Dreaming of a New Health Ecosystem*
*This writing was co-created with Dr. Alexander Krohuam and Prof. Felix Vallejo.
** To read this article in Spanish, click here.
Are you a doctor? A psychologist, nutritionist or dentist? Do you work in a clinic or hospital? Do you work in an NGO for nutrition, education or child development? Are you a consultant? Public policy? Do you have a health or wellness businesses? Projects that have to do with emotional, spiritual, economic, occupational or environmental health?
If your answer to any of these questions is yes, we can firmly say that you are part of THE HEALTH INDUSTRY and, most surely, you are frustrated and disappointed with the way in which health is understood culturally, socially, politically, medically or in the media. Most likely you are critical about the way health is taught in school, practiced in the professional world, lived in the family world and understood on a cultural level.
The truth is that THE DEFINITION OF HEALTH IS EXPANDING, but we are still not clear about its scope, and what our role is in the creation of this industry´s future. Doubts remain as to what the roles of technology, business, educators and practitioners will be in these paradigm shifts that are emerging ever more strongly.
Although we do not yet understand exactly what shape the new paradigm is taking (often we are not even clear about this word´s meaning), those of us who are attentive to the new trends are communicating more and more among us. We speak of the re-union of the mind and the body; the personalization of medicine; about healing and reversion and not just control; of well-being generation, and not just treating the manifestations of disease. We seek the empowerment of the patient and their increasing role in creating their personal journey to wholeness. We also comment on the imperative need to transform physicians and other health professionals, not only because of their dissatisfaction and disenchantment with their daily practice, but also because of the repercussions in their personal lives. We are talking about educating people, but not with sterile information, formulas, numbers, statistics and guides, but (trans) forming them through lived experiences and the recognition that those who are dedicated to healing others should always be aware of their own journey of constant healing.
We also intend to erase the arbitrary line that has been drawn between physical well-being and other forms of health (mental, emotional, spiritual, economic, social, environmental, planetary, etc.). We know that these divisions are unrealistic and that it is essential to consider all the factors that operate as health determinants. We recognize the indivisible link between population health, productivity and the economy, underlining that many governments have forgotten this by relegating society’s medical care to a very distant background on the agenda of national priorities. We speak about balancing all these elements, but we limit ourselves thinking that we are lacking in knowledge, experience or resources to become agents of change.
The health professional training schools are still attached to backward curricula that do not contemplate the current reality, sticking to a disease paradigm instead of one of health creation. They also perpetuate the individual´s fragmentation through disciplinary separation and over-specialization. Graduating professionals find very few slots for specialization, but at the same time they become frustrated since they are aware that hyper-specialization will not provide them with the necessary tools to wholly address problems in order to balance all the spheres required to achieve wellness.
As for updating curricula, what ends up happening is that new technological tools are introduced to teach the same old topics, or updates to the curriculum are restricted to the addition of new diagnostic or therapeutic technologies specific for each discipline, but they do not evolve the professional’s mindset. Likewise, graduates feel isolated and helpless because they lack communities or methodologies that promote interdisciplinary work, or provide them with business tools, marketing or administration skills, so as to be able to establish generative and sustainable businesses that transcend one-to-one consultation.
Businesses, on their part, are also attacking health from a war perspective. Almost always using drugs and surgeries to treat all diseases, even when the most important, costly and prevalent, are chronic multi-causal diseases for which it has been shown that conventional treatments, based on the linear bacteriological paradigm of to a cause an effect, are not effective. On the other hand, economically successful health businesses usually generate their income thanks to disease, through the sale of drugs, insurance, and interventions, fostering perverse stimuli since they rely on the existence of large numbers of patients for their subsistence. Although there is nothing wrong with this (and its added value to society is undeniable), few are the enterprises that generate profitability when their patients are healthy, strong and in complete autonomy.
