06/25/2014
Medicine today is a very precarious business. Time management, patient needs, lack of funding, all the above are factors in hindering our capacity for providing the most efficient and effective medical care and education to patients.
When my doctor has 6 rooms filled with patients and allotted 15 minutes between appointments there is very little room to dive into prevention and education instead of just triage and prescription. So this is what is on my mind tonight.. How do we allow our medical professionals to become swim coaches rather than just lifeguards???
First let's talk about education. Teaching a med student the functionality and efficacy of diet and exercise is not the same as teaching that same student about treating for symptoms of diabetes. Since our medical care system has traditionally been about treatment and not prevention, you can see why so much has gone amiss from the core classes you must take as an under grad or even during medical school. The role of Lifeguard is paramount to any other role in a patients experience. The argument can be made that the Kaiser model of 'preventative medicine' is taught to the Docs and systems are set up at work for them to guide patients into. So maybe this is the step in the right direction??
Patients that make their way into the office are usually there not to ask what type of nutrition plan to espouse or what type of fitness regiment they should be on but rather what type of blood pressure med will keep them from having a heart attack! So automatically we are biasing our Docs toward an existence where prevention is not even possible due to pre-existing 'problems' that require solving before any work can begin on lifestyle changes. As I can speak to with working in both the Fire/EMS world and the fitness world, people are lazy and would rather hear an answer to a problem that requires as little effort as possible.
This brings me to the financial dilemma which all Doctors find themselves in. Doctor Jones, (hypothetical), has a mortgage and mouths to feed at home. Dr. Jones also has a patient roll-a-dex that has over 1,000 names on it. He needs to pay the bills, be accessible to his patients, and actually make a difference in patients lives. Then there is Drug Company... let's call them... Pfizerinous. They make a plethora of drugs which have been proven by the FDA to change the disease process of many different ailments. Let's just say that Dr. Jones is an avid CrossFit athlete and believes that it can change many patients lives. Armed with his passion and knowledge of nutrition and fitness which he learned from reading his Coach's blogs daily; Dr. Jones approaches his day ready to make a change. Unfortunately patients are stacking up and time is short with each but decisions must be made and folks need to be processed in and out.
Dr. Jones then remembers that Pfizerinous does offer exactly what each patient needs to help stop the disease process in the short term or alleviate some symptoms of other diseases he finds. Against his better judgement he ends up pulling out the prescription pad and letting the drug do the work... what other choice does he have. He does hand out a pamphlet on diet and exercise and hopes that they read it but he is quickly squirting hand sanitizer on his way out of the room on the way to the next patient. Once again, he is a Lifeguard and doesn't even get the chance to be the swim coach!!
Being The Swim Coach takes time and patience, none of which is in abundance with today's medical professionals. Until we make a breakthrough in the minds of patients before they step into the office we are doomed to keep the cycle repeating. Doctors will still be lifeguards, the population will continue to be uneducated, not proactive, and Pfizerinous will continue to be the stop gap for all medical problems in this country. Sad but true.
I want to hear from you, post your comments below and come find me in class and let's have a discussion about how to change this starting right here in our community!
