Monday, December 3, 2012

Your health is ultimately up to you...

People often have a skewed perception of what is important with regard to health.  There’s no doubt that the current healthcare paradigm is terrible.  People tend to live a life that is convenient to them and when something bad happens they turn to pharmaceuticals to cure what ails them.  This has lead to high costs, bad outcomes, and a nation of sick people.  I was talking to a client who is also a nurse practitioner about this and she told me the average American takes 1 drug per decade of life.  In other words, a 42 year old person is on 4 different meds, a 61 year old is on 6.  Not only is this crazy, it’s not working.  But how did we come to this paradigm?  Is there a single smoking gun that we can point the finger at?  Unfortunately, the answer isn’t quite so simple as having one causative factor. 

In some respects, our healthcare paradigm is as American as apple pie.  What I mean by this is that it is so hardwired in to our society and the vital engine that is our economy that I wouldn’t expect any help from the powers that be.  Let’s take a look.

When you look at how clinical trials are currently funded, 85% were commercially funded.  This funding primarily came from the pharmaceutical industry.  You may look at this as being a benevolent contribution of the pharmaceutical industry to our society, but I don’t.  These pharmaceutical companies aren’t funding research on what you are supposed to eat or what lifestyle factors contribute to disease.  Their motive is profit and since you can’t patent natural food or lifestyle activities, they direct their initiatives at drugs they can patent and, therefore, profit from.  When you look at the results of the studies they report, 85% are shown to have some positive effect.  This is far greater than the 50% rate found in government sponsored studies, so it is highly unlikely that this effect happened only by chance.  How can this be?  Let’s look at how these drugs get the green light.

Most people look at the FDA as a government body that monitors clinical research in a way that unsafe or ineffective rugs never make it to market.  This couldn’t be further from the truth.  In fact, for a drug to receive the ok from the FDA, all the drug manufacturer needs to do is show that the drug is better than a placebo in 2 trials.  If the drug manufacturer performs 20 clinical trials and 18 of them show no benefit of the drug over placebo, but 2 trials show a mild benefit, the drug gets the green light from the FDA.  The drug manufacturer is under no obligation to report every finding from every study to the FDA so why would they?  They report the 2 positive findings, get drug approval, and wait for the money to roll in.  Hardly the actions of a benevolent contributor to society.

So, the blame lies solely with the pharmaceutical companies and their shenanigans, right?  Not quite, there is plenty more blame to go around.  Despite the pharmaceutical companies dominating the clinical research circles, there is still quite a bit of clinical research that involves healthy eating, exercise, and good lifestyle habits.  A large chunk of this research even compares pharmaceutical interventions with lifestyle interventions with lifestyle intervention being at least as effective and in some cases more effective than pharmaceutical intervention in a wide range of conditions.  These conditions include Type 2 Diabetes, heart disease, mild depression, ADHD, Alzheimer’s disease, chronic pain, high blood pressure, osteoporosis and a slew of other health conditions.  All of these studies show that regular physical activity, a healthy diet of unprocessed food, getting enough sleep, and managing stress are the cure for what ails you.  So, Doctors just need to start informing people of this and it is up to them to get people living the proper lifestyle, right?  Not even close.

Being a health and wellness coach, I work in the trenches.  In fact, I work in the trenches and actually work with quite a few physicians who want to live a healthy life.  They often tell me the progressions they go through with patients.  Patient X comes in and their blood pressure is a little high.  The doctor tells them they need to exercise and start eating right and in 6 months when they come back the patient’s blood pressure is no better or worse than before.  Since the patient isn’t being compliant the doctor now needs o put them on blood pressure lowering medications which fixes the symptom, but not the problem.  A few more years down the road and the patient comes in and it appears that their blood sugars are out of whack.  Again, the doctor tells them that they need to get their life in order and start eating better and getting regular physical activity.  A year or 2 down the road and this person has full-blown diabetes.  They now need to go on metformin to control their blood sugar because without intervention their risk for heart disease, Alzheimer’s disease and certain cancers rises dramatically. 

While there are certainly bad doctors who may never go through this progression, I know quite a few that do.  My experiences with clients mirror those with my physician clients.  For a vast majority of people, it is like pulling teeth getting them to exercise.  Getting them to stop eating garbage is even more difficult.  This is the root of the problem, no matter where the mindset came from you are ultimately responsible for your own health.  If society has somehow given you the misperception that you should live your life how you want and use drugs when problems arise, it is up to you to ignore that message.  Given that our economic engine runs on subsidizing processed food and the pharmaceutical drugs that inevitably come from repeated exposure to them, it would be wise to not wait for the solution to come from the government given that they are so invested in the current way of doing business.  Even if the solution came from the government it would be up to you to act on it, why not act now?  I think most people know that waiting for a problem to arise is a bad idea.  We understand the importance of preventative maintenance for our cars, why can’t we grasp that concept for our bodies?  Pharmaceutical drugs have their place as insurance for when a problem arises in someone who lives an otherwise healthy life, not in subsidizing poor lifestyle decisions.