Connecting The Dots of Healthcare

Despite my background as a traditionally trained M.D. in western medicine, I think I’m pretty tolerant of diversity in healthcare. I do know enough to know that none of us knows enough to have patient treatment all figured out. Actually, I’m more than tolerant… I’m downright accommodating for a wide variety of non-western healing sciences. Alternative medical therapies. I’m a supporter of acupuncture, chiropractic manipulation, and even modalities that are fairly off -the-wall far from western medical standards because they can get results. And when the practitioners are honest to acknowledge limitations and send a patient whose treatment is beyond their abilities to seek other modalities, that’s a mark of true professionalism. As a surgeon, I know what I can do, and what some other specialty needs to address. This is common sense.

But I do feel the public is more easily misled by snake oil salesmen than they should be. What is most distressing is all the slings and arrows traditional medicine must endure from the same public that swallows techno-psycho-meta-physical-babble-BS from modern snake oil salesmen. Mind/Body Wellness is great, but is not a stand alone for treatment; just like for the times when traditional western medicine is not a stand alone either.

Yesterday I endured a speaker who boasted of being a physician who had never personally seen a physician and had never taken an antibiotic. Well, the line got applause from some folks in the audience. “YEAH!!! , we don’ need no stinkin’ doctors!” was the audience response, like when someone had to see a traditional medical practitioner, it was our fault! But I’m a pretty good speaker and know a good emotional response line when I hear one… it’s all about sales and emotion sell. This was an emotional hook that was practiced and worked well. OK, I can live with that. It’s all part of the business of speaking.

But I also recognize the business of healthcare sales.

I went to the “Dr.’s” website. Actually couldn’t find any credentials listed, but through a conversation, and based on the practitioners of the type of recommended therapy on the website, coupled with a quick visit online to the state board of chiropractic physicians, discovered the speaker was indeed a licensed chiropractor. So, indeed a “doctor,” and by the third definition of “physician” from dictionary.com:

OK, so technically no foul here. But the hazy definition of “Dr.” and the difficulty to discover the actual credentials on the website, or in the program description, makes you wonder why “DC” wasn’t more readily available. But whatever.

But why would a physician boast of never taking an antibiotic or seeing a “doctor”? Does this self-proclaimed “physician” recommend to patients NOT to see doctors? I think not. How would one get patients? Whatever, judging from the website, the main purpose of he site was not patient care, but selling the modality of treatment to other “doctors,” some I noticed had NO degrees, in ANYTHING, along with patient purchased products to promote robust health.

What got me really mad was the proclamation on the website that the speaker holds a fundamental belief that people cannot get well until they understand what they were doing to make themselves sick. I don’t have a problem with chiropractors in the scope of legitimate practice but it was the implications of the stated fundamental belief that made me mad and made me think, “charlatan“.

Sure, people can do things to make themselves sick. Alcoholism, drug addiction, and tobacco usage are right up there on my list of bad things people do to themselves. But to saddle patients with the belief that they must have done something that makes them sick is right up there with the archaic belief that sickness comes from God to punish patients for sin.

And thinking drinking green tea variants, (naturally, the expensive variant), to restore the “acid/alkaline balance” or understanding “what you eat, what you drink, how you exercise, how you rest, what you breathe and what you think” will keep you healthy is SUCH a crock if people think this will prevent all illness. Of course the fall back could be some guff such as if you ate something even years ago, or breathed something unhealthy even once, that could explain your current sickness. That would explain why people still manage to die despite a new healthy regime of, expensive, pills and dietary supplements!

This seems a bit like a throwback to the balance between the humors of blood, phlegm, yellow bile and black bile that’s was kicked around “medicine” since ancient Greece right up to the nineteenth century.

Don’t get me wrong. In my practice, I became fully convinced that people can affect their own health by what they believe and think. But how does taking a supply of (did I mention expensive), dietary supplements to balance things out (if things really are “out of balance”) cure that? Might it also swing the balance scale too far the OTHER way?

When “doctors” of a multitude of alternative medicine specialties attempt to treat very real problems, like a patient I took care of who presented with abnormal vaginal bleeding with a variety of techniques, (but skip a pelvic exam), it’s distressing. On my exam, that included a pelvic, I discovered the cervical cancer before I sent her to a gynecologist. Is it correct to infer that the “reason” the patient is sick was simply because they weren’t doing something “right?”

We are increasingly in a culture of “evidence based medicine” but does the public demand statistically significant results of forms of therapy that can’t offer scientific proof of efficacy? I have seen patients die when western medicine fails. But I’ve also seen patients die of the same malignancies after they’ve spent vast quantities of out-of-pocket expenses on BS “medicine.” I won’t say “cures” never occur with what I may consider BS, but I simply haven’t seen any of them. And when I ask for real science, I see stuff that isn’t science, and most importantly, doesn’t appear real either. I speak on connecting the dots of healthcare which must be inclusive of all treatments, but I draw the line at proven treatments by strict scientifically measured standards and patient centric in its orientation.

As part of our Hippocratic Oath we are to “do no harm.” I believe telling a patient that ultimately they are responsible, in some measure, for the illness they are experiencing, but may be remedied by snake oil, does harm.

And the smug boast of never having taken an antibiotic or seen a physician? All I could think of was when despite what techno-psycho-babble BS the public might swallow, when a true believer in new-age snake oil gets appendicitis, (despite taking the recommended expensive diet and nutritional supplements), there ain’t no room for new-age compared to a surgeon.

People can believe what they want about how a variety of treatments can fix what ails them. I don’t have a real problem with this because, well, I don’t know how a transistor radio works, but I can use one. Who knows what might really work on one person and not another? I always tell my patients that tell me how well snake oil works for them, “great, I’m glad you’re doing so well, but if the problem persists, you might want to see your physician.” The kind that falls under the first definition of dictionary-dot-com.

When patients become sick, and are not well enough to believe the BS that is comfortable for enlightened patients and practitioners of snake oil to believe when they are healthy, they do need traditional healthcare professionals who aren’t trying to put a guilt trip on a patient for disease they have no control or personal responsibility for and who aren’t trying to sell the public unproven expensive snake-oil.

And that’s who needs us!