“The Czech population is facing several chronic diseases, the cause of which, in addition to heredity or age, is mainly poor lifestyle and obesity. That’s why I put prevention first and recommend regular preventive checkups with your general practitioner,” explains Dr. Dalibor Stoszek, General Practitioner at Canadian Medical. Every year, his clients undergo a broader examination, the basis for possible diagnosis and subsequent specialized treatment. Digitization of patient information and its secure sharing among practitioners, specialists, and nurses, not only within Canadian Medical clinics, is extremely helpful for continuous complex care.
Which chronic diseases are most commonly diagnosed in your practice?
Without relying on statistics, I am quite sure it is a trio of high blood pressure, high cholesterol levels, and diabetes. We probably won’t differ from other facilities or practices in this regard. In our clinics specifically, we are also seeing an increasing incidence of mental health issues, particularly anxiety, depression, and sleep disorders. A large number of people also suffer from back pain.
Do we know the leading causes of the most common chronic diseases?
The former, in addition to age and genetics, are associated with poor lifestyle and obesity. The latter and generally higher societal stress is influenced by the spectrum of our clients, who are often performance-oriented and under pressure. And back pain is a combination of both. To illustrate with an example, many clients come in with a “slipped disk,” but that’s just a marginal cause of their back pain. Most back problems result from faulty posture or working position.
How do genetic factors influence the predisposition to chronic diseases, and how does it affect diagnosis and treatment?
The inquiry about the occurrence of monitored diseases (especially tumors, high blood pressure, cholesterol, cardiovascular diseases, and diabetes) is part of the initial examination conducted by a general practitioner and is updated at each preventive check-up. Hereditary cancer diseases are relatively rare, accounting for about 5-10%. In women, it typically includes breast and gynecological tumors, and in both genders, colorectal tumors. In such cases, we recommend genetic testing at a specialized clinic, along with additional steps such as breast ultrasound or stool examination for hidden bleeding or even preventive colonoscopy at a younger age than recommended for the non-risk population.
Strong genetic predisposition is also observed in type 2 diabetes, which typically develops at an older age and is associated with obesity. If we have this information, we actively address overweight or obesity. If both parents have diabetes, there is a high likelihood that you will have it, too. However, the age at which it develops makes a significant difference, and that difference is influenced by lifestyle choices, particularly diet and weight management. In families with frequent early-onset cardiovascular events (heart attack or stroke), it is necessary to investigate inherited disorders of cholesterol metabolism.
Does it make sense to undergo genetic testing in case of a family burden?
As I mentioned above, patients suspected of cancer, especially breast, ovarian, and colon cancers, are referred to genetic counseling or oncology centers where genetic consultations are conducted. Individuals suspected of having genetically determined high cholesterol levels are referred to preventive cardiology centers or lipid centers for detailed analysis, and, if necessary, an examination of the extended family is recommended.
How can lifestyle and dietary habits impact the development and progression of chronic diseases?
An absolutely crucial one. However, proper lifestyle management is a topic that would require several hours or books to describe fully, and I am afraid I cannot do it justice here. Nevertheless, the most important thing is to find the courage to change your lifestyle. My fellow practitioners are well educated in this area and know where to refer the patient if necessary. Our team includes professionals such as a nutritionist and a psychologist.
Can you describe how chronic diseases can influence each other and how it affects the patient’s overall health?
I would like to take obesity as an example. This is not a cosmetic problem, let alone an isolated one. Obesity leads to increased blood pressure, cholesterol, and diabetes. Each of these three diseases, individually and much more in combination (which is the rule), leads to an extreme risk of heart attack, stroke, or kidney failure. Obese people have joint and back problems that make it difficult to lose weight to some degree. Immunity declines, infections become more severe, recovery takes longer, and the consequences of conditions like COVID or the flu are more severe. The constant feeling of illness leads to problems with mental health and sleep, which in itself is another independent risk factor for cardiovascular diseases. And that is “just” obesity. And given the obesity pandemic, we are facing an unimaginably severe problem.
What prevention and screening methods do you recommend for reducing the risk of the most common chronic diseases?
The basic recommendation is to attend preventive check-ups with your primary care physician. By law, they are recommended at two-year intervals, which is usually sufficient. However, Canadian Medical offers annual check-ups to all clients because we prioritize preventive medicine. These check-ups include updating all the important information about the patient, the so-called medical history or anamnesis, and additional examinations according to age and risk factors. For example, blood tests for sugar and cholesterol levels, urine analysis, referral to mammography for women over 45, stool tests for hidden bleeding from the age of 50, and many others. The basic set of examinations is determined by law for everyone. Our clients undergo a much broader scope of examination so that we can gather as much information as possible while avoiding unnecessary burdens on the patient.
What about your devices and digitization? Do your patients have to go from doctor to doctor with a folder of printed medical records?
Canadian Medical has the vast majority of specialties in our clinics. All examinations conducted by our practitioners or specialists are shared in digital form and are available to doctors and nurses for follow-up care. Most examinations conducted in surrounding facilities, such as university hospitals, are also available in our system. A huge advantage is our myCANADIAN application, where clients can browse their results, findings, medical reports, and prescriptions.
Dr. Dalibor Stoszek is a General Practitioner and Chief Physician at Canadian Medical AFI clinic. He is an experienced doctor with international experience and a diverse professional history. A seasoned doctor with diverse experience, he graduated from Palacký University in Olomouc, gaining expertise in internal medicine, emergency medicine, general practice, and family medicine in England. His extensive work as a general practitioner in England greatly informs his current role, where he aims to apply comprehensive healthcare practices.
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