. For example, for every dollar we currently spend on caring for those with Alzheimer’s less than half a penny is spent on the science that could wipe it out. Left uncured, Alzheimer’s could become the physical, social and economic sinkhole of the 21st Unless a moonshot treatment to stop or prevent Alzheimer’s is fast-tracked, Alzheimer’s is projected to cumulatively cost more than $20 trillion by 2050.
- Develop a humane approach to the end of life. When the end of life is near, older adults should be helped to whatever extent is possible, to have a “good death.” This includes enacting advance directives to ensure their final wishes are respected, having access to spiritual and emotional support, taking steps to minimize discomfort or suffering, and being allowed to die with dignity. Hospitals, health systems and home care programs can help with this by offering education for older adults and their families on advance directives, palliative and hospice care programs, and education for caregivers on the end-of-life options available to their loved ones.
By embracing this four-part solution, we can together create a new blueprint for healthy longevity. Note: all of this will also cause a serious ethical issue. If breakthroughs are available to everyone, that would be grand, but if they’re only available to corporate billionaires, that doesn’t seem fair and it surely would not be equitable. My deep personal hope is that tomorrow’s health system will equitably make healthy longevity available for everyone.
To learn more, including more about Ken Dychtwald’s award-winning presentations on topics like The Future of Health, Medicine, and Aging, click here.