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Do you need a lifestyle doctor?
We often discuss the importance of collaborative engagement with your doctors so your medical decisions account for how your own goals and values for with the benefits, risks, alternatives and unknowns of those decisions. Most of the time those decisions involve medications or medical technology. However, one of the most powerful and important components of our healthcare is our lifestyle; the behaviors we engage in for our nutrition, our exercise and our cognitive styles.
All doctors agree on the importance of lifestyle. But not all doctors are trained or have the time to engage patients to help them improve theirs. Many medical schools have begun to address lifestyle education in their training programs. Additionally, some doctors have organized into specialty groups such as the American College of Lifestyle Medicine, which applies evidence-based principles to the practice of lifestyle management.
Most insurers do not reimburse the practice of lifestyle medicine. They expect it to be part of the routine care patients receive in the course of their physician visits. While this may change as insurers embrace a wider approach to use preventive care for managing healthcare costs, for now, visits to lifestyle doctors are investments individuals must make out of their own pocket.
So is such an investment right for you?
If your own physician has the time and interest to help you engage in lifestyle management, then you don’t. However, if your doctors leave you feeling uncertain about how to best engage in lifestyle change, a consultation and followup with a doctor trained in lifestyle medicine may be very worthwhile, especially if they can also collaborate with your own physician.
Despite the obvious benefits of lifestyle change for your health, how you do it does have the same set of benefits, risks, alternatives and unknowns of any medical decision. We can help you evaluate the qualifications of a lifestyle physician you might want to engage with, and we can help you understand the benefits, risks, alternatives, and unknowns to consider so you can ask the right questions to get the most out of your engagement with your own doctor, or with a lifestyle physician you may choose.
Email us at ajc@www.operamhealthcare.com or call us at 203-692-4422 for a free consultation.
An important health risk factor often neglected by doctors.
At Operam Healthcare we educate, coach and advocate for you to help you collaborate with your doctors in making good medical decisions. But healthy living is not just about making good medical decisions when a condition requires that they must be made. It involves conducting our lives in ways that promote health.
One health risk that many physicians may overlook does not at first blush appear to belong in a doctor’s office. That’s because it is not one that has a simple prescription for treating it. However, a recent report from NPR discusses the powerful health effect of finding meaning in living.
While there is no simple prescription that will bring meaning into our lives, a good doctor can help us to ask the questions that will allow us to explore our lives for where it might reside.
At Operam Healthcare we can guide you to those same questions, and educate or coach you on where to find answers.
Statistics are about uncertainty, not certainty. Your doctor should respect that more.
“…Those teaching or communicating science — and those learning and listening — would need to understand and embrace uncertainty right along with the scientific community. “I’m not sure how we do that,” says Haaf. “What people want from science is answers, and sometimes the way we report data should show [that] we don’t have a clear answer; it’s messier than you think…”
This article from science news provides an understandable explanation of the uncertainty behind many medical decisions.
The science doctors use is inherently uncertain. The culture of modern medicine and society longs for certainty. The art of medicine should be about navigating together the uncertainty of the science to make good decisions on how best to apply treatments that have inherent risks, both known and unknown.
Such decisions must account for the values and goals of the individual patient. You should expect a full education about the benefits, risks alternatives and unknowns of any decision, and as the article shows, it should account for the inherent uncertainties in the science.
We can help educate, advocate and coach you to better collaborate with your doctors in that process. Check our website, and call or email for s free introductory consultation.
Critically analyzing the quality of health science news: the Eggs example
A recent new “study” of the risk in eating eggs is circulating widely in the news and social media.
It provides an excellent example to use for learning how to critically analyze the quality of “scientific” studies reported in the media. This one provides only an observation so weak that it tells us no more about the safety of eating eggs than the observation of a sprinter does about the seeming flat shape of the earth.
Good science measures phenomena under conditions that eliminate as many variables as possible so that the results reflect only the effect of the one being observed. If a test (study) does not do that, it’s bad science. And a famous physicist I know once said to me, “bad science isn’t even science”.
While I could argue at length about the weakness of the statistical results in this case, one need only look at the methods of the study to know that the study was not even science.
First, the authors used inaccurate measurements of egg consumption; a survey that asks people what they ate. Surveys for diet recall are inaccurate because of memory fallibility, as well as emotional overlays that skew answers given. Plus, it only measured egg consumption in one set of surveys at the beginning of the study, and never checked again over the ensuing 17.5 years to measure any changes in the answers. Do you think eating habits never change?
Second, although the authors tried to use statistical methods to account for variables that might have been affected the subjects, like weight, blood pressure, or diabetes, they did not eliminate or even account for many important variables that could have been linked to egg consumption, such as other unhealthy behaviors like high salt consumption or lack of exercise.
Think of it this way; a good way to eliminate variables is to take the thousands of people and divide them randomly into 2 groups. That would make each group likely to have the same distribution of important unmeasured variables, thus eliminating those variables from having any different effect in one group or the other. This study did not do that.
(And even in studies that do try to randomize out variables, the more possible variables, the larger the number of subjects that are needed to assure they are distributed evenly in both groups.)
The problems limiting this study are similar to the ones that lead us to discount a sprinter’s observations about the shape of the earth. First, the sprinter is only measuring the ground with her feet, not a carefully calibrated 3 dimensional ruler. Second, if the sprinter kept going in a straight line long enough she would return to the start from the opposite side, leading to the correct conclusion that the world could not be flat, as it appeared to be over the first few hundred yards. Her observations were too limited to be useful as science.
This study did not randomly divide the participants, it divided them based on egg consumption. Nothing they measured after that can be considered factually valid because the groups were not truly equal in the distribution of other unmeasured variables. But even if they did randomize, they would need hundreds of thousands of subjects to have measured enough to “randomize out” the large number of unmeasured variables. And they would have needed to measure the important variable, egg consumption, more rigorously over time.
Don’t be fooled by catchy headlines based on the conclusions of scientists trying to inflate the importance of their work. If the work was bad science, it wasn’t even science, and they weren’t acting as scientists. The media needs them to look smart so they can sell their news. You don’t need to listen.
If you want more guidance on how to critically analyze scientific reports in the news, we can help coach you on effective practices.
Call or email us for a free consultation.
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