You seem like a good candidate for a performance and longevity focused concierge doctor. Have you thought about trying it? Doesn't tend to be cheap, but you get what you pay for.
Many of my family members and colleagues have gone this route. I haven't yet. I've struggled with the expense. For 46 years I had next to no medical complications, then at 47 I had endless medical complications. So I've never been that focused on the PCP relationship -- didn't feel that needed/helpful until the day when I needed to go straight to specialists. But prospectively it is probably a great idea. As with all areas of life, for enough money, you can get treated like a person.
I admit that I have long and complex thoughts on this, and as a longevity focused doc am obviously biased.
BUT, the short version: I don't think the healthcare system is made for people like you (or me). We're not settling for okay, stumbling into the office once a year to be rx'd something for pre diabetes and told "eat better and exercise more!" We're chasing high end fitness, high end performance, and, want to live as well as possible for as long as possible.
(I'm going to drop the we and switch to I so it sounds less presumptuous.)
The healthcare system is there for me if I break my leg or get in a car wreck or find out I have a genetic predisposition to blood clots and end up in blood clot hell with DVTs and PEs. We need that, and, no matter what anyone says, that system is really, really good at keeping people from dying of issues like this.
But it's not particularly good at helping people avoid chronic disease and the sequelae of chronic disease. A huge part of that is because of the way the system is designed - impersonal, disrespectful of patients' time, varying opinions, shitty quality. Then part of that is because that piece relies so much on modifying shitty behavior... which is ludicrously hard if not impossible, especially in an impersonal system that is disrespectful of your time. That said, clearly you do not have issues on the behavior side.
A performance or longevity focused doc on the other hand, will cost more out of pocket but be much more available and should have the flexibility to work with you on your goals while diving into longer term health and also being up to date on the edgier parts of the literature. Some say it's cheaper in the long run. I am not convinced by that argument. Some say the value/dollar is better. I am more convinced by THAT argument.
(PS, this is not an advertisement, I don't have a CT medical license so couldn't work with you even if I wanted to. Just a big fan of yours and Vale Tudo and think we are at least partially kindred spirits.)
Super helpful/relevant. A tone shift could really help for people in this system that want to improve it. I love coaching and know that I have a lot to learn from my (many) coaches -- on jiu jitsu, strength, climbing, and other mountaineering skills. The relationship works well for me. We know what we're trying to achieve and that I can improve. That same relationship could carry over to an MD. But so far, I go simply to get scripts for when I travel abroad.
I show up with a shopping list and ask for approval. I get it but don't love the process. There is utter bafflement at my interest in hormones without being categorized as low T, interest in metabolic health without being diabetic or pre-diabetic, and interest in movement beyond basic box checking. There are people categorized as healthcare providers who are really just drug dealers and I'm not a great customer for SSRIs or statins.
I’d love to hear more about how you use LLMs to evaluate your health. Perhaps starting with some type of discussion on best practices on the initial measurements and data gathering?
I download my blood panels and other stats to see if there's anything that it would do differently. Hydration is one thing that it picked up on. Also, it was very relaxed about some things that can be caused by exertion (and exertions that I wasn't really willing to take a break on to get better data). I also give it all of my supplements to discuss any potential cross toxicities or risks. Have not IDed any problems there but it does point out potential issues.
You seem like a good candidate for a performance and longevity focused concierge doctor. Have you thought about trying it? Doesn't tend to be cheap, but you get what you pay for.
Many of my family members and colleagues have gone this route. I haven't yet. I've struggled with the expense. For 46 years I had next to no medical complications, then at 47 I had endless medical complications. So I've never been that focused on the PCP relationship -- didn't feel that needed/helpful until the day when I needed to go straight to specialists. But prospectively it is probably a great idea. As with all areas of life, for enough money, you can get treated like a person.
I admit that I have long and complex thoughts on this, and as a longevity focused doc am obviously biased.
BUT, the short version: I don't think the healthcare system is made for people like you (or me). We're not settling for okay, stumbling into the office once a year to be rx'd something for pre diabetes and told "eat better and exercise more!" We're chasing high end fitness, high end performance, and, want to live as well as possible for as long as possible.
(I'm going to drop the we and switch to I so it sounds less presumptuous.)
The healthcare system is there for me if I break my leg or get in a car wreck or find out I have a genetic predisposition to blood clots and end up in blood clot hell with DVTs and PEs. We need that, and, no matter what anyone says, that system is really, really good at keeping people from dying of issues like this.
But it's not particularly good at helping people avoid chronic disease and the sequelae of chronic disease. A huge part of that is because of the way the system is designed - impersonal, disrespectful of patients' time, varying opinions, shitty quality. Then part of that is because that piece relies so much on modifying shitty behavior... which is ludicrously hard if not impossible, especially in an impersonal system that is disrespectful of your time. That said, clearly you do not have issues on the behavior side.
A performance or longevity focused doc on the other hand, will cost more out of pocket but be much more available and should have the flexibility to work with you on your goals while diving into longer term health and also being up to date on the edgier parts of the literature. Some say it's cheaper in the long run. I am not convinced by that argument. Some say the value/dollar is better. I am more convinced by THAT argument.
(PS, this is not an advertisement, I don't have a CT medical license so couldn't work with you even if I wanted to. Just a big fan of yours and Vale Tudo and think we are at least partially kindred spirits.)
Super helpful/relevant. A tone shift could really help for people in this system that want to improve it. I love coaching and know that I have a lot to learn from my (many) coaches -- on jiu jitsu, strength, climbing, and other mountaineering skills. The relationship works well for me. We know what we're trying to achieve and that I can improve. That same relationship could carry over to an MD. But so far, I go simply to get scripts for when I travel abroad.
I show up with a shopping list and ask for approval. I get it but don't love the process. There is utter bafflement at my interest in hormones without being categorized as low T, interest in metabolic health without being diabetic or pre-diabetic, and interest in movement beyond basic box checking. There are people categorized as healthcare providers who are really just drug dealers and I'm not a great customer for SSRIs or statins.
Thanks for the post. What LLM did you use?
Mostly ChatGPT but have been comparing it with Claude. Still exploring around...
Thank you for sharing the assessment of your practical (and tactical) use of AI.
I’d love to hear more about how you use LLMs to evaluate your health. Perhaps starting with some type of discussion on best practices on the initial measurements and data gathering?
I download my blood panels and other stats to see if there's anything that it would do differently. Hydration is one thing that it picked up on. Also, it was very relaxed about some things that can be caused by exertion (and exertions that I wasn't really willing to take a break on to get better data). I also give it all of my supplements to discuss any potential cross toxicities or risks. Have not IDed any problems there but it does point out potential issues.