A couple weeks back I marveled at the ability of medical students to find time in their busy schedules for research projects. That goes double for residents, many of whom struggle to make it under the 100-hour workweek limit. Yet somehow Shantandu Nundy, an internal medicine resident at the University of Chicago, has not only survived the trials of residency, he’s also managed to write a book, maintain a blog, establish a clinic in India and volunteer with pregnant women in Uganda.
Nundy’s book, Stay Healthy At Every Age: What Your Doctor Wants You to Know, came out in April and is a primary care physician’s dream. The book focuses on preventive health care, making healthy choices and receiving appropriate screening to stave off disease, rather than being forced to treat disease after it occurs. That’s a message in line with the recently passed health care reform bill, which encourages regular checkups and screening by by reducing Medicare deductibles and co-payments for such services.
“We all know it is far better to prevent an illness than to treat it,” Nundy told my colleague John Easton, “yet because millions of Americans don’t know these things, and doctors don’t take the time to tell or remind them, thousands die each year from preventable disease.”
But as with anything in medicine, preventive health care gets complicated fast. Information gathered piecemeal from doctor’s offices, magazines, and websites can be overwhelming or confusing. So Nundy’s book attempts to filter and organize the myriad recommendations to prevent conditions such as diabetes, high blood pressure and cancer into an accessible format, including checklists for the screens and vaccines that are most important for each age group. There’s also an online checklist creator, available at the book’s website.
The inspiration for creating such a guide came from Nundy’s experience helping his mother with treat her diabetes. As a medical student, Nundy gathered a long list of established, verified recommendations for his mother. But he was surprised to learn that much of the standard advice was new to her, despite regular medical care.
“She has a doctor,” he said. “She has insurance. She has a college education and worked for the World Bank. But she didn’t know a lot of the basic steps.”
Nundy’s interest in preventive care is not limited to his immediate family. At his blog, Beyond Apples, posts range from cases studies from his own clinic to tales of volunteering in a Ugandan clinic for pregnant women. Some of the most interesting posts talk about the divide between knowing what is best for a patient and convincing the patient to adhere to that advice – a topic Nundy says he will develop further in his next book. There are also interesting posts on the cost/benefit of a vaccine not covered by health insurance, the controversy over controlling the amount of salt in food, and the ethics surrounding a patient’s code status.
The message of both book and blog appears to be that patient health and medical spending can be dramatically changed for the better by small improvements in preventive care. Instead, Nundy told Easton, billions of dollars each year go into developing new drugs or technology to treat advanced disease, much of which we could have prevented.
“We need new and better drugs,” he admitted, “but we also need new and better methods to transmit a few simple, basic messages to people in a way that they can understand and follow. That, and the notion that it could help people like my mom, helped me finish this project.”