Introduction
Concisely put, a Lifestyle Medical Doctor is and/or incorporates and has the knowledge of all of those professionals noted in the title above: a medical doctor, personal fitness trainer, nutritionist, psychologist...and that’s just the beginning...for Lifestyle Related Medicine entails the cumulative and coordinated knowledge and expertise in many different fields, pretty much any field which has to do with the way the individual biological organism--the human being...lives in and interrelates with the environment in health and disease.
You, your body and mind, are the biological organism. The environment in which you exist and with which you interrelate is the whole of the universe! The air you breath, the food you eat, the water you drink are obvious examples. But to believe that the cosmos...the planets and far off stars...might also be affecting you state of health and disease is not so obvious. And whether you believe in astrology or not (which is based on the idea that the planets are in some way connected to our lives), the fact is it has been quite well established that the moon does have marked effects on our health, lives, state of mind, and just about on everything else with which we come in contact throughout our lives. The moon’s gravity, for one, clearly interrelates with Earth’s gravity...and, thereby, in turn with just about all aspects of our lives. Although we might not yet be able to quantitate all the specifics as to how the moon’s gravitational field affects our lives, does not mean that what is obvious does not take place. We’re always in the grasp of the moon’s gravitational effects, and all life on this planet developed within its, and within the Earth’s, combined gravitational fields. If all this does not appear to be a ‘no-brainer’ to you, how about a specific ‘no-brainer,’ like osteoporosis, or the demineralization of bone that occurs throughout our lives (unless you know what to do to offset it, of course), and which demineralization is obviously is related to the effects of gravity overall upon the body, known and as yet unknown, and thereby in turn to the combined gravitational effects of both the Earth...and the moon.
The ‘Office Based’ Medical Doctor
Vs The Lifestyle Related Medical Doctor
...Who Rules?
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Much in the way of chronic disease comes from lifestyle factors: the way we think, the foods we eat, our activity levels and exercise, etc. In an office based setting, medications and other modalities are used in an attempt to offset chronic illness and other disease, but oftentimes these methods do not work as well as they could since the ‘cause’ of the illness often lies in the lifestyle factors, in the way the patient interrelates mentally and physically with the environment.
Thus, for the doctor to actually get out of the office as a Lifestyle Related Medical Doctor to work directly with the patient/client with regard to changing lifestyle factors--working directly with exercise, food, the mind, stress management, counseling, social behavior, occupations, and the like--the underlying causes of the chronic diseases are often thereby finally properly addressed. I guess you can sort of say that although the Lifestyle Medical Doctor can at times be centrally based, if you will, in a lifestyle facility, much of the time the Lifestyle Medical Doctor is making house calls...lifestyle related medicine house calls! In other words, the lifestyle medical doctor is often found to follow the patient along in their everyday lives through visits, counseling, telephone conversations, emails...you name it.
Disease is often an ongoing and continuous process. So, rather than ‘spot check’ the patient (and the patient’s disease process) occasionally in an office setting once every six months or every year (as in an office based setting), the lifestyle related medical doctor has the ‘choice’ and ‘potential’ to be contacting and interrelating with the patient, and thereby with the patient’s disease process, also on an ongoing and often continuous basis. Notice my use of the words “choice” and “potential to be contacting and interrelating with the patient on an ongoing basis and often continuous basis.”
... In other words, the lifestyle related medical doctor, depending upon the particular circumstances of the patient’s condition, etc, might also have the choice or option to see the patient one time as via a lifestyle related medical consultation, or a limited number of times, as it often is the case for the office based medical doctor. The point is, the lifestyle related medical doctor and his or her patient have the choice (depending upon circumstances) as to how many times or how often or how continuous contact between the two of them will be made.
The office based medical practice doesn’t work this way. After all, when is the last time your medical doctor accompanied you to a gym or while jogging down the street, ‘armed’ with a blood pressure cuff and stethoscope, so as best to be able to observe and check you while you were exercising? And when is the last time your doctor not only tailor formulated a dietary regime specifically geared for you and your particular circumstances or underlying disease process, but actually showed you how to prepare it, let alone called you up throughout the day or week to make sure your were eating properly? I could go on and on...
...The point is, if you want to get at the ‘root cause’ of and effectively destroy ‘disease,’ there’s no better way than for the doctor to be there with you, ‘at the front lines,’ as a compassionate human being and friend and lifestyle related medical doctor!
So, all in all, the office based medical doctor, in order to most effectively knock out disease, must therefore work hand-in-hand along with the lifestyle related medical doctor if we ever are to make any real dent in offsetting chronic disease and even many of the signs and symptoms of aging, let alone decrease the cost of medicine.
...In other words, alone, neither the office based medical doctor nor the lifestyle related medical doctor ‘rules’...while on the other hand, together, they pretty much ‘rule’ all of disease...and even, a good part of ‘aging’ itself!
