[Music]
[Applause]
what if I told you that getting your
annual physical is a complete waste of
time you think you’re doing the right
thing you schedule the appointment you
take time off work you fast you go to
your doctor feeling like you’re doing
something good and useful for your
health but you’re actually not research
shows it is worthless worthless and
making a difference in your likelihood
of getting sick or even of dying may as
a doctor have to admit I used to dread
the annual physical the quick review of
your complaints and ordering the same
lab tests for everyone whether need it
or not and then going over the results
talking about how you really need to get
the cholesterol down and start a new
exercise program I mean how many times
have you had the same conversations with
your doctor about those extra 10 pounds
or the need to get your cholesterol down
promising you’re gonna change your diet
completely have you ever actually made
any changes as a result of your annual
checkup for the majority of my patients
the answer was always no but this wasn’t
discussed when I was in medical school
many people know what they need to do to
get healthier but they’re not doing it
but with time and experience I realized
the key to driving real change is to tap
into one sense of purpose what drives
you what do you want your health for
with that clearly identified upfront
then the annual physical can be more of
a transformative experience leading to
meaningful change that does encourage
you to make those lifestyle changes like
starting an exercise program or changing
your diet but it took me years to
understand that because in my training
doing the annual physical I just felt
like I wasn’t getting to what really
mattered to my patients so I would try
and dig deeper and I would say okay so
what made you come
today for this checkup and I would hear
well my partner made me come in or as
one patient was upfront enough to say
just to make sure I’m not dying doc but
I would feel sort of like a fraud
because I knew deep down the way I was
doing it I wasn’t really impacting
whether or not they were gonna die
and unfortunately the impact of the
failure of the routine checkup at really
preventing disease as being felt
nationwide do you know last year saw a
decline in life expectancy in the United
States across all races a decline
attributable to a rise in heart disease
stroke and other preventable diseases
that means if this trend continues our
children will live shorter lives than we
will think about that it’s shocking it’s
partly due to statistics like this and
the rise and other negative health
indicators that leading medical groups
actually recommend against doing the
annual preventive wellness exam for
patients without symptoms but everyone
is still doing it because it’s how we’re
taught so you know when I was a medical
resident a doctor in training in New
Orleans I had a patient named Renee and
she made me rethink this annual physical
she came in with high cholesterol high
blood sugar a good 25 pounds overweight
so I had the same talk with her I had
with many of my patients about getting
control over blood sugar exercising and
she would listen politely nod like she
was taking it all in and then come back
the next visit the same way or maybe
even a little heavier with the same
cholesterol and blood sugar finally
after years of these redundant checkups
exasperated I said Renee why do you
think you haven’t lost any weight and
she said you know I hear what you’re
saying I need to lose weight for my
overall health but it’s just so hard for
me and I think I look okay and I said
well Renee does your weight affect you
in any real way in your life and here’s
where it all changed for me she said
actually I’d love to coach my
eight-year-old daughter’s soccer team
but I get out of breath so easily I
can’t keep up with the girls running up
and down the field and I know it’s
partly because of my weight so I said
you know what
now when you come in for your checkups
we’re not gonna be doing weigh-ins and
checking blood sugar your checkups are
gonna be all about checking in and how
long you can be active for to see if
these changes we’ve talked about you
making can actually help you be active
longer so you could maybe help coach her
team since I was a resident my teachers
would ask me how’s her blood pressure
how’s her blood sugar and I would say
you know we’re not checking that we’re
just checking how long she could be
active for you can imagine how they felt
about that what do you mean you’re not
checking it you need to record her blood
pressure in her chart you need to record
her blood cholesterol I caught hell for
it but it was exhilarating feeling like
I was on the patients team and letting
her control what measures of success we
would use when you know six months later
she came in having lost some weight and
telling me the yes she had had had
enough active energy to coach her
daughter’s soccer team and when we did
finally recheck her blood tests her
blood sugar and cholesterol were both
better so we both got what we wanted I
knew she had less risk of heart disease
and diabetes and she was engaged with
her daughter in a way that really was
important to her this was a huge moment
of realization for me reframing the
check up around what the patient really
cared about as opposed to around what
lab values I was supposed to help make
sure get better was way more powerful so
when I began talking to my patients
about what mattered to them did they
have any goals they wanted to achieve
that health could either hinder or
facilitate or have some clarity about
their sense of purpose that was exactly
the catalyst many people needed to
engage in the very behaviors that
ultimately would make them healthier I
mean imagine yourself starting your
interaction with your doctor with your
overall purpose for being healthy in
your goals rather than your chief
complaints you walk away from the visit
with a plan rather than just a list of
lab results and prescriptions for
medications in fact purpose is powerful
research shows identifying a clear sense
of purpose lowers your mortality rate
that means your risk of dying in five
years by
percent that’s on par with quitting
