The future is … what you make of your own present.jpg

The future is … what you make of your own present

By: Dr. MARIA ALICE

Consultant in General and Family Medicine

Director – Luzdoc, International Medical Service

[email protected]

I BELIEVE that many of you have heard about the Chinese doctors of the olden days and how they were regularly paid to keep their clients in good health.

No payment was made when they were ill. It is evident that we are quickly going back to that wise approach of doing anything to keep people healthy, not to wait for the equilibrium to be broken and then having to mend it. Like a wound, it will leave a scar. It’s much better if you are careful when using your knife and avoid cutting yourself. Be aware, foresee the danger and control it, at least as much as you can. This is prevention.

It takes good co-operation between the client (not the patient) and the doctor to make it work. And it works better if they both know what they are talking about, each one at their own appropriate level. They also have to trust each other. Note that I say client, not patient, but to be patient and understanding is indeed a very valuable quality for a client, when we are discussing prevention.

It is very important for us at our clinic (a relevant aspect of our philosophy) to say, and we mean it, that we want to have more healthy clients and less patients.

We really should see our doctor when we are healthy, which means when we still have no disease symptoms.

“Behaviour health”

Until recently, promotion of “behaviour health” was not considered as a matter of utmost importance in healthcare providing. The practice of Medicine was focused on treating the ill rather than maintaining health among the well. Promotion of health behaviours, in particular, was viewed as something apart from normal medicine because of depending heavily on patient self-management and direction rather than on a physician’s intervention.

Studies were performed proving that the vast majority of premature death and disability in the world results from preventable causes.

Today, healthcare professionals are beginning to realise the benefits from preventive care and patient education. Improving patient self-care is much less costly than repeated treatment to address the consequences of failing to motivate and educate patients. The “healthy ones” have to realise that working with their healthcare provider to stay well is as important as getting treatment when they are sick … and that by working together you make sure that you get the tests, immunisations and the guidance you need to stay healthy.

Costs for healthcare continue to rise in the world and, unfortunately, much of these costs can be attributed to the diagnosis and treatment of chronic diseases and conditions such as diabetes, obesity, cardiovascular disease and asthma. A much smaller amount is spent on preventing these conditions although there is evidence that much of the morbidity and mortality associated with these chronic diseases may be preventable.

Individual behaviour and lifestyle choices influence the development and course of these chronic conditions. Unhealthy behaviours, such as a poor diet, lack of physical activity and tobacco use are risk factors for many chronic conditions and diseases.

A high calorie diet and sedentary lifestyle commonly result in excessive weight gain. Being overweight and obesity are risk factors for a large number of chronic diseases, most significantly, type 2 diabetes, congestive heart failure, stroke and hypertension. Encouraging individuals to adopt healthy habits and practices may reduce the burden of chronic disease in the communities.

Recently, public and private efforts and programmes are increasingly designed to promote healthy behaviours. Employers are becoming more aware that being overweight and obesity, lack of physical activity, and tobacco use are adversely affecting the health and productivity of their employees and, ultimately, the businesses’ bottom line.

As a result, innovative employers are providing their employees with a variety of work-site-based health promotion and disease prevention programmes. These programmes have been shown to improve employee health, increase productivity and yield a significant return on investment for the employer. By changing the way they live, individuals could change their personal health status, and the health landscape of the world, dramatically.

Shaping health factors

Each individual’s health is shaped by many factors including medical care, social circumstances and behavioural choices. Increasingly, there is clear evidence that the major chronic conditions that account for so much of the morbidity and mortality, and the enormous direct and indirect costs associated with them, are largely preventable and that to a considerable degree they stem from, and are exacerbated by, individual behaviours. In particular, being overweight and obesity, lack of physical activity, and smoking greatly increase the risk of developing the most serious chronic disorders. Most of the money spent on health care, however, is for the direct care of medical conditions, while only a very small portion is targeted on preventing those conditions.

It is ironic that in this day of high-tech, complex and costly medical procedures and treatments, simple, inexpensive, easily-understood actions, such as increasing physical activity, controlling weight, and quitting smoking, could have such a huge impact on the quality of life and the cost of healthcare. Changing people’s habits has proved to be a challenging task as people often find it difficult to do so, because of demands and other constraints associated with their work, family, and community. But it is not impossible, if only the decision to do it is taken seriously.

So many of our health problems can be avoided through diet, exercise and making sure we take care of ourselves. By promoting healthy lifestyles, we can improve the quality of life for everyone and reduce health care costs dramatically.

A new American study shows that if more followed just five simple preventive health care steps, nearly 100,000 deaths each year could be prevented.

The top five under-utilised healthcare measures with the biggest benefits are:

• Daily aspirin therapy    

• Smoking cessation

• Colorectal cancer screening

• Flu vaccination

• Breast cancer screening

Death is the only lethal certainty that every human being has and, do not forget it, we share that with all living beings … including our pets!

Thus… let me leave you with the idea of a different way to define health: health is the slowest possible rate at which one can die.

Best health wishes,

Dr. Maria Alice

Consultant in General and Family Medicine

Director – Luzdoc International Medical Service

NOTE: Do not forget that the flu vaccine will be available soon.