Grasscutting, fertilizer, and healthcare

A guy named Jeff, a 60-something, taciturn, "How 'bout dem Brewers?" kind of guy, cuts my grass.

Once a week, Jeff drives over his rust-rimmed 1994 Chevy pickup and trailer, unloads his ride mower, and cuts the grass. For his 40 minutes of work, I pay him $35.

For $35, all he does is cut the grass--no trimming, no picking up debris, no working in the garden, no fertilizing, no weeding. Just cutting the grass. Occasionally, Jeff has proven to be a useful resource for peculiar problems. Last year, I had a drainage problem that he helped solve and two years ago he helped diagnose a tree disease that was killing a tree in the backyard; it's now recovered.

To save money, and because I like to work in the yard, I do the rest. I trim the edges, I fertilize the grass, plant new flowers and trees, fix damaged areas, trim wild branches.

In my view, my relationship with Jeff, a limited, as-needed relationship, in which I ask him to help with specific issues but I manage the rest myself, is how I believe that healthcare should also be conducted.

Your doctor should be like Jeff: Perhaps not taciturn, but an as-needed resource available while you do much of the work.

My simple relationship with Jeff is, I believe, the healthcare model of the future. You manage your own cholesterol issues, your own basic thyroid issues, supplement and monitor your vitamin D levels, use diet to suit your needs, order blood tests when necessary, even obtain basic imaging tests like heart scans, carotid ultrasound, bone density testing. Your doctor is a resource, near by when and if you need him or her: guidance when needed, an occasional review of what you are doing, someone to consult when you fracture an ankle.

What your doctor is NOT is a paternal, "do what I say, I'm the doctor," or a "You need these tests whether you like it or not" holder of your health fate.

It is a model of healthcare that will evolve over the next 20-30 years, only in its infancy now.

While we started Track Your Plaque as just a resource for in-depth information on prevention and reversal of coronary heart disease, I now see it as something much greater: a prototype for the emerging concept of self-directed health.

Enough for now. I've got some tomatoes to pick.

Comments (23) -

  • StephenB

    8/25/2009 5:30:30 PM |

    And here's another "I agree wholeheartedly". It can be hard to find a doctor on the same page though. Anyone have suggestions?

  • William Trumbower

    8/25/2009 8:46:13 PM |

    Amen brother!    One of the big problems with self directed care is the lack of true knowledge for the public to help them make choices.  For example  The dietary advice given from our government and other health agencies (ADA,  AHA, food pyramid etc) to cut the fat and red meat, eat whole grains and lots of fruit.

  • Pythonic Avocado

    8/25/2009 11:17:40 PM |

    Agreed. I've thought something like this would be very nice. In my mind, I've been calling it 'distributed medicine', but 'self-directed health' sounds more empowering. Smile

  • billye

    8/26/2009 12:30:33 AM |

    Hi StephenB,

    This is the future of medicine!!

    I suggest Dr. Kenneth Tourgeman. He is definitely on the same page as Dr. Davis.  He is a nephrologist who preaches a hunter gatherer lifestyle and practices scientific nutritional medicine with high dose vitamin D3 and high dose omega 3 fish oil. His blog is

  • HenryC

    8/26/2009 5:04:55 AM |

    This is one of the wisest suggestions I have heard in a long time. If other medical practitioners would accept this advice, it could revolutionize our healthcare system.

  • Anonymous

    8/26/2009 8:53:44 PM |

    Not that I disagree, but just how realistic is this.  Most people cannot even manage to keep their own computer running properly, how can they be expected to manage their health to the extent I suggest.

    Not that I approve of paternalistic "do as I say" doctors, but I don't see a system such as yours work for the majority of people.  I'd like to see a system that encourages patients to take charge of their health care, instead of considering them trouble maker when when they do.  But that will always be a minority.  Most people want to be told what to do.

  • Heather

    8/26/2009 10:24:56 PM |

    This is amazing. I was just thinking the same thing about one hour ago after doing some reading on my own health issues.

    Thank you for putting this forward, this idea will indeed revolutionize the health care "industry" for the better, when people start taking it upon themselves to manage their own tests, results, medications, supplements, etc. outcomes will improve dramatically.

    Mark my words. Smile

  • moblogs

    8/27/2009 9:29:56 AM |

    I know a handful of doctors who are like this, and they seem to make a psychological difference as well as a physical one.
    However, most might be worried that you'll think for yourself - in the wrong or right direction. They can't be having that.

    Dr. David Grimes (who once proposed that statins work by somehow activating the vitamin D receptor) published a book on the vitamin D/cholesterol connection this April.
    A very nice man as well. I've had an email conversation with him.

  • Anonymous

    8/27/2009 12:52:02 PM |

    I agree that healthcare should be largely self-directed, and I absolutely agree that the public should be allowed to make more informed decisions about their own health. However, I think that to assume that all Americans have the discipline and intelligence to truly take charge of their own care is very misguided.  Our health problems go far beyond the misinformation from the ADA and AHA.

  • Joanne at Open Mind Required

    8/27/2009 2:54:21 PM |

    This change can't come too soon. I recently went to the VA hospital to get bloodwork done. I wanted any sort of test to give me a baseline on which I could monitor improvements from changes in my diet.

    The nurse refused several tests because they cost money, said with mild scorn, "You apparently don't want anything from the VA other than testing" and later chastised me for refusing a mammogram and pap smear. (Aren't those costly, too?)

    This is my body. I call the shots. Please, just answer my questions and help me help myself.

  • Tom

    8/27/2009 4:00:22 PM |


    >It can be hard to find a doctor on the same page though.

