June 24, 2025 • 24 mins
What Really Keeps Us Healthy? The Truth from an 80-Year Study
What if the most powerful medicine isn’t in a bottle—but in the way we show up for each other?
In this episode of The Opt-Out Podcast, Dr. Kara Foster explores the groundbreaking findings from the Harvard Study of Adult Development—the longest-running study on human happiness and health—and what it means for patients, providers, and the future of medicine.
You’ll learn:
What the Harvard study reveals about the #1 predictor of long-term health
Why traditional healthcare models often miss this vital piece
How Direct Care makes space for the kind of connection that heals
If you're ready to rethink health beyond lab work and prescriptions, this episode is for you.
Tune in now and discover what real care actually looks like.
#DirectCare #HealthcareRedefined #OptOutPodcast #HarvardStudy #KaraFosterOD
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:07):
If you could invest in one thingto improve your health and
happiness, what would it be? A new medication?
A supplement? The perfect diet?
According to Harvard's longest study, the answer is something
money can't buy. Strong relationships.
Welcome to the Opt Out podcast. I'm Doctor Kara Foster,
(00:28):
optometrist, healthcare reform advocate, and believer that we
can do healthcare differently. Last week, we talked about the
Blue Zones, those magical pockets of longevity where
people live long, healthy lives,and how combining those lessons
with direct care model creates something truly transformative.
This week, we're going even deeper.
(00:50):
What really makes life longer and more fulfilling?
What does one of the most respected scientific studies
have to say about it? And how can we apply those
lessons to our practices, our families, and our communities?
Let's begin with a story that's almost too good to be true, but
it is true. It's the most comprehensive,
(01:11):
longest running study ever conducted on human well-being,
the Harvard Study of Adult Development.
It started in 1938 and set out to answer a very deceptively
simple question. What makes a good life not just
a long life, but a meaningful, fulfilling and healthy 1 Because
(01:32):
we keep talking about direct care in the Blue Zones, and it's
important to have a long, healthy life, but what makes it
more meaningful and more fulfilled?
So this study began with two very different groups of young
men. The first group, Group One, were
the Harvard sophomores, 268 malestudents at Harvard University,
White, privileged, well educated, many from affluent
(01:56):
families, among them future U.S.President John F Kennedy.
Researchers followed them through college, wore careers,
marriages and retirement. Group two were the Boston boys,
456 boys from some of Boston's toughest neighborhoods.
Many lived in overcrowded tenement housing with unemployed
(02:19):
or alcoholic parents. Several had no hot water or
indoor plumbing growing up. These were kids society often
overlooks, but the study followed them just as closely.
The research team conducted detailed interviews, home
visits, medical exams, and even brought in their parents and
teachers to contribute insight. The goal was to observe every
(02:41):
aspect of human development, notjust physical health, but
emotional well-being, relationships, career
satisfaction and overall life trajectory.
And the magic is the study neverstopped.
It's still going on. Over time, the researchers
expanded the cohort to include the men's wives.
They're more than 1300 children.And now it's in its 85th year,
(03:04):
and the study is still ongoing. An extraordinary window into
what fapes the human experience across generations.
So here's what they discovered. And these insights didn't just
come from a single snapshot in time.
They emerged over decades of data.
Close relationships, not money, not fame, not IQ, are what can
(03:25):
keep people healthy and happy. People with strong, supportive
relationships lived longer and were less likely to suffer from
chronic illnesses, memory decline or depression.
Loneliness kills. The data showed that being
socially isolated just as harmful to your health as
(03:46):
smoking 15 cigarettes a day. And quality matters than more
than quantity. A few deep, meaningful
connections were more protectivethan having a huge network of
acquaintances and conflict matters.
People in high conflict relationships, especially in
marriage, showed earlier mental and physical decline than those
(04:10):
in secure partnerships. And your relationships at age 50
were better predictors of your health at 80 than your
cholesterol levels. The clearest message from this
85 year old study is good relationships keep us happier
and healthier. Period.
That quote is from the current study director.
(04:31):
Let that sink in. Your social fitness, your
ability to connect, be seen and be supported is as important or
more so than your physical fitness.
And just like physical fitness, social health takes effort.
It requires time, intention and environments that support real
human interaction. What's beautiful about this
(04:57):
study isn't just the statistics,it's the people behind them.
There's the story of a man who started well, with little
education and a troubled home life, who built a warm marriage,
nurtured friendships and volunteered in his community.
He ended up thriving well into his 90s.
And then there's the opposite. An attorney who had everything
(05:18):
on paper, a high income, a prestigious job and luxury
lifestyle. But over time, he became
emotionally isolated, disconnected from his children,
and grew better. His health declined rapidly in
his 70s, not because of physicaldisease, but from the slow
erosion of meaning and connection in his life.