The Office Based Medical Practice
The World is changing. Medicine is changing. After reading this, you’re probably going to want to change it. But I’ll tell you up front. It’s going to take doctors like me and people like you to make it happen. To make it happen, we’re going to have to make it happen together. And why? Because with the office based medical doctor you say, “Doctor...treat me.” He then takes a test on you or prescribes you a pill or even operates on you while you simply have to do no more than take the pill or recuperate from the surgery. With the Lifestyle Related Medical Doctor however, he advises you, guides you, shows you, and even does things with you. In other words. You do things together.
Okay. Here’s the way it (medical practice) has always worked. You have something bothering you, a pain or ache or something. You make an appointment and go to see your doctor. You see him in his office. He asks you questions about how you feel and a whole bunch of other things. You tell him things. In other words, he takes a medical history. The way it used to work, the medical history, especially the first time you’d gone to see a doctor as a ‘new’ patient...the medical history took quite some time, perhaps even an hour or two. And it was supposed to take time. Otherwise the doctor could hardly have known enough about how to most effectively approach your problem and heal or cure you.
The History Is 90% Of The Diagnosis
When I first began private practice many decades ago I began doing talks for various groups or organizations. The title of my most popular and probably most important talk was “The History Is 90% Of The Diagnosis.” It had been embedded in my thought process in medical school, time and time again. And I had a very good medical school education, one of the best and of utmost quality medical schools. The point is: without an adequate medical history you can hardly make the proper decisions in terms of how to effectively go about not only examining the patient and taking the proper tests, but also in how to effectively and properly, and successfully, go about treating them.
...In other words, once the proper medical history is not taken, all else that follows in the long run, down line, and on the average...becomes garbage.
Nowadays...I don’t have to tell you, the health care system overall has been and is continuing to lead to less and less time being devoted to the medical history, or to an adequate one. There are, of course, doctors who are still taking adequate medical histories. But on the average, over the years, the taking of the medical history has gradually and relentlessly been deteriorating. The really bad part of all this is that doctors don’t become doctors in medical school. Medical school is actually just the introduction to being a doctor, despite having graduated with a medical degree. The ‘real’ learning and the ‘real’ doctors evolve over a period of time while in practice, over many years. And a great part of this evolution and learning stems in very large part from having spoken to and taken the histories of hundreds and thousands of patients.
...In other words, you cannot become a good or great doctor without having taking proper and adequate medical histories over a period of many years. The really ‘seasoned’ doctor becomes ‘seasoned’ after 15 to 20 years, on the average of course. The really great doctor generally ensues thereafter. I’m first now, after 35 years, first beginning to realize that I’ve evolved into a really great doctor, but that evolution for me is just beginning. Ironically, nowadays, because of the nature of the many adversities and inordinate stresses that have developed throughout the practice of medicine to plague the average medical doctor, a vast majority of doctors are even quitting and retiring well before their time would have come for their evolution into great doctors!
Nowadays you hardly see doctors happily practicing over the age of 60. Years ago, they just practiced well into old age...until they just dropped!
The main point here is that since the everyday practice of the average or usual doctor entails seeing too many patients, which in turn limits the time the doctor can devote to the taking of adequate and proper medical histories. So as a result, not only are the patients’ lives being compromised, but progressively so. This is because the ironic fact is that the greater the number of years a doctor practices medicine while taking only five and ten minute medical histories, the more over the years, rather than become ‘seasoned,’ that doctor becomes, to put it quite truthfully and to the point, a dummy. The doctor might have a nice white coat and a stethoscope and be well groomed and have plenty of money and a nice house and a Porsche, but nevertheless he or she will still have become a dummy! And woe thereby becomes your medical care.
You see, no matter how ‘smart’ a doctor is, without having spent years taking adequate medical histories and without sufficiently ‘talking’ of his or her patients, he or she will have no choice but to progressively evolve into a medical dummy. It’s like everything else. What’s that little saying?: “Practice (and experience) makes perfect.” Of course. And if you think about it, that very principle lies behind one of the most important underlying principles introduced on this web site: “Progressive adaptation and progressive de-adaptation” or phrased somewhat differently, “Use it or lose it.” You change the body for the better (or worse) by progressively and repetitively using it properly (or improperly). Your brain, and in turn your mind, changes similarly, by using it in multiple ways. We call that learning. In reality your brain and mind are continuously changing by progressively engaging them in multiple and appropriate activities, repetitively. And it is no different when it comes to progressively and repetitively taking medical histories, and the evolution or lack of evolution into a seasoned or great doctor, or a dummy.
Nowadays I have found it common, from the vantage point of my having been a practicing medical doctor now for many decades, as well as from my having been a patient going to doctors for a devastating and life-threatening disease...I have found it common for doctors to take inadequate, cursory, and short medical histories (and some of which could not possibly have even been categorized as a medical history) and for them to then to, in a sense, ‘order every test in the world’ just to cover themselves and their ignorance and lack of knowledge and insight. Nevertheless, you can still find the ‘seasoned’ or ‘great’ doctor. But he or she is few and far between, and I dare say, not just difficult, but oftentimes almost impossible to recognize. Most of you will judge by the big office and the large waiting room filled to the hilt with patients, and the big house and expensive car they might drive...