Both groups, healthcare professionals and health businesses (which in most cases are not founded or directed by health professionals and are not always aligned with well-being principles), feel powerless over their inability to influence and transform the forces that dominate health policy. The current political, economic, social and cultural forces promote and perpetuate society´s anxiety, haste, consumption, poor nutrition and community fragmentation. Not to mention the environmental forces that are intrinsically linked to health, economic, security and coexistence crises.
We are frustrated because we are in need of a space to dialogue and voice our concerns, where we can dare to change the definitions of health, to challenge existing healthcare models, and to participate and influence, whatever our area of expertise, in the generation of individual, community and planetary health.
And while conversations that spot the problem and offer alternatives are everywhere, we still feel isolated. We feel alone because we believe that we do not have the strength to move the structural conditions, the academic curricula, the political stagnation, media manipulations to confront the status quo. We all carry this silence with growing despair, aware that if we continue as we are, we will not be able to fulfill the objective that our industry is called to.
That is why we write these lines, which far from being desperate, are about hope, proposal and courage to recreate the system. Just as a physician searches for the correct diagnosis, however uncomfortable it may be, this diagnosis is not a chronic-degenerative judgement but a wake-up call to continue building the following pages of this personal, professional and community history. In some way we are honoring the symptom, since by attending to what hurts, we can plan on how to transcend this temporary condition.
Here we put forward some ideas to create a new health ecosystem, a seed that with the right support will germinate giving professionals, businesses and society in general, a forum for expression and action, where the generation of knowledge, practices, experiences and community outreach contribute to the construction of new meanings, ideas and methodologies to transform the underlying paradigm of this beloved industry.
A space where general allopathic physicians and specialists; the misnamed alternative practitioners, such as osteopaths, chiropractors, homeopaths, and acupuncturists; nutritionists, coaches, dentists, nurses, and psychologists; can meet, interact and invent new ways to care for each other and their patients. A space where movements such as Positive Psychology, Coaching, Lifestyle Medicine, Functional Medicine and Integrative Medicine can work together, cross-pollinate, and realize that all health professions, as well as health businesses, can only thrive through dialogue, if not communion.
A space to analyze and compare new health curricula already in use in other parts of the world, which incorporate more integrative careers and specializations that speak of epigenetics, psychoneuroimmunoendocrinology, integrative nutrition, planetary health, group consultations, behavioral sciences, health memberships, permaculture laboratories, etc. Where, recognizing our idiosyncrasies and needs, specialists and generalists meet always in a framework that favors a comprehensive understanding of all of health determinants. Where the educational methodology is thoroughly uprooted, from the archaic frontal model to one of experiences and transformation, from paternalism to empowerment, creating a brotherhood between professions and professionals.
A space where people come together through technology, supporting education and knowledge advancement, facilitating interaction, dissemination and training. A space that organically, dynamically and with transparency integrates virtual platforms with face-to-face contact, coupling the best of both worlds and not replacing one for the other.
Where companies, governments, researchers, universities, NGOs, can unite in the organic generation of wisdom, that recognize at each step that we are creating a new reality and that our collective transformation depends upon the transformation of the individual entities that compose it. A space for discussion, collaboration and strategic design for multisectoral and multidimensional initiatives.
It will have to be a space where Complex Thinking (which invites us to fully explore the deep interrelationships of everything that is woven together), Critical Thinking (not destructive, but of continued questioning of why we think as we think), Multidisciplinary Thinking (which goes beyond putting people with different backgrounds in the same place) and Systemic Thinking (which understands that reality can be questioned with more tools than those that the linear scientific method has bestowed). A space where we apply new methodologies for creating the future, that is, for creativity, such as Design Thinking and Social Design. Disciplines that integrate the power of engineers, entrepreneurs and researchers and that have the firm conviction that the future can be anticipated, planned and built, and not just “solved”, “optimized” or “analyzed”. Health problems are not minor and their interrelationships with climate change, pollution, loss of biodiversity, ultra-processed foods and poverty, promote vicious circles that require us to think holistically. Therefore, if we want to confront complex problems, we have to design complex and interdependent spaces and communities.