smoking or starting an exercise program
and according to Blue Zones author Dan
Buettner identifying a clear sense of
purpose which is one of those attributes
common to the five regions around the
world where people live longer and
healthier than anywhere else on earth
identifying that clear sense of purpose
adds seven years to life expectancy what
would you do with seven more years of
life now I’m not advocating getting rid
of an annual check of some sort some
sort of health check I’m just saying it
needs to be transformed from a check-up
to a check-in
a check-in about how you’re doing
related to how you want to be doing not
just how you’re doing it not dying what
does the check-in look like number one
it starts with purpose number two we use
health as a tool to achieve that purpose
not as the goal in and of itself and
number three as your doctor I can become
a resource in a facilitator I can work
as part of a team to support you and
hold you accountable to the goals you
have set for yourself we can develop a
customized plan for you what food should
you be eating supplements should you be
taking what tests might you need and
what other modalities or practitioner
should you see do you want to run a 10k
then let’s plan what you need to do to
cross the finish line the good news is
this way of changing the conversation to
be about a Purpose Driven approach to
health is catching on functional
medicine integrative medicine lifestyle
medicine are all fields that embrace
these concepts of shared decision-making
and patient-centered care medical
schools are teaching this approach and
doctors all around the country are
flocking to conferences to unlearn the
generic complaint oriented prescription
writing oriented checkup we hear a lot
about Purpose Driven Life
but this is about Purpose Driven Health
we’re used to doctors encouraging
patients to hold on to a sense of
purpose in order to beat cancer or other
serious diagnosis to stay strong long
enough to make it to a child’s wedding
or for the birth of a grandchild but as
doctors we don’t harness the power of
purpose enough when talking to patients
about prevention
yet preventable diseases account for 40%
of the causes of death in the United
States it’s simply about engaging on the
level of what matters to you not just
what’s the matter with you
you know Viktor Frankl quoted Nietzsche
in his book man’s search for meaning he
said he who has a why to live for can
bear almost any how now Franco was
referring to a more dire situation but
his message still applies to our health
in order to make true sustained behavior
change we all need a Y what I’ve learned
is that the trick to getting yourself to
do all the things you know you should be
doing is to spend some time thinking
about your sense of purpose and ideally
sharing that with your doctor
then you’ll transform the annual
physical into a powerful tool to lead to
a more more fulfilled and longer life
one who had seven more years to your
life then ask yourself this one question
what do you want your health for thank
you
[Applause]
[Applause]
what if I told you that getting your
annual physical is a complete waste of
time you think you’re doing the right
thing you schedule the appointment you
take time off work you fast you go to
your doctor feeling like you’re doing
something good and useful for your
health but you’re actually not research
shows it is worthless worthless and
making a difference in your likelihood
of getting sick or even of dying may as
a doctor have to admit I used to dread
the annual physical the quick review of
your complaints and ordering the same
lab tests for everyone whether need it
or not and then going over the results
talking about how you really need to get
the cholesterol down and start a new
exercise program I mean how many times
have you had the same conversations with
your doctor about those extra 10 pounds
or the need to get your cholesterol down
promising you’re gonna change your diet
completely have you ever actually made
any changes as a result of your annual
checkup for the majority of my patients
the answer was always no but this wasn’t
discussed when I was in medical school
many people know what they need to do to
get healthier but they’re not doing it
but with time and experience I realized
the key to driving real change is to tap
into one sense of purpose what drives
you what do you want your health for
with that clearly identified upfront
then the annual physical can be more of
a transformative experience leading to
meaningful change that does encourage
you to make those lifestyle changes like
starting an exercise program or changing
your diet but it took me years to
understand that because in my training
doing the annual physical I just felt
like I wasn’t getting to what really
mattered to my patients so I would try
and dig deeper and I would say okay so
what made you come
today for this checkup and I would hear
well my partner made me come in or as
one patient was upfront enough to say
just to make sure I’m not dying doc but
I would feel sort of like a fraud
because I knew deep down the way I was
doing it I wasn’t really impacting
whether or not they were gonna die
and unfortunately the impact of the
failure of the routine checkup at really
preventing disease as being felt
nationwide do you know last year saw a
decline in life expectancy in the United
States across all races a decline
attributable to a rise in heart disease
stroke and other preventable diseases
that means if this trend continues our
children will live shorter lives than we
will think about that it’s shocking it’s
partly due to statistics like this and
the rise and other negative health
indicators that leading medical groups
actually recommend against doing the
annual preventive wellness exam for
patients without symptoms but everyone
is still doing it because it’s how we’re
taught so you know when I was a medical
resident a doctor in training in New
Orleans I had a patient named Renee and
she made me rethink this annual physical
she came in with high cholesterol high
blood sugar a good 25 pounds overweight
so I had the same talk with her I had
with many of my patients about getting
