I’ve been pondering a lot lately about what it means to be healthy and well.
(I know, deep thoughts coming from a doctor)
But… I spend most of my days treating disease and not focusing on health and wellness. The disease model of healthcare encourages physicians to focus on diagnosing a problem or ailment and coming up with a treatment plan. Most of the time that treatment plan involves taking a prescription medication.
Simple right…
It follows basic logic… A –> B –> C
A = I’m sick
B = Give me a pill
C = I get better
This model, all started with the invention of penicillin and then other antibiotics.
Let’s review the basic case of strep throat.
A = My throat hurts. I have a fever. A strep test is performed and positive.
B = A course of penicillin is prescribed and taken.
C = The infection gets better.
In that case it works great. You take the medication for 10 days and the bacteria have been destroyed. Problem Solved!
… however… what about another problem… let’s say
HIGH BLOOD PRESSURE
A = My blood pressure is high
B = Blood pressure medication is prescribed
C = Blood pressure is controlled, by the medication, as long as I take it everyday for the rest of my life.
Problem solved?
WRONG!
That doesn’t look like a solution to me. Sure, it is great for the drug companies. You go back to the pharmacy month after month paying your copay to take an external solution to your problems. But that isn’t a true solution. As soon as you stop taking the medication, the blood pressure jumps back up.
(In all fairness, I prescribe blood pressure medications every day. They definitely have their place…but keep reading to understand my point)
My argument is that high blood pressure is a symptom of another problem and not the problem itself. It is an example of what Dr. Drummond, from TheHappyMD.com would call a dilemma (you can read his blog post here).
In short there is not a one step solution to this problem…it is a dilemma requiring a strategy (multiple steps) to control (and yes taking a pill can be one of those steps).
Here is an example of a strategy to treat high blood pressure.
1. Get cardiovascular exercise for 30 minutes a day for 5 days a week.
2. Lose weight — start with a goal of 10 lbs.
3. Eat less salt.
4. Eat more fresh fruits and vegetables.
5. Eat less red meat and eat more lean meats.
I’ve had a handful of patients take this type of strategy and successfully treat their high blood pressure.
And yes… they no longer (or in some cases never did) take prescription medication to fix their high blood pressure.
In short, I would argue, that wellness is not found in a pill. It takes a strategy to live a healthy and well life. It can start today. Look inside of yourself. Listen to your body. Your initial strategy could start today by…Eating less, and moving more.
Now to get off the couch and go for a walk : )
P.S.
If you’d like to work with me to come up with a strategy to help with medical concern the Join us at Blue Ocean Family Medicine.
