How to Get Better Healthcare & The Strange Ways Weather Affects You
Something You Should Know
This episode of 'Something You Should Know' explores the psychological phenomenon known as the 'return trip effect,' where journeys home feel shorter than trips there due to adjusted expectations. It then delves
Key takeaways
- The 'return trip effect' is driven by expectation adjustment rather than route familiarity, making return journeys feel shorter even when distances are equal.
- Healthcare systems prioritize transactions over relationships, leading to medicalization and overprescription without addressing underlying emotional or social issues.
Main topics
- Return trip effect
- Patient empowerment in healthcare
Notable quotes
"If you don't define what your health goals are, the system will define it for you."
"We just don't have a system that's set up to understand the whole person."
Conclusion
To improve healthcare and personal well-being, patients must actively define their health goals, engage in meaningful
Transcript preview
Speaker 4 (0:00) There is one word I think gets people in trouble with money. It's probably. I'm probably spending about this much every month. I'm probably saving enough. I'm probably on track for retirement. Probably is not a financial plan. I've been using Monarch. It's a personal finance app that puts your whole financial picture in one place. And it replaces probably with actual numbers. For example, Monarch showed me that our spending last month jumped about 30 % from the month before. 30%. We had some home repairs, but none of the bills seemed like a big hit at the time. But put them all together, and wow. But I didn't realize how much our spending had jumped until Monarch showed me. And I think that's how money can get away from you. It's not necessarily one giant expense that sets off alarm bells. It's all the things that add up that you don't really notice. That's what I like about Monarch. You can see your spending, accounts, investments, and savings goals all in one place and see what's really going on with your money. If you're operating on probably, maybe it's time to find out. Write your own money story with Monarch. Use code SYSK at Monarch.com. to get your first year of Monarch Core half off at just $50. That's 50 % off your first year at Monarch.com with code S-Y-S-K. Speaker 4 (1:35) Today on Something You Should Know, why the ride home from a trip seems shorter than the ride there. Then, how to take charge of your health care and your health goals, and what happens if you don't. If Speaker 1 (1:49) you don't define what your health goals are in our system, the system will define it for you. So you run the risk of being medicalized, meaning you get a prescription for every symptom, and you're on 20 medications by the time you're 80, and you have side effects from many of them. Speaker 4 (2:04) Also, hot and cold water sound different, and why you already know that difference. And how weather affects you. Rain, snow, sunshine, even the wind. Speaker 2 (2:16) Wind can provoke anxiety. Some winds make people irritable. You find that crime goes up. And even it has an effect on children. In the UK, there's one study that showed that when it's windy, it makes children misbehave. All this today on Speaker 4 (2:32) Something You Should Know. Speaker 4 (2:35) Something you should know. Speaker 3 (2:37) Fascinating intel. The world's top experts. And practical advice you can use in your life. Today, Something You Should Know with Mike Carruthers. Speaker 4 (2:49) You know, I suspect everyone has had that weird experience of going on a car trip and you notice that the trip home, the return trip, seems shorter than the trip to get there. Why is that? Well, that's what we're going to kick off this episode of Something You Should Know with today. Hi, I'm Mike Carruthers. So I'm sure you've driven somewhere and felt like the trip home went faster than the trip there, even though you traveled the same distance. Researchers have studied this, and it has a name. It's called the return trip effect. The obvious explanation is that the trip home feels shorter because the route is now familiar. Except researchers tested that explanation by having people return by a different route, and the effect was still the same. In experiments involving bus trips, bicycle trips, and even people just watching someone else make the journey, The return trip was perceived as shorter. In two experiments, it felt roughly 17 to 22 percent shorter. The explanation appears to have more to do with expectation. On the way there, the journey often feels longer than you expected. Your brain then adjusts its expectation for how long the return trip should take. When it doesn't take as long as the revised expectation, it seems surprisingly quick. And that's the reason why. And it's something you should know. We are constantly being told to take charge of our health. Okay, but how exactly are we supposed to do that? Most of us aren't doctors. Doctor visits can feel rushed. Getting an appointment can take forever. And between medical advice, Google, social media, and the wellness industry, there's no shortage of people telling us what we should and shouldn't be doing. So what does it actually mean to be a smart, informed patient without trying to become your own doctor? And how do you get better care from a health care system that often seems designed to move you through as quickly as possible? Dr. Lucy McBride has spent more than 25 years thinking about exactly that. She is a primary care physician and co-founder of the Ackerley McBride Group in Washington, D.C. And she's author of a book called Beyond the Prescription, A Doctor's Guide to Taking Charge of Your Health. She has some very practical ideas on how to get more out of your doctor, ask better questions, make better decisions, and take more control over