Do Not Lose the Battle Before It Starts

NOTE: This blog post was taken from Need to Know: How to Arm Yourself and Survive on the Healthcare Battlefield (2018) by Darwin Hale, COL (RET), USAR, the Founder & CEO of Advocate Health Advisors. Darwin is a respected entrepreneur, author and decorated military officer with more than 30 years’ experience in the corporate world to include serving in the United States Army and Army Reserve (USAR).

The American healthcare industry is a battlefield on which hospital medical errors kill a quarter million patients a year, where 3.8 trillion dollars was spent in 2019 and almost one quarter of that money was wasted. America’s medical expenditures were greater than the entire gross domestic products of nations like Canada and Great Britain. Let’s repeat that- according to an article in Forbes Magazine (Feb 21, 2019), our 2019 health care expenses exceeded the value of all goods and services produced in Canada or Great Britain!

Whether you realize it or not, you will eventually be on that health care battlefield. When that time comes, you don’t want to lose the fight before it’s even begun. If you are not prepared, battlefield opponents will deny you the ability to control your own care and to handle health complications when they inevitably arise.

Lifestyle choices and quality of care determine life expectancy

The average life expectancy for Americans is 79 years; that statistic sounds impressive until you compare it to other economically advanced nations. According to the U.N. World Population Prospects 2019, 33 other nations boasted life expectancies longer than ours. That 79 year figure quoted is an average across the entire nation, but there is a huge variance depending on where you live.

A 2017 study published in JAMA Internal Medicine showed that the average can drop to 67 years or be as high as 87 years – a variance of two decades! Geography is not the driving force here. The quality of our health care and our lifestyle choices are much more impactful in determining how long we live.

Enemies like cancer and heart disease are out to get us, but so are the enemies we invite in, like smoking and obesity. These personal choices are often the underlying causes of ailments like heart disease, stroke, cancer and diabetes. Physical inactivity, a lack of exercise, contributes to those conditions today and invites danger later in life as weaker legs and hips can cause falls and limit mobility.

The third leading cause of death, medical errors, is also impacted by our choices. Many people pay no attention to their health until a serious problem has already developed. Medical errors are not just simple mistakes in daily diagnosis and treatment, they are often the result of a fragmented system that results in missing warning signs that should have been caught.

Patients don’t help the situation when they refuse to get preventative care that could have avoided illness, sometimes because they didn’t know they needed it. There is also the enormous issue of non-compliant behavior, patients who refuse to do what their doctor has asked. Why do patients spend time and money to get sound medical advice and then ignore that guidance? We are already battling disease (and age), we should not be fighting ourselves as well.

Assess your own vulnerabilities

How can you be prepared for this fight? First, you need to understand where you’re vulnerable. To borrow a military term, you want to run a “vulnerability assessment” on your health to determine the factors that are most likely to cause problems. Whether due to genetics or to your own life choices, where are your defenses the weakest?

My military background has taught me the value of a systematic, thorough vulnerability assessment. When planning to defend a base, we thought about how we would attack it if we were the enemy. We tried to discover and correct weaknesses using another point of view. The same process can help you to defend your health.

Imagine that one day, you realize that you are not walking as steadily as you once did. Knowing that vulnerability, you can assume that sooner or later, falling is a likely outcome. You want to avoid this consequence, and here is the good news: slips and falls are largely preventable! If you’re not walking steadily, you might just need some physical therapy. You could also do some strength conditioning and balance work to help you walk better.

This is low-hanging fruit, something that everybody sees but few people do anything about. It’s obvious, inexpensive, and uncomplicated. Each person should conduct their own vulnerability assessment to find weak points. Is it your diet, your lack of proper exercise, the lifestyle choices you make or some other factor you can alter? If so, you are lucky, because you can change these vulnerabilities. If your vulnerability is a genetic disposition to heart disease, diabetes or some other familial disorder, you cannot change that, but you certainly can take steps to minimize your risk. In any case, it is essential to think about how you might be attacked and to create a defensive plan.

Pay attention to the signs your body gives you! In the military, we conducted vulnerability assessments because we knew that terrorists would be looking for any weaknesses they could exploit. Our job was to make sure they didn’t find any. Think of disease the way that soldiers think of terrorists- they’re looking to gain a foothold in your body, and often they’ll leave warning signs, so pay attention.

If my soldiers were in a tower protecting a base and saw the same car come up three times in a month taking photographs, we took that as an indicator something was about to happen. Indicators are clues, and you want to be aware of those clues.

Your body gives you clues too, so do not ignore them! The breathlessness felt after a brisk walk, a change in bowel habits, the mild tremor that sometimes appears but goes away- all these are signs that something might be amiss. Your physician can tell you if metrics like cholesterol or blood pressure are pointing to future problems. By paying attention, you can defeat these enemies before the battle even begins.

Make a plan and take action now
Medical science is making great progress in identifying potential problems before they become deadly. The presence of precancerous cells in the colon can be detected by a colonoscopy that shows the shape and the size of a polyp. The same principle applies to breast cancer screenings or prostate examinations. If these tests detect problems early enough, they can be successfully treated.

I once had to go through strenuous rehab for back and shoulder pain. Now, I realize that if I had recognized the problem early and done those exercises in advance, I probably could have avoided the therapy and rehab altogether. But I did not know to do them. That is why you must be alert, run your own vulnerability assessment and make a plan! As my mom used to say, “A stitch in time saves nine.”

Now is your chance to get ahead of things. Assess your risk and vulnerability, formulate a plan to mitigate those things, become informed, determine your course of action, and use wellness to fight the enemy. You don’t have to lose the battle for your health before it’s even fought.



Life expectancy: 78.6 years Source: United States Life Tables, 2017, table A pdf icon[PDF – 2 MB]

Life expectancy by nation ranking

JAMA Internal Medicine Life Expectancy Can Vary By 20 Years Depending On Where You Live

Healthcare Spending