“Don’t get old doc”
I hear this almost daily from patients who have lost their health, vitality, and independence. It makes me reflect on what I would like to able to do and be in old age. I want to be as fit and healthy as possible to avoid being a burden on my family and society for as long as possible. I want to be there for my 4 kids as they grow up to help guide them through the ups and downs of life. I want to play with and help raise grandchildren and ideally great grandchildren. Hopefully pass on some life wisdom to the next couple of generations. I want to use my knowledge to help others achieve the same healthy longevity.
As a doctor for over 15 years, I screen for disease, diagnose, treat, educate, and counsel generally in less than 15 minutes.
Over years of the brief interactions, I get to know my patients who inevitably accumulate diagnoses, surgeries, hospitalisations, and medications. It's inefficient and ineffective at maintaining people's health and wellbeing. I recently heard the thought that the term healthcare should be replaced by the term sick care and unfortunately this rings true to me.
Modern medicine has excelled in treating and managing disease, but prevention and cures are lacking. The duration of life, lifespan, has increased at a greater rate than the duration of good health, healthspan. This imbalance of lifespan over health span has created an ever-growing burden on private health, public and private hospitals, general practice, aged care, and disability care that will only get worse. The economic consequences of this burden will only be compounded by our ability to maintain a healthy aging workforce.
Part of the solution will be a pivot to healthy longevity by providing personalized precision preventative medicine. Our focus will be thorough history taking, physical examination, enhanced extensive screening, personalized therapy, lifestyle modification, education, transparent personalized patient ownership of medical records.
My preventative strategy will focus on cardiovascular disease, cancer, neurodegenerative disease (e. dementia), metabolic disease (e.g., diabetes, non-alcoholic fatty liver disease) and frailty. The testing will extend beyond regular routine tests which are based on whole population cost benefit analysis. In screening for these conditions and genetic predispositions we can focus on a precise personalised treatment plan for the individual. Regular follow up and repeat testing will assist with early detection and improve long term lifestyle changes.
The plan will utilise modification of diet, exercise, sleep, medication and supplements to extend healthspan with the potential side effect of extending lifespan.
