Long-haul Truckers and Patient-centered Care
Forbes is a financial and business magazine not inclined to overstatement. They blame, at least in part, our supply chain problems and high inflation on a massive trucker shortage. This deficiency has an impact on every business and family in the country.
Since 2020 you have probably seen for yourself some bare shelves in the grocery. You lose convenience and choice. Companies lose because they cannot get the necessary components to make their products.
Trucks move 71% of the things we buy. There is a massive shortage of drivers. Even before the pandemic, high driver turnover was a problem. This is huge. One in every fifteen people is employed by the trucking industry. There are seven million truck drivers on our roads. One of the largest trucking companies says 80,000 new drivers are needed and the Forbes article goes on to discuss the business side of that issue, but there is another issue that contributes to the problem.
We lose drivers from poor health and premature death. Traveling across the continent in a huge truck makes it extremely difficult to get enough exercise and eat real, fresh food. This is another crisis of driver health. Because of the prolonged sitting, lack of good food choices, and lack of sleep, twice as many drivers are obese and suffering from related diseases. More than twice as many smoke. A far greater percentage have high blood pressure and diabetes than in the general population.
The current life expectancy in the US is 76 years. For a truck driver, it is 61. Drivers have mandatory periodic health exams. Their blood pressure must be less than 140/90 (note: with diabetes it really should be under 130/80). Diabetes must be well controlled without insulin. If a driver’s pressure is not controlled or he goes on insulin, they can no longer drive.
Here’s the sad part. Even in the general population blood pressure control to less than 140/90 is only achieved in 44% of patients. Eighty-seven percent of truck drivers have high blood pressure. That is a lot of people who cannot drive because of poor pressure control. It is especially frustrating because if the system is designed properly, control rates of 90% are possible. High blood pressure and diabetes are the big problems leading to heart attack, stroke, heart failure, chronic kidney disease, and premature death that knock drivers off the road. Only thirty percent of drivers have a primary care provider.
IT DOES NOT HAVE TO STAY THIS WAY!
Patient-centered care is the core principle for effectively managing chronic conditions (diabetes, hypertension, etc.). It is care designed around the needs of the patient.
Everyone is talking about it. I just looked up patient-centered care on Pubmed Central and there are 155,000 articles on the topic. But it reminds me of a conversation that I had with my first cousin in northern Maine. He lives on a beautiful piece of property on US 1 with 75 acres.
One day I asked him, “Do you still have horses?”
“Yes” he replied.
“How often do you ride them?” I asked.
His answer was typical of his dry Yankee humor: “Oh, we just ride them around the table!”
They did not actually ride their horses, they just talked about them. That’s exactly the way it has been with patient-centered care. We talk about it, but most all care is still designed around the needs of providers and the buildings where they work. That is not the way to treat cardiovascular and related conditions that our truck drivers must contend with. No one is really making the system changes that are required.
We have looked at the data from a long-haul trucking company and found that 60% of the medical care spending was from drivers with cardiovascular and related conditions like diabetes and high blood pressure.
Here is what you do to meet the necessarily unique needs of our vital and essential drivers:
· Bring the service, the solution, to them. At least 85% of the care they need can be provided remotely.
· Blood pressure and sugar can be conveniently measured in their cab.
· Their numbers can be shared on the phone or digitally with their nurse coach, part of their care team.
· Telemedicine providers trained in optimal medical therapy (OMT) can make medication adjustments.
· Generic maintenance meds (pennies a day) can be dispensed in 90-day increments to prevent the risk of running out on the road.
· The nurse coach is their personal partner. This trusting relationship is proven to keep people actively making better choices and improving their health. This engagement must be regular, consistent, and ongoing for accountability and success.
Will this matter? You bet it will!
· Patients with type 2 diabetes on OMT live eight years longer.
· Their complications are pushed back 8 years as well.
· Patients with diabetes and hypertension have much more heart failure. OMT reduces hospitalizations due to heart failure by 70%.
We bring together the tools to identify gaps in care, along with the nurse coaching to educate drivers while closing those gaps, and the telemedicine providers to support the drivers and their coaches. That is patient-centered care. This keeps drivers on the road, earning a good living and producing for their employer.
Let us help you improve driver health and longevity…and reduce their medical costs too!
wbestermann@congruityhealth.com