The Health Care Forum was convened on April 3, 2024. The trigger topic for this forum was a recent best-selling book called Outlive by Peter Attia. This topic was introduced by Dr. Jerome Fish. This forum extended far beyond the opportunities and challenges introduced by Attia.

Following is a summary of the major issues being addressed during this forum.

Summary of April 3 Forum

Jeremy Fish kicked off the forum by noting that Peter Attia’s book (“Outlive: The Science and Art of Longevity”) is a best seller and is aligned with the basic principles of family medicine. Attia’s book also seems to speak to the younger reader and consumer of health care services. Attia uses terms such as “Medicine 3.0” and “hacking your health.” He writes about convenient and customized health care. The author writes about the “Four Horses of the Apocalypse” in health care – these are four major ways in which the lives of people are cut short (heart disease, cancer, neurodegenerative diseases and type 2 diabetes). In each case, a key factor has to do with the management of Insulin (metabolic dysfunction).

Jeremy speaks of the alternative to VUCA-Plus (volatility, uncertainty, complexity, ambiguity, turbulence and contradiction).  The alternative is Serenity—which is based on the SC²+ formula consisting of stability, certainty, simplicity, clarity, calm and consistency. In its negative form, Serenity requires a distortion of reality and reliance on authoritarian rule. It generates conspiracy as a justification of these SC²+ conditions.

Jeremy suggests that there can be a positive form of Serenity. For example, there can be a constructive simplicity that emerges from a thoughtful analysis of complexity. A focus on one factor (management of Insulin), for instance, can help health care workers effectively address the complex challenges of the Four Horses.  We could construct a Lens model with VUCA-Plus challenge being represented as a lens in the middle. The “old” reality of the 20^th Century would beam into the lens from the left. Two models are offered. In one model negative (false) Serenity radiate out from the right side of the VUCA-Plus lens. In the other model, positive outcomes (honest essence and brave essentials) radiate out from the right side.

Neither Bill Gillanders (Bill G) nor Jeff Smith are optimistic regarding addressing issues such as Insulin management—because big Pharma is in charge and wishes only to find big, cheap, drug-based solutions to health care issues. Jeff notes that health care in America is now an industry designed to generate a profit. Prevention does not earn the income that is to be found in treatment. Preventative medicine has been advocated for years by family docs—but to no avail. Even though there is ample evidence to suggest that prevention is key to improved health in the United States, this evidence has not made a difference.