Now that health care reform has been put on the back burner, maybe it is time to discuss what health care reform should really look like. Although we talk about a "health care" system and health care reform, what we're actually talking about is a "disease care" system and disease care reform. Doctors of modern western medicine are trained to treat disease with drugs and surgery. They are not trained to keep people healthy.
At medical school, we doctors are taught how to treat the symptoms of disease, rather than how to prevent disease in the first place. For example, throughout our training we receive very few lectures on nutrition, despite the fact that diet is fundamental to good health. Nor are we trained in other lifestyle modalities that help keep people well, such as exercise and relaxation therapies. We are taught nothing about the wisdoms of alternative medical systems that have been helping other cultures for centuries.
I will be the first to acknowledge that modern western medicine and science have made phenomenal advances. These improvements alleviate pain and suffering and save lives every day. Better treatment of trauma and burns for example, or the management of acute medical and surgical emergencies, are among the miracles of modern life. We have drugs today that, when used appropriately, work wonders. We are indeed blessed to have modern western medicine in our arsenal, and for disasters like the Haiti earthquake, this kind of medicine is life saving.
The problem is that although most of us are not permanently in a health "crisis", this crisis care model is being used to treat our every health problem or symptom - as if it is the only health care model we have. Most of us are not sick enough to be in hospital, and by far the majority of people who visit their doctor, do so for ongoing chronic problems like diabetes, heart disease and obesity - or less-defined ailments like joint pains, back pains, fatigue and headaches. Western medicine's solutions to these problems are drugs and surgery.
But apart from antibiotics, which can kill the bug causing the problem, most drugs treat symptoms and not causes. Similarly, surgery usually addresses the symptoms and not the causes. For instance, bypass surgery, although often life saving, does not address the underlying reasons for why one's arteries are getting blocked in the first place. And in the case of both drugs and surgery there are often significant side effects, which are then addressed with even more drugs, resulting in many patients being on multiple drugs at the same time. But these drugs are powerful agents interacting with very complex systems. Often the first one or two drugs have been prescribed to treat the original problem and the other five to 10 are treating the side effects caused by the first two drugs or the interactions of the other drugs. Clearly this understanding of how to actually cure disease is incomplete.
The tragedy is that most of the chronic problems that most people endure can so often be cured with diet, lifestyle and behavior changes and supplements. Drugs - along with their potentially-unpleasant or even lethal side effects - are often not necessary. Unfortunately it does not suit the drug industry to give patients a drug that cures or eliminates the problem. It is much more lucrative to use drugs to simply manage a patient's symptoms, ensuring that he or she stays on them for life, instead of eliminating the disease. Examples of this would be statins and anti-hypertensives.
What we should now really strive for is a health care system that shows patients how to stay well with a properly preventive approach. In fact what we call "preventive medicine" in the modern western model - pap smears, breast exams and certain blood tests - are really "early detection" measures. I am not saying these tests are unnecessary, but they are not teaching patients how to stay healthy or prevent the diseases they are being screened for. We need a complete rethink and overhaul of what early detection really means and implies.
A true health care system would incorporate the "disease care" model as part of the system. I most certainly would not encourage a patient with a medical emergency to see a nutritionist or acupuncturist. But by the same token, these modalities need to be seen as an important part of a much more comprehensive health care system.
My 30 years of experience as a doctor have shown me that in the areas where western medicine is weak - such as chronic disease and disease prevention - a combination of other modalities and systems actually excel; and where western medicine is particularly helpful, these other modalities are not as effective. It's about taking the best of both and going beyond the limitations of each and melding them into a new combination that works.
This means that western medicine should be used for crisis care, but for chronic disease we should find the root cause of the problem and uproot it - instead of merely suppressing the symptoms. We should look for the underlying metabolic processes that have gone awry or the underlying dysfunctions present. We then need to try to correct these safely, effectively and without side effects.
