E-mail a friendDr. Michael Roizen
airdate July 9, 2009
As co-founder of RealAge and of RealAge.com, anesthesiologist and internist Dr. Michael Roizen teaches the role of food and other steps in reversing disease processes. He's served on FDA advisory committees, published medical books (one, a medical best-seller) and has many U.S. and foreign patents. His first general-audience book, the best-selling RealAge, has been translated into more than 20 languages. In '07, Roizen became Cleveland Clinic's Chief Wellness Officer, the first such position in a major U.S. healthcare institution.
Dr. Roizen shares his hopes that President Obama's healthcare plan includes lifestyle treatment. (1:27)
Full interview. (10:38)
Dr. Michael Roizen
Tavis: Dr. Michael Roizen is the chief wellness officer at the Cleveland Clinic and cofounder of RealAge. He's also a "New York Times" best-selling author who's co-written a series of popular books with Dr. Oz. He joins us tonight from Cleveland. Dr. Roizen, nice to have you on the program, sir.
Dr. Michael Roizen: Privilege, Tavis.
Tavis: Let me start by asking this question - how hopeful you are about the conversation we're having right now around healthcare in America. As you know, we've tried this before.
Roizen: Well, if we really focus on healthcare and not just illness care, and if we focus on more than just access - access is important, but if we focus on more than just access I'm really hopeful, because we have a chance of radically improving health and radically decreasing costs if we do it right.
Tavis: Tell me about that first distinction that you referenced.
Roizen: Well, the Cleveland Clinic is great at illness care. We're rated number one in heart care by "U.S. News and World Report" 15 years in a row. But our leader, Toby Cosgrove, realized that if we've got a lead we can't just be great at illness care - we've got to be great at that - but that we've got to get into healthcare, and that is keeping people well.
And we want - in fact, we need a lot of organizations to join us in this because we spend a lot of money on illness care, and if we go to healthcare we can reduce that substantially.
Tavis: I know what illness care is. Define for me what you mean, and what the Cleveland Clinic defines as wellness care.
Roizen: Well, wellness care - if you will, the focus on lifestyle changes - is tobacco, physical inactivity, food choices and stress account for over 75 percent of our total cost of care.
That is, we're twice as expensive as Europe, three times as Asia, because we have twice the chronic disease of Europe, three times of Asia because of those four factors - tobacco, physical inactivity, food choices and stress. Those are under our control and helping our employees get control of those is what we're doing.
Tavis: A lot of those things are linked - you know that better than I do - so where does one start with wellness care?
Roizen: Well, we started with tobacco, if you will, because it is by far the greatest cause in getting all toxins off the environment. We're then doing the others simultaneously - that is, helping educate and, if you will, nudge, coax and make people understand that it's in their best interest, not just from an economic standpoint but from a jobs standpoint and from a feeling of energy, quality of life of doing more physical activity.
Just walking is a key component. Then it is of making the right food choices so we don't eat the five foods that age you, and then learning how to manage stress, which is really a small component, if you will, of time, but a huge component of how well you live life.
Tavis: I don't mean to be a cynic, Dr. Roizen, with the asking of this question, but I'm curious to get your take on this. Pretty much everything you've just listed, those things that are preventable, are things that any American with a bit of good sense - and I'm going to assume that most of us have a good bit of good sense - we know those things are bad fro us.
We know that smoking is bad for us; we've been teaching that lesson for years. You cannot - you may choose to smoke, but you know that smoking's bad for you. You choose to eat bad foods; you know that bad foods are bad for you. You know that being overweight is bad for you, and you know when you're overweight. You know when you're not exercising and you know that exercise is good for you.
I'm only walking through that deliberately to make the point so that I can ask this question - since this is stuff we already know, how do we get traction on these issues?
Roizen: Well, this is part of what we're doing and part of this continued effort of getting you, getting each of our employees, getting each of the citizens we touch, our patients, and then in fact our greater communities emotionally involved with their bodies. It's what Mehmet and I have been doing with the "You" series of books.
But we've shown - now we're showing at the Cleveland Clinic that we can do this for our employees. We have lowered our healthcare costs from roughly 50 percent of the national average for healthcare organizations on a per-person, age-adjusted basis to 44 percent.
