Health column: You don't want to see me unless you have to

Body: 

My name is Dr. Ed Ward, and I am a hospitalist at Mayo Clinic Health System in Red Wing. A hospitalist is a medical specialist who sees patients admitted to the hospital. We provide 24/7 care to patients because most patients in the hospital today are quite ill and require round-the-clock care. If you are my patient, I know you've had better days.

Now, don't take this personally, but I hope we don't have to meet. I would rather you visit your primary care provider to hopefully help keep you healthy in the first place.

But the one who is most likely to help you avoid seeing me in the hospital someday is you. You are ultimately in charge of your own health.

Let me explain.

I became a physician to help people. We doctors are trained to help ill people heal by providing our clinical expertise and knowledge. In my experience, I've also seen many well people taking medicines that do not benefit them. I formerly worked at an internal medicine office, mostly checking up on patients "numbers" like cholesterol and blood pressure. Taking pills for these risk factors usually makes the numbers look better, but doesn't necessarily make the patient feel better or live longer in majority of cases.

For example, millions of Americans take pills for their cholesterol because they were told they should. One review of the best studies found that 10 years of pills prevent an early death in 1 out of 100 people and prevent a nonfatal heart attack in about 1 out of 40 people. But 99 percent of patients died from another cause of death at the expected age, just with less cholesterol in their bodies (see footnote 1).

At least statin cholesterol lowering drugs are proven to prolong a few lives, unlike many other preventative medicines (drugs given chronically to people who feel fine).

The American College of Physicians estimates one-third of US medical care is completely useless. Because of clever consumer-based marketing and various health care providers who do not educate themselves on evidence-based research, some people have faith in pills more than they rationally should. Increasingly throughout my career, I see patients who take more than 20 different pills each day, yet most of those pills will not make them feel better or live longer. A patient once told me he takes his cholesterol medicine so he can eat greasy food. But betting on pills to save you is a longshot: If you want to feel better and live longer then seize control of your own health.

Own your health

To attain great health, your day-to-day lifestyle decisions make a greater impact than anything a doctor can do. Here's a recipe for good health: Exercise most days of the week, eat lots of vegetables and fruits, maintain a normal weight, and don't smoke. Research found people that do these four things live an average of 14 years longer than people who do not (footnote 2).

Why am I telling you all of this? I worked in medicine decades before I learned Americans are less healthy than people in other rich countries, prompting me to read the medical journals more carefully. Trying to measure how much I help average patients, I learned there are no medicines that commonly save lives in healthy people. Studies show living in a poorer ZIP code is far more likely to shorten life than having high cholesterol (footnote 3). The science is out there for those who read the fine print.

As a physician, it is my job to make sure the science is rigorous and that patients truly benefit. When it comes to treatment options, I try to present the best available information, then I let the patients decide for themselves.

Luckily, Minnesota is one of the healthiest states in the U.S., and only coincidentally we have some of the very best doctors. I encourage you to be as physically active as possible, eat plenty of fruits and vegetables, and cultivate kind relationships with other people. With these healthy choices and a little good luck, hopefully you won't have to see Dr. Ward in the hospital.

Ed Ward, M.D. is a hospitalist at Mayo Clinic Health System in Red Wing.

Footnotes:

• 2011 Cochrane review of research on 34,272 patients without diagnosed heart disease

• 2008 PLoS Medicine study by Khaw et al of 20,244 men and women in Norfolk, UK

• Mixed data: Whitehall study 1990's (cholesterol in the top 1/5 shortens life 1.9 years) and Minnesota Blue Cross 2010 (poorest 1/5 ZIP code shortens life 8.4 years)