    Absolutely. And in the UK, with its large General Practice centres, it is hard to see the same doctor twice. 'First consult you doctor' is written everywhere these days, but one doesn't have *a* doctor, so there can't be a relationship established on trust. It is also getting harder to buy simple non-prescription drugs like aspirin over here, due to nannying by pharmacists.

  • Helena

    8/27/2009 5:24:10 PM |

    Hello Dr Davis,

    I just found this article about Type-1 Diabetes and wheat; thought you would like it, unless you already red it.

  • Dr. William Davis

    8/27/2009 10:06:27 PM |

    Let me post a hypothetical question: What if your health were tracked, if online interactions were truly interactive, and you could be prompted/reminded/coached to consider various strategies for health using your individual health data?

    That is what we are working on here using Track Your Plaque as the prototype.

  • Thedailyreviewer

    8/28/2009 2:20:36 AM |

    Congratulations! Our selection committee compiled an exclusive list of the Top 100 heart disease Blogs, and yours was included! Check it out at

    You can claim your Top 100 Blogs Award Badge at



  • Nick

    8/28/2009 3:48:04 AM |


    Sorry to be off topic -- I love the nephropal blog but wonder if anyone else is having problems with it?  Everytime I log on it knocks out my wireless connection.

  • Anonymous

    8/28/2009 4:04:28 AM |

    Dont know where else to put this but I voted on your thyroid question. I answered "questioned why but ordered the tests"

    But the rest of the story is he said the results were fine although my TSH was High "normal" and my T4 was OUT of range low.

    Went to see a new doc this week.

  • billye

    8/28/2009 6:31:47 PM |


    I have not heard anything about connection problems from anyone.  Leave a comment for Dr T at and I am sure that he will look into it.

  • kris

    8/28/2009 7:29:40 PM |

    Dr. Davis, i agree with you what you just said. but, there is even bigger issue to deal with here. the FDA. for example: FDA is going after natural thyroid hormons. which have been selling safely in the market for 100 years now. talk about pure money muscle power. FDA have no problem approving dangrous drugs for cholstrol. it confuses the issue further for the people who are trying to learn about their own health.

  • Anonymous

    8/29/2009 4:10:00 AM |

    Dr. Davis said: Let me post a hypothetical question: What if your health were tracked, if online interactions were truly interactive, and you could be prompted/reminded/coached to consider various strategies for health using your individual health data?

    Well that would be just great, IF one didn't have to worry some about an insurance company accessing such data and using it against one to deny coverage or prevent one from obtaining future coverage. Such info would have to be COMPLETELY private.

    Until there are no "pre-existing condition" exclusions in health insurance, and it doesn't matter if such information could possibly be accessed by insurance, I will just "do it myself".

    Technology can be a two-edged sword.  I had a heart scan and my insurance wouldn't pay for it... but they apparently were interested enough in the results to make it damn near impossible to obtain life insurance, health insurance, and long term care insurance on the open market, due to my "pre-existing condition".

    Luckily we will have "lifetime medical insurance" through an employer's generous retirement plan and eventually Medicare.  Not so lucky about the long tern care coverage, though.

    Until technology can guarantee complete privacy, and no possible controverted use of information, I have great reservations, no matter how well intentioned and valuable the information.


  • Dr. William Davis

    8/29/2009 1:56:40 PM |

    Hi, Mad--

    Yes, indeed.

    I believe that, while imperfect, online security is the solution. Only you (or those you designate) can access your info. This is how Google Health, Microsoft Health Vault, and Revolution Health's health archiving services work.

    It's happening. And it will change healthcare for the better by putting more information and control into the hands of the consumer. This is a GOOD thing.


    Yes, this is very worrisome.

    The FDA is threatening to "clamp down" on thyroid preparations and "bioidentical hormones," two areas in which most of us agree no action is required and in fact will be destructive.

    I've written my letters to the FDA expressing my objection to their policies. Everyone else should, too.

  • Anonymous

    8/31/2009 7:50:19 PM |

    Just saw my doc for annual physical (I'm 49).  Mentioned the heart scan blog and he said calcium score tests are "bogus".  "insurance companies don't pay for them so they must not mean much, plus if the plaque doesn't reduce flow, it's not a problem".  And he's young (early 40's).  Kept quiet after that; no use trying to convince him to open his mind.

  • epistemocrat

    9/2/2009 2:28:51 PM |

    Hi Dr. Davis (and readers),

    I have conceptualized this movement to the 'Patient of One' healthcare system in a few essays:

    and then, more recently, through many of my recent blog postings:

    (feedback welcomed)

    Cheers to fostering an inviting and respectable community of self-directed self-experimenters.



  • trinkwasser

    9/10/2009 3:30:42 PM |

    To a degree I've had something like that for a while now. Our local surgery uses nurses, prescribing nurses etc. for routine stuff, which frees up the doctors' time for serious stuff. For example when mother is ill I can always get a doctor to call (or paramedics/ambulance) or take her to the surgery where she is seen by a triage nurse and a GP is called immediately if required.

    My GP (In fact all the GPs) are comparatively clueful BUT limited by accountants as to what they are and are not permitted to do - and here's the problem, when the doctor is cut out of the loop then even the receptionist is permitted to refuse tests or refuse to give out the results and otherwise hinder my looking after myself. The not-doctors are even more limited as to what they are and are not permitted to do and it still needs a real doctor to override these restrictions, for example to get a full lipid panel rather than TChol, and then be given the actual numbers.

    If these relatively recent financial restrictions were lifted again (some hope!) it'd be an ideal system, I get the tests I need and the prescriptions I need and as much or as little support as I require to work on the results. Reversing this back to a patronising  "eat up your carbs yum yum and we'll weigh you again in six months and check for statin deficiency once a year" may "save" money but only in the short term.

    The doctors themselves aren't happy about Big Brother - but they realise that opposing it will lead to loss of their employment Frown