The Dr. Is In

Happy New Year! As I reflect on the past year and look toward the year to come, the philosophy that guides my medical practice is at the forefront of my mind. There are many ways to practice medicine, depending on the situation and the health care provider’s training, but it broadly falls into two categories: 1) squelch the symptom, and 2) address the cause. This brings me to New Year’s resolutions. But first, let me explain.

As people, we seek care because something is bothering us, causing us pain or discomfort. We want it gone sooner than later, and are grateful when we can walk out of an appointment with a promise that we will be free from the pain as soon as we take this pill or supplement, or do a single exercise. It is a wonderful day when this approach works and we can then go on with our lives!


But what happens when if pain returns, either in its original form or in an altered form? The same remedy that addressed the first episode doesn’t always help the subsequent episodes, so we chase the symptom round and round, playing a health care form of whack-a-mole to just feel better.

From the other end of the spectrum, when the root cause is addressed, we deal with the symptom once and for all. Discovering the cause takes more time at the front end. Sometimes there is trial and error, sometimes labs are gathered for more information, and sometimes the right question is needed to uncover the instigating factor. Interestingly, once a deeper cause of discomfort is remedied, often other aspects of one’s life improve as well.

Now, back to New Year’s resolutions. You may recognize some of the most common resolutions are about appearance, lifestyle habits, exercise and finances. A common statistic is that over 90 percent of New Year’s resolutions fail. That is not because the resolutions are unattainable. They are just not the right ones, the specific and unique ones appropriate to you. Just as correct diagnoses guide the most appropriate treatment, successful resolutions are those that reflect who you are and speak to your true life desires.

Doctors ask questions, and lots of them. A simple technique you can use (credited to the business world) involves a series of “why” questions often known as “The 5 Whys.” Though any number can be used, it is recommended to explore at least one “why” past what you think is the obvious answer.


In medicine, we may ask why a symptom occurs, such as sleeplessness. There are many avenues to explore such as blood sugar regulation, stress hormones, sleep environment, life stresses, worries, etc. Using the example of blood sugar, we may ask why there are fluctuations at night. This might be due to eating an early dinner with the children many hours before bedtime. The next question would be to ask why eat with the kids rather than at a later time more suited to adult bedtime. Perhaps the answer is because it seems easier. A few more layers of this type of inquiry (at least one layer past the obvious solution) may reveal it is just as easy to set aside the adults meals, and have a quiet shared dinner after the kids are in bed. This solution addresses not only blood sugar, but also allows for a more relaxed meal and sharing quality time with a companion, resulting in better digestion, more social connection and less overall stress. The core cause may not have been blood sugar at all, but prioritizing all parts of yourself, in addition to being a parent.

So, give it a try if you like. Ask the whys, and discover the one thing that will make a deep positive difference in many aspects of your life; one whose results will be so satisfying that you wouldn’t think of giving it up. Wishing you the best of the New Year!