(05:39):
The take away is universal. It's not what you do for a
living. It's not what you drive, it's
who you're walking through life with and how deeply you're
connected. So what does this have to do
with healthcare? I mean, come on, everything.
Because when you step into the most modern medical offices
today, you don't see relationships being prioritized.
(06:01):
You see quick visits, rushed conversations, checklist box
ticking and insurance driven decisions.
And yet the science and frankly,our own lived experiences tell
us that connection is the very thing that keeps us alive.
And that's why today's episode matters.
Because if we're designing systems to support human health
but ignoring the human part, we've missed the whole point.
(06:25):
So if strong relationships are the number one predictor of a
long, healthy and happy life, you think our healthcare system
would be built around them. But the uncomfortable truth is
it's not. The modern medical system wasn't
designed for connection. It was designed for efficiency,
compliance and billing. Let's take a look at a typical
(06:47):
doctor's visit today. The average primary care visits
last 7 minutes. That's barely enough time to
greet the patient, review their medications and click through a
few boxes into the record, let alone get to know what's really
going on in their life. And even worse, in many vision
care settings, a routine exam under insurance might last 15
(07:09):
minutes total, start to finish, with the doctor interaction
sometimes clocking in at about 5minutes or less.
And that's not because we don't care.
It's because we literally can't afford to spend more time unless
we step out of the system. But what happens in those rush
visits? We miss subtle clues about
depression, anxiety or burnout. We don't have time to ask about
(07:33):
loneliness, even though it has the same health impact as
smoking 15 cigarettes a day. We check boxes, but we don't
check in. We look at the patient's lab
values or refractive error, but not their story, and patients
can feel it. In survey after survey, patients
report dissatisfaction, confusion and distrust in the
(07:55):
healthcare system. At the same time, chronic
disease and mental health struggles are climbing despite
all of our advances. So why is this happening?
Because healthcare today is transactional, not relational.
Think about it. Most of our system is structured
around billing codes and productivity metrics.
Not purpose, not presence, and certainly not prevention.
(08:20):
And if a doctor doesn't include the right CPT code with the
right diagnosis tied to the right documentation, payment is
denied or delayed to hit productivity targets.
They're booked every 15 minutes or less, and after hours.
Doctors are charting at home, trying to keep up with
documentation requirements that often feel more legal than
(08:40):
clinical. It's not sustainable, and the
burnout numbers prove it. Over 60% of physicians report
signs of emotional exhaustion ordepersonalization.
One in five doctors say they're considering leaving medicine
entirely. And more than ever, we're seeing
clinicians walk away not becausethey don't love their patients,
(09:02):
but because the system it makes it almost impossible to care for
them the way they want to. It's not just the doctors, it's
patients, too. You've probably heard the phrase
bedside manner, right? But when you're only given 7
minutes to talk and 30 seconds to document each decision,
what's left for compassion? For curiosity, For connecting?
(09:24):
Even in Pediatrics or OBGYN, where long term relationships
should be natural, the system ispushing for volume over value.
And here's something that gets overlooked.
Even primary care and vision care, The very front doors of
our healthcare system, are beingdriven by the same high speed,
high pressure model. But it doesn't have to be that
(09:45):
way. Imagine a system where doctors
have time to ask how you're really doing.
Visits don't end the moment the clock hits 15 minutes.
Mental and emotional health are part of the conversation, not
separate referrals. And you actually know your
doctor and they know you. That's why I love my practice so
much. That's not a fantasy, it's
(10:07):
direct care and we'll get to more into it in the next
section. But the bottom line is this.
We've over medicalized symptoms that are really rooted in
disconnection and we've undervalued the one thing that
the Harvard study proves mattersmost, relationships.
If we want better health outcomes, fewer chronic
(10:28):
illnesses, and a healthcare system that truly heals, we have
to rebuild the foundation. And that foundation starts with
time. Trust in human connection.
Let's go deeper. Direct care isn't just about
ditching insurance, it's about restoring the most powerful tool
(10:49):
that we have in medicine, the relationship between patient and
provider. In the traditional model, that
relationship is constantly interrupted by building codes
that dictate how much time you can spend, by documentation
checklists that take precedence over conversation, and by
insurance companies that act like they know what's best for
(11:09):
you even though they've never met you.
But when you remove all of that,when you take out the noise, the
red tape and the 8 minute visit model, something amazing
happens. Time becomes a healing tool.
In direct care visits, they often last 30 to 60 minutes, not
(11:31):
seven. That gives space for the full
story, not just a chief complaint, a discussion about
sleep, stress, relationships, goals, a deeper understanding of
your why, not just your symptoms.
Doctors can finally listen without rushing, ask follow-ups
without glancing at the clock, and pause long enough to really
(11:52):
notice the things that get missed.
