How to manage your health affairs

The topic of this post might make you wonder - what are 'health affairs' - isn't that some government bureaucracy? Well yeh...and it exists because individuals fail to take responsibility for their personal affairs - in this case health.
I have learned the hard way that its important to have a systematic and deliberate strategy and plan for managing your life, and that the earlier you develop such a strategy the more fluid the system will operate and the less cumbersome adminstrative challenge it will become. The intent of my health strategy is to know ahead of time the way I should live in order to maximise my capacity to enjoy it, as well as to prolong my life as long as possible so I can achieve as much as possible within the limits of my 'human capability'.
It is my firm believe that having a strategy is not a waste of time. I believe that the time I spend researching health issues, understanding my body and developing my strategy is going to be repaid in several respects, which I think will become apparent over the course of this posting.
Of course there is a trade-off. I am not suggesting that we need a study health issues for years. I am well aware that there are doctors who do that. I am saying that you need to take personal responsibility for your health issues, because unless you are wealthy enough to have a personal health care expert managing the health aspects of your life, I can guarantee that you know more about aspects (symptoms, medical history) of your health than your doctor. The problem with way health is currently managed is that:

1. Division of responsibility: There is no clear demarcation of responsibility when you visit a doctor. Its not readily apparent what role you should perform, what your job is. Many of us just turn up and expect them to know. Certainly no one helps us, which is why we have to take pro-active steps to prepare ourselves to get the best possible outcome.
2. Personal interest: Apart from the initial interest in your personal history, I think doctors tend to take little interest in patients personal care. That is a sad testimony to the level of empathy that doctors generally have. I truly think most of them hate their jobs...sticking fingers up people's arses...and the need to always be there. Its a job that requires a genuine paternal care, but I think alot of doctors grow weiry of that concept over time...which was perhaps idealistically conceived. Or perhaps its because they are dealing more with foot fungus and sexually transmitted diseases than with life threatening diseases.
3. Conflict of interests: Often you have medical centres with their own pharmacy (drug store). It might be 'seemingly independent' but rest assured if its in the same building, there is a relationship with the owner. Its worth finding out the cost of various medicines at various stores because I have found big differences...even huge mark-ups for late night service. Your doctor might recommend a medicine that he believes will do the trick, but is that because he receives a commission from a pharmaceutical company or the pharmacy. Is he rejecting a cheaper generic product or a home remedy. I am amazed when doctors and dentists claim that the results of the medical tests you undertake is their property by virtue of them holding them. Find out your doctors policy on that issue. Since the ascension of medical centres, I think the 'commercialism' has perhaps given away to the need of patients for flexible options.
4. Unorganised structure: Professionals are amongst the most self-indulgent and poorly organised people on earth because they always want to do their own thing - and doctors are no exception. Consider that its only now that we are seeing computerisation of medical records, which means doctors can actually read another doctors writing. It means a doctor can have access to a patients full medical history, and easily transfer these records to other doctors.
5. Lack of relationship: Unless you have been able to retain the same relationship with a family doctor over the years, its likely that your doctor has joined a medical centre, where they share facilities and administrative staff. There are pros and cons to this set-up. The benefit is that doctors can make more money sharing facilities, as well as have more flexibility with working hours. The problem is that patients no longer have a relationship with their doctor, and it means that bad doctors tend to be supported by this system. Why? Because you get a 2nd opinion rather than returning to the old one.

So I offer the following health care tips:

