If our patients hear one criticism over and over regarding our healthcare, it is that one size does not fit all. We see this with vaccines, medications, treatment of the musculoskeletal system that is our specialty, the management of blood pressure, and more recently, the treatment of diabetes type 2 according to a recent NY Times article. Why one size fits all is poor healthcare. We are all different. We have different blood types that originated years ago in distant lands, with different diets. We are all built differently. Some of us are of a different sex. Some of us have genetic variants that do poorly with certain foods. We learned that doctors who adhered strictly for years to a certain blood pressure caused dementia due to the reduced blood flow to the brain that higher pressure provides. This was featured in a multi-year study presented by 60 minutes years ago. Musculoskeletally, we are all different and are different heights, sexes, and shapes, yet most of the medical system treats us all the same and has poor outcomes with problems as common as back pain. Chiropractors understand this best as they have the best outcomes of all providers for conservative care. Perhaps, this is their holistic drug-free approach that is best supported by the current medical literature and they understand that treatment must be tailored to the patient rather than the symptom. Millions of seniors are on different medications that may interreact, to manage, rather than solve problems. Genetics may make you react poorly to a medication as well and healthcare becomes a balancing act rather than healthcare. Most diseases are collections of symptoms often named after a person or researcher and even though the histology may have similarities, different people have different experiences with these diseases. M.S. comes to mind as the effect on the nerves is the same but the experiences are different known treatments are again one size fits all and often, do nothing to cure as the true cause is not being treated. The more we know, the less we know. The overprescription of statins to treat what-if diseases that result in dementia and other physical problems later in life. Diabetes type 2 is now being discussed by the NY Times because overmanagement of the elderly may be causing hypoglycemia resulting in falls which can be devastating in this age group. Geriatricians have been warning for years that each decade of life may require a different understanding of the patient and the management of diabetes is one size fits all. Ironically, the cause of this may be the way children are introduced to sugar in their earlier years through snacks and juice boxes loaded with it. There are many more examples of this in our healthcare system, resulting in management rather than cures because what we often call diseases are miscategorized as one-size-fits-all things that happen to nice people. The NY Times recently published an article regarding how the overzealous management of A1C in elderly patients may be causing falls. As we have learned, overzealous management of blood pressure with good intentions causes dementia from hypoxia caused by lowering the blood pressure in their age group there are more falls in the elderly from the overregulation of sugar, which may be causing falls from a lack of sugar in their systems. You can read the article below however, the problem is larger than the overmanagement. The problem is doctors managing your health without fully understanding you. The problem is one size fits all. Why Older People May Not Need to Watch Blood Sugar So Closely