The REAL Preventive Medicine

By Michael Applebaum, MD, JD, FCLM

A lot of folks talk about preventive medicine and the failure of the heath care system to prevent heart disease, stroke, cancer and diabetes.

Talk, that is, between bites of food.

Between bites of food, that is, unless you speak with food in your mouth.  Hey, how about some manners?

I interrupt your program for this important announcement, “You just don’t get it.”

One—there is no “health care” system.  It is, and will continue to be, a sick care system.  Face it, value is the leading edge of reality.  Health care has NO value.  Need proof?  Need a reality check?  Call your health plan and ask them what your coverage is for a physician to examine you, confirm that you are well and advise you on how to stay that way.  I’ll bet the answer is zip, nada.  No value.

Here’s a fun test.  If you want to see a doctor cock his/her head like a dog who doesn’t understand a word when you’re talking to it, go to your physician, get diagnosed as healthy and ask him/her what he/she will do to keep you that way.  The physician’s ears will go straight up, the eyes will widen and the head will tilt to one side.  Physicians look so cute when they do that.

Physicians prescribe drugs.  Physicians perform surgery.  Physicians prescribe corrective lenses.  Physicians diagnose.  Physicians try to identify and fix already existing problems.  That is what they are trained to do.  That is what they do.  That is what the System supports them in doing.  Already existing problems, not preventing problems.

Still don’t get it?  Need an analogy?  Policepersons write traffic tickets.  They do not practice preventive law enforcement and keep you from going through the red light.  That is your responsibility.

Two—“preventive medicine” is arguably an oxymoron.  Here are the definitions of “medicine”:

med·i·cine [méddəssin] (plural med·i·cines) noun

1.            drug for treating illness: a drug or remedy used for treating illness • cough medicine

2.            treatment of illness: the diagnosis and treatment of illnesses, wounds, and injuries

3.            treatment using drugs: the treatment of illness or injury using drugs rather than surgery

4.            medical profession: the profession of treating illness as a doctor

[12th century. Directly or via Old French from Latin medicina “practice of medicine,” formed from medicus “doctor,” from mederi “to heal.”]

Encarta® World English Dictionary © & (P) 1999 Microsoft Corporation. All rights reserved. Developed for Microsoft by Bloomsbury Publishing Plc.

Does a single one among you see “prevention” or “prevent” anywhere?  Seems as if medicine needs illness or injury as a prerequisite.  No illness, no medicine.  No injury, no medicine.  No problem, no medicine.

Preventive :: medicine as giant :: shrimp.  Oxymoron.

Three—if you still want to believe in the Preventive Medicine Fairy, I’ll give you a hint where to find it.  “Who is Santa Claus?”  To most of us, the truth is known.  Each of us is Santa.  Santa, like charity, like preventive medicine, begins at home.  Ask not what preventive medicine can do for you, ask what you can do as preventive medicine.

Now that you know, or should know, that only you can prevent the need for medicine, the question becomes “How?”

The answer is easy.  Very easy because you have limited access to the tools of standard sick care (which tries to fix already existing problems, not prevent problems).  You cannot write a prescription (unless you are some sort of doctor), you cannot surgerize yourself (unless you are some sort of idiot).  So you have no choice but to take those actions available to you for preventing sick care.

There are basically three things you can do to take care of your body:

1.            Proper nutrition

2.            Proper exercise, which is called training

3.            Proper rest

Beyond these what is there for you to do?  Remember we talked about zip, nada before?  Let’s talk about it again.  Zip, nada.

Concerning Number Three, rest, most people can figure that one out.  It is the other two, collectively called “Fitness,” that seem problematic.

Too bad.

Fitness is the REAL preventive medicine.