Healthcare in America: The Good, The Bad, and The Ugly

Over a half-million COVID patients in the U.S. have died within the past year. But despite a significant decline in newly diagnosed cases, COVID remains an ongoing problem. Several new viral mutations have given rise to troubling new COVID variants which may precipitate another surge unless we remain vigilant and get vaccinated as quickly as possible. The disinformation campaign remains a real problem with many conspiracy theories clouding the truth about COVID and the vaccines available to us. Dr. Cole addresses all of these issues in this podcast. 

Alternative medicine has become extremely popular these past few decades, yet there is very little collaboration between those who practice traditional western-style healthcare and those who practice the alternative disciplines. Dr. Cole covers all of the major alternative topics including naturopathy, herbal therapy, and spinal manipulation. He evaluates the quality of the evidence which may or may not support them, he discusses some of the concerns all who seek alternative therapies should be aware of, and he articulates why integrative healthcare – rather than alternative healthcare – may be the best route for those who wish to pursue something other than traditional healthcare.

For as long as there have been substances that alter the mood, mind, and body, there have been those who abuse them. Over 20 million Americans fall into this category and about 200,000 people die annually as a result of ongoing substance abuse. For every fatal overdose, there are countless additional non-fatal overdoses and many of them have tragic consequences. The ongoing abuse of alcohol, cocaine, benzodiazepines, methamphetamines, and opioids continues to plague our nation. Dr. Cole discusses the biological, psychological, and social contributors to this extensive problem and elaborates on how healthcare agencies are working to combat the issue.

We have a serious mental healthcare crisis in this country. Perhaps one in every five Americans suffers from some sort of major mental health condition, yet mental illness remains a taboo subject that many patients and even health care providers simply do not wish to discuss. The unnecessary stigma of mental illness, the lack of available outpatient and inpatient psychiatric services, and the insufficient numbers of Psychiatrists in this country all contribute to the ongoing problem. In this podcast, Dr. Cole enlightens us to several of the common mental health disorders – anxiety, depression, PTSD, bipolar disorder, and schizophrenia. Through greater awareness of the prevalence of mental illness, increased social acceptance of this historically shunned area of human health, improved access to care, and better treatment options, perhaps we may become an overall healthier nation. In addition, Dr. Cole applauds the research scientists who have spent the better part of the past two decades conducting mRNA research leading to the new COVID-19 vaccines, detailing how they work and a few common misconceptions. 

Dr. Cole has spent the last eight months as the Medical Specialist Advisor in the COVID Incident Command Center for the hospital he works at, and he returns for a November 2020 update about COVID-19. This episode covers a variety of topics: (3:33) Why we should care about COVID-19 morbidity, and not just mortality  (8:18) How hospitals have responded and what happens when they're overwhelmed with COVID-19 patients  (14:30) What should you do if you had close contact with someone who has COVID-19?  (20:15) What treatment for those hospitalized currently looks like  (22:44) Are doctors and hospitals "getting rich off of COVID?" [Answer: NO]  (25:53) Wear a mask, and continue to social distance  Dr. Cole is most specifically referring to information about northern Illinois, but the vast majority of this information -- including about hospital response -- is relevant to everyone in the United States.

Dr. Cole elaborates on the relatively unhealthy status of our nation. There are plenty of reasons why so many Americans have such poor health and often live with out of control medical conditions. Whereas the healthcare system shares a portion of the blame, far too many Americans are their own worst enemy and seemingly choose to remain unhealthy.

There is a vast amount of healthcare information out there and, unfortunately, a large amount of the conclusions made may be inaccurate, misleading, or even fraudulent. Dr. Cole explains why so much of what is published may be flawed to some degree and gives recommendations as to how one might discern what material is likely trustworthy, and what may be potentially harmful misinformation.

Perhaps the most painful yet undeniable truth is that everyone eventually dies. Yet, so many people have unrealistic end-of-life expectations. There is a lot that doctors can do, but much of it comes with pain and suffering which does not necessarily improve quality of life. Dr. Cole navigates us through this topic, empowering us to direct our own end-of-life wishes. 

Healthcare in America is so egregiously expensive that only the richest of the rich can afford to be without some sort of health insurance. But it is so complicated, with so many component costs, that it can be nearly impossible to fully understand. Dr. Cole navigates us through the complexities of health insurance, shedding some light on this frustrating and painful subject.

America needs to revamp how we train our physicians. There are more doctors than ever before, but many feel uncomfortable managing much of what was commonly cared for in years past. Dr. Cole discusses why we need to expect more from our doctors in training, why we may need to extend residency programs, and how we might generate more confident, quality physicians.

Seemingly long gone are the days when most doctors had the fund of knowledge and broad-based skillsets enabling them to effectively manage most of their patient's healthcare conditions. Dr. Cole explains why America needs more specialists who think and act like generalists, and more generalists who think and act like specialists.

The increasingly aged population living with a large number of chronic diseases creates an ongoing need for additional healthcare workers. Countless people describe healthcare as rewarding in innumerable ways, however many entertaining a career in the field are not aware of all of the options, which Dr. Cole discusses at length.

Dr. Cole discusses how Emergency Rooms have changed over the years. Intended to care for genuine emergencies, people often go to the ER for issues once managed in an office setting. Problems include decreases in physician-to-patient staffing ratios and substitution of mid-level providers for board-certified Emergency Medicine physician specialists.

The Novel Coronavirus is a rapidly evolving health concern having the potential of becoming a global pandemic. Dr. Cole discusses this newly discovered strain, gives recommendations on how we might avoid this illness, and summarizes efforts being made by the agencies tasked with combating this crisis.

The depersonalization of US Healthcare has created confusion as to who or what entity is really in charge of our care. In this segment, Dr. Cole talks about how patients, physicians, insurance companies, and healthcare corporations all share a portion of the blame for this shift -- leading to the question of, who can we trust?

Being raised by a Primary Care Physician (PCP), and having worked closely with them for decades, Dr. Cole talks about the changing role of the PCP, and why many of them today do not meet our expectations, at times being replaced entirely by non-physician providers.

In this first episode, Dr. James Cole introduces Healthcare in America: The Good, The Bad, and The Ugly. Dr. Cole outlines his extensive experience in the U.S. healthcare system over the past 30+ years and summarizes various topics that will be discussed at a later date such as health insurance, primary care physicians, and mental health.