What's the largest group of people in the health-care workforce?
Doctors? No. As of 2008, America only had about 661,000 physician and surgeon jobs.
Nurse practitioners? No, only about 158,000 of those were working in 2008. And only about 75,000 physician assistant jobs existed that year.
How about nurses? Although about 2.6 million jobs for RNs existed in 2008, even they don't make up the biggest group of health-care workers.
So who does? The rest of America.
I've kept an editorial that appeared in the journal JAMA last year on my computer desktop, and it continues to resonate with me. The authors of the piece -- a doctor and nurse -- said that "Ultimately, patients are the largest health care workforce available."
They have a great point. Doctors and other providers can offer tools that help you stave off disease and stay healthy, like medications, surgery and other treatments. But oftentimes, you're the one who has to make sure these tools work. Most people spend a few hours in direct contact with their doctors each year. Between visits, they're on their own at home. It's this time that they're in charge of their own health that makes a big difference overall.
I discovered this myself after having major back surgery in my 20s. The surgery itself took just a few hours, but the months I spent preparing for it and regaining my strength and flexibility afterward played a large role in determining the surgery's success.
Unfortunately, many people aren't doing a good job of being their own health care provider. Adherence is a big problem in the United States, meaning that many people aren't taking their medications or following their doctors' advice properly once they get home. Nor are Americans taking full advantage of the lifestyle tools that can keep them healthy, whether it's keeping their weight in check, exercising 30 or more minutes a day or front-loading their meals with vegetables.
The truth is, doctors can do a lot to improve your health ... but their efforts fall apart if you don't step up to the plate and perform as an equal partner in the doctor-patient relationship. That's because:
Patients have power. You have the power to help to make the best treatment plan in the world work -- or fail. You have the power to make choices every single day that may determine if you're going to live to a ripe old age in good health, with a minimum of expensive medical interventions. You have part of the power to avoid many cases of diabetes, heart disease, certain types of cancer and other diseases.
You need to learn how to exercise your power. Doctors and other health care providers spend years cramming information into their heads about how the body works and how to treat disease. A good start for you requires much less work. Start by staying informed about your health, spend time reading reputable websites -- like www.nih.gov, www.heart.org and www.cancer.org -- and develop a doctor-patient relationship that provides good communication back and forth.
Take charge of own health. I believe that your health ultimately is not your doctor's responsibility. I also think it's not the insurance company's or the government's. It's yours. Rather than seeing this as a burden, why not see this responsibility as a great opportunity? Your ability to make healthy decisions every day is limitless, and for many Americans, just making a few healthy changes can lead to a big difference.
For even more tips on how to get better health and need the health care system less, check out "The New Prescription: How to Get the Best Health Care in a Broken System," which I cowrote with Eric Metcalf, M.P.H. This is a book about getting what you really want: better health on your own terms. More medical care doesn't mean better health. I reveal some of the most egregious problems with a medical system gone awry, opening readers' eyes to how to better navigate the changes underway. Using solid research, insiders' insights and patient anecdotes, the book offers cost-effective and potentially life-saving ways to get more out of health care while using less of it.