Broker Check

We only work with two types of people

August 26, 2020

There are only two types of people who go to the doctor. Can you guess what those types are?

It’s a tough question, but I’ll help you out: healthy people and sick people.

How do you know which one you are?

I suppose you could say that it’s based on how you feel—i.e., do you feel good or bad? But then how do you explain the people that claim to feel fine and are diagnosed with serious conditions and illnesses seemingly out of nowhere?

I suppose you could say that it’s based on symptoms—e.g., rash, congestion, pain, etc. But then you have to wonder how serious the condition is—i.e., is it something that Benadryl can handle or is the acute condition that you are experiencing a sign of a more substantial and chronic issue? I haven’t looked up any studies and I have no data to back this up, but I would be willing to bet that the vast majority of the acute issues that healthcare providers address are caused by chronic issues—i.e., conditions that are more related to the lifestyles that we adopt.

“Chronic inflammatory diseases are the most significant cause of death in the world. The World Health Organization (WHO) ranks chronic diseases as the greatest threat to human health.”[i] It turns out that it was actually pretty easy to find a source to substantiate the significance of chronic issues.

So, back to the question at-hand: how do you know whether you are a healthy person or a sick person? Diagnostics.

What does all of this matter?

Anecdotally, I can certainly tell the story of patients who visit the doctor and are prescribed blood pressure and/or cholesterol medication, but the fact that they are overweight is never discussed or not something that the patient wants to address. I can also tell the story of those of who go to the doctor for pain and are merely prescribed, or are merely seeking, opioids, with minimal or no investigation into what is causing the pain. I could keep going and talk about folks whose A1C, which is a measure of “your average blood sugar level for the past two to three months,” was elevated and ignored.[ii] Even a quick and simple Google search yielded a paper discussing the “[l]ong-entrenched acute care-focused treatment and reimbursement paradigms” that perpetuate the neglect of chronic issues.[iii]

My point? At minimum, the preponderance of the evidence would lead you to conclude that we have a healthcare system focused on the acute and that simultaneously ignores the chronic origins of the acute, which is what truly should be addressed to improve health.

That seems to beg a question, though, doesn’t it? Is the fact that our healthcare system seems to be aimed at the acute a sign of how we have prioritized health in our country—i.e., do we prioritize health? I would argue that it absolutely is a sign of the priority, or lack thereof, that we assign to our health. How is it that I connect those dots? POSIWID:

The Purpose Of a System Is What It Does.

POSIWID is a concept that comes out of cybernetics.[iv] It’s basically a way of saying that the results you reap reflect the design of the system and/or processes that you have employed. Simplifying it even further: the results you achieve, good or bad, are directly attributable to what you did and how you did it. So, if our healthcare system is not resolving the chronic issues that afflict a substantial portion of our society, then one must conclude that it’s simply not designed to do that.

One aspect of the kind of care that is provided is certainly how healthcare providers see their role. In other words, do they see themselves as basically order-takers who are in position to address only the immediate concerns of the patient, or do they see their purpose as being one to improve health and health-related conditions and outcomes? Certainly, as I mentioned above, the patient has a role to play as well—i.e., what does the patient want to address and how committed are they to improving their own health? However one sees him/herself, the way they address and interact with someone else will certainly reveal it.

When it comes to healthcare providers, the order-takers will be brief, perform minimal diagnostics, and prescribe solutions to mitigate the immediate concerns, seemingly only seeking to extend life, not necessarily to improve the quality thereof. The providers who want to improve health will function in basically the opposite fashion, including spending more time with the patient. Likewise, the patients who aren’t committed to improving their overall health will present their immediate issues and want to steer discussion away from anything that seems too involved.

Obviously, this is a blog related to financial topics, so I’ve got some dots to connect. Revelations of someone’s perspective through the interpretation of his/her conduct is not something unique to the medical world. Much like how the conduct of healthcare providers and patients will betray the role they seek to play, the same should absolutely be understood about financial advisors/planners/pracitioners and their clients.

Some questions to consider:

What is it like when you speak with a financial professional?

What is the nature of the conversation?

What do they ask about?

What do you focus on?

Does the practitioner listen and address the concerns that you express?

Do they place focus on understanding, explaining, and resolving the sources of your concerns?

Do they try to fix everything in one meeting or do they seem focused on forming a relationship, being a partner, and embarking on a journey with you?

How much time and effort are you willing to commit?

I could keep going, but I think you get the point.

There are some other dots that you could connect as well. For instance, just like there are only two types of people who go to the doctor, there are only two types of people that we work with: those who have more money than they need and those who have less. Can you guess how we go about determining which one you are? If you said perform diagnostics, you are 100% correct—if you didn’t, that’s ok, I would’ve told you anyway.

Financial diagnostics fundamentally reveal the same as medical diagnostics: they allow you to make the determination as to whether the issue(s) at-hand is acute or chronic in nature. To give you an example of how an acute financial problem can actually have chronic roots, consider someone unexpectedly owing taxes upon filing a tax return. The acute issue would certainly be the tax bill. The chronic cause of the tax bill, however, could be any number of things: inadequate use of income reducing contributions to retirement accounts, realizing capital gains, ignorance of tax credits, etc.

Here’s a twist for you, though: I’d be willing to bet that you automatically interpreted the words unexpectedly owing taxes as a problem and something that needed to be fixed. If I am correct about that, then you are guilty of focusing only on the acute. I’m sorry—I don’t make the rules.

Owing taxes is merely a sign that you have taxable income—maybe more than you expected. Income, in general, is a good thing. Income is necessary for us to achieve our goals. So, an unexpected tax bill is merely a sign that you have more taxable income than you expected and/or that your withholdings were possibly inadequate to account for your total tax liability. A focus on the acute would simply regard the tax bill, and/or income that created it, as the “problem” to be addressed. A focus on the chronic, however, would broaden the context and ensure that prescriptions aimed at reducing taxes don’t jeopardize your ability to achieve other goals—e.g., deferring more income to pre-tax retirement accounts would potentially make those funds inaccessible, or increase the cost involved to access those funds, for a purpose other than retirement.

In case it’s not obvious, whether the issues at-hand are of a medical, financial, or pretty much any other nature, it is much more advantageous for you and your practitioner to focus on the chronic, ensure a sufficiently broad context for your planning needs, and to ensure that perspective and solutions are holistic.

So, as you gear up to address issues in your life, remember: results are products of the systems and processes that you follow; the purpose of any system, process, or interaction begins with the focus that you define and plays out through conduct; thus, interactions and results will ultimately tell you whether your focus is in the right place—i.e., are you getting the results that you want?