In speed medicine, in patients, they open up.
They ask the questions they've been too embarrassed or too
rushed to ask before. They're more likely to follow
through because they trust the person sitting across from them
and continuity becomes the standard.
In an insurance based care, you're lucky if you see the same
(12:14):
provider twice. We know this.
In direct care, continuity isn'ta bonus, It's built in.
You're not just a chart, you're not just a diagnosis.
You're a person in a relationship with a Doctor Who
actually knows you. That relationship creates early
detection of issues before they escalate.
Personalized recommendations based on history and goals.
(12:38):
An ongoing partnership, not a series of disconnected
transactions. This is especially powerful when
it comes to prevention and mental health, areas often
ignored in traditional care because there's just no time.
And let's talk about the impact on doctors.
Because burnout is at crisis levels, especially in primary
(12:58):
care and eye care. And it's not because doctors
don't care, it's because they care deeply and are trapped in a
system that makes it impossible to do the kind of work that
lights them up. But direct care can change that.
Without the pressures of insurance building.
They get to practice medicine, not paperwork.
And that reignites something powerful.
(13:20):
The reason why we all went into this profession in the 1st
place. And it's science backed, too.
Remember the Harvard study we just talked about?
It shows the quality of your relationships.
Predict your health into your 80s better than your
cholesterol, blood pressure, or income.
And it's not just a nice idea, it's evidence.
(13:40):
Direct care aligns perfectly with this.
It creates the space for those relationships to exist.
Because we can't improve someone's health if we don't
know who they are. And we can't know who they are
if we don't have time to act. In my own direct care optometry
practice, here's what it looks like.
We don't rush. My patients know they'll have
(14:02):
time to be heard. We talk about nutrition, stress,
screen time, and how their lifestyle effects their vision
and overall health. And we follow up because it's
not about squeezing in more appointments.
It's about building more trust. And when someone is going
through a hard time, I don't send them to a portal or make
them wait three months. I reach out because in direct
(14:24):
care, we're not just managing problems, we're getting to know
people. The take away is that when you
take insurance out of the exam room, you make space for care to
walk back in. And that's what direct care
does. It doesn't just fix a broken
system. It rebuilds connection that
heals people, not just clinically, but emotionally and
(14:46):
relationally. And in a world where loneliness
is more dangerous than smoking, that kind of care isn't just
nice, it's necessary. So what does all of this
actually mean for you? Whether you're sitting in a
doctor's office as a provider orsitting in a waiting room as the
patient, whether you're a parenttrying to advocate for your
(15:08):
child or a caregiver walking through the healthcare maze with
someone you love, the message from the Harvard study and from
direct care is clear. It's not the tech.
It's not the tests. It's not even the treatments.
It's the relationship that's thefoundation of real health.
Let's break it down. If you're a doctor, maybe you're
(15:30):
tired. Maybe you've started to feel
like you're on a treadmill, clicking boxes, watching the
clock, charting late into the night.
Maybe you went into medicine to help people, and now you barely
have time to look them in the eye.
You're not imagining it. The system has made it almost
impossible to practice the kind of medicine you believe in.
But direct care offers a different path.
(15:51):
You decide how much time you spend with patients.
You set your schedule based on care, not codes.
You don't have to argue with insurance to do what's right,
and you get to reconnect with the reason you became a provider
in the 1st place. If you're a patient, maybe
you've left appointments feelingunheard, unsure, or even
dismissed. Maybe you've bounced between
(16:13):
specialist, never seeing the same face twice.
Maybe you've been told that yourlabs are fine, but you still
don't feel well. You deserve better.
Direct care gives you a space where your doctor knows your
name and your story. You're not limited to seven
minute rushed appointments, and you can talk about what's really
going on physically, emotionally, and socially.
(16:35):
You feel safe, respected, and part of the plan for your life.
And that's when the real healingbegins.
If you're a parent, a partner, or community leader, you want
the people you love to grow up in a system that values their
whole health, not just their ability to pay or check the
(16:56):
right boxes. You want your kids to know their
doctor, and you want your aging parents to have someone who
actually listens. You want your town to feel like
a community, not just a collection of buildings with
prescription counters. It's not a pipe dream.
It's possible, and the combination of direct care and
community based Wellness is how we build it.
(17:18):
The big truth is that relationships aren't a nice to
have in healthcare. They're the most powerful
intervention we have. They shape outcomes, they shape
behavior, they shape lives. And direct care is the only
model that was designed from theground up to protect and
prioritize those relationships. When you take out the middle men
(17:39):
and the profit first incentives,you're left with something
radical. Time, trust, follow-ups,
listening, purpose. That's the magic.
Not just a new drug or a better portal, it's being seen.
