Have you ever thought about how much personal accountability you have for your health? How much is attributable to your genetics, your behaviors and choices or just plain luck? As a physician who has the opportunity to save lives and prevent disease, I have pondered these questions often.

We are in a healthcare crisis in this country. The costs being born by taxpayers, employers and individuals is ever increasing in an environment where the quality of care, and access to care, is arguably diminishing. Our current pace of ‘costs versus access' are non-sustainable. Without substantive changes in how we reimburse and deliver healthcare, the collapse of our current healthcare delivery model is imminent. This time frame is measured in years not decades…

"Destiny is not a matter of chance. It is a matter of choice. It is not something to be waited for. It is something to be achieved."
- William Jennings Bryan

So what can we do to avoid a catastrophe that will impact our lives in ways that are truly unimaginable? This was one of the primary questions that I asked when I wrote Maximum Destiny. This book was written with the idea that our behavior and choices, as they relate to our general wellness, far outweigh our genetics and plain ole' luck. One of my operating philosophies is that we have a God-ordained destiny that is far greater than any one of us could ever imagine. The problem is that as fallible human beings we make bad choices predicated on exercising our free will that ultimately reduces our quality and shortens our quantity of life. As a society, but more importantly as individuals, we must accept accountability for our own wellness. The general public is not trained beyond ice, Band-Aids, basic cardiopulmonary resuscitation, and ‘a kiss to make it better,' when it comes to the reactive side of healthcare. Reactive care is provided by well-trained individuals in hospitals and clinics with their associated inflated costs. Conversely, proactive healthcare is patient driven, cost effective and empowering to the physician-patient relationship. The expense of developing and implementing a personal, proactive prevention and wellness program is nominal at best. With the help of your personal physician, and with a little self education, you can truly become a champion for your cause. Relatively small time and financial commitments following a proactive healthcare program can be leveraged into huge benefits and reduced exposure to the much more expensive, reactive aspects of traditional medicine.

"As fallible human beings, we make bad choices predicated on exercising our free will that shorten our quality and quantity of life."

Contrary to popular belief, I do not believe our prevailing medical delivery paradigm will require a total overhaul to accomplish a last minute save of our healthcare delivery system. Rather, we need to redirect some of our energy and focus away from antiquated procedures and protocols and toward patient empowerment and responsibility. So how do we accomplish this overwhelming task? Quite simply, we use two of the great motivators in human nature -- personal preservation and pocketbook protection. Nobody wants to get sick and/or die. It is painful and inconvenient. Everybody wants to protect their assets and disposable income. To create the necessary synergy, we align these motivators in a way that rewards good behavior and encourages change in bad behavior. The strategies for this initiative are beyond the scope of this article, but it doesn't take a Harvard-educated economist to construct a program of incentives to practice proactive healthcare. By encouraging accountability, we entrust responsibility back to the individual.

"The retooling of our healthcare system is founded on two of the greatest motivators in human naturepersonal preservation and pocketbook protection."

There is not a more powerless feeling than getting a life-changing diagnosis. However, patient empowerment is the antidote for regaining the feeling of control. By following a preventative program, you can minimize your exposure to getting the diagnosis that you don't want.

Our current reimbursement system is one in which doctors are rewarded for reactive care and are penalized for providing preventative care. Patients have the misconception that because their “insurance will pick up the costs,” they deserve (have earned) the right to the best in reactive medicine without any regard to their own responsibility for their own well being. Appropriate motivation for all players can assure that the game is played well. And wellness, after all, is our goal.

In my next column for NSIDE MD, we will further explore the necessary steps to achieve a proactive program of prevention and wellness, and we will explore how defining your personal legacy will embolden you to realize your Maximum Destiny.