The first prerequisite of agentic health is that you accept your right and obligation to take charge of your health and healthcare. The right is pretty self explanatory: your health belongs to you, as does your health data, and it follows that you have the final say in what happens to your body, within the scope of regulatory policy. The obligation is less clear. You’d be forgiven for thinking that it’s your doctor’s obligation to keep you healthy. It is not. Here are some reasons why the onus is on you:
The system has structural gaps
You might not even have a doctor. If you have no chronic diseases or disabilities, you likely don’t have a doctor who keeps track of your health progress. You might think then that since you are healthy, no further proactive action needs to be taken by you. But the answer is in the question: do you really want to start worrying about your health only once something is so visibly wrong you need to see a doctor to fix it? Effective healthcare lives in prevention, not reaction. And in the absence of a medical team, you’re the only one left to drive this.
You have limited face to face time with your doctor. Much as your doctor would like to spend enough time with you to understand your full lived experience, the reality is they can rarely give you more than 30 minutes of their time – and usually much less than that. And with those time constraints, the doctor can still easily see 300+ patients a month. To get maximum benefit from your appointment, you need to be informed and prepared, and that requires you to pay attention to your own health.
You likely have more than one doctor or healthcare professional, and they will rarely coordinate your care between them, unless they are treating the same condition from different angles. The onus is on you to convey relevant information between carers, and between appointments, which obligates you to keep a careful record.
Only you hold the full picture
Medical guidelines run on population means, but your body is a sample of one. Only you know your lived experience, and how different inputs affect your health. If there are any “weird” reactions you are the one who will be experiencing them, and it is up to you to keep track and inform yourself and your care team.
Your health is more than just the results measured on a specific day. There are 8,760 hours in a year, and almost each one is spent without your doctor present. Only you have the full context of your lived experience, and it’s difficult to convey that accurately in a short doctor appointment. And your doctor has no access to biometric data like the heart rate that your watch tracks. If you don’t share it, they don’t see it.
You are the only constant in your healthcare. Your doctors can change, your medical insurer can change, and your health situation can change. Only you hold the full history, and the full context, and only you are in the position to connect all the dots. It’s your obligation to be able to do so.
Big levers lie outside the healthcare system
Powerful interventions (exercise, sleep, nutrition) live outside the healthcare system anyway. It’s only up to you to make the decisions for a healthier lifestyle. Much as your doctor would like you to eat healthy foods and walk every day, they cannot force you to do this, yet any treatment’s effectiveness will only compound in the presence of smart lifestyle choices.
You bear all the consequences
The stakes are asymmetric. If the system gets it wrong, you bear 100% of the dire consequence. It goes to reason that the person with the most to lose should have the most say.