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Mainstream medicine- how did we get into this mess?

I have wanted to be a physician since I was six years old and someone commented after observing my fascination with a plastic stethoscope, ‘You know, girls can be doctors now.’ I thought until medical school I would go into family practice (lots of stethoscopes you know), but then fell in love with psychiatry because really, what is more fascinating than the ways people behave and think? I truly love my profession and am deeply grateful to the thousands of physicians and nurses who taught me how to practice this tricky art. So, it has been very painful at times as I have realized how terribly broken our system is, and how it is actually keeping people sick rather than fostering health. I am not alone; there is a small but distinct minority of physicians, nurse practitioners, and mental health professionals who are looking at ways to incorporate integrative, complementary, traditional, and functional medical principles into the care of their patients, as a way of delving deeper into root causes of illness and allow true healing.  

Our main medical system in this country is ‘allopathic’ medicine; ‘allo’ in this case meaning ‘other’ or ‘different’. The system is built on introducing ‘different’ substances into the body to try to correct disease, but then the body has to manage the disease AND the foriegn substance, which nearly always is only masking the underlying problem in the first place. An example would be the common practice of prescribing steroids to lessen the symptoms of autoimmune disease; steroids dampen the immune response further in an already compromised system, leaving the patient at increased risk from multiple other diseases. There are times when using allopathic treatments are necessary, but must be done after, or at least in addition to, working with the body’s natural healing abilities, which are formidable! 

Mainstream medical education in the US is very heavily slanted toward a heroic, no-holds-barred approach to disease, which works great if a patient needs surgery after a severe car accident, but not great at all if what’s needed instead is a trusted coach to help turn unhealthy habits around! The current system is designed for acute (immediate, pressing) situations- the physician is supposed to identify a disease or problem and then order tests, prescribe medication, and perform procedures, so the more of these, the higher the reimbursement received. There is very little if any reimbursement for education or preventative care. Even when there is, ‘preventative’ means some immunizations and screening tests- that only detect diseases like diabetes and cancer. There’s no prevention at that point at all, merely identification of a problem many years or decades after it began. True prevention involves identifying the root causes of illness and correcting the imbalances. This is not at all a new idea!  In 400 BC, Hippocrates wrote: 

“Illnesses do not come upon us out of the blue. They are developed from small daily sins against nature. When enough sins have accumulated, illness will ‘suddenly’ appear.”

In addition, modern medical and mental health care in this country fosters dependency and does not encourage accountability in either direction. I believe this is mostly unconscious, but it stands to reason that if underlying problems are not corrected, then the patient will need to return over and over with new (or ongoing) complaints, so doesn’t this set up a conflict of interests?? I believe most physicians do care about the well-being of their patients (at least they do before being burned out by this broken system, but that’s another topic.) So this idea that we are actually keeping people sick most of the time is very uncomfortable, and I admit I’ve despaired many times, feeling as though my training was a waste, or that I’ve not really helped anyone. However, in my more rational moments, I’m able to remember that modern medications and techniques have helped millions of people, and will continue to do so. A change of direction doesn’t mean to ‘throw the baby out with the bathwater’, but to learn to use the proper tools for the situation at hand. 

Another unfortunate situation associated with modern medicine is polypharmacy- when an individual is taking multiple medications (sometimes even dozens!) without clear indications. This happens for a variety of reasons. Often, it’s lack of time- patient comes in with a problem, physician prescribes ‘standard of care’ -all done! Medicines then get layered on over months or years. The physician or practitioner may also lack confidence or fear liability if they try to stop outdated medications. The reality is that stopping medications can be much more complex and challenging than starting them! Knowing which ones to taper or stop, in what order, and for how long is very complicated and time consuming, especially when someone is on multiple medications. 

Pressure to prescribe is a very real issue as well. Patients often EXPECT or DEMAND medications! A disclaimer- I do not blame all our medical woes on Big Pharma; I think like all large, complex systems there is a mixed bag of positive and negative aspects to the industry. However, I do think the scales tip toward negative in terms of direct-to-consumer marketing for prescription medications. This marketing furthers the message that whatever ails you can be fixed with a pill; there aren’t any commercials for cleaning up your diet or getting off the couch! It also can give the impression that if you have X symptom, you need Y medicine-simple. In reality an individual's particular history, symptoms, and treatment needs are anything but.

So, I do think our medical system is broken. I also think there is hope for using what we have learned- the good and the bad- to make something better. If we look back to tried and true principles that people have used for thousands of years to optimize health, and combine them with the amazing science available to us now, we can heal our system along with ourselves!

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A Piece of Mind

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