Effective Management of Health and Safety Programs: A Practical Guide, 3rd edition. Moser R Jr., ed., Berverly Farms, MA: OEM Press, 2008 Mar; :225-243
"Good health is good business" - from the worksites of employees to the homes of consumers and from the exam rooms of providers to the board rooms of employers. The key stakeholders in the health care ecosystem are increasingly aligned around the need to lower total medical and health-related productivity costs. The solution that is emerging revolves around population health and productivity enhancement by reducing the burden of illness and the burden of health risks in society through closing quality gaps in the management of medical conditions as well as investing in prevenrion and improving health. However, the current onslaught of patients suffering in the battlefields of daily life from chronic disease, illnesses, and injuries is utterly amazing. What is more disheartening is that many, if not most, of these medical conditions could have been avoided or significantly delayed - if only these patients would have known what to do to prevent their development and acted accordingly. Unfortunately, our current medical care system is focused on treatment and repair, with essentially no focus on prevention and promoting the health of people. That said, we are finally on the threshold of wittnessing the transformation of our health care delivery system beyond being a reactive/illness-oriented medical care system to becoming a more proactive, wellness-oriented health system. As Joseph Malins expressed so eloquently in his 1895 poem "The Ambulance Down in the Valley," it is not good enough to just mobilize more ambulances "down in the valley" when we should also "put a fence 'round the edge of the cliff" as a meanes of prevention. SUMMARY: There is a clarion call to action to engage in the battle to improve the health and productivity of our nation's work force. But make no mistake, our enemies in this battle are disease, disabling medical conditions, and serious, some dangerous, health risks. Our battlefields are the workplaces, the clinics, the hospitals, and the communities across the United States. Our weapons are quality-driven, cost-effective, prevention-oriented health care initiatives that align incentives of the key stakeholders to improve the health and productivity of the U.S. population. Fighting this battle requires inspired vision and focused leadership on the part of all health care professionals. In fact, together, we should assume a mantel of leadership and harness our intellectual capital as well as mobilize our collective consciousness in order to improve health and human performance. Based on the employer case studies and data described, one can define a compelling business case, delineate the tools to use, and determine an action agenda to implement. However, the battle we face in these times of health care cost crisis will be won not by better definition, delineation, and evaluation but by action on the front-lines. It is not what we know, but what we do that will make the difference. So, let us, as health care professionals, meet the challenge. We are in the unique position to stimulate local market initiatives as well as influence national policies. We can also empower the cooperation of key stakeholders in a more rational, more accountable health care system - if we implement at a local level and influence at a national level. We have an unparalleled opportunity to accomplish this on behalf of workers, employers, patients, providers and the communities we serve. In fact, we can reposition our current health care system and transform it into a system for health - one built on the cornerstone of quality, on the foundation of health and productivity improvement, and on the pillars of prevention. As mentioned at the beginning of this chapter, "The Ambulance Down in the Valley," a poem written by Joseph Malins in 1895, is an eloquent statement of the value of prevention . Instead of looking over our shoulder at the "good old days of medicine," let us look forward to the "good new days of medicine" on the horizon.