3-Point Summary Health insurance does two jobs. It caps your catastrophe and gets you negotiated prices. It isn't prepaid health care, and expecting it to be is the source of most frustration. The premium is what you pay every year. The out-of-pocket max is what you pay in your worst year. Most people compare only the first. You need both. Network status and the allowed amount decide whether your coverage works the way you think it does. Out-of-network care and uncovered serv

Overall: The roof is completed, thanks be to God. Just a little clean up and after 10 months I may be able to move in to my office. Exciting times. A personally challenging week, which I wish didn’t line up with a deload week from a workout perspective, because I needed to put some of that energy somewhere else. Did more reading this past week which lifted my spirits. I miss just sitting and reading and the deload did make workouts shorter and allowed for me to sit in the

The short version Most communication problems between partners are a mismatch, not a deficit. One person wants to be heard and the other shows up with a solution. The research on support says the unrequested solution often makes things worse, even when it's correct. Your partner is the one person who gets no benefit of the doubt. We over-trust experts and under-trust the person across the kitchen table, because we know every one of their flaws. Being right is not enough to be

Overall: Pretty good week. Roof is actively getting replaced, thanks Nuvant, which is a blessing. Took a couple days off clinically and was able to have a little staycation. Went to a Westerville South football game with the boys and it was good to go back there. Had the pleasure of going out to EliteFTS to speak with Dave Tate and had a lot of fun. My wife got to come with me and train there. Elite is special to me because of the influence they had on the strength and condit

Part IV of the Risks series. Parts I through III covered cardiovascular disease, cancer, and neurodegenerative disease. The short version This one is about function, and function is what people actually mean when they say "healthy." The first three parts covered what kills you. This one covers what takes your capability first, and then, by way of a fall and a hip fracture, kills you anyway. The account closes early. Peak bone mass is set by around age 30. After that you are m

Overall: Another stressful week. Still struggling with some reactive edema/swelling when training my right arm. Was hopeful this would calm down, but has been relatively persistent. Still trying to get the building in a good position and this has taken longer than expected. Some negative outcomes for people I care about this week has put me in a bit of a mental tailspin. It’s always the pain of caring about people that makes it hard. Still think they’re worth it. Learning:

3 Bullet Point Summary This is the most impactful class of medication released since I finished training. I say that as someone who was skeptical of it for a decade, for reasons that turned out to be wrong. The drug is not the plan. Roughly 85% of people started on one for weight loss are off it within two years, and the trial data say most of the weight comes back when they stop. The people who keep the result are the ones who built something underneath it. The right questi

Overall: Rough start to the week and not too bad of an end of the week. Was exhausted by Wednesday. Have been getting in the training, but body didn’t feel primed which is discordant from what my Garmin is saying. Recovery has been the highest it’s been in several months per that. I’m curious how much my posture has been contributing to my pec. With the roof waited to get a new desk and as such have been too slouched likely tightening up the pec and stretching the lat out. F

Part III of the Risks series. Part I covered cardiovascular disease. Part II covered cancer. The short version Lifetime risk is higher than most people think, and later than they fear. Roughly 42% of Americans who reach 55 will develop dementia by 95. But the risk is about 4% by 75 and 20% by 85. Most of it lands after 85. Midlife is where the risk gets set. About 45% of dementia traces to 14 modifiable factors, and most of the leverage sits before 65. The two largest single

Overall: Intensity in training and life backed off this week and it was the normal thing that pushed my body into more of a rest phase and I was tired. Need to be more disciplined from a time management standpoint and figure out a way to get more reading done. Still need to be more disciplined about blocking off Saturday morning as deep work time. Did a lot of work thinking about how to improve technology within the practice. Was able to train BJJ last Sunday for the first

Last month I laid out the 5/2 document and what it's for. Two questions: What do I want? and What do I do? Ten life categories, five timelines, one sheet you reference daily and modify rarely. This is the first category walkthrough, and I'm starting with health and physical because it's home turf. It's also the category people get most wrong, which is a strange thing to say about a list of goals written by people who are paying a doctor to help them stay healthy. The mistakes

Overall: Busy week again and that should continue for the foreseeable future. I am starting to feel better with a structured program and I continue to believe that a program that has progressive overload built in, is the way to go for most people. Stop thinking, follow the recipe and do the work. Spend a little time making or picking the plan, spend most of the time just following it. I’ve been using the HYBRD app and have been content so far and it’s held me accountable wit

Part II of the Risks series. Part I covered cardiovascular disease. Cancer is the second leading cause of death in this country, behind heart disease. For the age group I take care of — call it 38 to 58 — it is the one people are actually afraid of. Nobody lies awake worried about their LDL. Plenty of people lie awake after a friend their age gets a diagnosis. That fear is not irrational. Roughly one in two men and one in three women will get a cancer diagnosis at some point.

Overall: Another fairly stressful week. Sleep started to improve towards the back half of the week. Think a lot of that early in the week was from overtraining after restarting this program. Overall feeling good and significantly improving frequency of cardiovascular training. Did heavy BSS and felt wrecked for a couple days following. Having drill separated by 2 weeks was more taxing than I anticipated and limped into the weekend. Outside of the security system the gym i

The Health Score Card: Five Measurements That Are Good Enough One of the questions I keep coming back to is how we get a more accurate depiction of someone's overall state of health. Not a lab value. Not a symptom. The whole picture. In 2027 we'll be rolling out the health score card. The idea is simple: the same way a business has a scorecard, a person should have an objective evaluation of where their health actually stands — and a way to tell, year over year, whether it's

Overall: Hard to believe 9/11 was 25 years ago. This motivated me and a lot of my generation to join the military. I miss the unity that took place nationally right after this event. Wishing peace to all the lives impacted directly or indirectly from that event. Another up and down week. Sleep was really poor. Made a decision and we should have a roof at some point in the near future and my brain is finally able to refocus on getting systems set up to provide better patient

The 5/2 Matrix: What Do I Want, and What Do I Do? Goal setting and health go well together. The whole practice of medicine is more or less goal setting: we see something we're trying to accomplish or change, and we run an experiment. Humans are complex and things come up, so we're never running a clean experiment where only one variable changes. That's why medicine is a practice and not a classically controlled experiment. Goal setting is a lot like coaching in that both star

Overall: Challenging week, but overall good. Old partner from COPC got married, more or less recovered from procedure last Friday, gym equipment came in, still haven’t figured out what to do with the roof. Training will be wonky this upcoming week as well. Going to get back into standard training program this upcoming week. Know that's going to be a mistake as it will be a weird week, but feel like I need to start this progression. Learning: Podcasts WCI Attia Knowledge

There's a concept in personal finance called paying yourself first. Retirement contributions and tithing come out before the money ever lands in your checking account. The reason is simple and a little unflattering: money in the checking account gets spent. Not maliciously, not stupidly — it just evaporates against a hundred small, reasonable demands. So you take it off the top, before the demands get a vote. Your days work exactly the same way. The moment you interact with a

Overall: It’s been a long and short year. I can't believe we're entering into September and that means Professional Integrative Care is turning 2 years old. The second week in the building was more normal. It was my last week going to Pickerington, with the intention of freeing up more time for family. It will be the first time in my career I’ve been at one location. My biggest concern is that the staff will get sick of seeing me that much. I think it was a hard choice becau