Whether you’re at the beach, on a boat, or at a BBQ, summertime is all about sipping on sodas. It can be hard to resist a cold, sweet, bubbly beverage on a hot day. You’re probably already aware that soda contains a ton of sugar and that sugar can increase your risk of obesity and type 2 diabetes, but did you know that it can also increase your risk of heart disease, liver disease, depression, anxiety, ADHD and dementia?
“No problem, Doc, I’ll just have a diet soda!” Not so fast. In addition to the increased risks of bladder cancer, kidney disease, and heart disease associated with artificial sweeteners, they ALSO increase the risk of developing obesity and type 2 diabetes. Our brains cannot distinguish between sugar and artificial sweeteners, so when you taste something sweet, both your dopamine and insulin levels will increase. Dopamine is the “pleasure chemical” in the brain which promotes habit formation and can lead to addiction. Insulin is a hormone which decreases your blood sugar by storing it as fat, and when levels are high, your body is literally programmed for weight gain.
So, how about reaching for a cold, bubbly beverage without the sweet, such as carbonated water over ice with a spritz of fresh lemon or lime? Once you make the decision to give up soda, you really won’t miss it, and your body and brain will thank you.
Honestly, I have never been a big fan of insurance. I am not much of a gambler, and paying for insurance feels like betting on my own misfortune. I have never purchased insurance for a cell phone or appliance. I would rather save the money and make an effort to take care of my possessions. I reluctantly have car insurance, home owner’s insurance, disability insurance, life insurance and health insurance. The only insurance I have ever used is health insurance, and that’s because health insurance is not actually insurance.
Typically, insurance works by charging a large amount of people a low fee to protect against an unlikely catastrophic event, such as a house fire or a totaled vehicle. Health insurance was previously used this way. Patients paid their doctors directly for medical care and turned in their own insurance claims when needed. Routine medical care was affordable for most, and doctors would often write off bills for patients in need. Insurance was used for major surgery, hospitalizations, or cancer treatment. Health insurance has morphed into a comprehensive pre-paid healthcare plan with unaffordable premiums. Many families spend over $20,000 annually on health insurance premiums and STILL pay out-of-pocket for all of their medical care due to high deductibles. Insurance is meant to protect against financial catastrophe, but in the case of healthcare, insurance IS the financial catastrophe. Patients do not realize that their doctors are receiving ever lower reimbursement and are spending over half their time engaged in meaningless insurance paperwork to get paid and to get the appropriate treatment for their patients. They cannot understand why their healthcare quality continues to drop as they pay more and more.
Imagine if your car insurance worked like your health insurance. You would be forced to pay $1000 per month for car insurance, but it would cover gas, oil changes, car washes, tires, windshield wiper blades, regular maintenance, and repairs. Of course, the prices for all of these services would increase dramatically, and you would have no way of knowing the price until months later. Also, you would pay a $20 co-pay for all services and would be responsible for the first $3000 of costs each year. However, after paying that first $15,000, all costs associated with your car would be FREE! Keep in mind that you would need to stay in-network. You may have a habit of swinging into the Wawa every morning on your way to work, but one day you learn that Wawa is now out-of-network, so now you are responsible for paying $250 for a tank of gas. Of course, you could drive 15 miles out of your way to get your tank of gas covered at 7-eleven, after you pay the co-pay and deductible. Also, you have to go inside, wait in line, show the gas station attendant your car insurance card, and fill out five pages of paperwork prior to filling your tank.
Americans have been brainwashed to believe that our current healthcare system is the only way to pay for healthcare. Of course, this is not true. The main reason that healthcare is unaffordable is because of the health insurance companies and all of the administrative middlemen who profit off this system. The only way for this system to change is for doctors and patients to demand better. If doctors stopped billing insurance and instead offered affordable cash prices for medical care, patients would not need to purchase these expensive pre-paid healthcare plans and could opt instead for affordable catastrophic plans or for health-sharing plans, such as Sedera, for as low as $136 per month. In my Direct Primary Care practice, patients get all the primary care they need for $75 per month, and I help them navigate the system to find the best prices on screening and diagnostic testing, medication and other treatments.
