The Future of Healthcare: “Chronic illness is treated like acute illness, but they’re fundamentally different and should be treated as such”, with Dr. Bill Rawls
Chronic illness is treated like acute illness, but they’re fundamentally different and should be treated as such. An acute illness results from an isolated acute insult to the body, such as a broken bone or a heart attack, that can be treated with targeted therapy like drugs or surgery. But with chronic illness, the patient’s state of health has been chronically disrupted by long-term exposure to multiple stress factors such as poor diet, stress, a toxic environment, or a sedentary lifestyle, which inhibits the body’s ability to heal itself. Using targeted therapy to solve chronic illness is like patching holes in a failing dam — without solving the structural problem, you’re never going to get ahead. Beyond being complicated and expensive, eventually the toxicity of the therapies outweighs the benefits and the dam will fail.
As a part of my interview series with leaders in healthcare, I had the pleasure to interview Dr. Bill Rawls, an OB-GYN and leading expert in Lyme disease, integrative health, and herbal medicine. In the middle of his successful medical career, Dr. Rawls’ life was interrupted by Lyme disease, and in the more than 10 years since his recovery, he has helped thousands of patients find their path to healing from Lyme disease and chronic illness. He is the author of the best-selling book Unlocking Lyme, and the Medical Director of RawlsMD.com and Vital Plan, an online holistic health company and Certified B Corporation®.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
DR. RAWLS: I had a turning point in my career and my life one crisp fall day on the coast of North Carolina. I had been struggling with a health crisis for several years, but the waves were perfect, and I thought some fresh air and surfing would do me good. Surfing was a favorite pastime, but after only two waves my chest hurt so badly that I had to give up and go back to the beach. I’d been having chest pain for a while, but now it was so intensified that I worried my heart might just stop.
By the next morning, I was in the hospital having cardiac catheterization. The nurse plunged the IV right through my vein instead of into it, so I had no anesthesia during the procedure. I was awake to see on the monitor screen that my coronary vessels were perfectly clear with no blockages. After the procedure, the cardiologist said he couldn’t explain why my heart was behaving so badly. All he had to offer was a beta-blocker, a drug that I had tried in the past and wasn’t able to tolerate because of side effects.
For several years leading up to this point, I had been seeing a train of doctors for a range of seemingly unrelated and debilitating symptoms. All the tests were unremarkable, and the only diagnosis they could come up with was fibromyalgia, a diagnosis that I knew was chronic and had no good treatment options — aside from drugs to treat the symptoms. Now yet another dead-end test and another drug. I felt dependent on the medical system, but at the same time, I wasn’t being helped by it either.
I finally realized I needed to take my destiny into my own hands and figure out why I was ill, instead of just finding a diagnosis and treating the symptoms of the illness. That decision would force me to rethink everything I learned in medical school and look at illness from a whole new perspective.
Eventually I would regain my health, but not before giving up my successful but highly stressful career of practicing obstetrics and gynecology. My journey would lead me beyond the limitations of drug therapy and surgery to include herbal and other natural therapy alternatives. A key part of the journey was creating a new type of medical practice that focused on empowering patients to take control of their own health destiny.
Can you share the most interesting story that happened to you since you began leading your company?
DR. RAWLS: In my thirties, long before I launched my company, I was diagnosed with essential hypertension. “Essential” implied that the cause of my blood pressure elevation was unknown and that high blood pressure was inherent to me — I would have to deal with it for the rest of my life. I tried various medications, but they all carried significant side effects. I came to accept that I would have to live with the consequences of having an average blood pressure of 150/100.
Now at age 61, after making significant dietary and lifestyle modifications to combat chronic illness, my blood pressure averages a perfectly normal 115/70 — without medications. Turns out, hypertension wasn’t inherent to me, but instead, it was inherent to the way I was going about life. What this revealed to me was that all of the significant lifestyle changes I’ve made to recover from chronic illness are also contributing to healthier, symptom-free aging, which is an area of research I plan to explore more in the coming years.
Can you tell our readers a bit about why you are an authority in the healthcare field?
