The development and implementation of innovative heart attack and stroke prevention programs should lie at the forefront of healthcare imperatives as they will help save countless thousands of lives, reduce chronic disability and will save a large percentage of the $300 billion (and steadily rising) in direct and indirect costs of cardiovascular disease and stroke in the United States annually.
The mostly reactive and disease-care oriented practice of medicine that is observed today must give way to a much more effective and cost efficient practice that addresses the root causes of chronic, complex and debilitating diseases such as heart disease, stroke, diabetes, obesity and cancer. This transformation is already occurring with the rapid emergence of practitioners who practice a more personalized form of medicine, one that takes into account the whole person including all aspects of lifestyle. These practitioners have embraced, to various extents, the holistic medicine philosophy. Similar disciplines such as integrative medicine and functional medicine accept the basic tenet that the body has the innate capacity to heal itself and define health as a positive vitality, rather than mere absence of disease.
Provided that medical practitioners follow the rubric of holistic medicine while maintaining disciplined adherence to standards of conventional medical care and do not embrace and employ therapies that are not grounded in science (pseudoscience), the likelihood of decreasing chronic disease burden, especially reducing risk of heart attack and stroke in their patients, will be greatly enhanced as heart attacks and strokes are, to a great extent, preventible with aggressive lifestyle modification, optimal nutrition and judicious use of mostly inexpensive and well tolerated pharmacologic therapies that have proven their value in clinical trials.
When patients (consumers), especially those concerned with reducing their future risk of heart attack and stroke, try to navigate the increasingly complex health system, the process of selecting the most qualified preventive physician and/or heart attack and stroke prevention program may seem daunting.
Answering the following five (5) questions may prove indispensable for selecting the program and physician that will most likely help reduce your risk for heart attack and stroke in the future:
1) Does your physician provide at least **60 minutes of face-to-face time with you in the office which allows you to tell your story without interruption, and allows your physician to elicit a comprehensive history including elements of your medical history, relevant environmental exposures, possible genetic predispositions, social interactions, lifestyle habits, issues related to faith/spirituality and nutrition that may influence your health favorably or adversely?
**Generally speaking, integrative medicine and functional medicine practitioners schedule 60-90 minute office consultations.
2) Does your physician have a sound understanding of nutrition, spend a great deal of time discussing the vital role of nutrition in health promotion and provide instruction on how to select and prepare foods that are both healthy and flavorful?
3) Does your physician emphasize the importance of physical fitness in achieving optimal health and provide instruction and guidance on how to perform exercises that are prescribed based on your level of fitness, and respectful of any physical limitations you may have?
4) Does your physician obtain advanced laboratory diagnostic tests (such as an NMR LipoProfile test, or VAP cholesterol testing along with markers of inflammation, glucose tolerance testing, and select genetic tests) to help uncover some of the multitude of “non-traditional” risk factors for heart disease and stroke?
5) Is your physician board certified in clinical lipidology and/or cardiovascular disease and do they possess a firm grasp of cholesterol/lipid disorders, metabolic diseases, vascular biology and physiology?
If you answered “yes” to at least 4 out of the 5 questions above, you should be pleased with your selection of a physician to help you reduce your lifetime risk of heart attack and stroke. If not, I recommend you search for a more qualified practitioner, especially one that will empower you to play a more proactive and participatory role in your health and long-term prevention plan.
Christopher G. Stephenson, MD, FACC, RPVI