The Four Pillars of Healthcare

In considering the field of healthcare, there are four pillars. These pillars are disease management, quality of life/healthspan, longevity and performance. We may want all of these things, but there are obvious competing demands.

Traditional medical care has a focus on disease management. If you go to your traditional annual physical you are provided with little insight outside of whether you’re doing well or you need to take a medication. This approach to medicine is largely reactionary. This can be a frustrating situation for those whose goal is to optimize their health and not be dependent on medications. The traditional medical model is great for emergent or acute care but does not apply itself well to prevention. By neglecting preventative medicine there has been a significant increase in chronic disease and healthcare expenses. In Peter Attia’s book Outlive, he describes Medicine 3.0 which has a focus on prevention and individualized care. While we should not neglect the effective means of traditional care, there is likely a better approach.

Healthspan is defined as the quantity of time when an individual is fully functional. My personal bias is this is what we should be chasing in the healthcare industry. We should seek to be as resilient or anti-fragile as possible in multiple sectors of our lives. By seeking to become a resilient person we can weather the storms of life and have greater capacity to give. The foundation for healthspan is creating a structure in our lives that supports a healthy diet, adequate rest and recovery, living a life that displays our values, and a sufficient amount of movement or exercise. By supporting better health we have a greater capacity to give to ourselves, our families and our community.

The field of longevity is strictly focused on how we can live as long as possible. Many people would make the trade-off for a shorter life if it means that they do not have to suffer, can continue doing what they want to do, or don’t have to be a burden on loved ones. Longevity is attractive for many because it focuses on our most valuable gift, time. Many consider this increase in time to guarantee additional opportunities for pleasurable experiences. This is not always the case. We often seek longevity because we are not at peace with our current situation and we want to amend past mistakes or regrets.

Performance is chasing a specific goal for a set period of time. Naively we believe that we can be at peak performance at all times. Consistently seeking maximum performance leads to burnout and overuse injuries. This is whether it’s trying to complete a project at work, in the gym chasing a personal record, or at home trying to be the “perfect” family member. Persistent work without rest, recovery and celebration will lead to a less productive or fulfilling life. Sometimes we just need to rest and sharpen the axe. Performance is a wonderful teacher. We learn our capacities, we often rely on other people and build communities, and it encourages creative thinking. Recognize that seeking performance does not always equate to good health.

All four pillars have their place in the healthcare system and are something we should consider. It’s important to recognize which one of these pillars we are currently chasing. As providers, we should be seeking to maximize our knowledge in each of these pillars to ensure we can provide proper guidance no matter the goal.

Stay strong.