How to Be Your Own Doctor

Taking control of your health is easier than ever

Many doctors think all the data gathering has gotten out of control. (Patrick Leger)
doctor

Just as personalized medicine and health-related testing seem poised to transform how we diagnose and treat certain diseases, many doctors think all that data gathering has gotten out of control. "Many tests don’t result in valuable information,” says Randall Stafford, professor of medicine at Stanford University. When tests flag symptoms that don't need treatment, or show that something is wrong when it isn’t, they can do more harm than good.

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As a result, some doctors no longer prescribe tests that were once commonplace in annual physicals, including complete blood counts, urine screens, and EKGs. And with health organizations such as the American Cancer Society issuing revised screening guidelines that recommend testing less frequently for prostate, breast, and cervical cancer, it’s hard not to conclude that physicians and advanced-testing companies are heading in opposite directions. Either way, you don’t need a bunch of fancy diagnostics or expensive doctor visits to know whether or not you’re healthy. In fact, it’s pretty simple.

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Check Your Blood Pressure

A multiyear study by the National Heart, Lung, and Blood Institute found that people at risk for heart disease who dropped their systolic blood pressure (the top number) below 120 cut their chances of dying by a quarter. A healthy 30-year-old should check at least once a year. If you’re overweight, have had high blood pressure or heart disease, or have a family history of heart problems, check several times a month. You can pick up a monitor at most drugstores for about $40.

Can’t be bothered? Several studies have found that a resting heart rate of 60 beats per minute or below means things are probably OK. In one longitudinal project, researchers at Copenhagen University Hospital noted that above 50, a ten-beat jump in resting heart rate amounted to a 16 percent increase in the risk of dying from any disease. Newer wrist-based heart-rate monitors, like those built into GPS watches, are convenient but not terribly accurate. Chest-strap monitors are better, but the simplest approach is also the cheapest: when you wake up in the morning, set a timer for one minute, put two fingers on your wrist, and start counting.

Know Your Fitness Level

Exercise lowers the risk of everything from depression and diabetes to cancer, heart disease, and dementia. For people in middle age—roughly between 40 and 60—“the fit have extremely low ten-year mortality rates,” says Dr. Michael Joyner, an exercise-science researcher at the Mayo Clinic. Studies have shown that people who are fit enough to run a ten-minute mile—or achieve a similarly high rate of energy expenditure in another activity—are significantly less likely than their peers to die from any cause. That doesn’t mean you shouldn’t ever run faster, though: numerous studies have shown that the fittest people usually live the longest. Stafford recommends tracking how much you’re moving, but you don’t need an expensive smartwatch—stopwatches like Timex’s Ironman ($28) are cheap and do the job. “A little bit of info can be really useful. A huge amount may not add any value at all,” he says. American Heart Association guidelines say that people should aim for 150 minutes of moderate-intensity exercise—think brisk walking—per week. More than that is better, but less is still good.

Know Your Intake

Most Americans drink too much, eat a lot of sugar, and forget fruits and vegetables. What’s more, we lie to ourselves about it: in a series 
of surveys, a majority of Americans reported including enough fruits and veggies in their diet, but when nutritionists zeroed in by asking what they ate in the previous 24 hours, fewer than 15 percent had consumed the recommended amount. The good news is that research has consistently found that those who keep a food diary eat healthier. “That doesn’t mean you have to go into great detail,” Stafford says. “But you want to see how your diet compares with an optimal diet.” Optimal means six servings of fruit and vegetables per day and as little alcohol, refined sugar, and processed meat as possible. Apps like MyFitnessPal (free; Android, iOS, and Windows) make food monitoring easy. But if entering in every meal sounds like a chore, you can always just make a list.

What About Genetic Testing? 

Genetic tests can help diagnose disease and predict how you might react to drugs. But most people are interested in predicting illness. Unfortunately, the tangled relationship between genes and lifestyle has frustrated attempts to develop reliable genetic screens for many common disorders. In fact, the Centers for Disease Control and Prevention warns that testing is “being marketed prematurely to the public.” The FDA has limited the most prominent gene-testing company, 23andMe, to screening for genes that could cause disease in your kids—but not in you. That said, doctor-supervised genetic tests are useful for people who have lost family members to breast cancer or heart disorders like hypertrophic cardiomyopathy, especially if the relative died at a young age—55 for a father or uncle, or 65 for a female relative.

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