HEALTH
“With great power comes great responsibility” - the cliché, yet wise words Uncle Ben instilled in a young Peter Parker stands true in the healthcare system today. You, the patient, have a tremendous amount of power when it comes to your health. Power within your medical care, and the decisions that are made in the treatment of your life. The goal of this blog is to empower you as a patient to approach your care holistically, with a lifestyle-centered mindset.
The concept of shared decision making (SDM) became prominent in the healthcare system in the early 2000s. SDM has been summarized as an “approach where clinicians and patients share the best available evidence when faced with the task of making decisions, and where patients are supported to consider options, to achieve informed preferences.”1
SDM means you, the patient, have power when it comes to your healthcare. This power brings the burden of responsibility. What you do with this power is your choice. What I ask of you is to consider beginning to think of healthcare from a proactive mindset.
As advanced as medicine is getting, the current model still has flaws. Often, we as providers are practicing reactive medicine. Prescribing treatments, medications, or interventions as a response to a disease or condition. My request of you as the patient is to take charge of your health. Many (not all) of the most common conditions we as healthcare providers treat could be prevented with a proactive and holistic mindset. Begin to ask questions and shift your focus as a patient. What things can you do to prevent injury or disease? In conjunction with your medical care, what things can you do holistically to aid in the treatment of a specific condition?
Let’s put this idea into a common scenario. Imagine, a patient is at their primary care office. Annual physical screening labs are obtained. Results show the patient to be pre-diabetic.
After a long discussion and patient education, the clinician and patient decided to proceed with dietary/lifestyle changes and will recheck labs in 3 months. Pending follow up labs, they may proceed with a prescription for Metformin (a common drug used in the treatment of diabetes/ pre-diabetes).
First, let's look at this from a non-proactive mindset. The patient tried to make some changes and was able to diet and increase activity for a week or so, however life got in the way. They reverted to their normal routines shortly after. Their labs did not change at that follow up visit. They are subsequently placed on Metformin. A year later, this patient is living the same lifestyle. At this physical, labs show their A1c has increased again, and they are placed on a higher dose of metformin to control their diabetes.
Now imagine the patient took this scenario with a proactive mindset. They listened to the provider’s lifestyle modification counseling. They met with a nutritionist, joined a gym, and started cooking healthier meals. They took charge of their health. They were motivated to treat their diabetes from a holistic standpoint. Because of this, they lost 10lbs and reduced their A1c (average blood sugar) out of the pre-diabetic range. By taking a proactive and motivated approach to their care, the patient was able to lose weight, feel better, and avoid prescription medications!
The goal of that scenario is not to discredit medicine or to say that all conditions can be treated solely from lifestyle changes. Even with a proactive and integrated approach to treatment, medication and interventions are often required for proper care. My hope was to display how your mindset to treatment and lifestyle as a patient can vastly change the course of treatment and outcome.
As a provider, I hope the shift of medicine continues to move to a more proactive approach on both sides of the SDM equation. Changes in healthcare structure and systems take time. Time that you, the patient, do not need to waste. You can start practicing proactive medicine on your half of the SDM equation now.
My ask of you is to take the initiative for your health. Ask questions. “What can I do?” “What can I change?” “Am I doing something that is negatively impacting me, and how can I change that?” Take control of your portion of the decision-making process. Approaching injury or disease with this mindset can help progress the shift to a proactive medicine model.
We providers have moved to a more proactive healthcare model. Increased technology aiding in patient outreach, screening tests, and patient education, are just some examples of how we are able to do this. While this is a great start, it is only half of the coin. We as providers cannot enforce proactive and holistic changes upon the patient. That is up to you to adapt, adopt, and enforce. If we started with a corny cliché, we should probably end with one too. To quote the great Bill Belichick, “Do your job.” Take charge of your health, be an active participant in the treatment process. Approach treatment with an open and holistic mindset. Work together with your healthcare provider as part of a shared decision approach to improve your health.
References
1. Elwyn G, Coulter A, Laitner S, Walker E, Watson P, Thomson R. Implementing shared decision making in the NHS. BMJ. 2010;341:c5146. doi: 10.1136/bmj.c5146.
