With advances in biotechnology, the average life expectancy is significantly longer today than in the past. As practicing cardiologists, we observe firsthand that even though there are artificial means to prolong our patients’ lives, they are still prematurely aging at an alarming rate. Many are sedentary, overweight, deconditioned, and apathetic. Consequently, they experience heart attacks, strokes, musculoskeletal injuries, cancers, and premature death. The soaring healthcare costs and epidemics of obesity, heart diseases, and cancer are lifestyle-related.
Approximately 70% of disease and death is related to lifestyle choices, including heart disease, strokes, diabetes, obesity, and musculoskeletal maladies. We could eliminate more than 50% of these illnesses if we had the constitutional fabric to make healthy behavioral choices. Idleness and fast food are killing us. As physicians, we do what we are trained to do very well—we treat disease. Our training exposes us to every complex disease known to humankind and we learn the methods to control or cure these diseases.
However, for a large majority of these patients, their problems are the result of lifestyle choices. Patients would rather take pills or insulin shots to control their diabetes than make the necessary dietary and lifestyle modifications to consume more nutrient-dense foods, increase exercise, and lose weight. Lack of discipline to make the quintessential lifestyle changes is a significant problem because it leads to epidemics of obesity and coronary artery disease. Most of modern medicine is transactional. You experience a heart attack and undergo stenting or bypass surgery with a short period for recovery, and everyone goes their own way. This transactional approach to medicine is failing patients. The winners are corporate medicine, and the losers are patients.
The answer was simple: we need to identify how to seek health. The merit of an idea does not predict its adoption. The greatest barrier to any change lies in the continued acceptance of poorly thought-through decisions. Unhealthy “normative behavior” such as eating at fast food restaurants is sustained by a culture that is running on a hedonic treadmill at a rapid pace toward the unsatisfactory solutions of stents and coronary artery bypass surgery. Change will languish until the community can take direct action to embrace a new paradigm based on knowledge. The first step is recognition with open discourse. We must break the code of silence that sustains the status quo of fast food joints and couch surfing. We must spread the word. Members of every community must share their insights and views openly. We must jump off the hedonic treadmill now. The second step in creating this new healthy norm is to make everyone accountable by publicly encouraging healthy behavior and openly confronting the unhealthy behavior. The strength of the new norm depends on the consistency with which the community and community leaders are willing to speak up, act together, and lead through example. The entire village must embrace a whole new culture of healthy behavior. The challenge to change must be met by all of us together.
Every patient is an athlete
Why identify every patient an athlete? Athletes are perceived to be the healthiest members of our society. Prototypically, athletes have unique mental and physical characteristics that allow them to achieve peak performance. The truth is every single patient has an inner child waiting to become an athlete. Healthcare professionals must teach and mentor their patients in healthy eating habits and training routines necessary to become a heart healthy “athlete.” First, we must explore the unique characteristics of athletes. Athletes have a burning desire to be the best. They possess a deep commitment to always improving, taking their performance to the next level. The only standard for an athlete is excellence. They perceive no obstacles, only challenges to overcome. Failure is not an option. Taking on risks and pushing beyond their comfort zone is part of the championship mind. Athletes eat healthy foods and train to high levels to obtain peak mental, physical, and emotional function and peak performance in their sport.
Clearly, our patients need these characteristics as they pursue healthy eating and regular exercise to seek optimal health. For your patients desiring optimum health, physical energy is the fuel that drives alertness, vitality, and an ability to manage emotions, sustain concentration, think creatively, and maintain a mindset through superior brain executive function to obtain optimum health. The physical energy galvanizes the mental energy necessary to maintain the willpower needed to exercise and eat healthy on a sustained basis. The physical and mental energy are synergistic, taking athletes to optimum performance.
Timothy E. Paterick and Elizabeth Ngo are cardiologists and authors of Physician—Time to Invest in Yourself: Work-Life Balance, the Needs of the Patient, and Medical-Legal Risk Management.
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