Modern medicine continues to amaze me in so many ways. The growing sophistication of diagnostic techniques, life saving surgery and treatments (even for end stage results of chronic disease), pharmaceutical drugs and emergency/trauma medicine saves lives everyday and can also improve the quality of people’s lives. It is an unsurpassed intervention for trauma and acute emergencies.
It has done a lot of positive things for human health as it continues to develop. For example, the development of vaccines, hygiene regimes (e.g. sanitation, food health and safety, health and hygiene programs etc), trauma/emergency medicine and antibiotics has saved countless human lives – particularly in developed nations where people have access to medical care. Antibiotics have nearly eliminated the risk of dying from the infections that were the primary cause of death all the way up until the mid-20th century, now people are dying from chronic diseases as a result of poor diet and lifestyle choices. Also, certain medications and medical interventions have made a normal life possible for people who otherwise would have died at an early age. These interventions have extended our average lifespan. As our scientific knowledge, technological development and research skills have become more sophisticated, so has medicine.
While modern medicine has brought with it a lot of positives, like everything, there are also some concerning downfalls, which I would like to address in this post. This post is not to put down doctors and medical professionals. I am not against western medicine and in fact I work alongside many great doctors and medical professionals, however I am simply stating the reality of what is currently happening in our health care system and I am merely advocating for a paradigm shift. Doctors treat based on the way they are trained within a broken model, and they are under a lot of pressure to do so.
The current medical model focuses on treating/suppressing symptoms, while neglecting the underlying causes.
With the exception of antibiotics, chemotherapy and selective surgery, western medicine does not cure disease, it merely manages people with existing diseases. It is not preventative in nature.
In conventional medicine, one of the biggest problems is that it mostly focuses on symptoms and diseases. If you go to a doctor and you have high cholesterol, you get a drug to lower your cholesterol. If you have high blood pressure, you typically get a drug to lower your blood pressure. And if you go to the doctor for repeated and chronic infections, you get prescribed anti-biotics. However, there’s often little investigation into why your cholesterol or blood pressure is high and why you keep getting infections. There is often little investigation into the factors that may be the underlying causes of these conditions.
Symptoms are important in as much as they can give us clues as to what the underlying mechanisms might be that are contributing to the problem, but they’re not as important because when you focus on the underlying mechanisms and causes and you address those, the symptoms tend to resolve on their own, so you don’t have to worry about going after each and every symptom individually. You just address the root causes and the symptoms resolve.
In saying this, I do believe that sometimes, symptom relief is necessary in the treatment of a patient as these symptoms can be debilitating and medication can be necessary. However, the problem occurs when symptom suppression with drugs takes the place of other approaches that address the root of the condition. Addressing the root causes of a given health condition also increases the effectiveness of the drug and will eventually allow a person to reduce the dose of a drug or discontinue it fully. This is because addressing underlying factors decreases the exacerbating/contributing factors of symptom presentation.
It can take many years for a malfunction in the body to manifest as symptoms and if you just address the symptoms, without addressing the underlying cause, healing doesn’t occur. The underlying drivers of the symptoms will still be manifesting themselves leading to further dysfunction and therefore increasing the risk of other health issues. This is why so many people end up being put on a cocktail of pharmaceutical drugs over time as various symptoms keep popping up.
Also, a person can present with many different symptoms that may seem unrelated. And the medical model treats all of these symptoms individually with drugs, despite the fact that they are all manifestations of the same underlying causes. The medical model sees the body as parts, rather than a whole system working together. This is why we have doctors for every different part of our body. We’ve got cardiologists for our hearts, gastroenterologists for our guts etc. All systems of the body relate to one another, nothing works in isolation, therefore treating one system, while neglecting another, can never lead to complete healing.
What are the underlying causes of chronic health issues?
In our modern world, as mentioned above, the most common reasons behind premature death is chronic disease. And if these chronic diseases don’t cause premature death, they cause uncomfortable symptoms that may prevent us from living our best life and thriving. There is mountains of evidence to say that these chronic diseases are underpinned by poor diet and lifestyle habits. Yes, genes may play a role but we know that genetic predispositions for diseases usually only manifest (triggered) in the backdrop of poor diet and lifestyle habits. Therefore the key to treating, managing and preventing these conditions is addressing the underlying causes by changing diet and lifestyle factors.
The modern medical model is a downstream approach to treating patients.
The current medical model is very poor at preventing chronic disease as well as managing them. We are very good at dealing with acute illnesses but when it comes to the prevention and management of chronic diseases, the medical model fails. This is because modern medicine developed at a time where acute, infectious diseases, as well as trauma injuries were the leading cause of death/illness (these are still major causes of death in developing/war torn nations due to poor infrastructure, poor sanitation, close living quarters, lack of hygiene practices, poor food health and hygiene practices and famine). It wasn’t originally developed to assist in the management of chronic disease, which simply can’t be done using drugs, due to the multifaceted nature of chronic diseases that have a vast array of diet, lifestyle and environmental factors as underlying causes. Drugs don’t address the multi-faceted aspects that underpin chronic health issues, which is why they are only good for symptom suppression and don’t lead to resolve of health issues.
