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Date: October 1, 2010

You make dozens of choices every day that can affect your well-being — from big-deal ones like whether to spring for health insurance, to micro-judgment calls that can take a toll over time, such as whether to go to bed or watch another hour of TV. But which are super important and which can you let slide? We asked leading researchers to tell us the top-priority decisions you should make now. The sooner you cross these off your to-do list, the sooner you’ll know you’re doing everything you can to optimize your health and feel your best.

Who will your doctors be?

If you don’t have a primary care physician (PCP) and an OB/GYN (for women), it’s time to go doctor shopping. “Women should have both types of doctors,” says Michael Roizen, M.D., division chair at the Cleveland Clinic and co-author of You: The Smart Patient.

Why? OB/GYNs specialize in gynecological and obstetrical issues, which are especially important if you’re sexually active, pregnant or considering pregnancy. PCPs have broad-based medical knowledge and training in prevention. If your blood pressure is creeping up, your OB shouldn’t be the one to write a prescription for blood pressure medication.

“There are so many nuances in drug therapy and drug interactions that PCPs are expert in,” Roizen says. (Men just need a PCP for preventive care unless they need to monitor a specific medical condition, when a specialist may be necessary.) Your PCP should be the quarterback of your care.

To-do tactic: To choose a PCP, interview two or three until you find one with whom you’re compatible. For PCP recommendations, Roizen advises calling the emergency room nurse at a large hospital in your area between 9 and 11 a.m. Monday through Thursday, and asking her whom she thinks is good. ER nurses have insider knowledge, such as who are the most attentive doctors or who has a particular expertise, he says. To find an OB/GYN or another specialist, ask your PCP for recommendations. Then, again, go through the interview process.

Clues a doctor is right for you: The waiting room has other patients similar to you in age; the doctor isn’t near retirement (a sign that she won’t be able to care for you in the long term); and he’s up-to-date on what’s likely to happen to you. “If you have a family history of colon cancer, for example, you want someone who focuses on colon cancer prevention and knows the current medical literature,” Roizen says.

What health insurance will you choose?

“Everyone should at least have catastrophic medical coverage,” Roizen says, which covers major procedures, such as an operation or a hospitalization, if something serious happens. If you have kids, your policy should also cover routine preventive care and well-child checkups because kids tend to visit the pediatrician frequently. If you’re planning to have a family, your policy should include obstetrical and maternity coverage.

“Look at your situation and decide the minimum amount of health coverage you need, then go from there,” Roizen says. Take cost into consideration and whether your doctor accepts that insurance.

As part of the new Affordable Care Act, which was signed into law March 23, 2010, most people who can afford it will be required to obtain basic health insurance coverage or pay a fee to help offset the costs of caring for uninsured Americans. Individuals and small companies will be able to buy affordable coverage through an exchange system; tax credits may also be available for individuals who can’t afford health insurance. Those changes don’t take effect until January 2014, however.

To-do tactic: In the meantime, visit for ideas on how to obtain health insurance if you need it for yourself and your family. Tempted to go without health insurance for now? Think again. A recent study in the Journal of the American Medical Association found that the uninsured were less likely than the insured to receive any medical care after an accident or the onset of a new chronic condition.

In general, to choose a good plan, see how various health plans rate by checking out the health plan report at the National Committee on Quality Assurance at An Excellent score means a plan is handling claims superior to other insurers. You’ll be less likely to get surprised with bills for health services you only thought were covered.

Do you feel fulfilled and happy at the end of a typical day?

It’s important because if you’re flourishing in your life (an estimated 17 percent of the population), you’ll miss less work and have fewer chronic diseases and conditions. Flourishers also feel more in control of their lives, have concrete goals, learn from adversity, and feel close to family and friends. “You want to be one of those people,” says Carol Kauffman, Ph.D., a coaching psychologist at Harvard Medical School in Boston.

To-do tactic: If you’re dissatisfied with your career, determine your character strengths by taking the values-in-action inventory (, a free 240-question survey developed, in part, by Martin Seligman, Ph.D., director of the University of Pennsylvania Positive Psychology Center. The survey generates a report indicating your top five signature strengths, with a description of each. Use this information to work toward a job that’s a better fit with who you are or find ways to use your strengths in your current job.

“If you’re a truck driver, for example, and one of your strengths is creativity, you’ll want to find a way to be creative at your job,” Kauffman says. Would it be through noticing interesting things? Changing what you’re listening to on your sound system? By writing about your work experiences in hopes of publishing a book one day? Your efforts will pay off. “If you can make your full-time job line up with your character strengths, you will be happier,” Kauffman says.

When, if at all, do you want to have more kids?

If you’re a woman in your 30s, put this decision on the front burner or at least have an idea what “the right time” looks like.

“Good and bad things can happen at any age, but the balance begins to shift for women during the 30s,” says Dr. Carolyn Westhoff, medical director of family planning at Columbia-Presbyterian Medical Center in New York City. With each passing year after 30, fertility gradually declines, and the risk of intervening medical problems such as high blood pressure and diabetes begins to rise. The rate of miscarriage also goes up along with the chance of having a fetus with a genetic abnormality. “The probability of having any of these difficulties is just more likely to happen when women are older,” Westhoff says.

