Professional Point

Some who are knowledgeable about health care are beginning to argue that the broken health-care system is beyond reform. The number of uninsured individuals continues to rise. We are experiencing an unsustainable increase in costs. There is a growing shortage of health-care services and workers, due in large part to falling reimbursements. Availability and affordability of health care is climbing the list of those issues of most concern to consumers. Chronic health problems, such as diabetes and obesity, are on the rise. And 77 million Baby Boomers are fast approaching the age where their need for health care will place enormous strain on an already failing system.

The need for creating a new system rather than simply fixing the old one has reached a tipping point. More than just reform, what is needed is transformation. The health-care system's fixation with treating disease must give way to a greater priority to prevent disease and promote good health. The health- care system must be replaced with a health system.

So what can we in psychology do to help? In the past, I have reminded us of our profession's unique and central role at the intersection of psychological and physical health. A future vision of a health system that relies on connections between behavior and health actually reaches squarely back into psychology's past. What policy-makers and the public are now beginning to appreciate, psychology has known for years, if not decades--the research, the knowledge base and technologies to change behavior in ways that promote good health do exist. And much of the research, the knowledge base and technologies are psychology's work. No matter the mechanism of change occurring in health-care, we must continue our efforts to assure that our work is fully appreciated by policy-makers, employers and the public. Both our Mind/Body Health Public Education Campaign and our Psychologically Healthy Workplace Program are designed to do just that.

Through our public education activities (for more information, visit the APA Help Center), we have become better attuned to the extent that people try to manage their stress in unhealthy ways. Our recent stress survey findings--widely reported to tens of millions through newspapers, magazines, radio and television--highlight the many unhealthy behaviors such as smoking, drinking and comfort eating that the public frequently use to manage their stress. Educating people about stress, and importantly, helping people better manage their stress in healthy ways is clearly something psychology can do to contribute to the transformation from a health-care system to a health-promotion system.

If we consider that the most frequently cited source of stress is the workplace, psychology working in partnership with employers goes far beyond mental health benefits and services. According to the American Stress Institute, workplace stress costs this country $300 billion a year in turnover, absenteeism, decreased productivity and direct medical, insurance and legal costs. Helping employers create psychologically healthy workplaces is another important contribution we are making to the realization of a new health system in this country. In fact, the reported employee stress levels of our 2007 National Psychologically Healthy Workplace Award winners (see "The best of the best for 2007") is strikingly less than the national average. Similarly, the turnover rate of this year's winners is less than a third of the national average.

Important shifts are occurring in health care, and in our culture. It is incumbent upon us as psychologists to use our research, our knowledge base and our technologies in the service of those shifts. Our expertise in behavior--both for problem-solving and enhancing performance--makes our profession well suited to help manage the changes around us.

But we must also effectively manage change within our profession as well. We must continue to diversify our way of practicing to take advantage of the varied roles psychologists are capable of filling. We must transition away from a reimbursement model to an income model" of practice. Undertaking activities that do not depend on shrinking third-party reimbursement is crucial if we are to thrive economically. We also must find more ways to participate with the many communities that surround us--not just other health professions, but civic groups, cultural groups, religious groups and service organizations. To truly expand our roles, maximize our influence and increase our value, we must continue to build our relationships with communities beyond our walls. This is especially key at a time when the health-care system is changing, when the world is changing, and when we are changing.

Further Reading

This column was adapted from Newman's keynote address at the 2007 State Leadership Conference. See May 2007 Monitor Index for additional coverage.