Self-directed health is ALREADY here

It can't happen.

People are too stupid/ignorant/lazy or simply don't care.

It is irresponsible. People will misuse, abuse, misdiagnose, fail to recognize all manner of medical conditions.

It's all true. Most of the medical establishment believes it. And it is self-fulfulling: If you believe it, it will happen.

But it's not true for everybody. If readers of this blog, for instance, were to view the conversations we have in our Track Your Plaque Forum, you would immediately recognize that we have a following that is more sophisticated and knowledgeable about coronary heart disease than 90% of cardiologists. That is really something. Perhaps they can't put in a stent or defibrillator, but they understand an enormous amount about this disease we are all trying to control and reverse, sufficient to seize control over much of their own healthcare for this process and related conditons.

Anyway, self-directed health is already here. And it's happening on an incredible scale.


--Nutritional supplements--Now a $21 billion (annual revenues) phenomenon, booming sales of nutritional supplements are a powerful testimonial to the enthuasiasm of the public for self-directed health treatments. Sure, there are plenty of junk supplements out there, but there are also many spectacularly effective products. Information, not marketing, will help tell the difference. Over the long-run, the truth will win out.

The 1994 Dietary Supplement Health and Education Act has allowed the definition of “nutritional supplement” to be stretched to the limit. "Nutritional supplements" includes obviously non-nutritional (though still potentially interesting) products like the hormones pregnenolone, dehydroepiandrosterone (DHEA), and melatonin to be sold on the same shelf as vitamin C. There are also amino acids, polysaccharides, minerals and trace minerals, herbal preparations, flavonoids, carotenoids, antioxidants, phytonutrients.

In fact, I believe that the nutritional supplement pipeline is likely to yield far more exciting and effective products than the drug research pipeline! And you will have access to all of it--without your doctor's involvement.

--Self-ordered laboratory testing--In every state except New York and California, an individual can obtain his or her own laboratory testing. New services are appearing to service this consumer segment. As more people become frustrated with the silly gatekeeping function of their primary care physician and as more people gain more control over some of their healthcare dollars through medical savings accounts, flex-spending, and high-deductible health insurance, more are shopping for cost-saving, self-ordered lab testing. Even at-home lab tests are becoming available, such as ZRT Lab tests we make available through Track Your Plaque.

(In California, a doctor's order, or an order from a health professional allowed to prescribe, is still required which, for most people, is just a formality. Just ask your doctor to sign the form with the tests you'd like. Only the most cretinous of physicians will refuse, in which case you should say goodbye. New York is the only state in the U.S. that still dunks women to see if they float, divines the entrails of sacrificial cows, and prohibits lab self-testing.)

--Self-ordered medical imaging--Heart scans, full body scans; ultrasound screening for abdominal aneurysms, carotid disease, osteoporosis such as that offered by LifeLine Screening (who does a great job). There's plenty of room here for entrepreneurial types to develop new services, though there will also be battles to fight with hospitals, radiologists, and others invested in the status quo. But it is happening and it will grow.

(By the way, since I've previously been accused of making bundles of money from medical imaging: I have never--NEVER--owned and do not currently own any medical imaging facility.)

So the question is not "will it happen?" It is already happening. The question is how fast will it grow to include a larger segment of the public? How much more of conventional healthcare can it include? How can we develop better unbiased information sources, untainted by marketing, that guide people through the maze of choices?

Comments (12) -

  • Anna

    4/12/2009 6:03:00 PM |

    I can add few more examples.  The same was said for at-home pregnancy tests.  Now we can buy pregnancy tests in any supermarket, pharmacy, 99 cents store, mass merchandiser, probably even at a the corner 7-Eleven.  No one who suspects they are pregnant goes to a doctor's office first to find out anymore, they go for confirmation.  LH-ovulation kits are commonly available too, also, and the business of planning one's family has never been the same...

    Blood glucose monitoring is another example.    Dr. Richard Bernstein, a Type 1 diabetic for more than half a century, pioneered the use of self-glucose monitoring decades ago when he used his wife's medical license to purchase a glucose test machine commonly used in ERs, but there was significant resistance  by the medical establishment to allow diabetic patients to use this technology to manage their own BG control (the manufacturer was supportive, however).  Dr. Bernstein was originally an engineer, but he wrote many articles about self-monitoring for better glucose control, but he couldn't get the papers published in the medical journals, despite the tremendous potential for real benefit.  He went to medical school in his 40s to establish the credentials necessary to get his findings published, to the great benefit of diabetes patients everywhere.  Now witness the explosive growth in personal glucose monitors; one can buy them OTC without a prescription even.  While insurance companies are too stingy with test strips, glucose meters are a standard part of conventional diabetes management.

    I think I've seen at-home tests for A1c hemoglobin, cholesterol, etc. on drug stores shelves, too.

    But you're right, overall, they think we're too stupid to manage or understand our own health so they often suppress the development of such tools.  Public Health is turning into Public Health Control.  The only time TPTB  loosen their grip on control of health care is if there's money to be made or saved (for Big Medicine and Big Pharma, not for the patients) or if there is a huge public outcry (sending post-surgical patients right home after major surgeries like mastectomies and c-sections, for example).  Yeah, I'm a bit cynical overall about medicine lately, yet  I'm very encouraged and empowered to not give up, especially by places such as the Heart Scan blog and other highly credible internet sources.  What is the saying, when one door closes, another opens some where else?  This is a great "open door" you have here, Dr. Davis.  Thanks.

