who is your primary healthcare provider?

My dad is diabetic. Since his diagnosis, he has enthusiastically reformed his diet. In fact, he has improved his eating so much, he recently told me he now must carry glucose tablets in case he has a catastrophic drop in blood sugar. When I asked whether this meant he could eliminate or reduce his medication, he said that his doctor had, in fact, instructed him to halve his dose on days he would engage in a lot of physical activity. So there is at least some connection between my dad's habits and the amount of medication he needs to control his diabetes.

This conversation left me wondering how many doctors who treat behavior-related illnesses skip over the "recommend lifestyle changes" part of the process and just prescribe medication. I suspect it's more than a few, for the simple reason that few people are actually willing to make lifestyle changes.

I know of one friend whose doctor said he had to lose ten pounds. When he went back having only lost seven, his doctor, instead of being disappointed, was overjoyed. "You don't understand," said the doctor, "I tell people to lose weight all the time and hardly anybody ever does!"

So it's no wonder that we apply the phrase "primary healthcare provider" to medical professionals—but in reality, each of us should claim that title for ourselves. After all, we make the individual choices that form our habits—the small, everyday decisions that over time have the biggest impact on our health, insofar as health is related to behavior.

Doctors are there to treat illness; we are the stewards of our health. Until we, on a broad scale, recognize this and take responsibility for our bodies and their care, we will continue to see the trend of "instant" pharmaceutical solutions offered for every illness.

But what costs or side effects come along with the benefits of the drugs that lower our cholesterol, control our blood sugar, kill our appetite, and so on? Has technology, especially as manifested in pharmacology, erased the perceived need for an ethics of self-care?


M. Robert Turnage said...

There is so much involved with health care that it is difficult to pinpoint one specific area for improvement. Our culture (and the financial payout structure of the insurance companies) reflects the idea of, "Live your life the way you want, and we will rush in at the last minute to save you when it is a crisis."

So, the plan is to wait until someone has a crisis of some sort, then swoop in and save that person. There isn't much encouragement to do preventive care. Insurance companies don't want to give financial incentives for it, and people don't want to do it.

I can't remember where I read this, but there was this small business that was going to base insurance premiums on weight. They scrapped the idea when a 300+ pound person threatened to sue for discrimination. We have the right to make unhealthy choices. We also have the right to complain about it.

Kim Pospisil said...

I can testify that changing your diet is so much better than just taking medication.
When I was diagnosed with Type II diabetes at the age of 29, I was surprised to learn that my insurance company did not want to pay for my diabetes education classes, which are crucial for those lifestyle changes. We paid for them out of our own pocket. (What a pretty penny that cost.) Where would I be without that precious education? I was so lost and scared before those classes that I was paranoid about everything I ate. After the class, I was in wonderful shape. My A1C test was at 13. In a short time, it was 5.7. I changed my diet and exercise and avoided costly medications for 2 years. I dropped 20 pounds and my symptoms nearly disappeared. There was a time, after my first child, that I needed some medication however, after the birth of my son, I am now off medication again. The best complement I've ever received was from my new physician who assumed I was gestational and told me that I could now eat like I used to before gestational diabetes onset. My A1C test was 4.7 - a normal, healthy test result.