Habit 1: Be Proactive

• Take responsibility for your health and well-being.
• Develop good health habits and a lifestyle that fosters vitality and fulfillment.
• Continually educate yourself about health issues and research advances through reading, internet, discussions, etc.
• And find a good doctor!

What does it mean to find a good doctor?

Find a physician that you feel good rapport with and that you have confidence in.  You need to feel like you can comfortably discuss any health related issues with your doctor. You need to trust that your confidentiality will be respected. You should feel a mutual respectfulness that your concerns and needs and time are just as important as your physician’s. You get the feeling that your doctor genuinely cares about your well being. You are confident that your doctor keeps current and you should appreciate that your physician has confidence in their knowledge and skills, but is not arrogant.

A good doctor admits there are a lot of things we don’t know and every patient is unique and no treatment works for everyone. A good doctor is open to a variety of approaches and welcomes your questions or information that you bring in – not just about yourself but general information like an article you read about a new study. A good doctor doesn’t get defensive. You never feel that any of your concerns are discounted.

So what if you don’t have this kind of relationship with your doctor? It may be that by being open and honest with them you can gradually build this ideal partnership. So for example, you might say, “Doctor, I sometimes feel rushed – that I don’t have enough time to discuss all of my concerns with you.”   Your physician may say, “I’m sorry, take whatever time you need. My patients understand that I frequently run late because I’m willing to give my patients extra time when they need it.” Or they may say, “I’m sorry but we only have 15-20 minutes scheduled and I really need to stay on time today – but let’s reschedule as soon as possible so that we can address all your questions,” or there may be other considerate responses.

But if the doctor got annoyed or defensive such as “I’m behind, there are other patients to see and besides your insurance doesn’t pay well and you already got your money’s worth.” Or, “you have me confused with somebody who cares.” I hope it goes without saying – unless your doctor is just having a bad day you need to find another doctor.

Your relationship with your primary physician is so important that you have to make the time and take the trouble to find the right doctor for you. Ask your friends, ask your pharmacist, ask other health care professionals, but keep looking until you are satisfied. Your primary physician may be a family doctor, internist, OB-gyn, psychiatrist, or other specialist. If you need more than one doctor you can frequently get a referral from your primary physician and increase your chances. Although preferable, it is not essential that you feel as comfortable with every physician you see – as long as you can check things out with your primary physician.

In order to have complete confidence in your physician, you have to believe that they are thorough. My patients usually see my clinical assistant before they see me and they always fill out forms and symptom checklists. I also require that they check in with us at least every six months (3 months if they are on any controlled substances like stimulants or benzodiazepines). Sometimes we do “med checks” by phone. Every patient has to be seen in the office for a more comprehensive review of their status and treatment at least once a year, even if they are doing well – which fortunately most of my patients are. For new patients and patients not doing well, follow-ups are more frequent and are determined according to each individual situation.

There are a lot of good doctors that don’t use clinical assistants or don’t use many (or any) forms, and that’s fine. But, it will require more time with them to cover everything that needs to be covered.

Change starts with awareness. You can’t fix a problem you don’t know you have. A comprehensive evaluation is essential.

Certain problems like lung cancer and colon cancer have to be diagnosed before they cause symptoms or “you are toast!” So, you have a lot of headaches but Advil takes care of them, “it must be stress.” But what if it’s because you have high blood pressure. The Advil is not protecting your arteries (kidneys, heart, brain). The first symptom of heart disease in a significant percent of cases is sudden death. “Oops!” You are tired a lot, your concentration is not very good – maybe it’s ADHD. But what if it is sleep apnea? Eventually sleep apnea raises blood pressure and may cause a significantly shorter life span if not treated.

You have to have a complete evaluation before treating symptoms. Borrow some forceps if necessary, but get your head out of your sigmoid colon.

Being proactive means thinking about and preferably writing down your medical history and family history (at least to include all 1st degree relatives, parents, siblings, and children). Include all medical and psychiatric disorders. Also include any history of recreational drug use, especially any bad reactions you had.