What is Optimal Medical Therapy (OMT)?

Optimal medical therapy is a product like a hamburger. As such, it can be systematized, standardized, and scaled. When you consume a franchised product like a hamburger or a hotel room anywhere in America, you know what you are going to get. There is nothing like that in medicine. Even within the same practice and the same building, there is large variation in the quality and experience of care.

OMT is a collection of “evidence-based care processes consistent with best practices.” It emphasizes lifestyle and pharmaceutical measures equally. Usual care is designed around risk factors and organ systems. Usual care is about lowering the blood pressure, sugar, and cholesterol. OMT also lowers risk factors but in an integrated manner that maximizes impact. OMT lifestyle and medication recommendations block the core molecular biology that makes us age faster and develop chronic illnesses more rapidly. OMT reduces the risk of heart attack and stroke more than it lowers the risk factor. It protects every cell and organ in the body. “It is now critical for physicians to reconceptualize SGLT2 inhibitors as organ-protective agents rather than glucose-lowering drugs.” OMT helps us stay healthier longer.

Compared with usual care, the benefits of OMT are dramatic. Individuals with heart artery disease have up to a 90% reduction in mortality and a per patient per year savings of $21,900. Adjusted for inflation, the savings would be $30,000 per patient per year now. In patients with stable heart artery disease, OMT protects them from dying or having a heart attack. Adding a stent or a bypass to provides no additional benefit in stable angina patients.

Compared with usual care, in patients with diabetes, OMT lowers the risk of a hospitalization for heart failure by 70%. It prolongs life and delays heart attack and stroke by eight years. Patients on OMT have one fourth as many heart attacks, one fifth as many strokes, and one sixth as many people go on dialysis. One third as many people have amputation or go blind. Just imagine the impact if OMT was widely available for patients with diabetes. We have proof that OMT can prolong healthier life in diabetes now.

OMT is being recognized as the best approach to the chronic illnesses that generate most medical expense. The latest guidelines from the American College of Cardiology call for OMT first in patients with stable angina. Seventy percent of patients on OMT will have relief of their chest pain within a year. OMT provides the complete solution for most patients with heart artery disease. Evaluation for a stent is appropriate only if OMT fails to provide sufficient pain relief.

Outpatient primary care teams deliver OMT and most of the work can be done remotely. It can be much more effective, convenient, and less expensive than usual care. You should be able to be confident that you are receiving OMT no matter where you live. Today that care is usually not available. Ask your practice and community leaders to make OMT available for your family.