In the medical model, we also tend to wait until people get sick, then we decide to treat a person. Then we treat them with life long medications (that increase in dose overtime as the disease gets worse), 15-minute check ups and surgery, instead of addressing the underlying diet and lifestyle factors that are causing/exacerbating their health issues.
Some may argue that modern medicine is preventative in some ways, as people are put on medication (e.g. blood pressure medication), in order to manage risk factors that could potentially lead to a disease. However, like I mentioned above, this usually involves treating symptoms that are resulting from an underlying cause. For example, giving somebody a blood pressure medication for their high blood pressure to reduce their risk of a cardiovascular events is all well and good, however there is something at the root cause of the high blood pressure, which is not being addressed. If these underlying causes (usually diet and lifestyle factors) are not addressed, it is usually only a matter of time before the drugs become obsolete and disease occurs.
Drugs can only do so much for a given health issue (i.e. blood glucose lowering medications or anti-inflammatory medications will not be as effective if a person is still engaging in diet and lifestyle factors that increase blood glucose levels and drive inflammation in their body).
Therefore their effects are usually enhanced in the backdrop of improving the diet and lifestyle factors that are driving the health issue in which the drug is being prescribed for. While drugs may need to be prescribed temporarily for symptom control, diet and lifestyle habit change needs to be occurring as well, therefore allowing a person to wean off/reduce their medications because the as underling causes are being addressed.
Also, many people with certain risk factors for a disease are given screening tools/tests for early detection, which are also said said to be used as a “preventative” measures. However, until a disease detected by the test actually occurs and shows up, nothing else will be done. Rather, if a person is at risk for a certain disease given their family history and lifestyle factors, it is prudent to administer screening tools alongside diet and lifestyle coaching as a prevention. This is because we know diet and lifestyle choices are a major driver behind most of the chronic diseases that these screening tools are being used to detect.
Furthermore, many individuals present with signs and symptoms that do not fit the diagnostic criteria of a particular diagnosable health issue or disease. The doctor may run some tests and if the tests come back “normal” or “within range”, the patient is told that there’s nothing wrong with them, despite having certain uncomfortable symptoms. Or, they may also be given medications to suppress these symptoms that have side effects and adverse effects, that may put them at risk of developing other health issues.
However, we know that these signs and symptoms, while not yet part of a “diagnosable condition” based on a specific diagnostic criteria, can still eventually lead to a diagnosable disease with definitive signs, symptoms and pathology test results, if not addressed.
This is because these symptoms are usually manifesting as a result of underlying exacerbating factors, that usually link back to a persons diet and lifestyle. Therefore, if the underlying drivers continue to manifest, it is only a matter of time before certain symptoms become a fully fledged disease states with clear cut signs, symptoms and “out of range” pathology results.
Doctors usually only decide to treat a patient when their test values are “out of range,” and their symptoms fit into a diagnostic criteria. Treatment usually involves medications. Also, doctors can only “justify” their treatment using government health care funding if you are “out of range.” If you are not, then they can’t justify it and therefore funding will not be granted for treatment
What happens a lot of the time is that the tests may have been done over a few months or years and the person may have had test values on the lower or higher end of an arbitrary reference range (alongside symptoms) and it was only a matter of time before they went out, because the underlying causes were still manifesting and not being addressed. Whereas if preventative diet and lifestyle habits that addressed the underlying causes of the original presenting symptoms were put in place, it could have prevented the disease and the lab values going out of range to indicate clear pathology.
As mentioned, test values that sit out of a reference range usually indicate pathology, however we know that within a reference range, there are “optimal” values that most people should aim for.
Reference ranges for test results are based on studies where researchers take groups of people who are healthy and then measure a particular marker for a given test. The “normal/healthy” ranges for a given test result are based on these peoples results. Anything outside of this range is considered abnormal and could point towards a health issue/disease state. Also, people with particular diseases/health issues have test results out of the reference range when compared to the healthy populations.
The “healthy” populations recruited for these tests may be “disease free,” which is considered healthy based on the selection criteria, however they may have other health issues and symptoms that are not part of a diagnosable disease state. This means that the reference ranges have very large variations and people can still have symptoms or health issues with test results within reference ranges. This is because we know that within the reference ranges, there is also optimal ranges. Results out of the optimal range can cause symptoms.
Therefore, if you are within the reference ranges but out of optimal ranges, you can still feel unwell with symptoms but will not be considered to have a disease as of yet and may not be treated. However, when this happens, it is necessary to treat the underlying diet and lifestyle factors contributing to those symptoms, before the values go out of range completely and the symptoms get worse, which then indicates frank pathology.
