Part 2: Low medication compliance, high blood pressure—all safetys off
Chronic diseases are responsible for 83 percent of all health-care spending. These are diseases that drag on for years and get slowly worse, and require increasingly complex interventions. These are the diseases that keep doctors in business. And these are the diseases we have power to control. If we eliminate chronic diseases and embrace self-care reform, we could put millions of doctors out of work.
Let me tell you 10 ways to put your doctor out of business:
1. Take your medicine. America has a drug problem. Too many people are not taking drugs. Doctors prescribe them, pharmacists dispense them and the little bottles of pills sit on the nightstand drawer as the “use by” date slowly expires. Often, the patient is expiring right alongside them. It’s estimated about 50 percent of the two billion prescriptions filed each year are not taken correctly. One-third of patients take all their medicine, one-third take some and a third never even fill their prescriptions. Non-compliance is said to cause 125,000 deaths annually in the U.S, and may lead to up to 28 percent of hospital and nursing home admissions. As former surgeon general C. Everett Koop says, “Drugs don’t work in patients who don’t take them.”
That goes for contraceptives, too. We live in a golden age of contraceptive medicine. There is no excuse for unplanned pregnancies. Abortion should be unnecessary, but the pill doesn’t take itself. Condoms don’t slide on by themselves. Intrauterine devices, tubal ligations and vasectomies require a doctor’s appointment.
Compliance goes beyond drugs. Do the physical therapy. Do the special exercises. Stay off your feet if you’re supposed to. Get out of bed if you’re supposed to do that. Follow that special diet. If you don’t like your doctors, do what they say. You won’t have to see them again.
2. Lower your blood pressure. They call hypertension the “quiet killer” because it’s virtually asymptomatic. People with uncontrolled high blood pressure are three times more likely to develop heart disease and six times more likely to develop congestive heart failure. Also, high blood pressure is the No. 1 risk factor for stroke, for which you can control. Stroke is America’s number three killer and a leading cause of severe, long-term disability and nursing home placements.
No one knows what causes most cases of hypertension, but we know its fellow travelers. They are obesity, smoking, lack of exercise, too much salt, moderate alcohol consumption, stress, race and a family history of high blood pressure. If you want to put your doctor out of business, bury the salt shaker. Get a stationary bike. Lose weight. Pass the martini bar. Bypass the buffet table at your favorite restaurant.
3. Safety first. Most of us can expect to die of natural causes, but one out of every 22 Americans dies of something else. We call them accidents, but some experts don’t like that word because it makes these things sound unpredictable and unavoidable. Accidents are frighteningly predictable. We know for certain that about 50,000 people will die in motor vehicle accidents every year, without fail. These people won’t need doctors anymore, but accidents are like battlefield statistics. For every death, you can assume 10 or more have injuries that will keep doctors busy. Common sense seems to be the answer to most safety issues. Yet statistics show common sense isn’t as common as it’s expected to be. Accidents kill more children than all childhood diseases combined and fill the rehabilitation hospitals with sad cases.
Here’s how to give your pediatrician a boring life: Make your children buckle up, make them wear bike helmets, supervise them in or near water, check your smoke doctors monthly, set your water heater no higher than 120 degrees, keep guns out of the house or locked, and store cleaning fluid and medications out of reach.
National Safety Council statistics are fascinating. More people died from falling against furniture, most often from tripping over a rug, shoes or pet, than died in plane crashes in 2014. More than 3,500 people drowned that year. Nobody died of radiation exposure. Almost 900 people died from choking. How many of those 900 people could have been saved if someone nearby knew the Heimlich maneuver? Do you know it?
Check back tomorrow for Part 3 of “10 Ways to Put Your Doctor Out of Business.”