your health. Hi, doctor. Welcome to Something You Should Know. Speaker 1 (5:29) Mike, thanks for having me. Glad to be here. Speaker 4 (5:31) So as somebody on the inside who works in the medical world every day, how do you view it? What do you think of it? Speaker 1 (5:39) Modern medicine is brilliant at fighting diseases. It's terrible, however, at sitting with people who have them. We have a system that, unfortunately, and through no fault of doctors, treats patients like a set of transactions, a bag of organs, a set of symptoms, as opposed to whole people with real lives, different tolerances for risk. Speaker 1 (6:09) We just don't have a system that's set up to understand the whole person. Why Speaker 4 (6:14) not? Speaker 1 (6:15) It's very simple. The economics in our country favor prescriptions, referrals, and tests over conversation, over the dialogue. between patient and doctor, which is where the real action happens. The problem with U.S. healthcare is that we have lots of solutions, lots of fixes, but not enough time to surface the issues that people are actually struggling with. The questions that often matter most are the ones that no one has time to ask. Like, what keeps you up at night? Tell me what you're scared to say out loud. What is your worst fear about your health? Explain to me what you're not understanding about your lab tests. What are your health goals? Those are the kinds of questions that take time between patient and doctor to build rapport, to build trust, and to surface the questions that patients are actually asking. Speaker 4 (7:23) Okay, so here's my question about that. You say, you know, these are questions that nobody has the time to ask. There's not enough time. Why? Why can't the system be fixed? Why is everyone going, yeah, geez, I don't know. It's just other businesses that have problems fix them in order to continue. But health care seems to be this big, geez, I don't know. We just don't know what to do. Speaker 1 (7:46) Well, Mike, there's a lot of money being made by the pharmaceutical industry and by insurance companies. So the system is not designed for patients or doctors. In fact, we don't really have a health care system in this country. We have a health insurance system. Now, we need insurance. We need prescription medications. I prescribe them every day as a primary care doctor. But what we first need is what patients and doctors both want. Speaker 1 (8:13) time, relationship-based, evidence-based medicine that has to be rooted in the patient-doctor relationship. It doesn't help my patient who, for example, came in to see me last week with high blood pressure to lecture him about taking his medications. What helps him is me understanding that his wife just died, he's depressed, grieving, and struggling with a bum hip. which makes it difficult for him to get out to the pharmacy to pick up his prescriptions. That takes time to elicit that information. Speaker 4 (8:47) But my sense is that even if patients had more time, a lot of what you just said about, I'm depressed, my wife just died, I have trouble getting to the pharmacy, those are not things to talk to your doctor about. The doctor has no role in those problems. So even if you had more time, I'm not sure people would talk about that. Speaker 1 (9:11) I think because healthcare is so broken in this country, Mike, patients have conceptualized health as a set of lab tests, a set of transactions. But actually, health is about... Health is about me as a physician empowering you as a patient with information and experience and evidence on how to live your life socially, emotionally, mental health wise, physically, behaviorally. I'm not saying I'm a moral expert. I'm a habit expert. I'm saying that I am here to transfer power from me to you. It's not about a transaction. It's about an understanding of a whole person. Speaker 4 (9:50) It seems to me that the role of the primary health care doctor, which you are, has changed in this sense. When I was young, you got sick, something was wrong, you went to the doctor, the primary care doctor, and that was the last doctor visit you had. He fixed whatever was wrong. Now it's referrals to specialists and lab work over here. And the primary care doctor seems more like a traffic cop than put your arm up here and let me sew some stitches in it. Speaker 1 (10:25) That's right. Primary care at its core is meant to be a hub for problem solving. In the old days, even when I was a kid, the doctor, the primary care doctor, was the person who knew your family. They knew the kind of social context. of who you were, which then informed how you made decisions, how you approached problems, how you thought about risk. And you trusted that person because they knew about you more than just your cholesterol levels. But healthcare has evolved such that primary care has become a gatekeeping apparatus, like you said, kind of a traffic cop kind of thing. So doctors in primary care have either had to submit to that format where they are basically writing prescriptions, writing referrals. And then when someone comes in with a problem that is more complex, it's difficult for the system to hold that problem. Take mental health issues. What better person to help you with mental health issues than your primary care doctor, someone who's known you ideally for... years and years and years than you calling a random mental health provider out of the phone book. That just doesn't happen when there isn't, you know, rapport and trust between primary care doctor and patient. So to reframe that, I would say that you're right. Primary care is designed and ideally should serve as a hub for problem solving, not a gatekeeping apparatus. But because of the way reimbursement is in this country, Speaker 1 (12:09) primary care has become basically a traffic cop. And doctors don't like it. Patients don't like it.