Should We Lease Our Bodies?
As healthcare providers, it is our job to weigh the costs and benefits associated with an intervention. However, it is also our job to have an informed conversation with patients, providing them the information necessary to make a choice.
Prompting this opinion piece was the deluge of patients I see who feel invisible in the health system. Stories of being talked over, dismissed, rejected and downright scorned for voicing another opinion are distressingly common. When did we conflate the idea of healthcare professionals with being divine, and in doing so, give away our own autonomy?
When a patient and I have a meet & greet, I call those alignment sessions because it presents a chance to see whether the way I operate as a practitioner aligns with their goals. I tell them that working with me includes taking control and ownership of their health, and that my role is to help keep them on track. I operate within the boundaries that we establish and offer my input insofar as it helps the patient reach their goals. At no point do my visions for what this person ‘could be’ supersede their own. For majority of those I meet, this approach works, but it takes time as we break down decades of them giving away that choice to a system that fails to meet to listen time and time again. For some, they seek a different approach and that is okay. We thank each other and I make a referral to someone else, both of us walking away from the alignment session with the feeling that our time was valued.
Beyond this alignment session is the initial intake which lasts an hour and a half. If you have ever been on a first date, you know how short 90 minutes can be, or how each second seems to stretch towards infinity. I have the chance to learn about trigger events, explore their relationships and how they impact their symptoms, talk about surgeries and learn why they decided to start certain supplements or avoid the advice of a member of their care team.
These initial intakes are incredibly powerful as we establish their why behind choosing long-term wellness over the band-aid approach to illness. We explore barriers to health like time and cost, the motivation for getting better and more. Questions they have never been asked because illness forces us to look at the ‘right now’ instead of how our choices now will shape our health for decades to come.
This raises the question, should we lease our bodies?
At some point, you may have watched a show or read a book that highlights this dystopian thought, which for me was the novel Altered Carbon. In the series, your mind and everything that makes you you is uploaded to a chip which can be inserted in to replacement human bodies known as sleeves. If you get sick or injured and can afford a new one, just replace it!
When you lease a vehicle, included in the contract is the requirement of regular maintenance checks through the dealer. This includes inspections of dozens of components, changing filters and assessing whether bodywork is needed. They understand that when the vehicle is returned at the end of the lease, an investment in preventative checks ensures the vehicle lasts longer and maintains its value.
Why do we avoid this approach with our own bodies?
Many private insurers cover lab work ordered by a licensed ND. For most patients, an extensive lab panel assessing everything from kidney and liver function to nutrient status is run.
Why? Is that not wasteful? Does that not increase risks? All great questions because as mentioned earlier, we live in the world of right now. If you have no symptoms, why assess?
As we now know with countless chronic degenerative conditions, the foundation for disease is being laid years before symptoms appear. For my patients, an annual blood panel of this extent means they have years of objective data to fall back on. Similar logic to why regular blood pressure readings logged at home are far more reliable than the one-off measure during a visit to a clinic.
Critics of this approach would say why bother with the unnecessary testing? The worry is that something benign will appear and provoke anxiety around health. I agree when there are greater risks like with procedures involving ionizing radiation as unnecessary testing in this case can increase cancer risk, but these fall outside my scope to order. When something appears on blood work, an appropriate referral is made and I cannot overstate the number of times something of interest was discovered. This boils down to similar logic in avoiding an oil change in a vehicle until ‘symptoms’ show. Run it until it turns to sludge and forces your vehicle into complete engine (organ?) failure.
Having a robust referral network of incredible practitioners around me serves one purpose, to support the health of the patient walking through our doors. We direct to the expert when appropriate and work to make health literacy a normal part of life. Having a quarterly check-in with my patients and running routine lab work fosters a sense that someone is on their team.
Maybe if we leased our bodies, they would be treated better.
What do you think of this article? What was most interesting or surprising to you? Is there anything else you want us to know about your perspective on body autonomy and the evolution of healthcare?
Please feel free to leave a comment below. I'd love to hear what you think!
Thank you for reading.