Switching it up

Behavior Change article

When Amir and I first decided to make some dietary changes it was during our 4th year of medical school, just hanging out on clinical rotations, otherwise not a care in the world.
We had watched Forks Over Knives and decided it was time to try out being vegetarian.
Over the following years, we kept tweaking things, sometimes fluctuating toward cutting out animal products all together, sometimes swinging back to vegetarian.
The point is, we had the luxury to do this without too many barriers, be it financial, time, education, access, you name it.
But the fact of the matter is, for the average person, the barriers seem endless.
So what does "lifestyle" actually look like in real life?

  • You're on your way home from work, it's 8 degrees outside, 5:30 pm, and 2 kids in the backseat screaming for dinner. Are you going to 
    • A. stop at the grocery store, get the kids out, go in and find ingredients to make dinner, and schlep them back into the car to go home and cook. hopefully mouths could be fed by 7 if you're lucky
    • B. Go to the drive through at Burger King and get cheap meals that make everyone happy and fed before you even get home
  • You are the breadwinner of the family and money is tight. Both you and your spouse are working 2 jobs a piece, so you are like ships in the night when one works day shifts and the other nights. All the food in the fridge goes bad anyway because you are rarely awake enough when at home to cook...you eat food on the road between jobs.
  • You'd love to make some healthy changes. It would be great. You are on 3 meds for high blood pressure, high cholesterol, and diabetes. But your spouse, who is "healthy as a horse", has no interest in making any changes to what you are eating at home, will never quit smoking, and doesn't see why you want to do it anyway.
If the doctor for the person in any of the above scenarios says "you really need to work on diet and exercise" or "you need to quit smoking" in the last 15 seconds of your 7 minute appointment, what are the chances that any sustainable changes can be made?
I'd argue slim to none.

Successful behavior change requires this special sauce of willpower, time, motivation, support, and education. Most of us need to know WHY behavior change matters, and we need to have a WHY that motivates us to maintain the changes.
When at least 80 percent of the chronic diseases that I see in clinic can be traced back to preventable behaviors, I don't understand how the current healthcare model of 15 minute visits and lack of consistent visit with your doctor is going to help affect change on those behaviors. The environment is not ripe. The special sauce is not there.
Enter Direct Primary Care.
Enter time with your doctor, return visits without copays, and a physician who has special training and interest in tackling these big changes WITH you.
Let's do this together.


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