1. Be selective: When you go to a medical centre, never accept just any doctor, becaus you will be assigned to the doctor that no one else wants an appointment with, whether its because they are incompetent, impersonal or inexperienced. A better strategy is to ask for any specific doctor from the list on the wall. If they are not ready, have another choice. I have routinely found that if you dont ask for a doctor, you get a bad one. Often some immigrant doctor with poor training, offered a resident work permit because of the shortage of skilled local doctors. Rural areas have little choice unfortunately.
2. Know your risks: Few people have the spare time to get a medical degree, or to spend weeks learning about their health isues. However it is worthwhile understanding the top 10-20 biggests threat to your gender. These lists are often provided in the newspapers and are easily found on the internet. By researching these ailments and making some notes about threats, preventative measures you can take to avoid, and symptoms you can expect to identify.
3. Be prepared: I dont know about you, but for years I was going to doctors and expecting them to determine my health issue with little help from me. I simply didnt give it much thought, and they showed no concern for my lack of knowledge too. The implication is that they had to search for symptoms as opposed to me telling them. I could say I was in pain, but was not particularly sure where it was. I have since learned to attend a doctor's appointment PREPARED, which means that over the 3 day period in which I am ill, I will make a note of what symptoms I feel (note anything out of the ordinary), when it occurs, how frequent, where it is, and its nature. Writing a note on my PDA ensures I dont forgot it, since its always with me.
4. Know your symptoms: Another aspect is knowing how to describe how I feel. Often I found I didnt have the vocabulary to describe what I was feeling, or even what constituted a symptom. But its ok if you write down unrelated issues, as the doctor will know the difference. You can find a list of symptoms that you can check on the internet. Dont rationalise a disease - so read through the list dispassionately before you attempt to match a condition to it. See www.wrongdiagnosis.com.
5. Do your own research: I cant understate the importance of researching your condition on the internet. Many of my doctors are impressed when I display some knowledge of my condition. My family has a history of Celiac Disease - simply a gluton (wheat) toxicity or intolerance - yet a great many doctors didnt know about it. There are websites that allow you to type in your symptoms to get a list of possible conditions. My advise is to independently research those conditions to see if you have a match. You might identify other symptoms that were not readily apparent to you. Its important that you let the doctor diagnose rather than tell him his job. Tell him you did some research on the internet...ask him why he thinks your condition is not ...... since you display symptoms ..... By keeping your doctor accountable, you can have greater confidence in his professionalism. If you are in doubt, seek a second opinion before you self-diagnose. Doing research can actually save you money and time. Knowing that I needed to fast before taking a blood test, I didnt take any food or fluids for 10 hours before my appointment. Of course you might not care if you have a free health system.
6. Ask questions: You need to establish whether your doctor is credible becaus you need to know whether he is in a position to know your condition, and if not whether you need to seek a 2nd opinion. Doctors are humans, so if they have a low self-esteem or pride in their position, they might not willingly convey their ignorance on a medical issue, but look for other signs, eg. Body posture or tone. But by far the best approach is critical thinking. Asking probing questions is the best approach, and research is intended to help you identify those. A good doctor will respect you for taking an interest (I have found), insecure or incompetent doctors will get defensive and attempt to derail you. Dont be perturbed, they are telling you they are not capable of helping you at the standards of service you require....so dont see them again.
7. Understand the doctors perspective: Understanding the motivations of your doctor can help you get better service and save money. The longer time you spend with a doctor, the more he will treat you like a human being. The more you corner him, or attack his diagnosis, the more defensive he will be. In some countries (Philippines) doctors are illegally selling medicines directly. This can bias the doctor's judgement and result in you being prescribed medicines that have more severe side-effects. Avoid these doctors as they are crossing an ethical divide. Doctors often have deadlines for meetings or a queue of patients. Dont be surprised if they short-change you on service so they can alleviate these pressures. Protect yourself.
8. Prevention: Determine what is a healthy way of living. I am a great believer that our bodies give us a great deal of information about our health condition. Try different diets and see what impact it has on you. Consider your level of energy, gastro-intestinal condition, flatulence, weight control. You should get blood tests for cholesterol (HDL/LDL) as well. Doctors are only concerned with our health at times of ailment, but many conditions are discovered too late, and can be avoided through prevention. I am skeptical that there is 'one diet' for all people....maybe it depends on your genetic makeup. Maybe our bodies adjust if we adopt a regular diet. Regardless, you cant ignore empirical evidence of what constitutes a healthy body.
9. Family History: Ask your parents and grandparents if there is any medical condition or affliction that is affecting your family that might have a genetic link. Upon identifying any such issues, research the ailment and make notes. Dont forget to provide your information to other family members. I found out that my family had incidences of celiac disease and a rare (rubbing) eye condition. Fortunately pretty good with respect to cancer.
10. Standards of comparison: You really dont know what a good doctor is until you've had one, so experiment with some. I dont mean just a few at your local medical centre. Go to some up-market suburbs 20km away to see what type of service wealthy people are receiving, and what they are paying for it. Professionalism is mostly the result of personal ethics rather than anything genetic. Wealthy people are accustomed to paying more for service, so expect doctors in those communities to know better. If it costs more, then economise....just go there when you have a critical ailment as opposed to a common cold.

Alot of the advise here does not just apply to personal health. I dont know much about cars, but I apply the same critical thinking skills to car mechanics. Mechanics and other tradespeople are famous for over-servicing customers with no knowledge of their field. So ask probing questions to determine how necessary a certain component replacement is. The chances are they will be applying very 'high' standards to your car, or very conservative 'replacement policies' in an attempt to increase their profits. Alot of them aren't 'directly' dishonest, but they are not acting with regard for your best interests if they dont make you informed, and that is a breach of professional standards of care for the interests of the customer.