So we're doing that bending the curve, but we're actually bending it backwards. And we can do that because when you get people emotionally involved with their health they start to do those things that you've already said.
You go to our skyways, if you went there two and a half years ago they were empty both summer and winter. People weren't walking. Now they're crowded. That's a great sign.
We've taken our fitness clubs and they've more than doubled since we made them free. When we made tobacco cessation, if you will, we banned it on campus but in addition we put some teeth behind it and we actually said we're giving it away, we're giving tobacco cessation programs away not only to our employees and everyone in the community - we did for six months - we got 16,000 people in our county off of cigarettes and we got 4,000 of our employees, a thousand of our dependents off.
So you can do these things and it actually is changing costs. The question is, does it have a return on investment? And we're showing that these things have a real return on investment.
We take patients with diabetes or metabolic syndrome or coronary artery disease or one of, if you will, 21 diseases and get them in a lifestyle program where we teach them how to cook, we teach them, if you will, stress management and a little physical activity. It's really lifestyle treatment of chronic disease and we're lowering those costs and making them feel healthier. And that's the thing - they're feeling better in a short period of time.
Tavis: You hit on something I want to go back to now because it really is, I think, one of the linchpins for turning healthcare around in this country and that is that most American companies are now realizing, and I think the word is getting out to everyday Americans who work in these companies, that what's bankrupting America, what's bankrupting the system is that these corporations cannot continue to carry the cost of unhealthy workers.
And so I want to come back to the point you've made now about the way the Cleveland Clinic is engaging its workers. Two points I want to raise now. The first is something that blew me away when I learned this. At the Cleveland Clinic you all don't even hire people who do smoke, and somehow, that's legal.
Roizen: In something around 43 states it is legal to not hire smokers. That is, we test them. If they smoke and we were going to offer them a job, we offer them free smoking cessation program and we will re-offer them the job after they get off cigarettes.
But we think it is - we really believe that we should be a toxin-free environment, so our wall coverings, our carpets, we aren't replacing the ones, but as we get to replace them they will be replaced with things that anyone could eat.
So the point is we believe that it's better for our patients, better for our employees to be in a totally toxin-free environment and the greatest toxin we have in America is cigarettes.
Tavis: And talk to me, then, secondarily, about how it is that we can, in fact, turn this process around, Dr. Roizen, in America if we can figure out a strategy, a system by which companies don't have to carry unhealthy employees.
Roizen: Well, I don't know that we should say we don't carry unhealthy employees. What we do is we motivate healthy employees and we knock down barriers so unhealthy employees can get healthy.
People come into my office and say - who can't walk from here to the other side of the room and in four months we get them so they're walking 10,000 steps a day and feeling much better. It's only too late to reverse the problem for the individual when you're six feet under. But until then, we get to change it, you get to change it, and it's such an important problem for our competitiveness for jobs and for our standard of living that we've made it an issue trying to motivate people, and the motivation has to be fun.
It has to be edgy, like your show, and it also has to be scientifically valid. And we can make it that way.
Tavis: Help me understand from your perspective how this conversation can be, to the extent that it will be, at the epicenter of whatever kind of healthcare legislation we're ultimately, we hope, going to get from the Obama administration signed into law.
Roizen: Well, what we've had so far, at least what we've seen, is a plan that gets better access and that's worried about bending it with getting a little better competitiveness. But the real discussion is are we going to continue diabetic treatment as the treatment with medicines or surgery only, or are we going to start to pay for lifestyle treatment so that we can bend the curve by teaching people how to take better care of themselves?
We in America have knocked out that process of paying for teaching people how to do this themselves, and if we can get that into the discussion, if we can get a lifestyle treatment in there rather than just better access and rather than just a little less expensive drugs or less expensive surgery or more efficient systems - we need those, don't get me wrong - but we can really bend the needle and bend the curve when we get lifestyle treatment for chronic disease and then get people to infuse the culture by doing that all the time.
Tavis: The Cleveland Clinic is leading the way in this wellness conversation. Dr. Roizen is the chief wellness officer at the Cleveland Clinic. Dr. Roizen, congratulations on the success you've had already. Thanks for coming on the program and sharing your insights, sir.
Roizen: Thank you very much, Tavis.
Back to July 9, 2009