The Four Pillars of Good Health: The 4th Pillar-Personalized Medical Care

In the past few weeks this column has been devoted to the “pillars of health”.  We’ve covered the first three pillars: Nutrition, Exercise, and Care of Mind and Spirit. The fourth pillar, Personalized Medical Care, brings it all together in a practical way to enhance health and minimize disease, improving our overall wellness.
Each of us has a unique combination of food preferences (nutrition), activity capabilities (exercise), and attitudes and beliefs (care of mind and spirit).  We require a health care system which applies proven best practices and understands and builds on our uniqueness.

The nationwide average amount of “face time” with your doctor is only seven minutes per visit.  This results in a one-size-fits-all cookie-cutter approach to your care.  A few physicians are breaking away from this inadequate approach, embracing Personalized Medicine.
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By devoting the time it takes to really listen, ask the right questions, and thoroughly review your history, appropriate tests can be done to find the root cause of your symptoms. Then the best therapies are recommended, going beyond prescription meds to include lifestyle therapies.  Our team approach includes regular consultations with our Health Coach to support you. 

Let’s take the example of a 65-year old patient in our practice.  She came to us frustrated and demoralized because she felt drained of energy, had chronic pain in her back and shoulder, and felt out of breath with even mild exertion. After seeing multiple specialists, she was on prescription meds for chronic pain, hypertension, cholesterol, depression, and sleep.  No cause for her shortness of breath had been found, and she was worried.

My office gathered the records from the specialists she’d seen and the tests she’d had for my review. Careful questioning revealed that a decade ago she was a regular hiker and swimmer. She had given up swimming because of a shoulder injury that never fully recovered after surgery.  During that period she started having lower back pain that further restricted her. As her pain became chronic, her mood worsened and her sleep became disrupted. She had gained some weight but had a high-normal BMI, meaning that according to the guidelines she was at a healthy weight for her height.
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After our initial visit I walked her down the hall for a Lifestyle and Fitness Evaluation with our Health Coach.  Body Composition Testing revealed that in spite of her normal BMI, she had a profound deficit of muscle mass.  Inactivity and normal aging had caused her muscles to shrink and body fat to increase.  Her normal BMI had hidden this.  Also, her years of calorie-restriction dieting without careful attention to nutrition had starved her muscles of protein.  Without healthy muscles to stabilize her joints she had chronic pain. And her shortness of breath came from having so little muscle to move herself around.
Our Health Coach designed a nutrition, exercise, and stress management program for her. Gradually she regained muscle, strength, clarity, sleep, and a return to a sense of well-being.  Two years later she has returned to good health, is off most of the prescription meds and on a regular program of water exercise and walking with friends. When the four pillars are all strong and in balance, life is good! This is the power of Personalized Medicine – the fourth pillar of good health.

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By J. Dan Morris, M.D.