Gender politics aside, let’s talk about why the way doctors get paid matters to you as a patient. Female physicians don’t just get paid less because they prioritize their families, they get paid less because they prioritize patients. In the fee-for-service model, doctors are paid per patient visit, so the more patients they see, the more they get paid. This means that the worst doctors are paid the most. Healthcare administrators love “productive” doctors like Dr. Tigges who see 40-50 patients per day in 5-10 minute visits. These doctors make a ton of money rolling patients through the assembly line, and they produce even more money downstream with all of their referrals and tests and frequent return visits since their patients’ problems are never adequately addressed. One local hospital group times all patient visits, and any physician who spends longer than 15 minutes with a patient is reprimanded. The best physicians are literally punished for prioritizing patient care over profits.
Doctors who spend more time with their patients are better diagnosticians because they listen to their patients, get a thorough history, and perform an appropriate exam. They are less likely to need to order expensive tests or refer out to a specialist. The best doctors consider the cost of care and take extra time to ensure that their patients are getting the most affordable medications and that they are not subjected to costly and unnecessary testing. The best doctors respect their patients’ time and avoid making them return for another appointment for a skin biopsy or joint injection. Spending more time with patients is also important in building trust and motivating them to make healthy changes, such as smoking cessation or weight loss. Female physicians have been proven to have lower mortality rates, probably because they choose to spend more time with patients, make thoughtful diagnoses, order testing judiciously, address financial concerns for patients, and make sure that their patients understand and agree with the treatment plan.
I know many excellent physicians, both male and female, who make patients their priority and give them the time they deserve. However, this is very difficult to accomplish within the current system, and many good doctors get swept up in pleasing their bosses and paying off their medical school loans. The solution, for doctors and patients alike, is Direct Primary Care. By paying an affordable monthly fee, patients get access to a doctor who has plenty of time to give them the best possible care. Doctors are paid fairly because they are providing a valuable service directly to the patients who pay them.
The first time I tried meditation, I thought it was a waste of time. I was an intern, and as usual, I had a long list of work to complete. I wanted to get my discharge summaries dictated, but instead, I was being forced to count my breaths. I suppose I did waste my time, since I spent the entire session stressing myself out over how much I had to do and how I would never be able to complete it all. Of course, I did everything I needed to do, but my agitated internal dialogue was not a motivating factor; it was a distraction.
Years later, I finally discovered the benefits of meditation. At first I was doubtful when I read that meditation could help with mood disorders, addiction, pain relief, insomnia, and weight loss, in addition to increasing productivity and joy. In fact, Headspace is currently working on FDA approval to designate guided meditation as an official medical treatment. I started using the Headspace app this year, just ten minutes per day. Similar to physical exercise, this mental exercise is not enjoyable at the time, but its benefits last all day. I have noticed increased kindness and patience for myself and for others. I intentionally pause to enjoy moments like bedtime snuggles with my boys who won’t be little for long.
Most of our suffering occurs when we are thinking about the past or the future. We may be experiencing shame about something we said or did. We may be experiencing anger over something someone else said or did. We may be anxious about a future meeting or conversation or overwhelmed with tomorrow’s to-do list. We may feel fearful over the possibility of a car accident, a cancer diagnosis, or a terrorist attack. Our thoughts can become habitual, neural pathways carved into our brains. We may find ourselves thinking the same string of thoughts, which results in anger with a spouse, impatience with our children or frustration with our job. Even when we are experiencing physical discomfort, the majority of our suffering is created by our thoughts. Thoughts about how our pain is debilitating or unfair result in worsening pain, especially if there is anxiety over how long the pain will last or whether it’s a sign of a serious medical condition.
If we can let go of all those thoughts about the past and the future, we are left with a fairly neutral present moment. In the present, we experience only our senses. With our eyes closed, we can hear the sounds around us, smell any scents, and feel the weight of our body, the temperature of the room, and the air entering and leaving our lungs. This is a skill that takes a long time to develop, but it’s extremely useful. You can use it at any time to interrupt your current thoughts and allow the accompanying negative emotions to drift away. You can change the way you feel and react to the people and events in everyday life. You can change the way you respond to urges to snack, smoke or check your phone. You can learn to control your pain rather than letting it control you. You can learn how to let go of your thoughts in order to fall asleep more easily. Over time, you can literally rewire your brain to create new thought patterns and habits.