Dr. Jeff Kane: Too much health care?
Yes, we use too much health care. No matter what shape its financial reform eventually takes, we’ll only be halfway home. Costs may initially decrease but will soon rise again, since we ask the system to do much of what we could do for ourselves, and the system is rich in accommodating entrepreneurs.
For example, we’ve known for decades that the ways we choose to live affect our health. We know that ongoing stress weakens our immune system. We know that too much sugar and too little exercise predispose us toward obesity and diabetes. We allow ourselves to be exposed to agents known to cause cancer, lung diseases and hormonal problems.
Yet we’ve grown up in a culture that touts medical “breakthroughs” daily, subtly promising that whatever goes awry can be fixed. Many of us feel little need to amend our diet, avoid toxic exposure, or exercise since we believe medical science will correct the consequent damage. No need to respond to stressors, either, since a wide variety of pills will ease discomforts and control our blood pressure. That is, we act as though health care’s mission is, in part, to enable unhealthy lifestyles.
In addition, we doctors, too, generally think of our cabinet of medicines as the answer to whatever presents as a medical problem. That’s how we were trained, and the atmosphere of standard practice only reinforces that view. We happen to be in an opportune role to help patients change their ways, except that would require the trust of a close relationship and appreciable time — both in short supply these days. It’s easier to just scribble a prescription, especially when the patient has brought in a clipped ad advising, “Ask your doctor if HappyzacTM will help.”
It’s not like we don’t know how to take better care of ourselves. At some level we know what to do, but we seldom act. A therapist friend told me, “Understanding is the consolation prize,” meaning that comprehension without action is useless.
Much of inaction’s source is social. Whatever our habits, over time they mesh with those of people around us. Families and friendship circles evolve particular ways of interacting, and can be threatened when we go to make changes. “What? You’re a vegetarian now? You going to be a nudist next?” “I know your job is terrible, but if you leave it you’ll starve to death.”
Enacting healthful habits is simple, then, but far from easy. Still, I don’t know a more effective way of minimizing the necessity, costs, and hazards of medical intervention.
Jeff Kane is a physician and writer in Nevada City.
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