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Primary Care or the Emergency Room

Primary Care or the Emergency Room

| July 25, 2018

The Annals of Internal Medicine published a study that showed that approximately over 30% of prescriptions go unfilled. If you drill down a bit more you find that about 80% of bronchitis and 74% of skin irritation prescriptions go unfilled. The study also found that men were worse at following through than women, no huge surprise there.

So that means out of the ten people with bronchitis who actually bother to see a health professional and obtain a prescription only two go to the pharmacy and get the pills. What the study doesn't cover is whether those two people actually take the pills when they get home. Personally, if I'm prescribed an antibiotic I "forget" to continue taking once I feel better, even though the health professional says I need to take it for 7 days or until the bottles empty. So anecdotally, we can assume 1 in 10 bronchitis sufferers are taking primary care of themselves.

Physician, Heal Thyself

I have a theory about this phenomenon from my own financial planning practice and deep reflection while sitting in traffic. My theory is that there are to reasons that people don’t take care of themselves: negative self-regard or overconfidence.

Let's talk about overconfidence first. When you get that sneezy, coughy feeling you think to yourself, "Hey I'm strong, smart and I take my vitamins. This is nothing, I'll just walk it off. Tis but a scratch." Smash-cut to you at the emergency room with walking pneumonia and a three hour wait.

The other is negative self-regard. Lets say you take your dog to the vet and find out that he is in terrible pain. The vet gives you a prescription. Would you fill the prescription? Would you put the pills in their food to help ease their suffering? Of course you would, 100%. Same goes for your child. My wife and I will bend heaven and earth to administer the highest and best primary care to our daughter with laser focus and dogged determination. I'm not virtue signaling (okay, maybe a little), it's just the way we are wired.

So why do children and dogs get primary care and you and I wait for the problem to turn into an ER visit? We could have a case of negative self-regard. This is not the same as low self-esteem. It's simply when the duty to others is primary to you self-care. It's when the social constructs of what you ought to do as your function in society (parent, employee, employer, leader, follower) is a priority over taking care of yourself.

So stop for a moment, take your medication and then help others.

Primary Care and Financial Planning

As a Financial Planner, I have two roles, primary care physician and ER doctor. Let me explain.

When I engage with a new client we come up with a plan. Sounds great, but it is hard work. For years, their junk drawer of assets have turned into a junk room that has to be sorted, sifted and systematized. Have you ever seen the show Hoarders? It's not fun to clean out a junk room. Sure you may find that you have a treasure chest or an original Rembrandt in there, but it's mostly tedious organization that you put off for years.

Now my new client has me poking and prodding and nagging them to follow through with implementation. I've always been hesitant to not be too pushy or annoying. But I've concluded that I need to reframe the relationship. Our practice, the entire staff, is dedicated not just to writing prescriptions but making sure that our clients fill them and take primary care of their own finances as a top priority. We'll keep it professional. But we'll hold you to the standard of making your own financial care primary.

The reason is that I don't want to be an ER doctor. Too often I meet prospective clients when they are in emergency room. They haven't taken the small steps along the way and now they want to make the improbable, giant leap into retirement. They'll live, but they won't thrive. The worst part of my job is when we engage with prospective clients, assess their situation and must break the news. Your highest best retirement is dead on arrival. We did all we could do but your dreams just didn't make it.

Take Your Daily Pills

So here's the cure:

  • Get thee to a Financial Planner. I am happy to help.
  • Don't overestimate your ability to plan and implement.
  • Don't make everything and everybody else your primary concern. Put yourself first so that you are better prepared for a lifetime of service.

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