When I was 15 years old, I had to travel about two hours from my home in a rural part of Nigeria to a nearby town to seek care for chronic and painful headaches. I was born in Lagos, which was the capital city of Nigeria at the time. But, due to the violence that was directed at members of my tribe, life in Lagos became unsafe, and we had to escape to my village in eastern Nigeria.

I was alarmed at the treatment a female patient received from a doctor in the town where I went for my headache treatment. It appeared that the patient received less compassionate care due to her lack of money. I returned home that day and I told my mother that I was no longer interested in being in an aeronautic engineer. Instead, I said, I would become a doctor so that I could provide free treatment. My mother was somewhat skeptical because I could not stand the sight of blood when I was young man. I vowed to her that I would overcome my squeamishness so that I could become a physician.

After serving in the Civil War as a young fighter in my country, I went on to finish high school and finally made my way to the U.S. for my medical training.

While I never really figured out how to provide truly free healthcare, I did establish a nonprofit organization that went to third world countries, like Nigeria, to provide free medical care, making good on my promise to my mother. And, as I have navigated the U.S. healthcare system, I have learned some principles about how the human body works and about medicine that help me to provide the best possible care to those who need it most.

1. Prevention is better than treatment
   Much of the appeal of preventive medicine is that it can help avoid crisis management, the costs of which tend to be exorbitant. However, a preventive approach can also mean trying free or low-cost lifestyle changes before beginning pharmacological interventions. These approaches, like mindfulness exercises, can promote health while driving down costs.
   
   When I began practicing medicine, I found myself becoming frustrated at how often I was prescribing a specific medication to treat diabetes and other chronic diseases. I was giving my patients medications to block pathophysiologic mechanisms that they could prevent on their own by taking better care of themselves.
   
   I became adamant that my patients be empowered to prevent their health from deteriorating before relying on medicines. I have since shifted my focus to Integrative Medicine where I think first about the root cause of diseases and try to help my patients fend off disease through good nutrition and exercise, as well as other healthy lifestyle habits.
2. Sometimes, natural interventions can have positive effects
   Early in my career, I prescribed a drug to a patient with high blood pressure. When she came to see me for a follow-up, her blood pressure had improved. I told her that it looked like the medication was working. To my great surprise, she informed me that she hadn’t taken any of the medicine. Instead, she had been drinking garlic water – apparently a regimen long practiced in the South of the United States to lower blood pressure.
   
   This humbling experience made me dig into research on herbs and supplements to learn how the molecules in some of these substances behaved similarly to molecules in frequently prescribed drugs. Sure enough, garlic shared some properties with drugs aimed at lowering blood pressure. This experience made me very mindful of the science of medicine, and open to alternative approaches that sometimes work well for specific patients.
   
   Though it is not new for providers to recommend changes to diets and exercise routines, it is now becoming more common to suggest supplements and other non-pharmacological interventions before initiating pharmacological treatment. When these other strategies work, they are often both healthier and less costly for the patient.
3. Anticipating patients’ needs can promote health and prevent unnecessary spending
   In my practice, I see a lot of families. When parents entrust their kids to my care – and when middle-aged people bring their parents in – I take it as a great compliment and know that these patients feel that my approach to medicine promotes health and wellness over the lifespan. I work with these families to anticipate their needs and provide them with the tools that enable them to be largely in charge of their own health.
   
   The shift from fee-for-service to value-based care models of healthcare represents a growing recognition that doctors’ and patients’ goals and incentives should be aligned for care to promote health without unnecessarily increasing costs. With the value-based care mindset, we are focused on meeting our patients’ healthcare needs and keeping them out of hospitals and emergency rooms.
   
   Protecting health requires that we educate patients on how to care for themselves and how to build habits and routines that are conducive to wellness and longevity. The preventive nature of this care allows our patients to live healthier lives and require less healthcare spending. Guiding patients toward behaviors that can have profound physiological consequences is often ultimately what is best for them.

Dr. Chiedu Nchekwube, MD is a VillageMD primary care doctor in Merrillville, IN and has over 42 years of experience in the medical field.