DR. RAWLS: Possibly my greatest expertise is that I’ve been on both sides of the exam table. After medical school, I underwent specialty training and became board certified in obstetrics and gynecology. It was a very fulfilling career that ended up being cut short by my health crisis, which ultimately revealed to me the shortcomings in the medical system for treating chronic illness.
In the second half of my medical career, I created a wellness practice that focused on empowering patients to be proactive about their own health. During that time, I helped a lot of people and created programs to more efficiently educate and support patients. But I also learned the challenges of running a small practice in a small town.
In order to reach more people, I evolved my practice into a new online holistic health company, Vital Plan, that offers natural supplements paired with wellness education and support. Since then, I’ve helped thousands of patients restore their health with the same customizable program that helped me restore mine.
What makes your company stand out? Can you share a story?
DR. RAWLS: I am a strong believer in the power of herbal supplements, but I’m equally adamant that supplements are only a part of the solution. Without a healing foundation of the right diet and lifestyle, herbal therapy can only take you so far. This has been a guiding principle at Vital Plan from the beginning, and it’s what sets us apart from the many supplement companies out there that are marketing a ‘pill for a problem.’
The truth is, my company doesn’t have resources for those who are looking for a quick fix. Instead, we work with motivated people who are ready to improve their health, and offer them affordable access to tools, education, and support that enable them to make lasting health changes. Eating the right foods for your body, managing stress, working movement into your day, and avoiding toxins are all things you can do on your own — once you know how — to radically improve your well being.
In return, we’ve received hundreds of handwritten letters thanking our team for our guidance. Many of these letters are from people in rural areas, without ready access or even exposure to holistic care. They had spent years chasing a diagnosis and relief of chronic symptoms. When someone has exhausted the traditional healthcare routes and then discovers the simple, natural steps that become huge strides towards normalcy, it’s satisfying beyond words. We circulate every letter we receive around the entire office as a reminder of the impact we’re having on real lives.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
DR. RAWLS: In the past, researching the benefits of different herbs and finding trusted ingredient sources was incredibly time consuming, which has deterred many people from embracing herbal therapy. In addition, access to quality products has been challenging, especially in rural areas.
Today, I see the industry advancing rapidly and believe a new era of herbal therapy is soon to emerge, one that combines traditional herbal wisdom with a modern, science-based approach. New technology is opening the gates for research in the herbal industry and standardization of ingredients. It’s allowing supplement companies to collaborate with top herbalists and formulators from around the world to develop unique and powerful products. It’s enabling new extraction methods and delivery systems for more potent benefits. And it’s creating new communication methods that allow the sharing of information and education in an accessible and effective way.
At Vital Plan, we’ve taken advantage of all these advancements to build a robust network of brilliant herbalists, researchers, and farmers from around the world, to consolidate what we learn from them into effective product bundles, and to build affordable online education programs that are easy to adopt. Through the systems we’ve invested in, the impact we can have is magnified; in the time I once spent on a one-on-one consult, I can now deliver an interactive webinar for 3,000 people.
I believe that technology and innovation can make this one of the healthiest times to live in — if we do it right. We can access herbal extracts from all around the world alongside fresh, healthful food, expert advice, and inspiration at the click of a button. With mindful business and supply chain practices, I’m confident we can build a wellness system that is beneficial for all involved and dramatically lowers our cost of healthcare.
What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)
- Going against the norm can be hard, and you’ll want to quit at times. Most other doctors won’t understand what you’re trying to achieve. You will get ridiculed and shot down, and some people may even think you’re crazy. So you’re going to need to take care of yourself and follow your own philosophy. And you’ll also need to make sure your team prioritizes self-care, too.
- You’ll have to break through the noise of companies making snake oil claims and selling low-quality, low-potency products. The medical system has trained us to want a “fix,” and this is how people are searching for solutions; however, government regulations prevent supplement and wellness companies from positioning their offerings as any kind of treatment. It’s hard to differentiate yourself given the regulatory environment.
- The resistance to change is stronger than you think. The majority of people don’t want to work at achieving wellness; they want to be fixed. They simply won’t be ready to take ownership of improving their health, or to put in the time and energy to see a difference that motivates them to keep going.
- You’ll be inspired by the lives you’ve changed. It’s the unexpected success stories that will keep you going and fuel you to push forward.