A space where entrepreneurship is praised and teaches those who are not business trained, that researches and develops new ways of achieving productivity and sustainability while generating wholesome well-being for the individual and the collectivity. Where financial resources are nearby and businesses from other industries can participate in inter-sectorial ventures.
Furthermore, and here we continue to dream, an ecosystem that becomes the catalyst of a new paradigm with a different rationality, that at the biological-bodily and socio-cultural level, understands that health is a spectrum and not a fixed condition; that it is a journey and not a destination; that it only exists when the organism is capable of activating its own self-healing mechanisms and that, above all, understands that wholeness and well-being are the product of interdependent structural forces (political / economic; socio / cultural; medical / scientific; psycho / emotional ), and that it is illogical, unproductive and sterile to pretend to act over each of these forces in isolation.
It is clear that the Health Industry was never expressly designed. In other words, no group of thinkers analyzed what high social impact actions had to be implemented for future generations; it was not a proactive but a reactive model. It is an agglutination of initiatives, proposals, businesses, projects and emergency measures, which are often the product of structures and mental maps of the society it serves. And, as its name implies, “Health Industry”, it is the heiress of the industrial revolution, characterized by productive efficiency (mass production) and scientific-technological pragmatism, which also modeled the economic, educational, political and social systems. The great benefits that this historical stage has brought are evident, but the serious problems that it has left us are equally undeniable, to the extent that has become an unsustainable situation that requires new organizational paradigms.
The dream is to generate this space where, united under the banner of a “Health Ecosystem for education, knowledge development and business”, the values that unite us will not only be of “control” and “efficiency”, but also of “Interdependence”, “human capacity”, “integration”, “added value” and “social benefit”. May these be the forces (and not the pillars, because it is not a building that grows only upwards but in all directions) that allow us to continue co-creating the industry so that one day, we will stop calling it that.
The dream, as we have already mentioned, is that we focus on the process and not on the destination. If we want to generate integral well-being: physical, emotional, environmental, cultural and social, we can only move towards that goal if the path is paved with such well-being practices since inception. Therefore, this ecosystem cannot be anything other than generative: it will have to be a profitable business for everyone and not only for the owners, it has to be conceived as an integral part of the natural environment and function as a symbiosis laboratory with the city and society; it will have to generate immediate happiness for all of us who are part of it, instead of a painful process that will one day reward us. It has to be economically sustainable and productive, environmentally sound, culturally exciting, politically desirable, medically appropriate, academically transformative.
By broadening health´s definition, we realize that not only this industry would benefit from an ecosystem such as this, but also all those whom, although they may produce or sell material goods or services, be it real estate, tourism, food, architectural plans, insurance, cars, infrastructure, or anything else, ultimately, have as their mission to provide well-being for their customers.
This is a letter of hope and dreams. We announce them loudly because waking up is the only way to make them come true. We still refer to them as dreams because it requires dreamlike thinking for something of this magnitude to become tangible and become a reality. And we also announce them as dreams because in that ethereal world of ideas we have met dozens of physicians, psychologists, nutritionists, coaches, therapists, dentists, businessmen, philosophers, futurists, consultants, sociologists, educators, fathers and mothers and even politicians, who dream of similar things. But despite still being located in the world of the imaginary, it is very clear that building something like this requires adding not only experience, capital and knowledge, but, above all, our energy and our love.
We announce it loudly because other creators are needed to design and pave the way. There is no pre-established map or route, but we have ourselves to decide the next step. And despite the fact that it is a trip that fills us with emotion and anxiety, we have decided not to suffer or be overwhelmed by it, we decided not to allow fear or inferiority complexes guide the dreaming, planning, financing and execution processes that will take place.
The fact that this route does not exist is precisely what should excite us the most. As Ismael says in Moby Dick: “It’s not on any map; true places never are”.
Victor Saadia is a consultant and co-creator of New Paradigms in Health and Wellness.
Alexander Krouham is a Functional Doctor, author and director of the Vita Plenus clinic.
Félix Vallejo is a consultant and director of educational projects.
