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10 Ways to Put Your Doctor Out of Business, Part 3

Part 3: Unsafe sex and health disparities run rampant

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:

4. Practice safer sex. To take a calculated risk, you need data, but too many people have too little data about their sexual partners. The result is the persistence of sexually transmitted disease, including HIV/AIDS. An estimated one million people are currently living with HIV in the United States, with approximately 40,000 new infections occurring each year.

30 percent of new infections occur in women
75 percent of new infections in women are heterosexually transmitted.
Half of all new infection the the U.S. occur in people 25 years of age or younger.
Trich, hepatitis, syphilis, gonorrhea, Chlamydia and human papilloma virus are all sexually transmitted infections (STIs). You don’t get them by sitting on a toilet or relaxing in a Jacuzzi or hot tub. You get them by having sex with an infected partner. Can you believe that there are 19 millions STIs that occur yearly? More than 50 percent of cases occur among people young than 25 years of age.

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Women are more likely to get an STI and 10 times more likely to get HIV than men. Almost 65 percent of cases of HIV occur among heterosexual African-American women. Some often feel powerless to ask their partners to use condoms. I asked a patient of mine recently why she was not using condoms consistently. She said she was afraid to ask her partner. Another said her partner would get angry. A more vocal group of patients have said to me: “no glove, no love.” I like that mantra.

Talking about what kinds of people are getting HIV is not entirely to the point. People don’t spread HIV. Behaviors do. The rate of HIV infection slowed drastically among gay men over the past 25 years, largely thanks to educational programs that changed behavior. Each of us must be an advocate for our own safer sex practice. In doing so, we can decrease visits to the doctor for STI complaints.

5. Address health disparities. All the health conditions mentioned so far are worse for African Americans. For instance, African Americans have the highest rate of hypertension in the world. They are more likely to be non-compliant in regards to medication. African Americans have higher death and injury rates from accidents. African-American men are five times more likely to die of HIV/AIDS than Caucasians. Lower income status is linked to poor physical fitness and higher mortality from all causes. Lack of exercise opportunities is a major factor. Also poor diet and greater exposure to tobacco smoke among are noted among people with a lower income.

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Health disparities are also linked with less food choices. Multicultural communities need more supermarkets and farmers markets that sell fresh produce than they do another fast-food chain. Patients who live in low-income communities often live in “food deserts.” Often they have little access to real food; rather they are exposed to more processed food. (In fact, all of us are eating more manufactured food and manufactured calories.) Living in a food desert, they more often eat high-fat, calorie-dense nutrition-poor foods filled with high-fructose corn syrup, and are exposed to brightly lit neon signs that shout “super-size” and meals filled with chemicals they can’t even pronounce. Fewer food choices, coupled with limited transportation options, limit access to fresh food choices.

Check back tomorrow for Part 4 of “10 Ways to Put Your Doctor Out of Business.”

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