Healthcare or Illness Care?
Health and wellness. I used to think that this phrase was BS. I am in healthcare. We provide care for people’s health. Like real healthcare guys, we write prescriptions, perform surgery, manage hospital admissions. Or that’s what I used to think. But the thing is we don’t we provide care for people’s health. We provide care for people’s illnesses. I provide illness care. We try to put it all back in Pandora’s Box. But the thing is we all know that isn’t possible. Once something is broken does it ever go back to how it was? Maybe bones….may explain something about orthopedic surgeons. But in general, with few maybe no exceptions, despite what we do there is a hit that is taken with every illness. EVERY SINGLE ONE. And we think as we age these hits
keep piling up. The “problem list” is the list I create for every patient about what needs to be addressed. And there’s different ways to organize it or categorize it or manage it. But we need a whole list?!
And how does this all just pile up to uncontrollably?
I performed a procedures on patients and recently its been weighing on me (well...no pun intended). Now some of this may be related to things I’m going through personally. I’ve become more consistent then ever with my workouts. Six months and with rare exception I wake up every day, drink my preworkout, and get my sweat on. Six to seven days a week this happens. And this was challenging since during the week this requires at 3:50am wake up. But I’ve committed to myself and my to my health to do this. And the impact on all the aspects of my life is so amazing. It astounds me how much this one change can just positively changed my life.
I also watched 2 documentaries on Netflix. Gamechangers and Forks over Knives really made me think about so many dogmatic truths that I’ve accepted. So I’ve made many changes in a time in my life that is has involved so much change and a massive challenge. And I know these types of documentaries all have their own agenda but I also think there are some truths.
So when I get patients that are morbidly obese, out of control diabetics, people in their 30s and 40s have major strokes I want to go home and scream “WHAT ARE WE DOING TO OURSELVES?!?!”
Recently this has really impacted the thoughts and actions I’ve had at work. I performed a procedure on a morbidly obese patient. Now it’s not the standard obese patient that has become a cultural norm. This is someone who was almost not a candidate for the procedure due to his size limitation and the equipment. This is not the first time and certainly won't be the last time this is a problem. And as I sat in the hospital reviewing the chart, my realization that all of the health problems listed, and there were a lot, were from weight. And weight was something that we participated in, I daresay orchestrated in obtaining whether good or bad. Not to say this person wasn’t enabled, by friends, family and likely some healthcare providers. But nonetheless patients such as this see the increasing scale number or growing girth and the choice is not to change but to continue down the road they are on. I had another patient who had a blood sugar level in the 300s. Now the conversations that happened subsequently were “ what dose of insulin do we need” and “what do you do when this happens at home” and “what is a safe number we can proceed with his procedure”. And these things don’t happen all of a sudden-high blood pressure, diabetes, neuropathy, vision loss, kidney failure, and open wounds take time to develop. Each stage of something new is a choice we made, even if it is to not make a change or new choice and continue down this path. That is a choice.
And yes I can pass the buck and say this is not my specialty. See your primary care doctor or endocrinologist. This isn’t what I do. But am I doing harm if I do that? Isn’t that directly in contradiction to my oath?
Now so how do we address it? Well I am not a primary care doctor and I will never know the burden of managing all of these issues from the beginning. And I will admit I don’t typically approach these conversations. Maybe it’s because I’m in a never-ending cycle of training. I tell people to quit smoking as it’s very bad and increases your risk of stroke and heart attack. I counsel that less cholesterol is better, better diet choices of fresh food and vegetables will decrease risk of diabetes. But it’s all a catch phrase and not very specific. I admit I have missed opportunities, but these misses are starting to bother me. And this will change the opportunities I have when I finally start looking for a faculty position.
Back to health and wellness, why can we not push to reach this early on from the beginning, before all the complications happen? Let's stop this before Pandora's Box is opened. If I truly am in a business of health that is where we should start. Eat your greens and veggies. Move your body just for the sake of moving it. Sleep a good amount every night. And I will admit I have only started going down this path for myself just recently. But the way it makes you feel is second to none. And once you take control of one, the rest really seems to make so much more sense. And you empower your life and really are taking care of your health not your illness. I know there are some people that have already started this movement; my words are not novel. And to be honest I don’t know where to go from here…or even where to start. I was joking the whole week that my practice will include all my patients seeing a personal trainer and a registered dietician. But maybe it’s not a joke. I will be asking them about their diet and their nutrition. There has to be more then a discussion. As part of the Beachbody community I think they provide a great answer for me that I will continue to participate in and promote personally as a convenient option. And will continue to look for opportunities to push this concept first: to become a true health and wellness professional.
