Preventive Medicine and the Pursuit of Personal Health…By Dr. Andrea Arvan
By Andrea Arvan, M.D., Kansas City Internal Medicine
The buck stops here. One of my favorite quotes. This clearly states a sense of accountability and proactivity for one’s actions. It shows integrity, bravery and a sense of taking charge.
Taking Responsibility to Improve One’s Health
Preventive Medicine has the same sense of proactivity. Taking responsibility and seeking out ways to improve one’s own health. Most doctors want to prevent disease, but preventing disease is based on the will and desire of the patient who comes to the doctor as well.
For example, it would be great to stop the blood pressure medications that patients take. If a patient eats a whole food diet, walks daily, avoids sodium, reduces the stress in his or her life and possibly takes a supplement or vitamin, it might be possible.
But, if there is a family history of hypertension, it may be that lifestyle changes alone are not enough and conventional medicine may be necessary for the health of the patient.
What is Preventive Medicine?
Preventive Medicine is the field of medicine where the patient and the physician (and public health departments) are partners in the endeavor to eliminate illness and, more importantly, to prevent illness. This is key. It is no longer just about a patient being told what to do.
It is also about a patient seeking advice to produce an improved outcome in his or her life. Although separate fields, there is a synergy between Integrative Medicine and Preventive Medicine, and Integrative Medicine at the level of prevention can be very effective in the pursuit of personal health.
Three Levels of Preventive Medicine
Preventive Medicine is usually divided into three levels.
Primary Level: Refers to health promotion and keeping disease from being established. This is when your doctor tells you to eat healthy and exercise. It also refers to things like immunizations and wearing helmets.
Secondary Prevention: Refers to the detection and management of early disease. Examples include mammography and colonoscopies.
Tertiary Prevention: Refers to the treatment of symptomatic diseases to prevent progression of the disease or symptoms, such as physical therapy after a stroke or pain management treatments. The Integrative/Preventive Medicine physician should be able to give advice on prevention or to direct the patient to others who may also help them in their pursuit of health.
Treating the Whole Body
If, for example, breast cancer runs strongly in a patient’s family, the physician will want them to get yearly mammograms, breast exams, and MRIs, if necessary. The physician may advise them to eat a low fat diet, stop smoking, severely limit alcohol, etc. This is nice conventional advice.
But the Integrative Medicine physician might also refer them to a cancer prevention nutritionist or to meditate. He or she might want them to take supplements to boost certain aspects of the immune system. The purpose is to treat the whole body because all cures come from within.
Patients Often Need Help Changing Their Lifestyles
As a physician, I can only treat illness. I cannot cure it. I cannot even cure high blood pressure. Cures are more complicated. It may require conventional treatment, but it definitely requires treatment that involves the patient as a whole person and with the commitment of that patient.
And patients often need help changing their lifestyles. It is the physician’s responsibility to help that patient see their part and to guide them through their part of the equation for optimal health.
Because the cure may be complicated by a chronic illness, such as emphysema, the goal may not be to cure but to greatly improve. Because the problem facing a patient may involve issues outside of their control, for example inheriting the BRAC gene increasing the risk for breast or ovarian cancer, the goal may be to reduce the risk, increase the effectiveness of the patient’s immune system and maybe making hard choices like getting a mastectomy or hysterectomy.
The Greatest Gift of All: The Gift of Health!
The ultimate goal would be to provide the largest number of appropriate options available and the Preventive/Integrative Medicine practitioner could be their guide.
All of us can give our family the greatest gift of all, the gift of health. Those who model a healthy lifestyle promote a healthy lifestyle for the people they love around them.