Compounding and Health

There is no resource more valuable than time.

The more time, the more compounding possible. Compounding of good habits at any age can build what humans universally seek—health and wealth.

According to Naval Ravikant, health is more important than anything else, and

Compounding builds health, not just wealth.

So if we agree with Naval, who may be described as a modern-day philosopher:

• Health is priority #1

• Compounding is critical to health and all good things, like happiness, healthy relationships, wealth

• Compounding requires time, which is our most valuable resource

Let’s play around with these factors a little more and connect these concepts to healthcare.

What impacts our health and impacts compounding? A few big ones:

1. Habits-sleep, diet, exercise

2. Experience and upbringing

3. Perspectives and beliefs

4. Education

5. Mental states

6. Finances

We could draw the conclusion that optimizing these leads to better health over our life’s trajectory, right?

Let’s say I’m brought up learning resilience, good sleep habits, the importance of education, the basics of investing, and how to communicate effectively. Those skills should pay dividends over my life, building the foundations for a happy and healthy adulthood.

But maybe I struggled in my 30s with anxiety and self-doubt, which interrupted the good compounding. It impacted my relationships, career growth, and consistency with good habits.

I went to see my primary care physician.

She had 8 minutes of time allotted to evaluate and manage my complaint. She gave me a prescription for an anti-depressant and suggested I make an appointment with a therapist.

That was the extent of the visit.

There was no follow-up, no direct referrals to one or more mental health clinicians Of course, that also meant no collaboration.

• No one checked to see if I saw an improvement in a few weeks or so, if I had any side effects that bothered me, and made sure I was compliant.

• No one told me what could happen if I stopped the medication abruptly or what to do if I experienced side effects.

• No one explained that therapy along with the medication was more likely to improve my symptoms than medication alone.

So let’s say I took the medication for three weeks and then stopped because it made me groggy. I didn’t feel any better, anyway. I tried calling a few therapists but they had waiting lists, so I gave up.

That was it—an 8-minute transaction to address a concern impacting the trajectory of my health, which is the crucial building block for a happy life.

There was essentially no meaningful value to me in that physician visit.

Now let’s say my physician was in a team-based, advanced primary care practice and her pay was not based on the number of transactions and RVUs per day.

There was a mental health clinician on-site.

The physician met with me, engaged me in conversation, and asked if I could meet with the mental health clinician next.

The therapist and I spoke for a while, scheduled a follow-up visit for later that week, and the physician and mental health clinician made a joint decision on a medication based on their assessments.

They explained the medication choice and the starting dose, and what I might expect.

I returned five days later to meet again with the therapist, and we discussed my goals and a plan. I consented to receive text messages from the team.

A nurse on the team called a few days later to check on me, on how the medications were going, and confirmed my next visit with the mental health clinician.

She texted me reminders from my physician about taking the medication as directed, and that we can adjust or change them as needed. I could reply or call with questions at any time.

(Check out this January, 2024 article in Medical Economics about the role of texting in patient-centered care)

I made progress in therapy. I felt much better in a few months.

I was sleeping better.

I was connecting better with my partner and my children.

My confidence improved.

My work improved.

The positive compounding in my life resumed.

My life was changed forever.

Dramatic? Maybe.

Hyperbole? I don’t think so.

If offered, I’d take the bet that Naval would agree.

Which primary care visit would you have wanted in that one simple scenario?

The value-based care healthcare experience (communication and connection) or the fee-for-service healthcare experience (transaction)?

Value-based care gives healthcare providers, clinicians, and teams the opportunity to invest in TIME for their patients.

Quality time with patients is the most important tool providers are given when they enter into VBC payment arrangements.