Let's be honest, when we talk about changing healthcare or
(18:01):
even improving our own health, it can feel massive.
Like you have to quit your job, move to a farm, or start
meditating at 5:00 AM everyday. But the truth is, you don't have
to overhaul your entire life, you just need to begin and often
the smallest shifts are the onesthat create the most meaningful
(18:21):
results. If your provider that feels
stuck in the system, even those small moments of intentional
care can change someone's life and can reconnect you with your
purpose. Try this.
Make a follow up call after a visit.
Not just rebelling, but to checkin.
Add a simple question to your intake form.
(18:41):
What brings you joy? Do you feel connected to others?
Or send a handwritten birthday card to one of your long time
patients. Imagine how that could brighten
someone's day. Or invite a few patients to a
monthly Wellness walk or discussion group.
These don't require permission and they don't require funding.
They just require heart and a few minutes of your time.
(19:03):
Because patients don't always remember what you prescribed,
but they will remember how you made them feel.
If you're a patient, you have more power than you think.
You can choose providers who take time, who listen, who look
you in the eye. During your next visit, ask can
we talk about stress, sleep, or how I've been feeling lately?
(19:25):
And Share your story. Be your own advocate.
Talk to your employer or your HRRep about offering a direct
primary care option. It could change your whole
team's access to better care. Remember, you're not a chart
note. You're not a number, you are a
whole person and you deserve thecare.
This sees you that way. If you're a community builder
(19:47):
and really aren't we all, you don't need a nonprofit or a
public health degree to create Wellness around you.
You just need an invitation. Host a monthly potluck.
Ask people to bring their favorite whole food dish and a
story to go with it. Start a walking group after
school or before dinner. Create a book club focused on
(20:09):
personal growth or healing stories.
Organize a care circle for new moms, caregivers, or those going
through a hard time. There aren't big budget
programs. They're human programs where
people look out for each other. Because at the end of the day,
Wellness doesn't happen in isolation.
It happens in connection. That's what the Blue Zones teach
(20:31):
us. That's what the Harvard study
proved, and that's what direct care makes room for.
The world doesn't need more rushvisits, more prescriptions, or
more portals. It needs more moments that
matter. And yes, you can help make this
happen. The Harvard study didn't uncover
a magic supplement. It didn't find the perfect blood
(20:53):
pressure number, diet trend, or gene sequence.
It uncovered something deeper, more human, and honestly, more
hopeful. It gave us proof that our
relationships are the medicine. Let me leave you with the two
stories from the study that still stick with me.
A teacher, He never became famous.
(21:13):
He didn't build an empire, but he showed up every day for his
students. He had dinner with his family.
He coached baseball and walked his neighborhood well into his
80s. When researchers looked at his
health outcomes, they were stunning.
Low inflammation, minimal chronic disease, strong
cognition, and most importantly,a deep sense of purpose and joy
(21:36):
that lasted into his 90s. Isn't that what we all want?
Another patient was a high-powered attorney, had the
kind of resume that most people dream of.
Ivy League degrees, a mansion, an office with a skyline view.
But he spent most of his time alone.
He worked long hours, he lost touch with old friends, and he
(22:00):
admitted feeling like no one really knew him.
His physical decline began earlyheart issues, anxiety, and deep
emotional fatigue. Despite his access to the best
care money could buy, he never really felt well.
Same study, same start, but vastly different endings.
(22:21):
And the deciding factor wasn't cholesterol or willpower or a
gym routine. It was connection.
Not IQ, not income, relationships.
So what do we do with this? We have to take it seriously.
Not just as nice to have, but asa core metric of real health.
(22:42):
So share this episode with someone you care about, your
provider, your patient, your best friend, your mom.
Let's get more people talking about what really matters in
healthcare connection. I have a free one page PDF if
you'd like a copy of it. Send me a message or leave a
comment on this as well. It's called the Harvard Study in
(23:06):
Direct care, what it means for your life.
It's perfect for your waiting room, classroom, coffee table,
or community bulletin board. Visit my website,
carefosterod.com to learn more about my work in direct care,
healthcare reform, and helping people reclaim their health with
purpose. You'll find podcast episodes,
(23:27):
speaking info, resources, and a whole lot of heart.
And most importantly, choose onesmall action this week to
strengthen a relationship in your life.
Make the call, send the text, invite someone for a walk, not
just a scroll. Because that's how change
begins. Not with legislation, but with
(23:47):
intention. We don't need a nationwide
revolution to start seeing change.
We need thousands of small revolutions in our exam rooms,
our living rooms, our classrooms, and our hearts.
Direct care gives us that space to reconnect, but it's up to us
to use that space to build what matters most next.
