Here’s the latest article for my column on Fast Company:
As we all know, the economy ain’t doing so well. And there’s good evidence to suggest that people are cutting back on preventive doctor visits–when times get tough, people reduce frivolous spending.
Doctor visits are frivolous?
American medicine is absolutely horrible at preventing disease. Docs have done a phenomenal job prolonging the American life. Life expectancy has risen from 49 to 77 years in the past 100 years. In 1900, the top four killers were pneumonia, tuberculosis, diarrhea, and heart disease. But today, the number one killer in America is bad behavior. Smoking, food addiction, alcohol addiction, and lack of exercise create the top four killers – heart disease, cancer, stroke, and COPD. I have to give my physician colleagues in the past 100 years a huge pat on the back. We solved the simple, acute problems with antibiotics, vaccines, and rehydration. The dirty little secret is that the life expectancy of a 65 year old in 1900 was only about six years less than a 65 year old living today. In other words, the extra 28 years of life expectancy in America in the past 100 years is overwhelmingly due to antibiotics, vaccines, and surviving childhood. It’s surely not due to our ability to change your behavior and prevent your chronic disease.
The Great American Health-Care System was created in conjunction with the technologies designed to solve simple, acute problems with pills, shots, scalpels, and eight minute visits. And rightly so: Acute illnesses killed us when our brick and mortar infrastructure was being built, and theory of modern health care was built to cure those ills. The problem is that pills, scalpels, and eight minute visits are still all that today’s docs know. They are the tools doctors use because we’ve always used them. And they are horrible tools to use for changing your behavior.
So how many doctors does it take to change your bad behavior? That sounds like a lightbulb joke because, well, it is a bit of a joke. In med school, we got about one week of behavioral modification training during our psychiatry rotation. The other 207 weeks of school were spent preparing us to be real doctors that simply prescribe and cut. Since doctors have no idea how to change your behavior, we’re treating the symptoms of chronic behavioral-based diseases like we’ve always treated acute illness–with pills and scalpels. We’re using the wrong tools.
It’s time face the fact that doctors in our current health-care system practicing today’s medicine aren’t going to significantly improve our nation’s health. Only you, by leveraging the power of human will to change your lifestyle for the better, will fix your own health. You are the CEO of your body, and physicians are simply your consultants. Because, on average, you spend one hour with your doctor per year, and 8,765 hours without. We don’t need more doctors or more pills. We need you to understand, and to care, that your behavior today affects when and how you will live in the distant future. Unfortunately, doctors need you to give up all your fun, and behave. No wonder you don’t want to pay us for that advice.
DISCLAIMER: I fully support this kind of prevention.