The medical model is much too focussed on putting a diagnosis (via testing, signs, symptoms) on a health issue because this ultimately dictates the pharmaceutical treatment. While a diagnosis is certainly necessary, it is also very important to take a look at a person’s collective symptoms, look at the inconsistencies around their diet and lifestyle habits and treat these first.
Once this happens, it is likely symptoms will start to resolve. Once the foundational diet and lifestyle habits are addressed, if some symptoms are still manifesting, then it is possible to do further testing and more specific treatments to address these issues. While pharmaceutical treatment can be very necessary if a person’s health issue is chronic/severe and the medication will help decrease uncomfortable symptoms, improve quality of life and prevent further illness or death, however this prescription must still happen within the backdrop of diet and lifestyle coaching. This will improve the efficacy of the medications, decrease the side effects and decrease the dose/amount of medications. It will also improve the persons quality of life, decrease symptoms, slow disease progression/worsening and prevent other chronic health issues. This is because underlying causes/exacerbating factors are being addressed via diet and lifestyle change.
Doctors aren’t trained to change peoples diet and lifestyle
As mentioned, many of the chronic diseases we see today can be managed and prevented by diet, lifestyle and environmental changes, as well as evidenced based herbal and nutritional supplementation, which don’t carry side effects like drugs. However, to no fault of their own doctors are not educated/trained in nutrition and coaching people to change their diet and lifestyle, which is a difficult task.
Doctor’s ultimately specialise (and are trained) in diagnosing diseases and drug administration to treat those diseases. They are usually very good at this and are under a lot of pressure and legal obligation to treat in this manner. Therefore, most chronic diseases are just managed with drugs. Disease management is important and we certainly need it in the modern world, however at the moment it is our sole focus rather than focusing on preventative measures and addressing underlying diet and lifestyle causes of health issues. Once disease actually occurs, it is much harder to treat, manage and even reverse. Depending on the chronicity/severity of the disease, the damage on the body may be irreversible and therefore at best, we can manage a person to improve their overall quality of life. Where is we could have tried to prevent the disease from occurring in the first place well before the disease manifested.
Moreover, many doctors fail to recognize the connection between diet/lifestyle factors and health issues (based on their training), and if they do, they rarely have time to discuss it with patients in their consults. This is because consults are mostly spent around understanding the presenting symptoms of the patient (via questioning and examinations/interpreting testing). This is so a diagnosis can be made and the relevant treatment can be given. If a person is coming in for a check up of their health issue, time is mostly spent around adjusting and maybe adding/removing medications, as well as monitoring signs and symptoms, while looking over test/examination results. Even if they have a little bit of time to talk about diet and lifestyle, it is often said in passing, without much coaching around the advice, making it unlikely that the patient will follow it. Diet and lifestyle changes are hard to make and people need coaching around it. Telling a person to simply eat more vegetables and decrease sugar intake may not illicit the desired change.
Doctors ultimately are trained to diagnose and prescribe medications, therefore they approach treatment and health from this perspective, which is why they don’t address and always recognise diet and lifestyle factors that are contributing to a persons condition. It is not their realm. They are trained to diagnose and prescribe. Not to give diet and lifestyle advice or understand the complexity of the connections between diet/lifestyle and disease states.
Also, some doctors may refer a patient to a dietician if they recognise and looked at research that a particular issue is related to diet (e.g. intolerances/allergies, IBS, diabetes, obesity). However, these individuals are usually trained to treat based on the government model of “healthy eating.” This is problematic as this model is out-dated, some of it is incorrect (e.g. avoiding saturated fat to prevent heart disease) and it is based on populations. We should treat individuals, not populations. The government nutrient recommendations are based on populations who are “free of disease,” however there is more to health than being just free of disease, hence these recommendations are a lot of the time based on the lowest amount of a nutrients needed to prevent disease, rather than thrive.
Moreover, a lot of the time these services are overwhelmed, therefore they give patients general eating guidelines based on research, however a lot of the time dietary research studies are unsustainable to people in the real world in an uncontrolled environment. There is also no coaching around these guidelines, in order to help people integrate it into their diet. Diet change is difficult and requires coaching. Also, the new dietary information may be restrictive, unsustainable and contain too much information, which overwhelms people, therefore decreasing compliance.
Lastly, these practitioners don’t address other lifestyle factors, aside from diet, which we know are vital for health.
Drugs are harmful and not always effective.
