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An Argument for "Preventative" Medicine

If you follow our Instagram, you may have seen our post on the "Public Health Parable", originally written by Irving Zola. Regardless, it is one of our favorites at Thrive HQ and worth sharing again! Here is the story:

You and a friend are having a picnic by the side of a river. Suddenly you hear a shout from the direction of the water. A child is drowning. Without thinking you both dive, grab the child, and swim to the shore. Before you can recover you hear another child cry for help. You and your friend jump back in the river to rescue her as well. Then another struggling child drifts into site… and another… and another. The two of you can barely keep up. Suddenly you see your friend wading out of the water seeming to leave you alone. "Where are you going," you demand. Your friend answers, “I’m going upstream to tackle the guy that is throwing all these kids in the water!”
Public Health Parable

Our “health”-care system has evolved into what we see as more of a “sickness”-care system. It is AMAZING at “helping the drowning individuals”, but has fallen far short on going upstream to “tackle the man throwing the people into the water."

Our goal at Thrive is to challenge the status quo by helping you move “upstream” to tackle the root causes of many common health issues we face in our current world.

Despite most people agreeing that upstream efforts make sense logically and economically, putting upstream efforts into place is no easy feat. Additionally, often times when taking upstream measures, we are removing one of our bodies most primitive reward systems, the dopamine response. When we "fix" something that is broken, we can physically and/or emotionally see or feel progress. Our body responds with a nice jolt of dopamine reminding us to do more of that in the future! On the flip side, preventative upstream efforts, if successful, will not "fix" anything because nothing will be "broken" in the first place. Therefore no dopamine surges and no feel good chemical reminders.

We already mentioned it in the last paragraph, but I think it is worth re-iterating. With upstream efforts, you never really fully know if they were successful. For example, let's say you make the upstream effort to help your kids "get ahead" academically by reading to them every night before bed. Assume they do show advanced proficiencies in reading and other academic skills. How do you truly know if it was the nightly reading ritual that actually led to the success? Was it actually there amazing 2nd grade teacher who challenged your child to push out of their comfort zone? Were they genetically bound to be advanced and would have achieved those same high scores without reading every night? In either case, I don't think any of these other possibilities would stop you from making the effort to help your chid get ahead with a nightly reading ritual. In fact, parenting is often times where upstream efforts are actually most prevalent!

So, given the difficulties we face with upstream efforts, how do we help make sure we are moving in the right direction and doing the right thing? The excellent book, Upstream, by Dan Heath, shares 3 suggestions for upstream efforts:

1) Be Patient: "Be impatient for action but patient for outcomes." is an excellent quote from the book. This is essentially getting to the point that doing something you believe could be preventative is almost always worth the undertaking. Don't wait around for "the perfect" solution, because then you are just downstream and reacting to problems once again. The second part of the quote hits on the idea that we must be patient and know we will not see outcomes immediately.

2) Start Small: To take another excellent quote from Dan Heath's book, "Macro starts with micro. Upstream victories are won an inch at a time, and then a yard and then a mile and eventually you find yourself at the finish line. However you can’t help a thousand people until you understand one." Don't try to start by ending world hunger, but rather start by helping the one person down the street.

3) Monitor your Course: It is essential to have some form of a "scorecard" that allows you to track results in real time. Using these results, be open and ready to make alterations and switches. Don't let your ego get in the way, and most importantly, don't expect to have it perfect at first!

We believe that preventative medicine is 100% worth the challenges it brings with it. We also know that it won't be perfect, but we are ready to continue to measure, monitor, and reiterate as we push forward. If no one makes the effort, then we as a collective will "continue to have to swim and drag out the drowning children from the river." We don't want to make that our fate. We want to "tackle the man upstream throwing them in."

Questions about how preventative medicine works or how Thrive HQ implements strategies to make Upstream efforts? Feel free to reach out by sending us an email to

Keep Thriving,

Dr. Matt

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