1: Preventing or delaying disease is a fundamentally better approach than treating disease.

What’s in the way? 

Only our entire healthcare system.

Disease prevention “doesn’t really fit into the business model of our current healthcare system,” Dr. Peter Attia writes in Outlive: The Science and Art of Longevity.

“Health insurance companies won’t pay a doctor very much to tell a patient to change the way he eats,” he observes, “or to monitor his blood glucose levels in order to help prevent him from developing type 2 diabetes.

“Yet insurance will pay for this same patient’s (very expensive) insulin after he has been diagnosed.”

There’s no billing code for having a patient begin an exercise program designed to maintain muscle mass and a sense of balance.

“But if she falls and breaks her hip, then her surgery and physical therapy will be covered,” Peter writes. 

“Nearly all the money flows to treatment rather than prevention,” he notes. 

“And when I say ‘prevention,’ I mean prevention of human suffering.” By not focusing on preventing or delaying disease from occurring, “not only condemns people to a sick and miserable older age but is guaranteed to bankrupt us eventually.”  

2: The focus on treating disease rather than on preventing or delaying it starts in medical school.

Creating more years where we are free from disability and disease was not a topic that was discussed when Peter was enrolled at The Johns Hopkins University School of Medicine, one of the nation’s top medical schools.

“My professors said little to nothing about how to help our patients maintain their physical and cognitive capacity as they aged,” he writes. 

“The word exercise was almost never uttered. Sleep was totally ignored, both in class and in residency, as we routinely worked twenty-four hours at a stretch. 

“Our instruction in nutrition was also minimal to nonexistent.”

3: What does this mean for me and you?


With our current healthcare system, we are passengers on a ship, “being carried along somewhat passively,” Peter observes.

Which is a dangerous path to be on. 

Instead, we must become captains of our own ships.

We “must be well informed, medically literate to a reasonable degree, clear-eyed about our goals, and cognizant of the true nature of risk.

“We must be willing to change ingrained habits, accept new challenges, and venture outside of our comfort zone if necessary. 

“We are always participating, never passive. We confront problems, even uncomfortable or scary ones, rather than ignoring them until it’s too late. 

“We have skin in the game, in a very literal sense. 

“And we make important decisions.”

Peter understands this responsibility may sound scary or overwhelming.

But there is good news.

While the diseases that can kill us are “intricately complex” and “the product of multiple risk factors adding up and compounding over time. . . 

“Many of these same individual risk factors, it turns out,” Peter notes, “are relatively easy to reduce or even eliminate.”

Ultimately, the answer is to focus on habits and behaviors we control: Exercise, nutrition, sleep, and paying attention to our emotional health.

It’s that complicated. And that easy.

More tomorrow!


Reflection: How might I change my mindset regarding my health to focus more on prevention than treatment? 

Action: Discuss with a colleague, friend, or family member.

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