Just One, But It Has to Want to Change

Earlier today, a girl was born in Atlanta who was, symbolically, the 300 millionth American.

Because of advances in medicine, her life expectancy as of today will take her to the year 2083, by which time technology may have given her 100 years – nearing the maximum lifespan for our species.

But from this day forward, her family, her community, her environment and her own behavior will work to shorten that horizon. Why her behavior? Because as Dr. David Nathan, a Boston diabetes researcher, says, “We have recognized that although lifestyle can be miraculously effective (in prolonging life), it often isn’t, because people won’t change.”

That is the crux of the dilemma described in the New York Times, between doctors who, when they encounter a patient at risk for diabetes, prescribe diet and exercise and doctors who grab a pad and write a prescription for new drugs.

The argument for the former is based on research evidence that self-management is more effective. The argument for the latter is based on Dr. Nathan’s observation – if people are going to take forever to change their behavior, why not give them the easy way out?

Which reminds us of the riddle: “How many psychiatrists does it take to change a light bulb?”

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