Living should be thriving, not just surviving: The 4D health approach


“I’m alive, which is better than the alternative,” a new patient once told me when I asked him how he was. The alternative to being alive, we are to assume, is death; being alive is better than being dead.

 This certainly wasn’t the first time I had heard someone reply this way, but it was the first time I considered it as more than a mere cliché. What if there was another alternative, a better alternative? Was I misinterpreting the man? Perhaps he was telling me a great deal more than I realized.


He was really saying, “I’m alive, but I could be thriving.”


The Old Medicine: To Fix what is Broken


Our understanding of disease that has emerged over the last century is among the greatest achievements of humankind. When someone is ill, we use sophisticated tests to name the disease, use safe medications to ameliorate it or precise surgery to correct it. We know that something is wrong because it departs from the standard, a patient’s number dips below normal or deviates from the mean. By identifying disease by its departure from the mean, we declare success when we have restored the patient to, well, average. Is the role of the modern physician to just make people average?


Restoring people to average has been quite successful by some metrics. We have greatly expanded life expectancy. We now live long lives. But are those lives active and vibrant? If we are not living a high quality life, we are simply surviving. While I suppose life is better than death, living the average life is certainly not the standard by which we should rate success.


I believe we need a new medicine—a new health paradigm, actually—that enables people not just to survive, but also to thrive.


The New Health: Shifting the Curve


I envision this new era of health as one in which physicians do not simply treat illness, but prevent illness from occurring. Instead of seeking to restore a person to their former self or worse, to the average person, we should be seeking to make them as healthy, as active, as exceptional as they can be. As we age, our muscle mass shrinks, we deposit fat, our metabolism changes, and we tire more easily. When did simply allowing these things to occur become “normal aging”? I submit that simply allowing the body to age without intervention should define accelerated aging. Why? Because if can intervene and do not, then we are doing all we can as physicians.


The 4D Health Approach


This new health has four dimensions, which I have given the name, “4D Health.” It is a comprehensive and truly holistic approach to health that considers all aspects of the patient, in health, in illness, in their environment, and as the person they want to become. The system is personalized; we learn what is important to each patient and plot a course to help reach those goals. The 4D process starts with an asymptomatic disease screening. Is there occult disease? Are you as healthy as you could be? Are you doing all that you can to thrive?


The 4D Health approach includes nutrition, fitness, hormonal augmentation, and thoughtful use of supplements. Medicines and surgery are still considered, but they are used with precision in the context of a truly holistic program. When surgery is needed, it is followed by a carefully tailored rehabilitation program focused on maximizing function and vitality. The goal of 4D Health is thriving, not just surviving, to be greater than better.


As a specialist in the advancement of spinal health, spine surgery, total disc replacement and motion preservation for more than 30 years, Dr. Todd H. Lanman's attention to guaranteeing his patients the utmost in compassionate and skilled care under his watchful eye and steady hand has earned him top honors, his patients’ trust and respect, and recently in being named one of the Top Doctors in America. As one of L.A.’s Top Doctors by The Hollywood Reporter, Dr. Lanman has become the go-to Spinal Neurosurgeon for many of the world’s top business leaders and Hollywood’s biggest stars. He is also sought after by those from around the globe, with many of his patients traveling thousands of miles to see him and receive his sophisticated professional care.


A Diplomate of the American Board of Neurological Surgery and a Fellow of the American College of Surgeons, Dr. Lanman earned his M.D. at Chicago’s Northwestern University in 1983 with top honors and went on to complete his residency in Neurological Surgery at University of California at Los Angeles. Since then, Dr. Lanman has led his leading spinal neurosurgery practice, Lanman Spinal Neurosurgery, in the heart of Beverly Hills, which is affiliated with Cedars-Sinai Medical Center, UCLA Medical Center and Saint John’s Medical Center.


As a leading innovator in medicine, as well as a media educator and contributor, Lanman has published more than 10 peer-reviewed articles, as well as book chapters on topics relating to his field, and has presented more than two dozen papers at national and regional medical society meetings. His expertise is often sought out as he is often tapped to be the principal medical investigator on a wide swath of clinical trials for motion preserving surgeries and artificial disc replacement devices, most recently the Prestige LP and M6, with the former recently receiving FDA pre-market approval on July 6, 2016, through his continuous support. He has also remained an assistant clinical professor at UCLA for the past 20 years. For more information on Dr. Lanman and Lanman Spinal Neurosurgery, visit


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