(24:13):
Next week on Opt Out, the human side of Healthcare, Why customer
service matters, we'll dive intowhat actually makes patients
feel safe, respected, and heard.Why hospitality isn't extra,
It's essential. I'll share what I do in my
office to make care feel, well, like care from the front desk.
(24:33):
To follow up, we're not here to copy the old system.
We're here to build something better from the ground up with
trust at the center. So until next week, go
strengthen a relationship that matters because health starts
with connection and connection starts with you.
Thank you for listening. This is Cara Foster opting out.
If you could invest in one thingto improve your health and
happiness, what would it be? A new medication?
A supplement? The perfect diet?
According to Harvard's longest study, the answer is something
money can't buy. Strong relationships.
Welcome to the Opt Out podcast. I'm Doctor Kara Foster,
(00:28):
optometrist, healthcare reform advocate, and believer that we
can do healthcare differently. Last week, we talked about the
Blue Zones, those magical pockets of longevity where
people live long, healthy lives,and how combining those lessons
with direct care model creates something truly transformative.
This week, we're going even deeper.
(00:50):
What really makes life longer and more fulfilling?
What does one of the most respected scientific studies
have to say about it? And how can we apply those
lessons to our practices, our families, and our communities?
Let's begin with a story that's almost too good to be true, but
it is true. It's the most comprehensive,
(01:11):
longest running study ever conducted on human well-being,
the Harvard Study of Adult Development.
It started in 1938 and set out to answer a very deceptively
simple question. What makes a good life not just
a long life, but a meaningful, fulfilling and healthy 1 Because
(01:32):
we keep talking about direct care in the Blue Zones, and it's
important to have a long, healthy life, but what makes it
more meaningful and more fulfilled?
So this study began with two very different groups of young
men. The first group, Group One, were
the Harvard sophomores, 268 malestudents at Harvard University,
White, privileged, well educated, many from affluent
(01:56):
families, among them future U.S.President John F Kennedy.
Researchers followed them through college, wore careers,
marriages and retirement. Group two were the Boston boys,
456 boys from some of Boston's toughest neighborhoods.
Many lived in overcrowded tenement housing with unemployed
(02:19):
or alcoholic parents. Several had no hot water or
indoor plumbing growing up. These were kids society often
overlooks, but the study followed them just as closely.
The research team conducted detailed interviews, home
visits, medical exams, and even brought in their parents and
teachers to contribute insight. The goal was to observe every
(02:41):
aspect of human development, notjust physical health, but
emotional well-being, relationships, career
satisfaction and overall life trajectory.
And the magic is the study neverstopped.
It's still going on. Over time, the researchers
expanded the cohort to include the men's wives.
They're more than 1300 children.And now it's in its 85th year,
(03:04):
and the study is still ongoing. An extraordinary window into
what fapes the human experience across generations.
So here's what they discovered. And these insights didn't just
come from a single snapshot in time.
They emerged over decades of data.
Close relationships, not money, not fame, not IQ, are what can
(03:25):
keep people healthy and happy. People with strong, supportive
relationships lived longer and were less likely to suffer from
chronic illnesses, memory decline or depression.
Loneliness kills. The data showed that being
socially isolated just as harmful to your health as
(03:46):
smoking 15 cigarettes a day. And quality matters than more
than quantity. A few deep, meaningful
connections were more protectivethan having a huge network of
acquaintances and conflict matters.
People in high conflict relationships, especially in
marriage, showed earlier mental and physical decline than those
(04:10):
in secure partnerships. And your relationships at age 50
were better predictors of your health at 80 than your
cholesterol levels. The clearest message from this
85 year old study is good relationships keep us happier
and healthier. Period.
That quote is from the current study director.
(04:31):
Let that sink in. Your social fitness, your
ability to connect, be seen and be supported is as important or
more so than your physical fitness.
And just like physical fitness, social health takes effort.
It requires time, intention and environments that support real
human interaction. What's beautiful about this
(04:57):
study isn't just the statistics,it's the people behind them.
There's the story of a man who started well, with little
education and a troubled home life, who built a warm marriage,
nurtured friendships and volunteered in his community.
He ended up thriving well into his 90s.
And then there's the opposite. An attorney who had everything
(05:18):
on paper, a high income, a prestigious job and luxury
lifestyle. But over time, he became
emotionally isolated, disconnected from his children,
and grew better. His health declined rapidly in
his 70s, not because of physicaldisease, but from the slow
erosion of meaning and connection in his life.
(05:39):
The take away is universal. It's not what you do for a
living. It's not what you drive, it's
who you're walking through life with and how deeply you're
connected. So what does this have to do
with healthcare? I mean, come on, everything.
Because when you step into the most modern medical offices
today, you don't see relationships being prioritized.
(06:01):
You see quick visits, rushed conversations, checklist box
ticking and insurance driven decisions.