- You will survive and thrive. A growing number of people are listening and the message is getting out there. People are taking responsibility for their actions and their health. Our country is determined to find a way forward.
Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
- Chronic illness is treated like acute illness, but they’re fundamentally different and should be treated as such. An acute illness results from an isolated acute insult to the body, such as a broken bone or a heart attack, that can be treated with targeted therapy like drugs or surgery. But with chronic illness, the patient’s state of health has been chronically disrupted by long-term exposure to multiple stress factors such as poor diet, stress, a toxic environment, or a sedentary lifestyle, which inhibits the body’s ability to heal itself. Using targeted therapy to solve chronic illness is like patching holes in a failing dam — without solving the structural problem, you’re never going to get ahead. Beyond being complicated and expensive, eventually the toxicity of the therapies outweighs the benefits and the dam will fail.
- Money and incentives are misaligned. Reimbursements to healthcare providers are tied to the complexity of diagnoses and procedures, not to patient outcomes, so there is little incentive in the system to restore a patient to normal health. Patients are often left passively dependent on a system that isn’t helping them. Pharmaceutical companies, technology companies, doctors, and hospitals benefit financially, but patients end up with the short end of the stick.
- The coding systems are excessively complex. Medicare and medical insurance companies rely on diagnostic and procedure coding systems to define care and control costs. The current diagnostic coding system (ICD-10) alone contains more than 70,000 different codes. Healthcare providers end up spending more time documenting and coding than they do understanding why the patient is ill.
- There’s unequal access to healthcare. People who can afford healthcare insurance have access, but even that access is variable depending on the patient’s insurance policy. Those who can’t afford insurance or qualify for government assistance receive substandard care. Without nationwide open access to primary care, they clog up emergency rooms and increase the total cost of healthcare.
- The focus on prevention is minimal. If we shifted even a small percentage of the resources we currently allocate to treatment toward prevention, it would tremendously change the trajectory of the health of the country as a whole and significantly decrease the cost of healthcare.
You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
- Focus the current system on managing acute care. Giving credit where credit is due, the U.S. healthcare system excels at providing acute care. If you are in an accident and need urgent attention, there is no better place in the world to be. The system is working great for acute care, so let’s let it shine there. Treating chronic illness, however, should not fall under this umbrella.
- Change the fundamental approach to chronic illness to be more holistic. There is a place for both drug therapy and surgical technologies for managing chronic illness, but the system is overly reliant on these treatment modalities, which alone have little capacity to restore true wellness. These therapies should always be complemented by other healing modalities to promote lifestyle modification and non-toxic natural therapies.
- A perfect example is in how Lyme disease is best treated. While a short course of antibiotics can help get an acute bacterial infection in check and give your immune system the leg up it needs to continue the fight, if your immune system is weakened, those microbes are going to come surging back and result in chronic illness. The only solution then is to focus on the underlying causes: What’s hamstringing your immune system? Address those issues — which are typically factors like stress, poor diet, and toxin exposure that respond well to lifestyle modification and natural remedies — and the immune system will rebound and illness will go away. This holistic approach to chronic illness, if universally implemented, would dramatically reduce costs and promote a higher standard of health across all sectors of the population.
- Incentivize doctors and systems to promote wellness and prevention. There’s too much money in maintaining patients in a dependent state of managed illness with prescriptions and procedures, and too few incentives to promote wellness — doctors don’t get paid for that. I learned this the hard way: The more counseling I did in my medical practice, the healthier I made people, and the less I got paid, because I was doing fewer and fewer procedures. As long as the biggest financial incentive is to make a diagnosis and prescribe a drug or a procedure, things will never change.
- Incentivize patients to follow wellness and prevention strategies. Insurance companies incentivize patients to use acute care services simply by covering them. If I can get a prescription that’s free but have to pay out of pocket for complementary therapies like herbal therapy and acupuncture, guess which one I am incentivized to go for? I can’t tell you how many people have told me that they would like to continue taking herbal therapy, that it’s working for them and delivering tangible benefits, but they can’t because it’s not covered by insurance and they simply can’t afford anything more than the typical co-pay.
