At the heart of Primary Care medicine is the idea of prevention. Admittedly, it is not a glamorous idea, and rarely are the benefits immediately seen. Let’s take a closer look at this concept: When a General Surgeon performs an emergency appendectomy on a patient, the benefit to this intervention is recognized the moment the infected appendix comes out. We pat the surgeon on the back and call it a job well done. Instant gratification – something that is a big part of our culture these days.
What the Primary Care Provider (PCP) does day in and day out is a little (okay, a lot) less flashy, although no less important. All those physical exams, blood pressure checks, and diabetes management visits are usually pretty anticlimactic and may seem even downright boring. You don’t leave the office with a showy battle wound, but rather with a quiet prescription for medications to normalize blood pressure or blood sugar, a lifestyle change goal, instructions for weight loss, or a recommendation to stop smoking. And these instructions are usually hard because they frequently involve behavior change, but the benefits of effective prevention, supported with strong scientific evidence, are a longer, healthier and higher-quality life.
So, one can think of prevention as “proactive” health care, rather than “reactive” health care. Think eating well to prevent heart disease (proactive) versus getting a cardiac bypass surgery for blocked coronary arteries (reactive). Most of us would prefer the former to the latter, but this sometimes takes some guidance, and this is where the PCP comes in. Here are three proactive health tips that are at the top of my list for helping people forge a life rich in good health.
- Maintain a Healthy Weight
Obesity increases the risks for many preventable medical conditions, including cardiovascular disease (including strokes and heart attacks), diabetes, sleep apnea and breathing problems, depression, pain disorders (such as arthritis), and certain types of cancer (uterine, breast, colon, kidney, gallbladder, and liver). The power to PREVENT these illnesses rests in part with maintaining a healthy weight. This is frequently not an easy feat, and takes a fair amount of behavior change to see results.
As we age, our body composition starts to change. In place of muscle mass, fat mass becomes more prevalent. This change also slows our body’s metabolism. One mistake people make is thinking that losing or maintaining their weight in their 20’s is the same as in their 40’s or 50’s. We all know that choosing healthy foods is important, although as we age, we sometimes need to change not only our calorie amount, but the type of calories as well in order to maintain a healthy weight. This frequently has to be individualized based on sex, age and underlying medical conditions.
Physical activity is the other side of the coin to maintaining a healthy weight and/or promoting weight loss. Even incorporating as little as 30 minutes a day, 5 days a week can have positive effects on your health. Beyond weight maintenance, exercise itself is an independent factor in reducing risks for chronic illness.
Finally, stress reduction and getting enough sleep are two other ways to help maintain a healthy weight by balancing those hormones that can trigger hunger cues in our bodies. Whereas acute stress can cause us NOT to eat, chronic stress tends to make us want to eat more and store more fat. Getting adequate sleep and finding ways to manage stress can help keep these hormones in a better balance.
- Don’t Smoke (or STOP if you’ve started)
Smoking is the leading cause of preventable death. It claims the lives of an estimated 7 million people (worldwide) a year – and the number is rising. Smokers, on average, also die 10 years sooner and have a lower quality of life than their non-smoking counterparts. Currently in the United States, there are 16 million people living with preventable diseases which are directly caused by smoking cigarettes. These illnesses include (but are not limited to): heart disease, stroke, diabetes, emphysema and lung disease, certain cancers, immune system irregularities (such as some autoimmune conditions such as rheumatoid arthritis), and erectile dysfunction.
One of the simplest recommendations to make is to stop smoking, though the associated behavior change needed to make this happen can be one of the hardest things for someone to actually do. One average, it takes someone 7 tries (and fails) to finally quit smoking for good – that’s a lot of failed attempts. Instead of becoming disheartened about failing, realize that this is a NORMAL part of the process. Just put this behind you and plan for your next (hopefully successful) attempt.
- Have Regular, Preventative Health Care Visits
Making and maintaining positive lifestyle choices can be hard, especially with the busy, stressful lives that many Americans keep. Having a coach to assist in setting goals, redirecting bad habits, and introducing helpful new ideas can be essential in finding success in anything that we do. In the “game of life” the Primary Care Provider can be just that coach, and the better the relationship with that coach, the more successful the outcomes. However, we can’t lead you to good health if you don’t routinely see us. Annual physical exams help pick up early heart disease, high blood pressure, diabetes, and even depression, all of which can shorten your life. We all see the cardiothoracic surgeon putting in the bypass graft after a heart attack as the savior – but wouldn’t it be better to prevent that heart blockage in the first place? Sometimes winning the game means being around to finish it, and that is where proactive, preventative medicine wins every time.
Healing in Kindness, Acting For Change.
Dr. Cecily D. Havert