And yet the science and frankly,our own lived experiences tell
us that connection is the very thing that keeps us alive.
And that's why today's episode matters.
Because if we're designing systems to support human health
but ignoring the human part, we've missed the whole point.
(06:25):
So if strong relationships are the number one predictor of a
long, healthy and happy life, you think our healthcare system
would be built around them. But the uncomfortable truth is
it's not. The modern medical system wasn't
designed for connection. It was designed for efficiency,
compliance and billing. Let's take a look at a typical
(06:47):
doctor's visit today. The average primary care visits
last 7 minutes. That's barely enough time to
greet the patient, review their medications and click through a
few boxes into the record, let alone get to know what's really
going on in their life. And even worse, in many vision
care settings, a routine exam under insurance might last 15
(07:09):
minutes total, start to finish, with the doctor interaction
sometimes clocking in at about 5minutes or less.
And that's not because we don't care.
It's because we literally can't afford to spend more time unless
we step out of the system. But what happens in those rush
visits? We miss subtle clues about
depression, anxiety or burnout. We don't have time to ask about
(07:33):
loneliness, even though it has the same health impact as
smoking 15 cigarettes a day. We check boxes, but we don't
check in. We look at the patient's lab
values or refractive error, but not their story, and patients
can feel it. In survey after survey, patients
report dissatisfaction, confusion and distrust in the
(07:55):
healthcare system. At the same time, chronic
disease and mental health struggles are climbing despite
all of our advances. So why is this happening?
Because healthcare today is transactional, not relational.
Think about it. Most of our system is structured
around billing codes and productivity metrics.
Not purpose, not presence, and certainly not prevention.
(08:20):
And if a doctor doesn't include the right CPT code with the
right diagnosis tied to the right documentation, payment is
denied or delayed to hit productivity targets.
They're booked every 15 minutes or less, and after hours.
Doctors are charting at home, trying to keep up with
documentation requirements that often feel more legal than
(08:40):
clinical. It's not sustainable, and the
burnout numbers prove it. Over 60% of physicians report
signs of emotional exhaustion ordepersonalization.
One in five doctors say they're considering leaving medicine
entirely. And more than ever, we're seeing
clinicians walk away not becausethey don't love their patients,
(09:02):
but because the system it makes it almost impossible to care for
them the way they want to. It's not just the doctors, it's
patients, too. You've probably heard the phrase
bedside manner, right? But when you're only given 7
minutes to talk and 30 seconds to document each decision,
what's left for compassion? For curiosity, For connecting?
(09:24):
Even in Pediatrics or OBGYN, where long term relationships
should be natural, the system ispushing for volume over value.
And here's something that gets overlooked.
Even primary care and vision care, The very front doors of
our healthcare system, are beingdriven by the same high speed,
high pressure model. But it doesn't have to be that
(09:45):
way. Imagine a system where doctors
have time to ask how you're really doing.
Visits don't end the moment the clock hits 15 minutes.
Mental and emotional health are part of the conversation, not
separate referrals. And you actually know your
doctor and they know you. That's why I love my practice so
much. That's not a fantasy, it's
(10:07):
direct care and we'll get to more into it in the next
section. But the bottom line is this.
We've over medicalized symptoms that are really rooted in
disconnection and we've undervalued the one thing that
the Harvard study proves mattersmost, relationships.
If we want better health outcomes, fewer chronic
(10:28):
illnesses, and a healthcare system that truly heals, we have
to rebuild the foundation. And that foundation starts with
time. Trust in human connection.
Let's go deeper. Direct care isn't just about
ditching insurance, it's about restoring the most powerful tool
(10:49):
that we have in medicine, the relationship between patient and
provider. In the traditional model, that
relationship is constantly interrupted by building codes
that dictate how much time you can spend, by documentation
checklists that take precedence over conversation, and by
insurance companies that act like they know what's best for
(11:09):
you even though they've never met you.
But when you remove all of that,when you take out the noise, the
red tape and the 8 minute visit model, something amazing
happens. Time becomes a healing tool.
In direct care visits, they often last 30 to 60 minutes, not
(11:31):
seven. That gives space for the full
story, not just a chief complaint, a discussion about
sleep, stress, relationships, goals, a deeper understanding of
your why, not just your symptoms.
Doctors can finally listen without rushing, ask follow-ups
without glancing at the clock, and pause long enough to really
(11:52):
notice the things that get missed.
In speed medicine, in patients, they open up.
They ask the questions they've been too embarrassed or too
rushed to ask before. They're more likely to follow
through because they trust the person sitting across from them
and continuity becomes the standard.
In an insurance based care, you're lucky if you see the same
(12:14):
provider twice. We know this.
In direct care, continuity isn'ta bonus, It's built in.
You're not just a chart, you're not just a diagnosis.
