How often should you go to the doctor? Well, to me, that depends on whether you are working on your illness or on your wellness. Of course you can go to the doctor for a sore throat or painful joint but how about going to work on actually improving your health.
I think people, even people who think they are healthy, should go to the doctor once a year for a review of their health. From kids to old age. I know you think I am just trying to keep up the business. We are way too busy now to try and round up more work. Trust me…as long as you are eating at fast food places and gobbling sugar like hummingbirds, we health care professionals are going to stay busy.
I recommend a yearly review to consider your overall health. What meds are you on and why? What tests should you consider and why? What’s likely to kill you and can we do any testing for these issues? Are you getting fatter or fitter? There are relatively cheap devices that can tell your doctor how much muscle and fat you have. Why would you not want to track this over time? Are you up to date on tests like bone density, mammograms and colonoscopies? I am not saying these are mandatory tests but they are tests you should consider and review with your doctor. Do you know your omega 3/6 ratio and your insulin resistance? These are reliable and reproducible markers of your true health.
Unfortunately most health care workers are better with the acute illness stuff like sore throats and sprained ankles than the chronic health issues. Oh, we have plenty of experience with chronic health issues, but our current medication forward approach doesn’t ever really improve the underlying conditions. Giving you a sugar pill or a blood pressure pill can improve your numbers but they do absolutely nothing to correct the underlying condition. Lifestyle changes can correct the underlying condition. Medications cannot. It’s just that pills are easier. Easier for you and the doctor. Check out the Michael Gregor video about the relative merits of medication versus lifestyle.
https://nutritionfacts.org/video/The-Actual-Benefit-of-Diet-vs-Drugs/
Not taking any medications and all the tests you want are up to date? So maybe once a year is all you need. However, if you are trying to lose weight, quit smoking, develop an exercise routine, etc. you can improve your chances of success by scheduling more visits with your provider to review and reinforce your progress.
Sustaining your motivation can be difficult and I find it helps people stay on top of an issue if they know they are going to be held accountable at the next visit. Most of my patients need to work on some aspect of their health and I like to see them quarterly but I also have patients that I see weekly or monthly depending on the issues. As onerous as it can be sometimes to deal with the insurance companies, I have yet in my 35 years of practice ever to have the insurance companies complain that I was watching the patient too closely or seeing them too often.
When you go to the doctor you should have a list. Two lists actually…the first list should be your meds and supplements. Your doctor may not believe in supplements but they should know what you are on. The second list should be YOUR list of issues you want addressed.
What I focus on with the wellness visits is my basic four…Diet, Exercise, Sleep and Stress. Where are you now and where do you want to be and what are you willing to do to get there. Unfortunately the current primary care training doesn’t focus on lifestyle so YOU have to bring it up. I know I seem to be the odd man out medically, locally anyway, when talking about this stuff since so many providers just won’t address them. I take some succor in the words of Thomas Alva Edison; “The doctor of the future will give no medicine, but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease.”
As Doctor Casey Means writes in her book “Good Energy,” we “siloed” health care with so many specialties that medical care is overly fragmented. People are going to cardiologists, urologists, GI doctors to treat various symptoms and each provider looks at the problem through their narrow perspective and if the pill they give you doesn’t work they suggest the next specialist. Her book is just one more in a growing series of books that comment on how broken our current system is…exorbitant expenses and poor outcomes and no change in sight. In reality your lifestyle choices result in 80% of your outcomes. Most “experts” say that genetics accounts for only 20% of your health destiny. I don’t know the right ratio but I know a big percentage is lifestyle and that’s really where doctors should focus their attention. Headaches, stomach aches, skin conditions, arthritis, etc. etc. all respond to lifestyle changes. This has been shown over and over again but my healthcare partners all say they don’t know anything about nutrition or what diet or exercise program to recommend. If only there was some repository of knowledge the doctor could access to get some insight on these issues. Maybe some electronic device that we could somehow interface that might have this much sought after knowledge trove. Oh, wait, it’s called the internet and patients are accessing it and so too should we providers. I hate it when patients tell me the doctor they went to scoffed at them for doing their own research and say something about, “where did you get your degree?”
It’s not rocket science…look at the careful sustained scientific work on health by Drs. Gundry, Lustig, Perlmutter, Breseden, Hyman, Gregor, Malhotra, Knobbe and a host of others. The way forward to improve your health and the health of the nation is to get back to the basics…it’s not as easy as prescribing medications but it’s much much more effective. The same lifestyle changes that will improve your symptoms will ultimately improve your health-gevity and that’s really what it’s all about.
Until next month, get well and stay well.
JT BARRY MD