New Year's, and the time I always resolve to lose more weight, is arriving. Will I once again choose a diet du jour, and try to follow it for a few months, only to slip back into my favorite high-calorie snacks and desserts? Or should I take a serious look at 2014 and make better choices?
Starting back in ancient times, new year's resolutions have long been made. Babylonians began that custom. Vows to the god Janus were common in Roman times (vows were made in January, a month named after that god), and making a peacock vow concluded Medieval knights' days of Christmas.
And today, making resolutions is very common. 41 percent of individuals make resolutions, and 56 percent of those who make such resolutions are so confident they will be successful that they initiate changes within one month. Tragically, only 46 percent actually do succeed in keeping their resolutions at 6 months, and only 19 percent at one year.
Commonly-made resolutions include reduce weight (that's me!), increase exercise (again, me!), stop smoking, stop excessive drinking, improve finances, reduce stress, get along better, and travel. Are these the same ones we should make again?
What can we all really expect in 2014? Since I am a doctor, I will focus on health care. In this next year, we will see changes in health insurance coverage, new insurance companies for many people, more patients for doctors resulting in shorter office visits, greater use of nurse practitioners, more expensive medications, better treatments for most diseases, and a need for more personal responsibility for our own health.
So perhaps there are more important suggestions for 2014 new years resolutions, rather than our usual ones. Here are my tips for better New Year's resolutions:
• Find a doctor (or specialist) who truly cares about you. I hope you already have such a doctor, but if you don't, it's time to get a second opinion (for more information on getting second opinions and finding the right doctor for you, see my book "Surviving American Medicine").
• When you have the right doctor, see your doctor at least once every year, and get complete advice on what to do about your illnesses, conditions or medical risks, and then follow the physician's advice. This means you should understand it, remember it, commit yourself to it, and then monitor yourself to see that you are following it. And you should have follow up visits with your doctor to be sure the advice is updated.
• Take your medicines. Just an apple a day does not necessarily keep the doctor away, but taking your medicines each day as prescribed certainly does keep the doctor (and even paramedics) away. This is not as easy as you might think. Overall adherence to medications for chronic diseases is only 40-50 percent. Even in life threatening breast cancer, compliance with taking curative tamoxifen pills, which is 90 percent in the first year, is only 51 percent in year five, and adherence less than 80 percent results in decreased survival!
• Get all your immunizations. Your doctor can tell you which you are due to take.
• Know your health vital information: blood pressure, BMI, blood sugar, cholesterol, CRP, vitamin D, bone density, and markers of activity of diseases you have.
• Keep your home medical record (medical history, diseases and conditions, medications and reactions, allergies, pathology reports, surgical reports, medical visit notes, consultation notes, hospital discharge summaries, laboratory and radiology reports, genetic tests, summaries of treatments received).
• Keep two emergency cards (listing medicines, doctors, illnesses, allergies, and emergency contacts), one in your wallet or purse, the other on your refrigerator door, or in the first shelf in the refrigerator door in a red envelope (that's where most paramedics look when arriving at your house following a 911 call).
• Have health insurance.
• Do your screenings for illnesses (pap smear, mammogram, PSA, low dose chest CT scan in smokers, bone density test, colonoscopy, carotid ultrasound, at appropriate ages).
• Keep a daily diary to record if you are getting some exercise every day. Also record any severe symptoms you might develop.
Of course, you can also resolve to do other things that fulfill or improve your life, and you should! My list is to help remind you of commitments that you should consider in this time of political and legislative pressures which are changing health care and even many of our own doctors and hospitals.
Now for two important clues.
• First, if you set goals that are measurable and/or set a target time to complete the resolution, you will be more likely to keep your resolutions.
• Second, if you share your resolutions with others (family friends) and show them a list of your resolutions, they will support you and help you keep the promises you make.
Good luck for 2014!