You're a person in a relationship with a Doctor Who
actually knows you. That relationship creates early
detection of issues before they escalate.
Personalized recommendations based on history and goals.
(12:38):
An ongoing partnership, not a series of disconnected
transactions. This is especially powerful when
it comes to prevention and mental health, areas often
ignored in traditional care because there's just no time.
And let's talk about the impact on doctors.
Because burnout is at crisis levels, especially in primary
(12:58):
care and eye care. And it's not because doctors
don't care, it's because they care deeply and are trapped in a
system that makes it impossible to do the kind of work that
lights them up. But direct care can change that.
Without the pressures of insurance building.
They get to practice medicine, not paperwork.
And that reignites something powerful.
(13:20):
The reason why we all went into this profession in the 1st
place. And it's science backed, too.
Remember the Harvard study we just talked about?
It shows the quality of your relationships.
Predict your health into your 80s better than your
cholesterol, blood pressure, or income.
And it's not just a nice idea, it's evidence.
(13:40):
Direct care aligns perfectly with this.
It creates the space for those relationships to exist.
Because we can't improve someone's health if we don't
know who they are. And we can't know who they are
if we don't have time to act. In my own direct care optometry
practice, here's what it looks like.
We don't rush. My patients know they'll have
(14:02):
time to be heard. We talk about nutrition, stress,
screen time, and how their lifestyle effects their vision
and overall health. And we follow up because it's
not about squeezing in more appointments.
It's about building more trust. And when someone is going
through a hard time, I don't send them to a portal or make
them wait three months. I reach out because in direct
(14:24):
care, we're not just managing problems, we're getting to know
people. The take away is that when you
take insurance out of the exam room, you make space for care to
walk back in. And that's what direct care
does. It doesn't just fix a broken
system. It rebuilds connection that
heals people, not just clinically, but emotionally and
(14:46):
relationally. And in a world where loneliness
is more dangerous than smoking, that kind of care isn't just
nice, it's necessary. So what does all of this
actually mean for you? Whether you're sitting in a
doctor's office as a provider orsitting in a waiting room as the
patient, whether you're a parenttrying to advocate for your
(15:08):
child or a caregiver walking through the healthcare maze with
someone you love, the message from the Harvard study and from
direct care is clear. It's not the tech.
It's not the tests. It's not even the treatments.
It's the relationship that's thefoundation of real health.
Let's break it down. If you're a doctor, maybe you're
(15:30):
tired. Maybe you've started to feel
like you're on a treadmill, clicking boxes, watching the
clock, charting late into the night.
Maybe you went into medicine to help people, and now you barely
have time to look them in the eye.
You're not imagining it. The system has made it almost
impossible to practice the kind of medicine you believe in.
But direct care offers a different path.
(15:51):
You decide how much time you spend with patients.
You set your schedule based on care, not codes.
You don't have to argue with insurance to do what's right,
and you get to reconnect with the reason you became a provider
in the 1st place. If you're a patient, maybe
you've left appointments feelingunheard, unsure, or even
dismissed. Maybe you've bounced between
(16:13):
specialist, never seeing the same face twice.
Maybe you've been told that yourlabs are fine, but you still
don't feel well. You deserve better.
Direct care gives you a space where your doctor knows your
name and your story. You're not limited to seven
minute rushed appointments, and you can talk about what's really
going on physically, emotionally, and socially.
(16:35):
You feel safe, respected, and part of the plan for your life.
And that's when the real healingbegins.
If you're a parent, a partner, or community leader, you want
the people you love to grow up in a system that values their
whole health, not just their ability to pay or check the
(16:56):
right boxes. You want your kids to know their
doctor, and you want your aging parents to have someone who
actually listens. You want your town to feel like
a community, not just a collection of buildings with
prescription counters. It's not a pipe dream.
It's possible, and the combination of direct care and
community based Wellness is how we build it.
(17:18):
The big truth is that relationships aren't a nice to
have in healthcare. They're the most powerful
intervention we have. They shape outcomes, they shape
behavior, they shape lives. And direct care is the only
model that was designed from theground up to protect and
prioritize those relationships. When you take out the middle men
(17:39):
and the profit first incentives,you're left with something
radical. Time, trust, follow-ups,
listening, purpose. That's the magic.
Not just a new drug or a better portal, it's being seen.
Let's be honest, when we talk about changing healthcare or
(18:01):
even improving our own health, it can feel massive.
Like you have to quit your job, move to a farm, or start
meditating at 5:00 AM everyday. But the truth is, you don't have
to overhaul your entire life, you just need to begin and often
the smallest shifts are the onesthat create the most meaningful
(18:21):
results. If your provider that feels
stuck in the system, even those small moments of intentional
care can change someone's life and can reconnect you with your
purpose. Try this.
