How to get the best care when you don’t even need it, plus: Help!
Mom won’t listen to us.
I’m a young man in my late 20s, busy building my career, and in pretty
good shape. My parents keep pressuring me to find a primary care doctor.
Can you get them off my back?
Leslie Michelson: I can understand your frustrations. But being a healthy 20-something
doesn’t absolve you of planning for continued good health. Developing
a relationship with a trusted primary care physician is central to being
a mature adult. Just as you need mentors in your professional life, having
a good internist prepares you for a stronger future. When the day comes
when you twist an ankle on the tennis court, come down with an illness
while abroad-or something worse, you’ll have a physician who knows
your health history and is ready to help you.
But there’s another reason why it’s so crucial to develop this
relationship. There may be serious illnesses progressing in your body
that you can’t perceive no matter how in tune you are. The classic
examples are diabetes and the cardiovascular risk factors of elevated
blood pressure and cholesterol. By getting regular physicals, you can
take advantage of preventative measures your doctor provides, such as
flu and HPV vaccines, and get early screening if you have a family propensity
toward cancer, heart disease, or other conditions with genetic components.
And by detecting health problems early, treatment is more successful and
you’ll have fewer side effects.
When you’re young is also the
optimal time to get a baseline of your overall health! For example, if you have slightly
elevated blood pressure, it will be a huge benefit to you in the future
to establish that baseline now, so your physicians can track change over
time. And let’s not forget about skin cancer, the most common form
of cancer, which is
rising dramatically among young adults. Your physician can identify suspicious looking moles that may need to
be removed or watched over time.
But you won’t get any of these benefits if you don’t have a
trusted relationship with a caring primary care physician-someone who
can help you to monitor your health now, while you feel well, to head
off a potentially disastrous medical crisis in your later years.
Question: My mom is in her late 70s. She has myriad health problems (hearing, arthritis,
blood pressure, etc). I’ve begged her to take her medications, use
a cane, and wear a hearing aid-but she won’t listen to me. Help!
Leslie Michelson: It’s important to recognize that everyone is going through developmental
struggles at all phases of life. We’re familiar with the terrible
twos, with adolescent rebellion, and with midlife crises. It could be
that mom, in her late 70s, is similarly grappling with developmental struggles.
And if you treat her like she’s a child who’s misbehaving,
you’re never going to reach her.
Author David Solie wrote a terrific book,
How to Say It to Seniors, which may be of help. Solie offers simple and profound insights as to
how to persuade mom to engage in safer conduct, while also strengthening
By the way, you’re not alone. I see this issue a lot with very loving
families who have strong bonds. A few years ago, I had the pleasure of
working with such a family, whose 89-year-old mother, “Alice,”
was a real firecracker. When Alice came down with a terrible, obstructed
small-bowel problem, which wasn’t resolving on its own, her family
urged her to have surgery at a major hospital, two hours from her home.
Alice was in a lot of pain, and we knew that if she didn’t have
the surgery, she could die. But she put her foot down and said, “I’ve
had enough. No more doctors.”
As hard as it was for the family, they had to back off. They told her,
“Ok, Mom. You’re in charge. It’s your decision.”
Thankfully, she changed her mind and had life-saving surgery. At her 90th
birthday party, family and friends flew in from all over the country to
The point is: respecting your mom’s sovereignty over her own body
is often the pivot point. Sometimes we must accept that our loved one
is in charge, even when their decisions give us grief.