- Make smarter decisions about providing healthcare to the elderly at the end of life. As much as half of the current healthcare dollar is allocated to providing medical care and procedures to elderly individuals in their final year of life, most of which does little to prolong life or significantly reduce suffering. Having recently been a caregiver for my father in his last year of life, I can testify that there are very strong incentives in place for providers to do unnecessary procedures on people who are in the process of dying. Aging is universal; we all need a system in place that doesn’t promote and reward excessive and costly treatment.
Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?
Simplifying our diagnostic coding system and de-incentivizing medical practitioners to prescribe medications and procedures is a high priority. Doing so would save doctors a significant amount of time in the diagnostic process, enable them to spend more time speaking with patients to understand their concerns, and encourage them to recommend effective lifestyle and behavioral modifications. Admittedly, this is a huge and time consuming undertaking, so I would charge leaders in the healthcare community to begin tackling this now. Though it’s not going to be easy or the perfect answer, we need to encourage leaders to take the necessary steps toward a universal healthcare system, which would simplify the coding system and de-incentivize overprescribing drugs and procedures.
Money drives change, so I also encourage leaders to commission research to examine what happens when hospitals embrace wellness and prevention in their patient care. If we can illustrate that preventative care increases physician productivity, improves patient outcomes, and in general reduces healthcare costs and financially benefits hospitals and insurance companies, it would prove as powerful incentive to make changes.
One of those changes should include what’s taught in medical school. Thirty years ago, when I was in medical school, I received little education about prevention of illness, nutrition, or alternative therapies that promote healing in the body. My son, who recently finished medical school, reports that not much has changed. If prevention and alternative therapies were required learning, and the medical board examinations contained questions about this subject matter, future acute-care practitioners would have to learn the material. As a result, they would be better equipped to offer holistic approaches to patients, and also to facilitate conversations with practitioners working in the wellness system.
Wellness education should also be made more accessible and affordable to consumers. My company offers free online education on topics such as proper nutrition, better sleep tactics, stress management techniques, and more. Technology has helped us to expand our reach and positively impact more lives than I ever could with one-on-one consultations, and I highly encourage other corporations to take advantage of online wellness education with their own employees and customers.
Finally, individuals can drive change by being accountable for lifestyle decisions that are under their control. You can significantly reduce your risk of developing chronic and acute illnesses with the right healthy behaviors. I know how difficult it can be to find the time, energy, and sometimes even money to do all of the things we know are good for us — eating a natural and plant-based diet, exercising regularly, reducing stress, avoiding toxins — particularly in our modern world that’s full of processed food, sedentary jobs, and toxic chemicals. But at the end of the day, we’re each responsible for our own diet and behavior, and taking ownership of that is not only incredibly empowering, it can also make all the difference in whether we’re well.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
I’m a voracious consumer of written content, but in the past several years, peer-reviewed science articles downloaded from PUBMED has been my primary source of reading. Outside Magazine, which prints a surprising amount of content on health and wellness, is my favorite consumer magazine.
I also follow a wide variety of health and wellness websites. One, MindBodyGreen, served as a great platform to share my personal story about Lyme disease early on, and it allowed me to start getting my message out there. It’s serving an important role for others in the natural health world to share information, and is putting out a lot of good quality content.
Another is The Mighty, a community-focused site for people who are struggling with all sorts of chronic health issues and disabilities. This site is truly inspiring; the shared stories and advice from real people with real struggles is reassuring, motivating, and illustrative of the different paths people can take to finding better health and happiness.
The People’s Pharmacy is an NPR program available via podcast that I highly recommend. Their content empowers people seeking a natural path to wellness, and can help you navigate when to use the conventional medical system. They share my viewpoint that the medical system is valuable when you know how to use it.
Finally, for those interested in learning more about Lyme and chronic illness, check out Stephen Buhner’s work. He’s an herbalist and book author whose research informed a lot of my philosophy and approach to natural healing.
How can our readers follow you on social media?
DR. RAWLS: You can follow me on Facebook at Facebook.com/RawlsMD, subscribe to my YouTube channel at YouTube.com/c/RawlsMD, and follow me on Instagram at Instagram.com/RawlsMD, and on Twitter at Twitter.com/RawlsMD.
Thank you so much for these insights! This was so inspiring!