By Peggy O'Farrell
The Cincinnati Enquirer

Staying healthy is all about balance, says Dr. Walt Larimore.

Larimore, who specializes in sports and family medicine in Colorado Springs, Colo., outlines strategies for balancing the physical, emotional, spiritual and social parts of life in his 10 Essentials of Highly Healthy People (Zondervan; $19.99).

Larimore surveyed more than 3,000 doctors around the world to come up with his list of "essentials" - balance; self-care; forgiveness; reducing stress, anxiety and depression; relationships; spirituality; positive self-image; aspirations; personal responsibility and empowerment; and teamwork.

"Ten sort of seemed to be the irreducible minimum," he said in a recent telephone interview with the Enquirer.

Question: Which of the 10 essentials do you consider the most essential?

Answer: I think the foundational one is understanding that your health is a balance.

I use the metaphor that your health is a vehicle with four wheels: Physical, emotional and mental, social or relationships and spiritual.

To show how intricately those four wheels are connected, if one of them is out of balance a little or underinflated or the bearing isn't oiled just right, it impacts the entire health vehicle. Understanding that balance, I think, is crucial to becoming highly healthy.

Q: How do you define someone who's "highly healthy?" A: It's someone whose health, particularly in the emotional, social and spiritual "wheels," continues to improve throughout their life. The physical wheel kind of wears down. That's a phenomenon of time and aging. But even in the midst of disease, disorder or disability, if those other wheels remain healthy, a person even in poor physical health can remain highly healthy.

Q: What's the patient's role in protecting his or her health?

A: I think it's just critical. One of the essentials is how to become your own health-care quarterback. When we look at the growing data on medical errors and the cost of those errors in pain and suffering and lives, not to mention health, it's pretty clear from the research that patients and their families could play a significant role in reducing them by being responsible for their own health care. In other words, instead of medicine being doctor-centered, it's now switching to being a patient-centered model. and that's better, I think, for patients and doctors. The key is understanding not only the rights you have as a patient, but what your responsibilities are as your own health-care quarterback. You have to understand the health-care system is designed to serve you. The servants might be overpaid, but nonetheless, they are paid servants.

One of your obligations is to be careful in how you hire those servants. The book includes interview questions that you should ask a doctor while you're looking for a physician. In primary care, that practice is becoming more common.

And you also have to understand that you have both a right and an obligation to fire a health-care provider who is not meeting your needs.

E-mail pofarrell@enquirer.com