The annual physical exam might be a waste of time, Myles Spar, MD, says. For many years, these checkups have followed a similar pattern: a doctor reviews a patient’s complaints, orders lab tests, goes over the results, and has the same discussions about how the patient should lower their cholesterol or start an exercise program. But, research shows that annual checkups are practically worthless in making a difference in one’s likelihood of getting sick or even dying. After all, how many people have actually made meaningful changes based on an annual checkup?
Many people know what they need to do to stay healthy, Dr. Spar asserts, but they’re not doing it. Time and experience taught him that the key to driving real change is to tap into a patient’s sense of purpose by asking: What do you want your health for? When that question is answered, the annual checkup can be a more transformative experience that leads to meaningful health changes.
Dr. Spar, a Diplomate of the American Board of Integrative Medicine (ABOIM), says it took him years to understand why the annual checkup was failing to get to the root of what mattered to his patients – until the case of Renee, one of his patients during his medical school residency. A checkup showed that Renee had high cholesterol, high blood sugar, and was at least 25 pounds overweight. So, Dr. Spar recommended lifestyle changes that he’d always recommend to such patients. But at her next checkup, Renee showed no improvement. After years of more redundant checkups, he finally asked her why she thought she hadn’t lost weight. She replied that though she had tried to lose weight, it was very difficult, and, in any event, she thought she looked okay just as she was. He then asked her if her weight had negatively affected any areas of her life. She wanted to coach her daughter’s soccer team, she said, but she frequently got out of breath. An idea came to Dr. Spar. He told Renee that from now on, she should see him not for checkups but to “check in” to see how long she could be active for, with the goal of eventually coaching her daughter’s team.
Six months later, Renee had lost the weight and was able to coach the team. Not only that, but she had also lowered her blood sugar and cholesterol, and was engaging with her daughter in a way that was important to her. It was then that Dr. Spar realized the importance of reframing the annual checkup around what patients cared about as opposed to what lab values were supposed to make them get better. What mattered, in short, was the patient’s clarity of purpose for being healthy.
In fact, research shows that identifying a clear sense of purpose lowers our mortality rate – the risk of dying in five years – by 20 percent, which is on par with quitting smoking or starting an exercise program. Dr. Spar says we should think of the checkup as check-ins during which a doctor helps a patient identify their sense of purpose so that health becomes a tool to help them achieve this purpose. In this purpose-driven model, a doctor should serve as a resource, working as part of a team to support patients and hold them accountable to the goals they set. Doctors can develop customized plans for their patients that include which foods to eat and supplements to take, and which tests, other modalities, or practitioners they should seek.
“Integrative medicine is all about goals rather than chief complaints,” Dr. Spar says. “We approach our patients from the point of view of health as a tool to be optimized in service of a life well lived as opposed to simply focusing on disease treatment or avoidance.”
It’s not so much what’s the matter with you as it is what matters to you, he adds. Identifying a sense of purpose can help us all live more fulfilled and longer lives.
The American Board of Physicians Specialties® is a dedicated advocate for patient-centered heath care through integrative medicine. Through its Member Board, the ABOIM, the ABPS is committed to the career development of physicians who embrace all relevant modalities in order to achieve optimal health for their patients. To learn more about the ABOIM, contact the ABPS today.