Dr. Marc Siegel: Here's a secret to a longer and healthier life

While death is inevitable, we’re fortunate that medical science can now prolong our lives to an amazing degree. In 1900 the average life expectancy in the United States was only 46.3 years for men and 48.3 years for women. By 2017 life expectancy was 76 for men and 81 for women.

Think about that – many of us alive today would have died long ago if we’d been born at the dawn of the 20th century.

But medical science can’t help us if we don’t take advantage of it. And to do that, we need to pay regular attention to our health and also see a doctor. Unfortunately, too many of us live in denial of the consequences of not taking these critically important steps.

Millions of Americans put off medical exams, vaccinations and tests that could keep them alive and healthy for additional years. They may exhibit avoidance behavior.

Some people are simply unaware that they need certain regular tests and exams or treatments. Others are in denial of their health challenges or are too embarrassed to talk about personal health issues with a doctor or other medical professional.

A third group has had bad experiences with doctors and may be reacting negatively to a doctor’s personality or bedside manner. Others may simply not want to be told to change things in their lives – like eating less, quitting smoking or exercising more.

Some people may fear that certain tests – like preventive colonoscopies – will be too painful or too unpleasant. Invariably, people in this group – after putting off a colonoscopy for years – tell me the procedure wasn’t as bad as they anticipated.

A survey published in Medical Care in 2014 discovered that one-third of all patients avoid doctors’ visits that they deem necessary. Be honest: are you one of them?

And so, too many people continue to engage unwisely in unhealthy habits that make them sick and shorten their lives. For example, 36 million Americans still smoke. This greatly increases their chances for 17 kinds of cancer, including lung cancer, along with COPD (chronic obstructive pulmonary disease) and heart disease.

There is also a diabetes epidemic in America. An estimated 29.1 million people in the U.S. have diabetes, but 8.1 million may be not even know they have the disease. An astounding 400 million people worldwide have diabetes – a group larger than the entire U.S. population.

Diabetes is much more manageable – and sometimes even curable – for those who control their diet. Some 90 percent of those with Type 2 diabetes (the most common type) are overweight or obese. Even though simply cutting their carbohydrate and sugar intake and losing weight would greatly decrease their need for medications, too many diabetics aren’t doing these things.

And consider yet another shocking statistic. Patients who don’t properly take their medication account for 10 percent of all hospitalizations and 125,000 deaths in the U.S. per year. The cost of these needless hospitalizations and deaths is between $100 billion and $300 billion annually. Imagine the uproar if a war or an inadequate response to a natural disaster claimed so many American lives and cost so much in a year.

What can we do about all this? A study published in the Journal of General Internal Medicine in 2015 had some important suggestions.

“Education about the importance of seeking preventive health care and regular checkups is critical,” the authors of the study wrote. “Public health efforts might include telephone or printed client reminders that medical visits are vital to health maintenance, that regular checkups can identify risk factors and problems before they become serious, and that treatments are often more effective when disease is caught early. Interventions utilizing technology such as telemedicine and eHealth (e.g., patient portals) may increase patient engagement with health care, provided they facilitate awareness of health care services and disease management.”

The study authors also pointed to crucial barriers to access to health care, including inadequate health insurance and high copays and deductibles. They cited cost-reduction strategies to lower out-of-pocket costs and the multidisciplinary team care as being crucial to getting people to take better care of their health.

It’s particularly important that you find a doctor or members of a team (if you have multiple health issues) who are all competent, caring and clear in explaining your health status to you and giving you good direction and treatment.

If you don’t have faith in a physician’s trustworthiness and expertise, you’re not likely to pay proper attention to what he or she tells you. That means it’s time to find another doctor.

In addition, health-care access needs to be made more user-friendly. There needs to be more room for communication and patient feedback, even at a time when we doctors are overwhelmed by the necessity of computer documentation.

I trained as a young doctor at Bellevue Hospital in New York City at a time when continuity of care was one of the most important concepts in health-care – too easily replaced by what I referred to in my novel “Bellevue” as “shift mentality.”

In those days I frequently sacrificed sleep to make sure that a patient remained stable. Doctors routinely acknowledged that a medical handoff to a fresh and rested physician – though often unavoidable – also necessitated sacrificing nuanced medical information and well-established doctor-patient rapport. The tradeoff was frequently not in a patient’s best interest.

Indeed, a new British study just published in BMJ Open confirms that when a doctor and a patient see each other repeatedly, according to study co-author Prof. Philip Evans, there is “better communication, patient satisfaction, adherence to medical advice, and much lower use of hospital services.”

In addition, patients who maintain a productive relationship with a physician over time tend to lead longer and healthier lives. Previous research has shown that they are also more likely to follow the direction of their doctors.

Think of your doctor or doctors as coaches in the game of life. We want you to remain healthy and in the game for as long as possible. But we can only advise you – you are the player on the field and ultimately the ball is in your hands.