Return to Main Menu

Lifestyle factor affects patient's health by Dick Peterson Public Relations  There’s more to a patient than a medical history. The way National Primary Care Week keynote speaker Robert S. Lawrence, M.D., sees it, factors like lifestyle, family, job, community, and education can affect a patient’s health. Lawrence is professor of health policy and management and associate dean for professional education and programs at the Johns Hopkins School of Public Health. He was interviewed by The Catalyst prior to addressing a gathering of MUSC students and faculty Oct. 4. Sure, the physical exam, immunizations, medications, past office visits, surgeries and hospitalizations are important in a patient’s evaluation. But if the primary care practitioner is doing his job, he’ll ask about a host of other factors that have been shown to affect a person’s length and quality of life. “It’s a challenging dilemma,” Lawrence said, “to get people who are trained in clinical medicine to focus their energy beyond the individual patient. It’s getting the clinician to develop a dual mission —to do what is best for the patient, but also to use knowledge of the patient to be an agent for change for others in the practice and community.” “You can’t be a good clinician by simply doing good science,” said MUSC associate dean for primary care David Garr, M.D., who was also on hand for the interview.  “The doctor can write the prescription for the right drug, but if the patient can’t afford it or can’t get to the drugstore to fill it, he doesn’t take it, and he reduces his chance to improve his health. And the doctor doesn’t know unless he asks the right questions. Many patients in a clinician’s practice may encounter these type of problems.” Changes are needed nationally to make health care affordable and available, Lawrence said. He cited studies and statistical analyses of health conditions in several industrialized nations to buttress his point. They indicate that the availability of affordable primary and preventive care—woefully lacking in the United States, he said—raises the overall health of a society. “When people have a sense of control to determine their fate,” Lawrence said, “they live a healthier life.” That sense of control builds an individual’s self esteem, and that, Lawrence said, can produce measurable improvements in health status. Evaluations across the income spectrum indicate, he said, that as income drops, health drops, with the poorest in the population having the least access to disease and injury prevention services. Lawrence urges an economic approach to the plight of the most disadvantaged in American society. His solution, he said, would be to rewrite the current U.S. tax code. An income tax system that would shift more tax money from the upper income classes for distribution in the form of better and affordable health care and national health insurance for those in the lower income status could improve the health of all members of American society, he said.  “People who feel they can control things in their lives, who are not fatalistic, who sense a degree of fairness in society where everyone seems to be getting a fair share will produce a healthier society,” Lawrence said.