Crisis of Conscience

Infusing vitality into healthcare reform
By Craig Gustafson

Finally, he said “Enough.”

In 2006, Pedram Shojai, OMD, was president of a large, successful medical group where he specialized in acupuncture treatment of back pain.

“I had Dick Butkus as my spokesperson and I spent $50,000 a month advertising for patients with back pain,” said Shojai. “We had a bunch of innovative programs, and all the orthopedists in town were taking me out to lunch because I was sending out a lot of surgical consults.”

Healthcare costs were spiking and the system’s payers, such as Blue Cross and Medicare, were responding by squeezing payments to doctors. “You’re trying to do the best you can, but you’re just not making enough per case.” Shojai laughed in disbelief and interjected, “Patients are called cases once you get bigger, right?”

For most doctors the answer to this dilemma is an increased workload—seeing 30 to 50 patients a day. Shojai and his partners started down that road, retooling to maximize revenue within the system. “[We] realized that we should probably get a MRI on a trailer and we should get a one-bed operating room.”

That’s when Shojai hit a wall. “I had a crisis of conscience, realizing that I only got paid when people were sick and that there was no incentive to get people better,” he said. “In fact, I made a lot more money if people stayed sick.”

To Shojai, it felt wrong. “It is not a healthy business,” he said. “It is a great business, actually—it’s just not one that helps you sleep at night.”

Despite his dissatisfaction with the status quo and his “alternative” roots, he refuses to buy into the conspiracy theories and damning accusations leveled at orthodox doctors by some opponents of the current system.

“Most MDs have come through an education system that has been sponsored by pharmaceutical interests and they are not necessarily aware of the latest research,” he said. “They are stuck in a system that only pays for people when they are sick, and that is not how wellness is wired. That is not how doctors should be making their living.”

Once Shojai’s conscience intervened, he closed one of the offices, sold the rest to his partners, and slowly extracted himself from that system. He opened a small practice while he looked for a new direction. During that time he also did some corporate consulting. Eventually he was asked to produce a set of DVDs on qigong (he had previously spent four years as a Taoist monk), and sales far exceeded expectations. Based on this success, the company approached him to host a documentary they had planned.

Unfortunately, his conscience got in the way again. “As we started filming it, they started angling toward [allegations of] government conspiracy: sensationalizing things that the government doesn’t want you to know and machines that can cure AIDS that have been hidden from us.” Shojai felt that the filmmakers were missing the actual point of the healthcare crisis.

“I was just trying to get people to eat more vegetables,” he said. “It’s a lifestyle crisis. It’s how we live. If people just understood how to avoid environmental toxins and stop eating the garbage, 90 percent of this stuff would go away.”

The two parties decided to part ways, with Shojai purchasing the rights to the film. “They were interested in sensationalizing and selling. I just wanted to tell the story as it really is. So there I was holding the rights to a movie, and I am not a filmmaker.”

Fortunately, he had some friends in the right places. “I have good friends in Hollywood, and they helped me finish Vitality.” Shojai set the expectations early for the new team to complete the project using his vision. “We needed to sexy it up in a way that is not boring, not preachy, and tells a story—get in, get out, and help people help themselves.”

For Shojai, the problem boils down to inertia. For various reasons, dietary recommendations got moving in the wrong direction and then industry grew up around those assumptions and created a tremendous amount of momentum—especially economic momentum. “If I can just get people to start taking care of themselves and create an industry around that, then the healthcare crisis in this country begins to take on a new face.”

“People need alternatives,” he said. “Don’t tell me what I can’t eat; just tell me what to eat. ‘Everything out there is bad for you’ is not an empowering message.”

That is what Shojai’s film intends to provide. “Here is a diet that could help you and your children stay healthy—great! And solutions-based, right? That is the type of positive messaging we have been working on developing,” he says. “Health is all you’ve really got. What I care about is being able to ski and play basketball and not feel like a wheezing old man … Vitality is the energy of life that you carry, and your health is the basis of that. So we are trying to tie health together with life so that it isn’t some sort of weird test metric that people are trying to impose upon you. Your vitality is everything.”

Shojai admits that this is a pretty lofty goal. “But you know what? The lofty ones are the ones worth attaining.”