Lyrics to Life
Growing up in 90s Manchester, music was on everywhere. Oasis were impossible to escape, and one lyric lodged itself in my head: “You gotta make it happen.” I must have heard it a hundred times before it started meaning something beyond the song.
It comes back to me in clinic fairly often. That lyric captures something at the heart of why some people get healthier and others stay stuck. Self-agency. The belief that your choices actually count.
What is Self-Agency?
Self-agency is the belief that you can influence your health outcomes through your own actions. In practice, it means understanding that daily decisions matter: what you eat, how much you move, when you seek help. Those choices accumulate. You are not a passive recipient of whatever health you end up with.
Self-Agency in Practice
In clinic, I can usually tell within a few minutes whether someone sees themselves as an active participant in their health or a passenger waiting to be told what to do. A ten-minute appointment rarely changes that on the spot. The best I can usually do is plant an idea and trust that it takes root later, sometimes months after the conversation. The people who tend to do well over time are those who eventually decide that their choices count. That shift tends to produce:
- Better questions at appointments, rather than leaving with information they half-understand
- Greater persistence with healthy habits past the first setback
- Better-informed lifestyle decisions, rather than following whatever trend is in the news
- Preventive action: booking screenings, seeking help before something becomes a problem
- More engaged management of long-term conditions
- Less health anxiety, because engagement tends to feel less frightening than avoidance
High Agency vs Low Agency in Health
High-agency patients tend to arrive prepared. They’ve looked something up, they have a question or two written down, they want to understand the plan. They follow through because they understand the reasoning behind it. When a treatment isn’t working, they come back and say so.
Lower-agency patients more often arrive expecting to be managed. They accept suggestions without asking whether the advice fits their lives, then struggle to follow through. Results drift, motivation drops, appointments get less frequent. The pattern usually starts with never feeling that their input mattered.
Which tends to describe you?
Developing Your Self-Agency
Self-agency is something you build in small steps. A few places to start:
- Write down one question before your next GP appointment. Not to challenge anyone, but to make sure you understand what’s happening. It changes the dynamic.
- Learn the basics of any condition you’ve been diagnosed with. NHS.uk and Patient.info are decent starting points.
- Track one health behaviour for two weeks. Sleep, movement, or food. See what’s actually happening rather than what you assume.
- Make one small change and sustain it for a month before adding another. Small proofs build belief.
Overcoming Daily Challenges
Building self-agency has real obstacles. Worth naming them:
- Information overload: stick to NHS.uk, NICE guidelines, and peer-reviewed sources. Health influencers are not the same thing.
- Conflicting advice: bring the contradiction to your GP. That’s what appointments are for.
- Slow results: health changes take weeks to months to show. Track behaviour, not outcomes.
- Social pressure: the people around you may not share your priorities. You don’t need their agreement.
- Time: most useful health habits take under 10 minutes. The bar is lower than people think.
- Motivation dips: they’re normal and they pass. On flat days, do the minimum and keep the habit alive.
The Part Only You Can Do
Healthcare still works best as a partnership. You bring knowledge of your own body and daily life; clinicians bring medical expertise and a broader perspective. The best outcomes tend to come when both sides are engaged.
Nobody else makes the daily choices for you. To get to bed at a sensible hour, to book the appointment you’ve been putting off. Those are yours. They matter more, accumulated over a year, than any single consultation. The lyric is 30 years old. It still applies.