To-do tactic: Pregnancy has its own set of health risks, so you only want to get pregnant when you want to. To avoid unintended pregnancy, go with the birth control method you’re most comfortable using. (For a list of methods, visit

“I love IUDs, NuvaRing and the pill, but different women are going to be happy with different methods,” Westhoff says. So feel free to experiment. One caveat: If you want to get pregnant within the next year, avoid Depo-Provera, an injectable method. “Depo is designed to give you protection for three months, but it can easily last in your body for a year,” Westhoff says. She only recommends it for women who are done having children or spacing between babies.

What time will you go to bed?

If you routinely go to bed in time for 7.5 to 8 hours of shut-eye, you’re on the mark. That’s the amount of sleep most of us need to feel alert the next day, says Joyce Walsleben, Ph.D., associate professor at the NYU School of Medicine and author of A Woman’s Guide to Sleep. But according to the National Sleep Foundation, 63 percent of Americans don’t get that recommended amount of sleep. In fact, nearly one-third report sleeping less than seven hours each night.

Sleep deprivation and sleep disorders are estimated to cost Americans over $100 billion annually in lost productivity, medical expenses, sick leave, and property and environmental damage (from sleep-deprivation-related accidents). Chronic sleep deprivation also negatively affects short-term memory, weight control and immunity. “Getting enough sleep is as important to your health as drinking water and exercise,” Walsleben says.

To-do tactic: If you’re getting less than 7 hours of sleep on average, move your bedtime up by an hour in weekly 15-minute increments. If you typically hit the hay at 11 p.m., for example, aim for 10:45 p.m. for a week, then 10:30 p.m. the next and so on. The gradual approach gives your brain time to adjust so you’re sleepy earlier, Walsleben says. Meanwhile, as a parent, protect your sleep. “If your kids wake up in the middle of the night and think they want to sleep with you, train them to pull their blanket on the floor and sleep next to your bed rather than getting into bed with you,” Walsleben suggests.

Do you make eating healthy a priority?

To eat healthy, you have to be proactive. “It’s not going to happen by accident,” says Katherine Tallmadge, a registered dietician, author of Diet Simple and spokesperson for the American Dietetic Association. Still, that’s not how most of us think, Tallmadge says. We leave the house without eating breakfast and grab a coffee or a muffin at Starbucks. We mosey into a deli for lunch. We resort to take-out for dinner all too often. It’s a recipe for a “toxic” diet (read: devoid of fruits and vegetables) and weight gain, Tallmadge says.

To-do tactic: Use the weekends to plan menus, shop, batch-cook, and prep healthy meals and snacks for the workweek. One weekend, for example, Tallmadge bought four quarts of strawberries that she washed, de-stemmed and bagged so she’d have a week’s worth of grab-able snacks. Also, plan for the last minute by stocking your freezer with quick-fix meals that only need a side salad to become complete: Boca burgers, healthy frozen meals, a bag of stir-fry chicken and veggies, pasta sauce and so on.

Overall, at least have an idea of what you’re going to have for lunch and dinner before leaving the house in the morning, “You can’t make last-minute decisions and think you’re going to eat well,” Tallmadge says.

Decision: How will you find time to exercise today?

You need at least 30 minutes of moderately intense physical activity five or more days a week for health benefits. That doesn’t sound like a lot. Still, according to the U.S. Centers for Disease Control and Prevention, 62 percent of Americans fail to meet that basic recommendation.

Lack of time is the most common excuse, but Laurie Bagley, an online fitness coach who managed to summit Mount Everest in 2006, isn’t buying it. “The key is to make time for exercise by blocking out increments in your day planner, just as you would a business meeting,” she says.

To-do tactic: Sign up for a fitness event in your community that requires training, such as a walk-a-thon, a 10K road race or a century, a 100-mile bicycle ride. “When you have an event to train for, with the overall goal of getting to the finish line, you’ll be more apt to stick with an exercise routine,” Bagley says, no matter how busy you are. But make sure it’s fun. If it’s not, you’ll soon abort the mission.

Decision: What are you doing to stay socially connected?

Having at least five people you can confide in is as important to your health as eating right and exercising. “Good interpersonal relationships act as a buffer against stress,” says Micah Sadigh, Ph.D., associate professor of psychology at Cedar Crest Women’s College in Pennsylvania. But not just anybody will do. “These friends should be people you can talk to without being judged, evaluated or criticized, somebody who will listen to you and provide support,” Sadigh says.

To-do tactic: Think of whom you would call right now if you were in a crisis and needed help. “A lot of people have this huge list on their cell phone, but can name only one person,” Sadigh says. “Or they say, ‘I would just talk to my dog.’ And that’s the truth because that’s the only ‘person’ who wouldn’t judge them.” If you can’t come up with a list, go out and meet new friends by taking a class, getting a dog (if you’re up for it; they’re people magnets) joining a professional group, or culling your life for acquaintances with good-friend potential, then get together for coffee or drinks.

Sandra Gordon specializes in writing about health. She contributes frequently to national magazines and is the author of Consumer Reports Best Baby Products.


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