control over blood sugar exercising and
she would listen politely nod like she
was taking it all in and then come back
the next visit the same way or maybe
even a little heavier with the same
cholesterol and blood sugar finally
after years of these redundant checkups
exasperated I said Renee why do you
think you haven’t lost any weight and
she said you know I hear what you’re
saying I need to lose weight for my
overall health but it’s just so hard for
me and I think I look okay and I said
well Renee does your weight affect you
in any real way in your life and here’s
where it all changed for me she said
actually I’d love to coach my
eight-year-old daughter’s soccer team
but I get out of breath so easily I
can’t keep up with the girls running up
and down the field and I know it’s
partly because of my weight so I said
you know what
now when you come in for your checkups
we’re not gonna be doing weigh-ins and
checking blood sugar your checkups are
gonna be all about checking in and how
long you can be active for to see if
these changes we’ve talked about you
making can actually help you be active
longer so you could maybe help coach her
team since I was a resident my teachers
would ask me how’s her blood pressure
how’s her blood sugar and I would say
you know we’re not checking that we’re
just checking how long she could be
active for you can imagine how they felt
about that what do you mean you’re not
checking it you need to record her blood
pressure in her chart you need to record
her blood cholesterol I caught hell for
it but it was exhilarating feeling like
I was on the patients team and letting
her control what measures of success we
would use when you know six months later
she came in having lost some weight and
telling me the yes she had had had
enough active energy to coach her
daughter’s soccer team and when we did
finally recheck her blood tests her
blood sugar and cholesterol were both
better so we both got what we wanted I
knew she had less risk of heart disease
and diabetes and she was engaged with
her daughter in a way that really was
important to her this was a huge moment
of realization for me reframing the
check up around what the patient really
cared about as opposed to around what
lab values I was supposed to help make
sure get better was way more powerful so
when I began talking to my patients
about what mattered to them did they
have any goals they wanted to achieve
that health could either hinder or
facilitate or have some clarity about
their sense of purpose that was exactly
the catalyst many people needed to
engage in the very behaviors that
ultimately would make them healthier I
mean imagine yourself starting your
interaction with your doctor with your
overall purpose for being healthy in
your goals rather than your chief
complaints you walk away from the visit
with a plan rather than just a list of
lab results and prescriptions for
medications in fact purpose is powerful
research shows identifying a clear sense
of purpose lowers your mortality rate
that means your risk of dying in five
years by
percent that’s on par with quitting
smoking or starting an exercise program
and according to Blue Zones author Dan
Buettner identifying a clear sense of
purpose which is one of those attributes
common to the five regions around the
world where people live longer and
healthier than anywhere else on earth
identifying that clear sense of purpose
adds seven years to life expectancy what
would you do with seven more years of
life now I’m not advocating getting rid
of an annual check of some sort some
sort of health check I’m just saying it
needs to be transformed from a check-up
to a check-in
a check-in about how you’re doing
related to how you want to be doing not
just how you’re doing it not dying what
does the check-in look like number one
it starts with purpose number two we use
health as a tool to achieve that purpose
not as the goal in and of itself and
number three as your doctor I can become
a resource in a facilitator I can work
as part of a team to support you and
hold you accountable to the goals you
have set for yourself we can develop a
customized plan for you what food should
you be eating supplements should you be
taking what tests might you need and
what other modalities or practitioner
should you see do you want to run a 10k
then let’s plan what you need to do to
cross the finish line the good news is
this way of changing the conversation to
be about a Purpose Driven approach to
health is catching on functional
medicine integrative medicine lifestyle
medicine are all fields that embrace
these concepts of shared decision-making
and patient-centered care medical
schools are teaching this approach and
doctors all around the country are
flocking to conferences to unlearn the
generic complaint oriented prescription
writing oriented checkup we hear a lot
about Purpose Driven Life
but this is about Purpose Driven Health
we’re used to doctors encouraging
patients to hold on to a sense of
purpose in order to beat cancer or other
serious diagnosis to stay strong long
enough to make it to a child’s wedding
or for the birth of a grandchild but as
doctors we don’t harness the power of
purpose enough when talking to patients
about prevention
yet preventable diseases account for 40%
of the causes of death in the United
States it’s simply about engaging on the
level of what matters to you not just
what’s the matter with you
you know Viktor Frankl quoted Nietzsche
in his book man’s search for meaning he
said he who has a why to live for can
bear almost any how now Franco was
referring to a more dire situation but
his message still applies to our health
in order to make true sustained behavior
change we all need a Y what I’ve learned
is that the trick to getting yourself to
do all the things you know you should be
doing is to spend some time thinking
about your sense of purpose and ideally
sharing that with your doctor
then you’ll transform the annual
physical into a powerful tool to lead to
a more more fulfilled and longer life
one who had seven more years to your
life then ask yourself this one question
what do you want your health for thank
you
[Applause]
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