We must use the objective information we get from blood tests, X rays, MRIs and so on. But we need to consider the actual patient or person as well, by taking into account subjective information too: feelings, intuition, attitudes, belief systems and relationships.
In a true health care system, we must use modern western medicine for what it is good at - crisis care, acute medical and surgical emergencies - and natural, non-toxic and non-invasive therapies whenever possible. The most effective ways of preventing and treating most chronic diseases are diet, supplements, exercise, stress management and other benign modalities. And herein lies the rub. Although guidance may be helpful, lifestyle changes can't be imposed from above - they have to come from you. There is no greater reward than being the master of your own health.
--------
Frank Lipman MD is an internationally recognized expert in the fields of Integrative and Functional Medicine. A practicing physician, he is the founder and director of the Eleven Eleven Wellness Center in NYC, where for over 20 years his personal brand of healing has helped thousands of people reclaim their vitality and recover their zest for life.
To bring his approach to a wider audience and not just his NYC patients, he recently created Eleven Eleven Wellness and Total Renewal, a leading edge integrative health program to get your health on track.
To hang with Frank, visit his blog, follow him on Twitter or join his Facebook community today.
He is the author of REVIVE: Stop Feeling Spent and Start Living Again (2009) (previously called SPENT) and TOTAL RENEWAL: 7 key steps to Resilience, Vitality and Long-Term Health (2003).
Dr. Lipman lectures throughout the world on chronic disease prevention and sits on the Board of two non profits from his native South Africa, the Ubuntu Education Fund and Monkeybiz. He also has an intense passion for World music and is a frustrated DJ.
Follow Dr. Frank Lipman on Twitter: www.twitter.com/drfranklipman
Christiane Northrup, MD: The Best Breast Test: The Promise of Thermography
Thomas Goetz: Is Your DNA Dangerous to Your Health?
Mark Hyman, MD: Haiti Weather Report: Mostly Foggy With Rain Storms Expected
Quite right.
DP Burkitt set out the epidemiology of Western diseases, and, their dietary antecedents that result in increased transit times and reduced bowel weights in Western societies in 1972.
PRJ Burch set out stochastic support suggesting a similar source for many Western diseases in "Growth, Disease and Aging" at the same time.
Then we get immunogenomics and ..... nothing. Not a squeak of insight into any chronic disease. Pan-genomic post-translational gene sequencing AND ..... diddly SQUAT.
What are we missing - it looked in large part like injuries to autonomic nerves caused by physcial efforts during defecation, duing labor, during surgery, during trauma, etc Each is exacerbated by stress, alcohol, tobacco and - of course - pharmaceutical drugs.
See "Autonomic denervation and the origins of chronic Western diseases" on www.pubmed.com or www.bristolanatomycourse.co.uk
How can anything ever be corrected long term, if what's being fixed is not the root cause, but the symptom. The challenge is -- judging by how we humans act -- we're all about masking symptoms.
Just look at any aspect of our lives, from politics to health. Cause and effect are put aside for expediency and easy choices.
Have cholesterol, type 2 diabetes, heart disease... well... take a pill to cover the symptoms, rather than change behavior and make the lifestyle choices that will excise the cause.
The government wants to spend more... well... borrow, or put it off-budget, or use funds from the social security trust, rather than raise taxes, cut pork, implement cost-cutting efficiencies.
It seems that no one is willing or able to look deep in and identify causes and deal effectively with them. And the result is the society that we have. Can't change society if we can't change ourselves.
Yep.
Jgarma
www.GarmaOnHealth.com
(3) Your use of cholesterol-lowering and blood pressure controlling medications as an example of how the pharmaceutical industry is not curing these diseases but just trying to make more money really makes me question your scientific credentials. It has been well-established that cholesterol levels are much more influenced by ones genetic makeup than all other influences combined and hypertension increases with age (here's a clue, check out an actuarial table looking at blood pressure).
(4) As far as diet is concerned, if you can't or haven't figured out what is and what isn't healthy to eat, then you really aren't that smart, so why waste the resources.
