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Purpose-Driven Health

Myles Spar, MDThe 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.

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Medical organizations throughout North America understand that our rigorous certification standards prove that ABPS Diplomates are capable of delivering the best patient care possible.

Far too often, medicine is led by less than 5% of non-practicing physicians taking away and replacing the voice of the 95% of physicians practicing and placing patient safety and care first on the front lines every day. The American Board of Physician Specialties has raised the standards in physician board certification not only in the quality of their boards of certification, but in hearing and allowing for the voice of those active physicians caring directly for patients. Having been a part of the ABPS over the last 28 years has allowed me to grow as a woman leader in a field often wrought with challenges. It helped me and others raise the bar of the standards of care in my specialty, Emergency Medicine, through their Board Certification in Emergency Medicine (BCEM). ABPS also helped raise the standards of care for 21st century medicine through their certifications in other specialties, particularly in Integrative Medicine & Disaster Medicine. Having physician voices heard matters to medicine and is essential in the betterment of patient safety and care.

Sarah E. Gilbert, MD, FAAEP
Sarah E. Gilbert, MD, FAAEP
Emergency Medicine
On October 18, 2007, President George W. Bush released Homeland Security Presidential Directive 21 (HSPD-21), calling on our nation, among other initiatives, to “collectively support and facilitate the establishment of a discipline of disaster health”. It is a great testament to the wisdom and foresight of the American Board of Physician Specialties that it immediately set to work and created, within the short span of only one year, an educational blueprint and set of certification examinations, both written and oral, for a new subspecialty of disaster medicine—and it is why I chose to be part this vital initiative and this wonderful organization. This is but one of the many innovative programs initiated by the American Board of Physician Specialties over the years, and why I am proud to support its work on behalf of our nation’s public health.

Art Cooper, MD
Disaster Medicine
When the American Board of Physician Specialties offered to host the American Board of Integrative Medicine, ABPS became a landmark organization working to move medicine into the twenty first century. Certifying physicians who have completed rigorous academic training in Integrative Medicine ensures that the field of Integrative Medicine will continue to develop academically, clinically, and professionally. The leadership of ABPS continues to impress me - they are diligent in constantly innovating to provide certifications for physicians who want to advance their careers and their areas of expertise. I am honored to be a part of this organization.

Ann Marie Chiasson, MD
Integrative Medicine
There are many ways board certification advances a physician career. ABPS Board examination verifies your accuracy, precision, and reflects your mastery of your residency training verifying your expertise. ABPS Board certification demonstrates your level of expertise beyond your practice experience, primary education degrees, and training which are necessary for insurance reimbursement and practice privilege requirements. Attaining your ABPS Board Certification will clarify your purpose, secure your practice growth, and expand into leadership positions. Board certification can serve as an indication of a physician’s commitment to medicine, beyond the minimal standards and competency of training, their measurement to quality of care, and attaining an award for excellence.

Chris Kunis MD
Internal Medicine
When I think historically, advancement in medicine and patient safety and care has been driven by the diversity of people and scientific thought. That’s what I found at the ABPS and more. For over 60 years that is just who we are. I found a physician certifying body that provides a choice and voice to all physicians ensuring that patients are always placed first.

Jerry Allison, MD
Emergency Medicine
When I decided to pursue a full time role as a physician executive it was important to me to obtain additional professional training, education and work experience. Board certification through the ABPS in Administrative Medicine is validation of my efforts and a demonstration of dedication to professional development. We need more physicians to become full time health care executives, knowing there is a board certification option in Administrative Medicine encourages physicians to take the leap from full time clinical practice to healthcare organizational leadership.

Richard Paula, MD
Administrative Medicine
The American Board of Physician Specialties has provided me with the opportunity to demonstrate mastery of internal medicine through board certification. As a hospitalist, board certification is an expected credential, and hospitals recognize the American Board of Physician Specialties (ABPS) as one of the three standard credentialling bodies for Internal Medicine. Additionally, the ABPS has helped me develop leadership skills as a Board member and Committee Chairperson. ABPS has also helped me sharpen critical thinking skills as a test question developer and reviewer. The Allopathic (MD) and Osteopathic (DO) physicians in the ABPS are lifelong learners and frequently pursue multiple board certifications. I enjoy the camaraderie of my peers in ABPS.

Loren Jay Chassels, DO
Internal Medicine
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