In a new book, Dr Lucy McBride aims to help us navigate US healthcare – and tread carefully in the wellness industry
Most of us want to be healthy, but it’s easier said than done. In the US, people are caught between a broken medical system and a well-resourced wellness industry. The failings of the former – cost barriers, rushed appointments, impersonal attention – push them towards the snake-oil solutions of the latter.
Over 25 years of practicing medicine, running a primary care practice in Washington DC, Dr Lucy McBride has seen patients struggle to navigate the medical system.
In her new book, Beyond the Prescription, McBride presents a practical framework for getting the best results from a flawed system. It begins with defining what health means to you. For one person, it might be running ultramarathons and extending longevity at any cost; for another, it might be balance and the freedom to indulge.
“The relationship between a patient and their primary care doctor is, at its best, one of the most protective forces in human health – and, right now, we’re systematically dismantling it,” says McBride over Zoom.
It’s no wonder patients feel unheard, unsatisfied and lost. We spoke about how people can advocate for themselves and pursue their vision of health. Our conversation has been condensed and edited for clarity.
Why do you think people have lost trust in medical institutions?
Who do you trust in your life? Someone who listens, who has time, who’s curious, who asks appropriate follow-up questions. In the case of medicine, it’s someone who isn’t trying to give you quick answers for profit or rush you out the door.
But the medical system in the US has become episodic, transactional and impersonal; it privileges the volume of patients seen, and processing them instead of caring for them. The system tends to treat people like a set of body parts. The US public is frustrated.
I think we all know the insurance industry [is at fault] as well, but when your doctor’s hand is on the doorknob and they’re rushing you through an appointment, it’s easy to blame them.
Have we overcomplicated the question of health?
The basics of human physiology – the need for physical activity, regular nourishment, sleep and social connection – haven’t changed over time.
The hardest part of my job is helping people to effect behavioral change and meet those basic needs: starting an exercise program, prioritizing protein in their diet, quitting alcohol, whatever it is.
People like protocolized routines, such as intermittent fasting, but most can’t adhere to them; it just sets them up for failure. The way to help people is to meet them where they are, acknowledge the real limitations of their life and set them up with a program or plan that’s sustainable and supported.
Is it fair to say that everyone defines health differently?
