I’ve been practicing medicine for 10 years now and over the last 2-3 years I’ve realized that I’ve been doing it wrong. Our health care system at this point has really become a disease care system. We engage with you really only after you are sick or after we have diagnosed you with some condition. There is little if any prevention or proactive care. Also–we focus narrowly on certain diseases and conditions but totally neglect overall health and wellness. I’ve realized that health doesn’t always just mean not being sick.
But what is the definition of wellness and health? I’ve realized that more than anything health and wellness are personal. What it means to me is different from what it means to you.
Unfortunately as a physician I often skip all of this and try to define health for someone. Rather than really try to get to the bottom of how people are feeling and how well they are I have often gotten stuck looking at numbers and tests and medicines. It’s easy to do. Whether its blood pressure, blood sugar, cholesterol levels or a host of other metrics, too often I’ve been focused on the numbers and not on the person.
I’ve been quick to tell patients that based on their numbers they have hypertension or diabetes or even rather new-fangled diagnoses like pre-hypertension and pre-diabetes. Sometimes it seems like it is only a matter of time before we start calling people with normal numbers pre-pre-hypertensives or pre-pre-diabetics. This way we can make even “normal” people sick (and probably give them medication).
Over the last 50-100 years medicine as we know it has made enormous strides. We have medications that treat previously deadly infectious diseases like pneumonia. We have vaccines that prevent these diseases in the first place. At the same time we have developed methods of surgery and anesthesia that are remarkable. We can remove an infected appendix and replace a worn out joint.
These are wonderful advances and we are good at them. We are also good at emergency care and interventions. But I think that all of this has given us too much faith in medicine and too little faith in ourselves.
Now when we’re sick or tired or depressed or not sleeping we have the idea that there must be a pill or a procedure for it. There must be an easy and miraculous treatment. We can cure pneumonia with a medication–why not insomnia? We constantly see commercials on TV about various drugs and interventions: Do you have these symptoms? You might benefit from this or that new medication. Its just not true. We don’t have a pill for every ill.
Most of the conditions and concerns that my patients are faced with involve lifestyle and habit choices. They really involve taking personal responsibility and the willingness and courage to make changes. It’s not easy but its the only way. I feel like my role as a physician is to facilitate this change in any way possible.
So Here are a couple of idea:
1. Take some time and write down what wellness and health mean for you.
2. Think about a small change that you could make for better health that is congruent with your vision of health.
3. You might try focusing on making just one of your meals as healthy as possible.
4. You might start walking–even once a week is great.
5. You could pick one day out of the week and make it a “health day.” Eat as well as possible that day and be sure to get some exercise.
Small changes over time build on each other and it won’t be long before you are feeling better than you have in a long time.
