I guess I should start by introducing myself. I’m Michelle. I was born and raised in the Pittsburgh area but moved to Charlotte a little over a year ago. I’m a physician assistant by profession. I spent my educational years in this in Chicago and practiced in Morgantown, WV for a few years before I made my way here. I love my job. I love the people I work with and I love the patients that I see. I work with some of the sickest patients out there; those with peripheral vascular disease. On the surface, some of these patients actually do not look that “sick.” A lot of them look like any 60-something year old you may pass on the street. However, their medical charts tell a different story. This leads in to one (of many) of my talking points that I have on conventional medicine, nutrition, and overall health and wellness.
Medicine is amazing. We can do more now to prolong the lives of people who otherwise would likely have perished given the vast amount of research, technological advances, and life-saving medications that halt these otherwise fatal diseases in their tracks. There is a place for emergency medicine, surgery, and all other conventional medicine. However, as we become more and more advanced it appears we have forgotten what is most important. Prevention. You can’t blame us though. Current medical education teaches us very little about what causes the diseases we are treating. It simply teaches us to diagnose the problem and fix it. Usually with some type of expensive testing, expensive medication, or expensive surgery.
My predominant focus when going to work every day is to take the best care of the patient sitting in front of me at that given moment. Sometimes that is simple, often it is chaotic. And often, the patient will ask, why did this happen to me?
That is not necessarily an easy question to answer. Vascular disease (and most other disease for that matter) can arise from a variety of things. However, when you break it down to the nuts and bolts the answer often times is lifestyle. Spend 50 years of your life smoking, don’t be surprised when you develop lung cancer, COPD, or both. Spend 50 years of your life not exercising, don’t be surprised when you have more physically disabling pain and weakness than your exercising counterparts. Spend 50 years of your life eating processed food (yes, even foods labeled “health foods” I could talk about this for hours, maybe another blog post) don’t be surprised when you have a heart attack or a stroke or your skin starts to wrinkle and sag or you develop arthritis. In my opinion, a vast majority of adult onset chronic disease can be prevented with a simple nutritional and lifestyle shift.
It has essentially become the norm for most of our population to carry a diagnosis of hypertension, hyperlipidemia, or diabetes and take some form of medication for it. Sometimes so frequently I rarely need to ask patients if they have this diagnosis. Sometimes even more alarming is that they shrug this off as if “of course I have that, my parents both did.” They decide it is hereditary and there is nothing they can do to prevent it. But what if there was more to the story?
We tell patients all the time that with lifestyle changes they can reverse conditions and may even come off of medications. But how many really do make these changes successfully? I think the reason for this lies solely in the fact that we do not have enough ancillary support in the health care system to educate patients on the life-saving tactic of nutrition and exercise. (These go together by the way, you can’t out exercise a bad diet and you most certainly can’t gain superior health eating salads and sitting on the couch, again another tale for another time.) We may lack this support because it is not necessarily a money maker. Sitting and talking with patients about what foods they can buy and how to prepare these foods and what exercise regimen may work best for them doesn’t necessarily constitute a largely billable visit. We can bill if we talk to patients about smoking cessation for 3 minutes of the visit, we can bill more if we put them on a high risk medication, and we can bill even more if we sign them up for a high risk surgical procedure. Furthermore, most patients are only seen once every 3 months, sometimes only once every year. How can we possibly instill the knowledge necessary to make these types of sometimes drastic and frankly occasionally socially isolating changes with one 30-minute visit in a 12-month period? The answer is that we cannot. So until something changes with the way we are paid by insurance companies or the amount of staff we are allow to have on board, conventional medicine is never going to live up to the degree of prevention that I would constitute as acceptable.
Fortunately, I think a lot of people, including those who are licensed medical professionals are slowly starting to see these systematic flaws. And even more fortunately I believe the majority of doctors, physician assistants, nurse practitioners, and other health professionals really do want what is best for their patients, regardless of the pay out from it. Less people on life-long medications means less money from drug companies. Less people with uncontrolled atherosclerosis of the arteries means less heart catheterizations, peripheral vascular procedures, and open heart surgeries.
In the health-conscious community, I think it is fairly well understood how nutrition and exercise plays into our overall longevity and prevention of disease. We need to better spread the word that lifestyle changes, not fad diets, not losing those last 5 pounds are what it will take us into our 80’s, 90’s, and 100’s, still living independently and enjoying life.
So for now – keep exercising, keep encouraging, and keep eating real food.