Letter to Honorable, Mr. Doug Ford and Ms. Elliot on personal and population wellness

Dear Honorable, Mr. Doug Ford and Minister Ms. Elliot,

On behalf of my patients and myself I am expressing gratitude for the arbitration result.  It means I can continue to enjoy the innovative opportunities the FHO model makes possible, to eliminate modifiable risk factors using “Physician-led self-management education and support groups” and to promote population health through collaboration with local community organizations.

In his book “The beautiful bailout - how a social innovations scale-up will solve government’s priciest problems”, Shaun Loney, an Ashoka fellow, shares his inspiring message of social enterprises.  He demonstrated his success of using one social need to meet another social need.

He got me thinking about the potential cost savings of running “physician-led self-management education group” on Type 2 diabetes alone!
According to Mr. Loney, the annual healthcare cost per Canadian = $6604
Annual health care cost per Canadian with diabetes = $26416
Difference per year = $19812

 In 2016, more than 1.6 million people in Ontario are living with diabetes, and another 2.3 million people have prediabetes.
Ontario population = 12,764,195
Prevalence of diabetes and prediabetes = 30%
In the case of Ajax Harwood Clinic:
Patient population = 6000
Ajax Harwood Clinic population with diabetes or prediabetes = 1800
Average household size in Ontario = 2.9
Cost saving per year  = 1800 x $19812 = $35,661,600
Downstream savings is 2.9 fold = $103,418,640
(assuming the changed dietary habit positively affects other member of each household)
The physician-led self-management education groups is paid by existing payment model and does not require any other investments.

The potential savings by empowering patients in my patient population to take action for wellness to prevent and manage type 2 diabetes alone is $103,418,640. (In a patient population 
of 6000; my apologies for making many assumptions for the sake of making a point.  Of course, I’d be grateful if someone with the know how would do the proper math and correct me.)

The collateral benefits of preventing and managing a chronic physical condition such as type 2 diabetes using an integrative approach will also include decreased chronic mental conditions, increased quality of life and increased economic productivity from a physically and mentally healthier workforce.
I would be grateful for a new culture of wellness.  A self-empowered and wellness mindset.  I believe this paradigm shift is achievable and just requires personal and population wellness conversations at every patient-encounter with healthcare providers, in every school classroom, in social media, in traditional media, inside private corporate boardrooms and government meetings.   In doing so, we can generate phenomenal cost savings that can pay for better access, better technology and most importantly an even more compassionate publically accessible and sustainable healthcare for future generations.
I have started doing my part as a citizen by making sure I eat 400 grams of non-starchy vegetables per day and learning to be truly grateful for the privilege of being a Canadian.  As a physician, I share these basic wellness messages at every single patient encounter and in groups.  I vote for Wellness with each and every meal I eat and every wellness conversation I partake.  

Thank you!

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