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I am a cardiologist. Mostly, I see people over 65 years-old who are interested in preventing dementia and heart failure. Both of these things are largely, if not entirely, related to the health of our heart and circulation. If you want to know how to prevent vascular dementia, read my book You Can Prevent a Stroke.
But that is not the resolution you should make.
Whenever I meet a new patient, I ask the following questions first:
- Who asked you to come see me?
- Who is your regular doctor?
- Do you have any immediate worries or concerns?
If you were asked these questions, could you answer them all? You are allowed to refer yourself to a doctor (especially if you are over 65 and on Medicare — you are generally not restricted in self-referral). You are allowed to be concerned about any aspect of your health. Heaven knows that there are major health concerns all around us. But could you answer that second question? Who is your doctor?
Can you name your doctor? Do you just see a clinic? Do you just plan to see a clinic or an acute care facility or an ER only when something goes wrong? Do you rely on your friends or even better, the internet for your medical care?
If you can't name your doctor, then you are at a great disadvantage when it comes to every aspect of your health care. You are more likely to get sick. You are more likely to have a bad outcome if you do become sick. You are more likely to get bad medical advice or downright bad care if you wait until everything falls apart before you seek medical attention.
So, your New Year's resolution should be: Get a doctor.
Have a doctor before you get sick. Know your doctor's name, and create an opportunity for your doctor to learn your name, and get to know you. Know how to reach your doctor in case you have questions.
The fundamental advantage to having a doctor is simply this: It is easier to keep something working well than to fix something that is broken.
And, when we get older, things will wear out. If we do nothing to actively maintain our health, our health will decline as we age. That's simply how age works, but there is a lot you can do (with your doctor's help) to prevent a lot of the disability that comes with age.
"Health" is not just about physical appearance. It's not simply being thin. Fitness is good but does not make you immune to vascular aging (or to COVID!). Diet likely matters a lot less than you might think. How are you supposed to know what health news matters to you? How are you supposed to know what is an internet conspiracy and what is good science? How are you supposed to know what medical advancements are relevant to you? You're not. Your doctor is supposed to know these things and answer your questions.
We have developed a climate where doctors are not always viewed with the same professional respect that they once were, but it does take quite a bit to become a doctor. First, you work in high school to get into a competitive college. Then you work hard for four years to have a shot at medical school; that's another four years before you can begin your medical training. There's a year of internship and usually three to five years of residency, and then specialists often have three to five more years of fellowship. When I was finishing my training (a while ago), I had a son starting kindergarten. The school had a survey asking for your parent's level of education. My son had the idea that I was still a student and asked, "Dad, what grade are you in?'' To which I responded, "27th."
The point is, your doctor had to learn an awful lot of stuff before they were allowed out in the world to give you advice.
You don't have to listen to your doctor's advice, but by and large, it's still good advice.
Now, there are a great many reasons that it can be difficult to get a doctor if you don't have one. Some reasons are better than others, but I would encourage you to not let these reasons become excuses.
Can you name your dentist? Can you name your hairstylist or barber? Can you name your favorite barista? Can you name your auto mechanic?
How much effort do we all spend on things that are important to us, but don't include our own doctor?
Another story: When I was in med school (back in the dark ages), just after the class on how to use leaches, we began the debate on the question, "Is health care a right or a privilege?"
Well, the answer in the 21st century became clear. Health care is a commodity. That may be unfortunate for those of us who consider it a "calling," but it is the reality of today. As a commodity, it follows all of the rules of any other commodity. It is regulated by the government. There is a supply-and-demand balance. It can come in many styles and variations. Different people may want different things, and not every product has the same quality.
But have hope. There are doctors, and no one becomes a doctor without a lot of training and an unshakable belief in the importance of helping others.
So, this New Year, do the one thing that can make the most difference in your life: Get a doctor.
