Whatever happened to individual responsibility for health?

I had a patient admitted with his second diabetic foot infection, who was demanding that I treat him with the most powerful antibiotics, and he wanted the surgeon to recommend hyperbaric oxygen therapy. “I want everything done!” he kept saying, “throw the kitchen sink at me!” But yet, for the past 2 years, his diabetes had been uncontrolled with his HbA1c’s ranging around 11% (normal <6.5% for a well controlled diabetic). He had also made no attempt to loose some of his excess weight, and was not making the effort to stick to a diabetic diet, stating that he was too much on the go because of his job.

I had another patient who came in with numerous complaints, including a recurring rash which she thought was shingles. shooting pains about her body, joint pains, and tiredness. She was diabetic and had not seen a doctor for this in almost a year. She admitted to eating and drinking anything, including sweet tea because, she said, “I love it too much!”

Then there was a middle aged woman who came to me because she kept getting sores all over her skin, and wanted them gone, once and for all. She did not have any chronic medical illnesses, but on questioning, she admitted to smoking at least a pack of cigarettes per day, and drinking 12 cans of Coca Cola every day!

Yet another example, is a patient weighing over 500 pounds, who had chronic swelling of her legs. She had a sore on one of her legs, present for about 4 years. The sore got infected on and off, so she was back in hospital for treatment of the infection. Her mother was quite argumentative, demanding “what are you all going to do, to prevent this infection from happening again?!”

The common theme in all the patients given in the examples above, is that the root cause of their problems was something directly within their control. Getting blood sugars lowered, would greatly help the first 2 patients. In the third example, the patient needed to eliminate the sodas from her diet, and quit smoking. And the last patient needed a serious weight loss plan.

Many patients have come to expect ‘million-dollar work-ups’ to attempt to solve their problems. They want additional medications, procedures, etc. but still don’t feel much better, because the root cause of their problem, has not been addressed.

When did it become the norm to expect the doctor to fix everything? Whatever happened to individual responsibility? A recent article I read, entitled Society’s health should not be doctors’ responsibilities, had me asking myself these questions.

I can’t explain why many people choose to spend time and money on more and more procedures and medications, rather than make lifestyle and dietary modifications.

For a positive shift to be made, the pain of undergoing procedures and taking medications, will have to outweigh the pain of gathering the courage and discipline to make healthy lifestyle changes. In life, the choice made, is usually the less painful one.