Bottom line is if Obama really wanted to affect healthcare, he would have everybody report for calisthenics for an hour every morning, seven days a week and force people to put up or shut up when it came to the health issues they can control. This will never happen, because nothing is ever anybody's fault and we as Americans want a quick and simple fix. Thank you liberals for instilling an entitlement mentality into the psyche of the nation.
(1) Show me ONE randomized controlled study where eastern medicine has outperformed western medicine. People LOVE eastern medicine for the same reason they go to chiropractors...we have an innate need to be touched, and western medicine physicians, i.e., real doctors, don't do a lot of touching or hand holding.
(2) Our healthcare system should be single payer, but vastly different than anyone has put forth. I say everyone pays the exact same base premium; BUT we use BMI or body fat percentages, nicotine usage and sexually transmitted diseases as modifiers to increase premiums. Examples: (a) Joe is an 85 year old man who has a BMI of 22, no evidence of nicotine in his urine and no HepB, HepC or HIV - his premium: $1,000 a year (the base premium) and (b) Ricky is a 24 year old man who has a BMI of 29, uses nicotine and has HepC his premium: $25,628.91 per year (the base premium plus 50% [compounded] for each incremental increase in BMI over 23 and an additional 50% increase each for the nicotine and the HepC). The government would be allowed to subsidize the base premium only, if someone chooses not to maintain a healthy-lifestyle AND not pick up the tab for their poor choices, then nature should be allowed to expeditiously run its course.
But when it comes to supplements, I really have to dissent: I've seen as many studies that show no effect or adverse effect from taking supplements, and there are too many examples of supposedly safe supplements that had to be taken off the market after people got hurt from them (ephedra being one example.) No doubt. there are some "alternative" healthcare practices that are effective--yoga for stress reduction comes to mind--but there are plenty of purveyors of snake oil out there as well. Perhaps, rather than thinking in terms of Western vs alternative medicine, we should draw a distinction between methods and practices that promote good health, and those that have not been shown to do so. Fund and/or support the former, subject to further study or abandon the latter.
Google scholar is full of studies proving supplements work in various ways and on various illnesses. Or look for them on thousands of websites. Orthomolecular medicine - using vitamins in large enough doses to cure - has a lot of MD's in it.
Ephedra is no more dangerous than it ever was. It works - and you can prove danger if you want to. It's a lot less dangerous than drugs - but it is a danger to the pocketbooks of drug companies.
The drug companies are pulling the wool over your eyes. And loving every moment of it.
Nicola http://simpledivorceadvice.com
I wonder what it would be like if everyone didn't smoke, drank in moderation or not at all, exercised 5 days a week and ate organic (no fertilizers, pesticides, antibiotics, growth hormones or GMOs). We simply wouldn't recognize the place.
Are you nationally recognized economists with authority to say it will be a budget buster?
If you know of so many better ways to achieve good health care, why don't you write the health care reform legislation?
Obama has been asking the GOP for their ideas for a year, but they do nothing but whine and offer NO solutions to anything. They are responsible for our broken government.
A disturbing upshot of the health care reform conversation as been a widely expressed impulse to blame the victims for their own illnesses, say, for eating pleasurable foods or thinking bad thoughts. It's cruel, it's immature, and it's wrong.
I'm all for urging people to exercise, eat sensibly, shun junk food, and guard their health, but I reject the llogical conclusion that if people ate more of this or less of that we wouldn't need a health care system. I reject the strong suggestion that people get incurable diseases because they aren't sufficiently hyper-vigilant regarding what's healthy and what's not.
Pleasurable food and junk food are not necessarily the same thing. Name any mainstream wholesome food and I'll find you an expert who'll tell you it's poison. Prevention is a racket as prone to corruption as the health care industrial complex.
Here's the sad truth that people try to deny: Sickness happens, and usually it's completely random. And everyone's going to die. Sorry, but someone had to say it. Suggesting we need preventive care system instead of a health care system is inane.