Healthcare on Offense: why performance is the real medicine
Healthcare in the United States runs on an interesting loop. One decade butter is demonized as the cause of atherosclerosis and heart attacks, and the next it’s being blended into coffee as a health food. Recently, there’s been a renewed focus on exercise and nutrition as the most impactful interventions a person can make for their health, wellness, and longevity. The funny thing is… this has always been true. We’ve known it the whole time. Yet it’s suddenly being treated like a brand-new discovery.
It’s great that this message is finally getting the attention it deserves, because it is the best way to improve health in a meaningful way—especially in today’s largely reactive medical system. In fact, what most people think of as healthcare isn’t actually healthcare at all. It’s illness management.
Think about why most people go to the doctor: they’re sick, hurt, or dealing with something negative that suddenly entered their life. The response? More often than not a medication is prescribed. The issue is that in many cases, that medication is designed to mitigate symptoms, not address the root cause. That’s illness management. It’s “healthcare” on defense and not the most effective approach.
Even when you do go to a physician proactively (an annual physical, for example), you typically get a quick once-over. If there are no alarming signs of imminent disease, you’re essentially labeled “healthy” and sent on your way. If you don’t need a prescription, you’re “fine”—until you’re not. The mindset shift that needs to happen is a shift from reactive to proactive. How do you prevent illness instead of simply treating symptoms when they appear?
Enter exercise—again. This is the proactive approach, or what I like to call healthcare on offense. And it’s not just exercising to reach a baseline. It’s pushing your level of performance as high as possible. That upward capability has profound effects not just on life span but, more importantly, health span. Nobody wants to reach 100 if the last 25 years are spent simply surviving. Improving your physical capability has measurable effects on chronic disease risk and overall quality of life. Which raises an important question: what should we be measuring?
As it turns out, while smoking is harmful and high blood pressure matters, being weak and out of cardiorespiratory shape are far more predictive of poor outcomes than many of the commonly tracked health metrics. We’re constantly told what not to do—don’t eat this, don’t do that—but this restrictive approach is far less impactful than focusing on what you should do.
Recently, Dr. Peter Attia’s book Outlive: The Science and Art of Longevity rocketed in popularity, and for good reason. Among many topics, he highlights the massive impact of strength and VO₂ max (cardiorespiratory fitness) on all-cause mortality. A great summary of that topic is available in this segment of the Tim Ferriss podcast:
This proactive, performance-driven mindset is the real healthcare. It’s actually caring for, protecting, and improving your health—not just mitigating symptoms to get you back to “not sick.” If you want to truly be healthy and enjoy a high quality of life in your later years, it’s time to go on offense.
While this approach plays the long game and results build gradually over years—not just weeks or months—it’s never too late to start. You can take steps today that move your health meaningfully in the right direction. When done consistently, the benefits compound. The beauty of this approach is that you’re in control, and it’s additive. You don’t need to remove everything you enjoy—you simply need to prioritize getting stronger and improving your conditioning. The science is clear: strength and cardiorespiratory fitness dwarf other common health markers. Put them first, and you’ll reap the rewards.
The question then becomes: do you have the discipline to do it consistently over time? If you can do it on your own, that’s fantastic—keep going. If you want guidance, feel unsure where to start, or need a plan to progress beyond where you are today, connect with a professional who can help. A qualified physical therapist or personal trainer can assess, guide, and coach you toward a performance-based approach to health—one that builds true capability and adds not just years to your life, but quality and enjoyment to those years.