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Disease By Choice

“Why should I take my blood pressure medication,” you ask? The more I do this thing called hospitalist medicine, the more I appreciate the power of lifestyle choices we all make.

Every opportunity I get I give my patients my smoking lecture and charge their insurance  a CPT 99406. Everybody knows that smoking is bad for you and it causes lung cancer. Nobody knows all the other stuff. They’re always shocked.

Maybe it’s time for me to start a blood pressure lecture. I often have  patients who say: “Why should I take my blood pressure medication?” They always answer their own question with the same answer: “I was feeling fine. I didn’t see a reason to take my blood pressure medication.”

You see, these are people with insurance. These are people with the Medicare National Bank. These are people who don’t have to lift a finger or a dime to pay any out-of-pocket expenses for their healthcare. And yet, they still lack the motivation to care for themselves, even with incredible resources out there these days to help them — things like great online blood pressure chart sites for home monitoring.

Whatever the reason — whether it’s ignorance, laziness, lack of motivation, lack of remembering, or selfishness — people just don’t take care of themselves.

We could cut by 80 percent the incidence of diabetes, stroke, heart disease and cancer with lifestyle modifications. That’s all it would take to radically change the health of our nation. And that has nothing to do with whether they have health insurance or not. It’s one reason I’ve kept my own exercise log for almost three years now.

Look at it like this: More than 85 percent of this country has more health insurance than they know what to do with. Eighty-five percent of us have all the healthcare resources our reduced income can buy through our employers without being given a choice. Yet more than 85 percent of all the people I care for in the hospital are fully insured.

That says to me that people aren’t getting sick because they lack insurance, people are getting sick because they ask themselves: “Why should I take my blood pressure medication when I feel fine?” Well, ma’am — you’re not fine. You ended up in my hospital with a devastating hemiplegic stroke. But at least you have insurance.

The journey towards death is filled with disease by choice. Which diseases are you striving for today?

*This blog post was originally published at The Happy Hospitalist*


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