Vail Health provides direction to those overwhelmed by modern health care options for longevity
Whole-person health involves diet, exercise, socialization, purpose, effective testing and medication
Zoe Goldstein/Vail Daily
The future of medicine has arrived, and it brings with it a lot of confusion. From tests to supplements, dietary and exercise advice, it is often difficult to know how to use new medical information and technology to live a longer and healthier life.
Vail Health is trying to help answer some of those questions.
The health care system hosted an event on the future of medical prevention Thursday morning at the Singletree Pavilion. The event, part of the health care system’s wellness speaker series, brought together three of its experts — primary care physician Dr. Melissa O’Meara, interventional cardiologist Dr. Kate Schuetze and Vail Health Behavioral Health Executive Director Chris Lindley — to share the actual steps everyone should be taking to live long and healthy lives.
Before looking to the wide variety of medical interventions available in the modern age, from testing to supplements and medications, Lindley advised the audience to start with the basics.
“Think about the healthiest 80-year-old you know,” Lindley said. “They exercise, they sleep, the probably lift weights, they have some type of purpose, they have friends, community, and they play.”
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Nearly everyone should be lifting heavy weights that challenge them every week, eat 30 grams of protein per meal and go to bed and wake up at the same time every day, Lindley said. People should also make an effort to build strong social communities and take on tasks that give them purpose.
“Don’t waste your money going and spending it on supplements or tests … or any other influencer thing if you’re not doing the hard things,” Lindley said.
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The best part about these “hard things” is that they largely come at no financial cost.
What to ask the doctor
Individuals should also, however, see their primary care physicians annually.
Through those visits, O’Meara said, patients should undergo one or more of the five routine cancer screenings: Mammogram, pap smear, prostate-specific antigen (PSA), lung cancer test, and colon cancer screening. For those living at high elevations in mountain communities, she adds a sixth test: an annual skin cancer screening.
O’Meara is the medical director of Vail Health’s concierge medicine program, a subscription-based primary care program that gives enrolled patients more access to their doctor, along with access to a battery of advanced screening tests that are not offered through the health care system’s traditional primary care route.
“Not that this is something that everyone should be doing, but it’s something to think about whether it’s right for you,” O’Meara said.
The tests include continuous glucose monitors, Prenuvo scans, liquid biopsies and genome testing. The purpose of the extra screening is to provide patients with accurate information so they can make choices in their day-to-day life about habits like diet and exercise, along with whether to see certain specialists.
Continuous glucose monitors are wearable patches that monitor blood sugar. While not generally covered by insurance for people without diabetes, the patches can show information about blood sugar patterns that can guide behavioral changes like taking walks after eating.
The Prenuvo scan is a functional MRI of the entire body, completed in about 45 minutes. It is not recommended for everyone because “the issue with full body MRIs is they always find something,” O’Meara said. “We really want to … make sure that what we’re finding is making a difference in your health instead of causing more testing, biopsies that you don’t need, putting you at risk for potential harms.”
Liquid biopsies are blood tests that look for free floating cancer DNA, indicating that a person has cancer in their body. “You may have seen commercials for them during the Super Bowl,” O’Meara said. The tests are better at detecting stage II cancer and above, making them less effective as an early detection tool.
Genome testing is “the technology I’m watching the closest,” O’Meara said. There is a set of genetic conditions that, if identified early, “have a profound impact on longevity and quality of life,” she said.
The catch is that the test is not very good at identifying true negatives yet. In other words, people might test “positive” for a disease without having it. But the test is rapidly improving.
“One day in my practice lifetime, it will be a universal screening,” O’Meara said.
Why statins?
Heart disease is “a really big category,” Schuetze said.
The heart can have many problems, exacerbated by the fact that as the heart ages, plaque builds up in the body’s vessels.
“As we get older, we get wrinkles in our skin, we get arthritis in our joints, we get plaques in our vessels,” Schuetze said.
Cardiologists focus on the plaque because too much buildup can lead to artery wall ruptures, which lead the body to send blood clots, which can cause heart attacks or strokes.
Despite decades of research, it is still challenging to predict exactly who will have a heart attack or stroke. While smoking, diabetes and high blood pressure are all indicators, cardiologists have also adopted an approach designed to shield all patients from possible heart attacks: prescribing statins.
Statins are a cholesterol medication doctors have found that both lower LDLs, a kind of cholesterol associated with coronary artery disease, and transform plaques from more inflammatory to more stable.
Taking statins is like wearing sunscreen, Schuetze said. Putting sunscreen on a large group of people every day will protect some people who might otherwise have gotten skin cancer, and will not hurt others.
While recommendations vary, Schuetze suggested patients would be well served if their LDL numbers come in below 50, or even 30, as lower LDLs are associated with lower risk of heart attack, and statins have improved greatly in their ability to control them.
There are many preventative tests cardiologists can run, but they only matter if patients want to take definitive action, like starting more medications or making lifestyle changes.
“Tests tell us what we can do, but patients tell us what we should do,” Schuetze said.
“Stress testing can be very, very helpful” for patients with potentially heart-related symptoms, Schuetze said.
For many individuals, walking for 30 minutes every day is a good stress test, Schuetze said. If something feels off during an everyday activity, that may be a sign to see a doctor.
Why concierge medicine?
Vail Health introduced concierge medicine to fill a gap it says the community identified.
“It’s trying to tailor the approach to the resources that we have and also the needs of the community and also leverage what technologies we have to serve the greatest number of people as efficiently as possible,” O’Meara said.
O’Meara said people who have touch points with their doctor once per year in traditional primary care and once per month in concierge medicine are getting the same quality health care. “But there is a different satisfaction level, so it’s more about knowing yourself,” she said.
It has become increasingly difficult, particularly since the pandemic, for Eagle County residents to access their primary care providers. The shortage of primary care physicians extends throughout the United States.
“What it costs me to bring a PCP here, a physician, is very different than it costs in Denver,” said David Kaplan, president of Colorado Mountain Medical. “Finding a way to meet all the needs and ensuring that every provider is working at the top of scope is the goal.”
Vail Health’s concierge program includes more access to physicians, additional testing and possible home visits. “You can’t do that in a traditional primary care setting,” Kaplan said.
“The hope is that these unique tests will not be unique to concierge in six months, a year, and will be offered to the general public,” Kaplan said.