  • Jenny

    4/12/2009 9:41:00 PM |

    Unfortunately, this self-directed model works for the "worried well." When you are ill with something painful, debilitating, or brain impairing, a system where you have to figure everything out yourself does not work. And sadly that is where we seem to be heading.

    I agree with the comment on the previous post that what we need is a different health delivery system. My belief is that it needs to be built on an engineering model rather than the medieval guild model within which doctors are currently trained.

    I have seen many very bright people go through medical training and emerge with their curiosity and ability to think and research completely stamped out. They end up hating what they do, but they have to keep doing it because of what they've sacrificed to become doctors.

    The all or nothing medical model with godlike MDs and everyone else subservient and poorly trained is inefficient and keeps us from having bright people functioning independently at every step of the process as is characteristic in other disciplines.

  • Tim-

    4/13/2009 12:09:00 AM |

    I talk to oncologists all the time. When I try and have an intelligent discussion about disease, they quickly ask of my credentials and dismiss any thought I may have when they discover I have none. Whats even more interesting is that very few of them have any idea what nuclear receptors are, and most of them don't see what relationship they might have with cancers. I usually say... "you're right, being that they are part of the nucleus what could that possibly have to do with our dna changing."

  • Trinkwasser

    4/13/2009 1:00:00 PM |

    You only have to look at almost any diabetes forum to see this on a grand scale.

    The ADA Position Statement gives "medical nutrition therapy" the potential to decrease A1c by 1 = 2%. Since they reduced their minimum carb requirement to 135g they have improved this to 1 - 2.9%

    Yet on their very own forum we routinely see people making 5 - 8% improvements, losing scads of weight, hugely improving their lipids etc. Almost none of these successes are achieved by following the ADA's official protocols. What's wrong with this picture?

    The answer leaps out at you when you see their list of Corporate Sponsors, which is also true of many other Authoritative sites: carbohydrate suppliers and drug manufacturers.

  • Anne

    4/13/2009 1:05:00 PM |

    Another home test is a stool test for gluten sensitivity from In addition, Enterolab also tests for sensitivity to dietary yeast, cow's milk, chicken egg, and soy sensitivity. Kenneth Fine, the physician who developed these tests, offers them directly to the public. This test cannot tell you if you have villous atrophy(celiac disease). It identifies immunologic reactions to dietary proteins.

    I have met many people who tested negative for celiac disease through blood and biopsy, but were positive on Enterolab tests and Health improved after eliminating gluten. This is the test I used to confirm my gluten sensitivity.

  • Jessica

    4/13/2009 6:40:00 PM |

    You are exactly right about Self-directed health care.

    The number of physicians going into primary care is shrinking and they aren't being replaced. The lack of primary care may very well be the catalyst that drives more self-directed care.

    You can get a mammogram without an order (at least in IL you can). A mammogram doesn't prevent cancer; it detects it.

    But, you can't get a simple blood test to measure your 25-OH levels (without an order)and take OTC supplements to optimize your D levels...which can PREVENT cancer.

    I truly admire your desire to educate patients and encourage them to take charge of their own care.

    You're one in a million. Literally.

  • Anna

    4/13/2009 10:20:00 PM |

    I've used Enterolab,too.  I'm quite satisfied with the tests they perform.

  • Dr. B G

    4/14/2009 3:59:00 AM |


    Fantastic!! This is why Dr. Davis deserves a Nobel...!!!! He optimizes all the NRs, for CAD, CANCER and LONGEVITY protection!

    I have a post scheduled in 1-2 days regarding NRs. Looking to hearing your thoughts  Smile


  • Dr. B G

    4/14/2009 3:59:00 AM |


    Fantastic!! This is why Dr. Davis deserves a Nobel...!!!! He optimizes all the NRs, for CAD, CANCER and LONGEVITY protection!

    I have a post scheduled in 1-2 days regarding NRs. Looking to hearing your thoughts  Smile


  • Joelle Reizes

    4/20/2009 6:22:00 PM |

    Dr. Davis: Thank you for your kind words about Life Line Screening. We do indeed hope that our services help individuals who are interested in being proactive about their health care. We would like to take this opportunity to remind people that a Life Line screening, even when self-ordered, is one component of a person’s overall health care.  And while many of our screenings are in fact self-ordered, many are not. Doctors and hospitals across the country work with us and refer patients to us.  Of course, we also recommend individuals who are tested share their results with a physician, even if they show no risk of heart disease, osteoporosis, etc.  This can help improve a person’s medical record and can help doctors recommend the best course of action in the prevention of a medical emergency.  Thank you again for your nice words about Life Line Screening.  It is very much appreciated.

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    9/19/2010 7:35:55 AM |

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    11/3/2010 10:21:16 PM |

    Just ask your doctor to sign the form with the tests you'd like. Only the most cretinous of physicians will refuse, in which case you should say goodbye. New York is the only state in the U.S. that still dunks women to see if they float, divines the entrails of sacrificial cows, and prohibits lab self-testing.)