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From the President of the MPA
While our profession and practice revolves around drug management, pharmacology, pharmacokinetics, and overall drug expertise, sometimes it is the non-drug advice that we give our patients that augments their care the most. Recently, I was in Billings on some business and was talking with my good friend Gary Meyers, who is also a pharmacist. We were discussing the poor physical condition of a preponderance of Americans and the paradoxical reason many people end up taking or relying on medication…..that being the lack of a healthy lifestyle, good nutrition and physical exercise. Much too often, we think of drugs as being the safety net. “…Let’s see, since my Lipitor has my cholesterol in range, I can still eat my bacon and eggs in the morning and avoid the treadmill in the evening and that Prevacid allows me to eat my 11PM chilibuger with a few beers on bowling night…” At times, clearly, we are our own worst enemy. Riding back on the plane, this thought was perpetuated by the throw-away magazine I was reading that is supplied by the airlines. A gentleman by the name of Peter DeHaan wrote an article about health insurance and looked at it, well, quite frankly, from the perspective in which it should be….using health insurance for those catastrophic things in life, not necessarily because of poor preventative maintenance. Mr. DeHaan made a nice analogy to one’s car and car insurance if people used it like their health insurance. Pirating Mr. DeHaan’s case:
“First, there would be a two dollar co-pay for gasoline. It wouldn’t matter if the tank were half-full or empty, the cost of a fill up would be two dollars. This would provide little incentive to buy fuel-efficient vehicles or drive in a cost-effective manner…we would merely want cars with bigger gas tanks. Oil changes would probably not be covered but that’s okay. Just skip the changes and when the engine seizes up, there’s nothing to worry about because engine replacement is covered. If you hadn’t reached your deductible, you might need to pay 20% of the “reasonable and expected charges” for an engine rebuild, but that’s all. Now the tires….your policy would pay to have them replaced every two years whether you needed new tires or not. So even though there is still usable tread on them, you have them replaced – insurance will pay for them. Of course, if one of these new tires has a blowout before the two years are up, then you’re out of luck – and you get mad at your insurance company. What about the cost to keep that old beloved car running? No problem, insurance covers it. Never mind that the parts are no longer being manufactured, hard to find or expensive….insurance will pick up the tab. The downsides to this incredulous scenario are that there will be lots of paperwork and you can only go to mechanics that are “part of the system”.”
Most people take better preventative care of their cars than they do their own bodies. They see the value in doing so. Why not do the same for one’s own self? “Well, I’m paying a lot for my insurance and I damn well better get something back for it”…..ever hear that one? For some reason, some people believe health insurance is like the lottery and they will get back more than they put in. In part, our health care systems are to blame. What incentive is there to not get sick or become sedentary, hypertensive, and hypercholesterolemic….my health insurance premiums are still there every month and if I don’t use them, someone else will, right? If my health deteriorates, there’s a drug to fix it, insurance to pay for it and a way for me to keep my phlegmatic lifestyle…right? Unfortunately, insurance companies are in the business to make money, not provide a golden parachute. But many companies and organizations are now passing on the costs of health insurance to workers, simply because of the expense. Those that pick up or subsidize the cost of health insurance are beginning to realize the value, in real dollars, of preventative health care and healthy lifestyles. So too, can our patients. Along with giving out medication advice, some of the best information we can render is simple and effective such as not only taking one’s antihypertensive correctly but also engaging in activities and exercise to improve aerobic conditioning. Eating more nutritiously, cutting calories and imbibing in moderation can synergize with meds for more effective outcomes such as decreased cardiovascular disease and lowered serum cholesterol. Adding a holistic approach to better health may make you a better health professional. Did I say exercise?