...And that would be your downfall!
Even as a ‘medical doctor patient’ I found it quite difficult to find that ‘great’ doctor who would make the difference between my own life or death. Not just a few years ago I’d become emaciated and down to just over 100 pounds by the time I’d found him. But I did find him. Evidently, I have found, I walk with angels...for he was the hand of our Creator. Short of having found him, I would not be writing these words, and I would be dead. But he saved me...they saved me...and I saved myself...so from now on I can help and save others. I do not advertise this web site. You have to find it...with who you are as a person and with your mind...just like I found him.
So, without proper and adequate medical histories, and without getting to really know the patient and their problems, I don’t have to tell you what that does to the office based practice. It turns it into...you guessed it...like I said, garbage.
All this having been said, it would be important to note that patients and their symptomatology as well as the nature of medical practices, and medical specialties, vary considerably. So the medical history is thereby also likely to vary. For example, sometimes the medical history might take a short time, but it can still nevertheless be quite adequate. Repeat visits on known patients also often entail shorter initial discussion periods with patients, but again, all this is dependent upon circumstances, the patients’ complaints, symptomatology, etc. The main point is that the ‘proper’ medical history cannot be exactly quantified, so that ‘proper’ ultimately remains within the mind and conscience of the doctor, and in the doctor being honest to himself and to his or her patient in feeling confident that an adequate and proper medical history or discussion with the patient had ensued.
For me personally, when I was practicing obstetrics and gynecology in a private practice setting, as opposed to a clinic setting, I found the need to talk to patients first in my office, before doing the physical examination in the examination room. Thereafter, depending upon new or old patient, the nature of what the patient had come to me for, the nature of what I had found upon having performed the medical history and physical examination and so on, I would then bring the patient back into my office and therein discuss treatment. Many times the entire time involved varied from one to two hours.
I had thought it so important to take the time to talk to patients and to treat them with due respect, that before I had gone into private practice I built a huge eight foot long by feet feet wide wooden desk, hard wood stained in appearance. That time was a highlight of my carpentry days wherein I took such pride in the important and symbolic meaning of that desk in terms of properly practicing medicine, that I learned to use radial arm saws, jig saws, band saws, routers, lathes, shapers...you name it. I had fun, but most importantly I felt pride in the finished product because of what it represented: the proper practice of medicine as a ‘one on one’ between doctor and patient, and with no other interfering influences. One day, as you will see, I will be using that desk again, but this time in a new kind of practice. Rather than being within a usual doctor’s office, it will be the symbolic fulcrum around which a multifaceted Lifestyle Related Medical Center will evolve. As you will see, that is the only viable future of medicine if we are to do what is right for people, their health, and their lives.
Assuming Proper and Adequate Medical
Histories, What Comes Next?
Well, the proper medical history having been performed, the doctor is much more likely to be pointed in the right direction in terms of how to go about taking the physical examination, what to do in that regard, etc, and what course to take in terms of the patients complaints. Physical examinations vary tremendously depending upon circumstances. Oftentimes, having performed a proper medical history, you can almost zero in on the exact aspect of the physical examination, as well the tests to be taken, so as to make an accurate diagnosis. And remember, without an adequate and reliable diagnosis, the ensuing treatment, as you might already have guessed, turns into nothing but...garbage...failed treatment, often high financial costs, and loss of life!
Now, in this conventional ‘office based’ medical practice we are considering here, once having derived upon the diagnosis, whether after weeks of tests in laboratories or in the hospital or whatever, the treatment is then determined, discussed and then administered to the patient, usually in the form of a prescription for a medication, or perhaps even, and on a broader scale, a hospital admission for a medical test or procedure or operation. All of this, mind you, comes under the heading of a conventional ‘office based’ medical practice.
Getting down to the exact specifics as to how this all works in terms of a given disease process, let’s take the general term ‘heart disease’ and see how it is often found to be practiced in this office based medical practice setting. Then we will be able to compare it with how heart disease is practiced, or will one day be practiced by other doctors, via Lifestyle Related Medicine.
The Diagnosis And Treatment Of Heart Disease In
A Conventional Office Based Medical Practice
As discussed elsewhere, the term ‘heart disease’ is a general term inclusive of a multitude of cardiac and cardiovascular diseases or conditions. But I will nevertheless still use it here in its general sense (inclusive of a multitude of diseases) for demonstration purposes only, although I will from time to time make references to specific conditions not only as to how heart disease is diagnosed and treated, but as to how diseases in general are diagnosed and treated in a conventional office based medical practice.
CONTINUE TO:
‘Diseases’: Multiple Diseases Treated The LifestyleMedicine Way!
Let’s Take Coronary Artery Blockage, Angina & Heart Attacks
Exercise ‘Lung Machines’ -- Heretofore As Yet ‘Unknown’
As Effective Treatment For Lung Disease!
Take Heart Failure
Take High Blood Pressure!