Make a follow up call after a visit.
Not just rebelling, but to checkin.
Add a simple question to your intake form.
(18:41):
What brings you joy? Do you feel connected to others?
Or send a handwritten birthday card to one of your long time
patients. Imagine how that could brighten
someone's day. Or invite a few patients to a
monthly Wellness walk or discussion group.
These don't require permission and they don't require funding.
They just require heart and a few minutes of your time.
(19:03):
Because patients don't always remember what you prescribed,
but they will remember how you made them feel.
If you're a patient, you have more power than you think.
You can choose providers who take time, who listen, who look
you in the eye. During your next visit, ask can
we talk about stress, sleep, or how I've been feeling lately?
(19:25):
And Share your story. Be your own advocate.
Talk to your employer or your HRRep about offering a direct
primary care option. It could change your whole
team's access to better care. Remember, you're not a chart
note. You're not a number, you are a
whole person and you deserve thecare.
This sees you that way. If you're a community builder
(19:47):
and really aren't we all, you don't need a nonprofit or a
public health degree to create Wellness around you.
You just need an invitation. Host a monthly potluck.
Ask people to bring their favorite whole food dish and a
story to go with it. Start a walking group after
school or before dinner. Create a book club focused on
(20:09):
personal growth or healing stories.
Organize a care circle for new moms, caregivers, or those going
through a hard time. There aren't big budget
programs. They're human programs where
people look out for each other. Because at the end of the day,
Wellness doesn't happen in isolation.
It happens in connection. That's what the Blue Zones teach
(20:31):
us. That's what the Harvard study
proved, and that's what direct care makes room for.
The world doesn't need more rushvisits, more prescriptions, or
more portals. It needs more moments that
matter. And yes, you can help make this
happen. The Harvard study didn't uncover
a magic supplement. It didn't find the perfect blood
(20:53):
pressure number, diet trend, or gene sequence.
It uncovered something deeper, more human, and honestly, more
hopeful. It gave us proof that our
relationships are the medicine. Let me leave you with the two
stories from the study that still stick with me.
A teacher, He never became famous.
(21:13):
He didn't build an empire, but he showed up every day for his
students. He had dinner with his family.
He coached baseball and walked his neighborhood well into his
80s. When researchers looked at his
health outcomes, they were stunning.
Low inflammation, minimal chronic disease, strong
cognition, and most importantly,a deep sense of purpose and joy
(21:36):
that lasted into his 90s. Isn't that what we all want?
Another patient was a high-powered attorney, had the
kind of resume that most people dream of.
Ivy League degrees, a mansion, an office with a skyline view.
But he spent most of his time alone.
He worked long hours, he lost touch with old friends, and he
(22:00):
admitted feeling like no one really knew him.
His physical decline began earlyheart issues, anxiety, and deep
emotional fatigue. Despite his access to the best
care money could buy, he never really felt well.
Same study, same start, but vastly different endings.
(22:21):
And the deciding factor wasn't cholesterol or willpower or a
gym routine. It was connection.
Not IQ, not income, relationships.
So what do we do with this? We have to take it seriously.
Not just as nice to have, but asa core metric of real health.
(22:42):
So share this episode with someone you care about, your
provider, your patient, your best friend, your mom.
Let's get more people talking about what really matters in
healthcare connection. I have a free one page PDF if
you'd like a copy of it. Send me a message or leave a
comment on this as well. It's called the Harvard Study in
(23:06):
Direct care, what it means for your life.
It's perfect for your waiting room, classroom, coffee table,
or community bulletin board. Visit my website,
carefosterod.com to learn more about my work in direct care,
healthcare reform, and helping people reclaim their health with
purpose. You'll find podcast episodes,
(23:27):
speaking info, resources, and a whole lot of heart.
And most importantly, choose onesmall action this week to
strengthen a relationship in your life.
Make the call, send the text, invite someone for a walk, not
just a scroll. Because that's how change
begins. Not with legislation, but with
(23:47):
intention. We don't need a nationwide
revolution to start seeing change.
We need thousands of small revolutions in our exam rooms,
our living rooms, our classrooms, and our hearts.
Direct care gives us that space to reconnect, but it's up to us
to use that space to build what matters most next.
(24:13):
Next week on Opt Out, the human side of Healthcare, Why customer
service matters, we'll dive intowhat actually makes patients
feel safe, respected, and heard.Why hospitality isn't extra,
It's essential. I'll share what I do in my
office to make care feel, well, like care from the front desk.
(24:33):
To follow up, we're not here to copy the old system.
We're here to build something better from the ground up with
trust at the center. So until next week, go
strengthen a relationship that matters because health starts
with connection and connection starts with you.
Thank you for listening. This is Cara Foster opting out.
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