Is better health all about mind over matter? Health is much too complex to be summed up by any kind of platitude. One of my main tenets in life, one that applies to almost all scientific and health-related matters as well, is that we live in the huge gray area between the extremes. And while this creates a lot of uncertainty, we have much to gain if we can just tolerate a bit more of that ambiguity and uncertainty. Then we can make better use of whatever tools we use – including medical and scientific research and other health and wellness options. And we will also be better able to listen to our mind-body and use the wealth of knowledge there to advance our own well-being.

Today’s post is the first of many that relates in some way to this all-important health maxim. Here is a recent full text study of the relationship between hypertension and positive emotions. You likely have heard that increased anger is associated with higher blood pressure. There are many studies that have researched this connection.

But amazingly – or perhaps not – there are almost no studies of the relationship between positive emotions and blood pressure. In posts yet to come, I will posit an explanation for the discrepancy. The current study is a milestone in a number of ways. It appears to be one of the very first to study whether folks who exhibit positive emotions tend to have lower blood pressure.

The results of the study support this hypothesis. The study used senior Mexican-American subjects, which is also significant. Cultural diversity has not exactly been valued in most scientific research. However, there was also a completely unexpected finding. The benefits of positive emotions were highest among those who didn’t take a hypertensive medication. This result suggests a hidden price to pay for using medication to control high blood pressure. This type of consequence of using medications for all of our health and medical problems is likely much more widespread yet is virtually ignored by the scientific community.

The point is not that you should immediately throw away all of your medication, but that there are often safer, yet effective, methods to manage our health. And when we try to do a risk-benefit analysis of using medication, the deck is stacked. We just don’t have all the information we need. Finally, the point of this post is not to suggest that by just thinking happy thoughts that you will lower your blood pressure. Remember, it is not mind over matter, but in the vast space between the polarities that we can find what we need. This does not mean taking a safe, middle path that is just a compromise between the poles. As we will see, this path actually requires great courage and hard work.

Today is the formal launch of my new health and medicine blog. Be sure and read the Mission Statement to see what it is all about.

To get things rolling, I will give you a couple of links to newspaper articles. The articles are the typical kind of published “debate” that you see these days. This is one is interesting because it is the bean-counter’s argument that actually makes the case for physician and quality choice in one small area of health care. Today, a small step . . . Tomorrow, who knows?

Are cost controls for medicine bad? No

Are cost controls for medicine bad? Yes

Dr. Jeff Kamil is the chief medical officer of Blue Cross of California. He tries so desperately to make the case for providing as many less expensive, non-hospital based colonoscopies as possible that he inadvertently proves the point that Dr. Emmett Keefe, chief of hepatology at Stanford University, attempts to make. Namely, that it should be your doctor’s decision as to whether or not you need to have the procedure done in a hospital outpatient setting.

Dr. Kamil cites the telling statistic in this “battle” of quality versus quantity. He indicates that at the current time, having a colonoscopy performed in an outpatient surgery center is just as safe as having it performed in a hospital outpatient setting. I, for one, wouldn’t want to argue with him.

Why do you suppose that the risk is the same in both settings? Could it be that by allowing the physician to make the call as to what setting is most appropriate for each patient minimizes the risk while containing costs? And as Dr. Kamil also points out, right now about 2/3 of all colonoscopies are performed in outpatient surgical centers and physicians’ offices. It seems to me that our physicians’ clinical judgments are safe and effective.

Yet, Dr. Kamil proposes to abolish a system that is working and in its place proposes another in which the cost of the colonoscopy would become the primary determinant of the setting. Dr. Keefe would propose that we continue to let physicians make this determination. Do I want my doctor to have the final say or do I want the cost to Blue Cross as the most important factor?