Patient A walks into your clinic shortly after getting his cholesterol and complete blood count labs drawn. They labs are flawless – perfect across the board. Even better, the nurse weighs him prior to the visit and he is smack dab in the normal range of body mass index (BMI). Patient A is thrilled with the good news.
Only, patient A is limping into the clinic. His body is studded with fat, especially in his abdominal compartment, surrounding his internal organs. He has little when it comes to muscle mass. Perhaps worst of all, his liver has been steadily filling up with fat like the rest of his body. He has the typical body composition often seen in “healthy” males these days. He is “skinny fat”, and his “dad bod” may leave him in the normal range for many common medical tests that judge someone’s health by a number, but he is a ticking time bomb. He does not exercise or cook, his breakfast consists of oatmeal muffins, and the last time he lifted a weight was in high school.
Patient B, on the other hand, has raised multiple red flags during his recent medical visit. He came to see you directly from his morning walk, and after the visit, he will be heading to the gym for “legs day.” He even recently started doing power cleans, attracting astonished looks from others at the gym since he is the only one there engaging in compound movements and power lifts. Oh, and he is 60 years old.
However, patient B has a cholesterol of 220, flagging him as high risk in your digital record system that your practice was forced to purchase for a quarter of a million dollars. Furthermore, patient B is a muscular guy from all these power lifts, and his high BMI places him squarely in the overweight category. He now has two strikes against him and his insurance company is concerned, listing him in their system as a high-risk client.
You caution him about guidelines advising that his cholesterol be kept below 200. You also recommend he start a low fat, low calorie diet coupled with more exercise like jogging to lose weight. You tell him that if he doesn’t make these changes, he may be at a high risk of a heart attack. His insurance follows up your appointment with an email also letting him know that he may be at risk.
Patient A leaves his appointment with a subtle and general recommendation to eat healthy and exercise. He is given a script for repeat labs and told to come back in six months. Patient B leaves with a couple prescriptions for medications, a naughty report from his insurance, and a recommendation to overhaul his dangerous and unhealthy lifestyle.
As you ponder this all too common scenario, consider the following questions:
- Do you want to be patient A or patient B?
- If you were the doc, how would you help patient A?
Do you tell him continue his course, keep eating more and more, and don’t worry about exercise or a healthy diet? Do you advise he stay comfortable and live his convenient and luxurious life fueled by consumption? When his blood glucose eventually starts to rise to concerning levels and his pancreas stops making enough insulin, do you offer him diabetic and other medications to keep his laboratory values within the normal range while his body falls apart on the inside?
You might if you directly benefit from his unhealthy lifestyle. Furthermore, you probably will want him to keep eating and consuming if you produce the medications that are in his future and will gradually increase in number the less he changes his actions. You may even be tempted to continue to prescribe more medications since his insurance company does not compensate you for preventative care and helping to keep your patients healthy, but rather you receive compensation for managing sickness and medicines.
[stextbox id=’custom’ color=’fcfcfc’ ccolor=’000000′ bgcolor=’000000′ cbgcolor=’000000′ bgcolorto=’000000′ cbgcolorto=’000000′ image=’http://colinchamp.com/wp-content/uploads/2016/03/CC-Icon.jpg’]
If the economy is behaving like a diabetic patient addicted to consumption in all forms, will telling him to take these pills and eat more help?
[/stextbox]
As any good doctor knows, you don’t treat an illness with more of the cause.
Judging by the title of this article, you may have guessed that our economy and society are looking a lot like patient A these days. The good news is that we have an opportunity to turn it into patient B. It will take hard work, discomfort, resiliency, and turning away from general excess, consumerism, and convenience. It will take some hunger for life and our health, finding purpose, and trying to avoid healthcare instead of consuming it. Its numbers may not look as pristine with the change, but you can rest assured its health will be greatly improved.
The choice is ours.
© 2020 CDR Health and Nutrition, LLC. All Rights Reserved.