Level three on the Hierarchy of Health is The 4 Doctors. The four doctors is a concept developed from Paul Chek and his work The Last 4 Doctors You’ll Ever Need. Chek defines the doctors as Drs. Diet, Quiet, Happiness and Movement. This level is all about lifestyle interventions that can be performed to improve your health. Lifestyle factors are generally of your control and can greatly impact your long term health outcomes. The American College of Lifestyle Medicine (ACLM) has a similar model which they describe as their Six Pillars of Health - Nutrition, Physical Activity, Restorative Sleep, Stress Management, Social Connection and avoidance of Risky Substances.
Dr. Diet
Diet is challenging because food is not simply the items we put into our mouth. There are cultural, social, educational, financial and occasional ethical considerations when it comes to our dietary choices. The biggest challenge for most people is consistency. The barrier for consistency that I tend to see is education and skill when it comes to cooking. Learning basic knife and cooking skills can make cooking less burdensome, tasty and enjoyable. The general rule of thumb with nutrition is if you can increase the percentage of whole food in the diet you’ll probably feel better. Whole food is food without an ingredient label. Small changes over time matter. Michael Pollen’s book Food Rules: An Eater’s Manual gives very reasonable suggestions when it comes to what to eat. Most of our patients are low on protein intake and fiber content in their diet. Speaking to a nutrition professional can be very helpful when it comes to individualized recommendations on dietary changes.
Dr. Quiet
Quiet is not just sleep. It can include restorative techniques that help improve recovery. Sleep is the most important time to recover. Matthew Walker’s book Why We Sleep is often the lay resource that is recommended. The last page of this book summarizes sleep hygiene factors that can be targeted if you have issues with sleep. If you have persistent issues with sleep it’s reasonable to speak with a healthcare professional for further suggestions or evaluations. Persistent sleep disruptions can greatly affect your quality of life.
Meditation, journaling, breathing exercises, creative outlets, prayer, and recovery modalities (soft tissue work, heat, and cold therapies) are also something that we generally support quieting the mind and recovering.
In our fast paced hurrying society we generally do not practice shutting off. When we go on vacation it may take several days to just calm down and relax. Many of us need to practice relaxing and turning our minds off.
Improving sleep hygiene and spending a little time each day to quiet our minds can greatly benefit your health.
Dr. Happiness
Finding joy can be a challenge in modern society. Comparison is the thief of joy and this may be the biggest detriment of social media. Comparing ourselves to others, and the comparison of their outcomes without knowing or seeing the sacrifice involved can make us feel insignificant or incompetent. It is common to look at our current position and not be content. At times it can feel like nothing is going well, and in reality nothing may be going well. We may not look like we want, be in the relationships that we want, have the job or have the financial situation that we want. This does not mean that these things are not modifiable. We live in an uncertain world and we know that the grass isn’t always greener in another situation. We compromise and we settle. Even given all of these things there is always an opportunity for change.
Sometimes the answer is as simple as do less of what does not bring you joy and do more of what brings you joy. Spend some time thinking about what you really want out of this life. Developing a long term plan can make seeking your ideal life more achievable. Time is a wonderful gift and expanding our timeline reduces the anxiety to get things done immediately.
Our long term goal should be striving to make our current life match our ideal life. This takes thought, prayer and most importantly action. Clearly defining what your ideal life looks like is an appropriate first step in pursuing your ideal life. Give yourself the grace that great things take time and effort. If you have no clue where to start, seeing the perspective of a health coach, counselor or mental health professional can be beneficial.
Dr. Movement
Movement is a double edge sword. Generally speaking, most of the US population is too sedentary. In our practice it’s not uncommon for individuals to overtrain. Determining where you are on this continuum can be beneficial when evaluating what you need more or less of. If you work a desk job and don’t exercise, you need more movement. If you are doing hard two a days and feeling run down, you need to improve recovery or to decrease your training load.
Movement is a drug. Many of us abuse exercise because of the psychological feeling we get from training. This tends to be more socially acceptable than other types of addiction, but can be just as harmful.
Paul describes the concept of working out and working in. Working out is energy taking and is what many people call exercise. Working out is restorative movement - walking, yoga, tai chi. These are more gentle movements that can aid recovery, provide energy, and allow us to clear our minds.
Getting regular exercise is one of the best ways to improve your health and quality of life.
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