For years, I hid behind the knowledge that three of my grandparents lived into their 90s, eating pretty much anything they wanted. No way was I going to be among the two-thirds of Americans with a chronic disease.
I felt confident about my health because I'd been an athlete in my youth: I ran my first marathon at 13 and had been a competitive swimmer. I figured I was an exception.
However, deep down, I knew something was wrong. There were signs. I could jog but had to walk the first mile. I had pains in my jaw and neck. My blood pressure was high and my weight gain was unprecedented. Classic angina. After a 10-minute meeting with a doctor, he felt medication was the best solution. No diagnosis of blocked arteries or angina, he just felt that I should start a heavy regime of drugs. No explanation why.
So I took them and I felt terrible. Soon I began to blame my angina symptoms on the medication, so I stopped taking the pills. I started lying to my wife about my blood pressure readings at night because I didn’t want her to worry.
Finally, I could not continue hiding from the truth. I went to a cardiologist and it was determined that I had four major blockages in my heart.
I faced my fears on March 23, 2011, when I had open heart surgery at the age of 40. I was no longer the exception, but now I was a statistic. I was now a part of a new club, with millions of members, the "Zipper" Club !
Why didn’t I listen to my doctor?
Since my experience, I've learned just how stressed the doctor/patient relationship is. This is unfortunate because doctors are, and will continue to be, the frontline for most patients facing chronic diseases. Ultimately, 67% of patients will end up with diabetes, heart disease, obesity, or a combination of all of them.
Doctors just don't have enough time.
The doctor is in a position of influence and patients generally anticipate his or her advice as gospel. However, as the health care system gets bogged down, doctors have very limited time to diagnose and treat patients.
Today's visits are incredibly short. One Canadian and U.S. study found that doctors interrupt their patients, on average, within 23 seconds from the time the patient begins explaining symptoms. Often, the doctor never even asked the patient what was bothering him!
Doctor's don't always communicate with their patients effectively.
In another study of physicians during more than 300 patient visits, the doctors spent, on average, about 1 minute conveying crucial information about the patient’s condition and treatment. Most of the information they provided was far too technical for the average person to grasp. Disconcertingly, those same doctors thought they had spent more than eight minutes!
In another study, three out of four doctors failed to give clear instructions on how to take medication. When asked to state the instructions, half of the patients had no idea what they were supposed to do…
So as more and more Americans acquire chronic diseases, fewer doctors are expected to treat sicker patients. And they are expected to do it within 10 minutes. It's not a formula for success.
The pressure eventually creates tension in the doctor/patient relationship. The patient realizes the doctor is busy and encapsulates his or her issues into a few details. The doctor, who is on the clock, rushes to a diagnosis, and seeks the fastest route to a solution. Generally, it's medication. Perhaps the best course of action involves medication, but it should also outline an overall objective towards prevention of the root cause. The plan should incorporate short-term goals and endpoints instead of simply, "you'll be on medication for the rest of your life."
Patients need to be accountable, too.
One cannot expect a doctor to unwind years of neglect in a single visit. The onus is on the patient. A cardiologist remarked to me, after discussing my plan to attack heart disease; “I don’t have a lot of patients like you, who have made a 180 degree change. Most of my patients ask me why they have to quit smoking and eating steaks after I put stents in them.”
Doctors are skeptical and rightly so.
Imagine a typical day of patients, filling the office with obesity, diabetes, and heart disease. These are all largely preventable diseases. The doctor suggests they eat better and exercise. Deep down they know the only possibility to relieve the immediate health risk is to seek the most expeditious solution; medication. After all, if the doctor did not prescribe medication to the high risk patient. And sent the patient home to go for a jog, they would be sued when that patient dropped dead of a heart attack.
It’s about Trust. Doctors need to do a better job of slowing down the situations and customizing therapy. And once they have charted a course of action, they need to follow-up in a personal fashion.
Patients, too, need to take control of their own health. They need to become their own CEOs (to steal a line from Kris Carr).
When they meet a doctor, they have to provide a thorough and honest assessment of their situation. And be honest in their ability to make changes in lifestyle. There is no room for skepticism in the doctor/patient relationship. It creates a dishonest and ineffective communication.
I didn’t trust my doctor and I ended up on the operating table. The communication has to improve on both sides of the relationship.
Now I trust my doctor because he trusts me.