Friday, April 24, 2009

Helping Patients Take Charge of Their Health (Part II)

Might God help them get better?

Helping patients make life-saving changes can be a challenge. Many of the behaviors that contribute to the development of preventable illness are habitual and some are even addictive. Last week we talked about using money as a motivating factor to help patients to take responsibility for their health. We showed how a fee-for-service system and a personal assumption of medical costs might help diabetes patients to better control their disease. But we acknowledge that even patients who are resolved to make major lifestyle changes may fail to do so. Changes, even the major changes that survival often requires, are often difficult to pull off.

A couple of weeks ago I attended a meeting where visiting physicians talked about their past histories of drug abuse. They talked about how they, even with their understanding of medicine and the body, became desperately addicted to various drugs. They knew the effects of what they were doing. They saw the havoc the drugs were wreaking on their professional lives and on their families, but they would not quit.

One physician told about his addiction to prescription painkillers. At night he would return to the the hospital he worked at and rummage through the garbage and sharps containers looking for old needles and syringes that might have residues of the painkillers he was addicted to. He would collect these residues little by little until he would have enough to take a hit of the drug. Another physician told of a crack house in Detroit that he often visited. He had a credit card with a $100,000 line of credit. Seeing his affluence and his dependence on the drug, the crack house opened a room just for him to stay in during his frequent visits.

But a couple things happened to these physicians to help them turn their lives around. First, they hit rock bottom and realized they had to change. Second, they found God.

The physicians described the desperation they felt when they realized that their lives were out of control. They were losing everything that was dear to them. They realized they had to change and made the decision to change. They told us about the support they received from professional organizations and the Twelve Step Program. The physicians then related, boldly and unabashedly, that only through the help of God were they able to break free from their addictions. Without Him, they would have been lost. Every single day, they told us, they thank Him for helping them escape and remain free from the drugs that once dominated them.

Let's return to our patients who struggle with habits that impact their health and shorten their lives. As physicians we counsel, we educate, we set goals and do everything in our power to help these patients change life habits. But our experience demonstrates that most patients will not change their behavior. Have we come to believe that change is impossible? Are our patients helpless? Are they irreversibly locked in habits of smoking, drinking, over-eating, drugs, inactivity, and damaging sexual practices?

Most physicians and patients believe in God. Do physicians believe that God can help patients overcome their habits? More importantly, do patients believe in a God that would help them change their lives?

As physicians we use all sorts of tools to try to help our patients to change unhealthy habits. Have we tried applying the patient's own faith to the problem? To the patient that is sincerely but unsuccessfully trying to quit smoking, we might ask, "Do you believe that God will help you have the strength to stop smoking?" How powerful it will be if we can follow their affirmative response with, "I know He will."

Change is hard to make, but it is not impossible. We are not treating animals who have no control of their destiny, but Man. He can choose to change. If our patients need help in making change, why not tap into the resource of their faith to help them clinch that change? If our patients believe in a God who watches after the life of each sparrow and cares for the lilies of the field, then perhaps he will help them control their diabetes or quit smoking.

Rusty Scalpel

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