Pharmaceutical drugs are not harmless and carry some very harsh side effects and potential long-term risks, especially if they are taken for a long period of time. Yes they are necessary in some cases and do serve a valuable purpose in the treatment of patients in order to decrease unpleasant symptoms, manage life threatening symptoms and prevent complications of a particular health issue. Also, within our medical model, there is no doubt that these pharmaceuticals keep people alive and extend lifespans of people who have severe chronic disease and are unwilling to change their diet and lifestyle. Drugs can help extend peoples lifespan despite poor diet and lifestyle habits, however they will unlikely be thriving.
So while they do play a necessary role, I believe we turn to them far too quickly and overuse them, before we try other less invasive forms of treatment, or at least try these treatments alongside a medication prescription to help wean a person off their medication, reduce their dose/amount or negate the side effects. The advances of modern medicine combined with good diet and lifestyle habits, should be a recipe for a long and healthy life.
Because drugs treat symptoms, the underlying problem doesn’t go away. The drug has just replaced a certain function of your body. But as soon as you stop taking that drug, the problem will come back.
Though drugs provide symptom relief in the short term, over time they may worsen the underlying condition because they interfere with our body’s self-healing mechanisms, which are extremely powerful, we just need to harness them correctly. Facilitating the bodies ability to heal itself given the right nutrition and environment is often undermined, which is why we tend to use very aggressive forms of treatment first.
Drugs may correct a specific imbalance, but in the process, they cause at least one other and often several other imbalances. When this happens in western medicine, other drugs are prescribed to address the side effects caused by the first drug, until the patient ends up on many drugs treating the side effects of other drugs.
The pill for every ill mode of treatment has bread a culture of people wanting to be given a “treatment” from the practitioner for their ill health, rather than recommendations to change their diet and lifestyle. It is a lot easier to take a pill, a supplement or be given a physical treatment, compared to changing habits in a person’s life that are causing their health issues. It also causes laziness in patients as it breeds a culture of relying on quick fixes like drugs instead of living a healthy diet and lifestyle.
People want to put in the least amount of effort to have their issues fixed but sometimes what they don’t realize and what is not always communicated to them, is that a lot of the time they won’t get better unless they address the underlying causes of their health issues, which are usually diet and lifestyle factors. Medications may clear some symptoms (sometimes), but they often cause side effects and can lead to other health issues.
This is also a reason as to why the medical community is spending millions of dollars on research to find the magic medications to cure chronic diseases, which in fact can’t be cured with a pill. Rather, they require a multifaceted approach involving diet and lifestyle changes because the causes of these diseases are multifaceted, which is why a pill will not “cure” anything, it will merely suppress symptoms to allow someone to live with the disease but not thrive.
In saying that some people get sick of the pill for every ill treatment but don’t get the diet and lifestyle treatment they require from the conventional medical model.
The overuse of pharmaceuticals are having a profoundly negative impact on peoples health. There are even some drugs readily available over the counter, which people take for long periods of time (e.g. ant-acids), which can be extremely detrimental to health and increase the risk of health issues/disease. It also amazes me that every day, people get hospitalized from adverse drug reactions and people die every year from adverse drug reactions and mistakes/negligence of medical practitioners, yet no one kicks up a huge fuss about this? Also, each year medical errors and adverse effects of the health care systems are responsible for physician visits, extra prescriptions, emergency department visits, hospitalizations, long-term admissions, additional deaths and extra costs.
Moreover, drug companies are very powerful businesses that have a conflict of interest within the current medical model, because disease is profitable for these companies based on the way the medical model treats. They have a lot of influence over how doctors treat patients, due to marketing and the funding of pharmaceutical research studies, which is obviously going to affect the legitimacy of the results. Drug companies also don’t publish a lot of their drug trials that give back negative results on safety and efficacy, in order to keep certain drugs on the market.
Although drugs companies and their products are strictly regulated and require substantial amounts of evidence behind the drug for safety and efficacy before it can be put on the market, this does not mean that once on the market it won’t cause unintended issues. This is because research studies are not fool proof, they have pitfalls and can only guarantee a certain amount of safety and efficacy. Once a drug is widely used on the market, it may show long-term issues that the research did not and despite overwhelming independent research evidence against the ineffectiveness and harmfulness of certain drugs (e.g. anti-depressants, ant-acids and statins), they are still allowed on the market.
Ultimately, drugs (and surgery) should be a last resort and if prescribed they must occur with diet and lifestyle modifications that treats underlying causes, which may lead to symptom resolve or at least lowering the dose/amount of medications, as they are not harmless, they have side effects, adverse effects and can increase the risk of other health issues.
Why is there a growing a need for “alternative” medicine practitioners?
Chronic diseases are the leading cause of disability in our society. This is having a huge impact on our quality of life and it is causing a huge economic burden due to the loss of productivity to employers, as well as the high governmental cost to medically manage a person with a chronic disease over their lifetime. Chronic disease is bankrupting individuals and our government. Due to these pressing issues, something needs to drastically change in the way our government addresses health, because as seen above, the current model is not very effective.
Research shows that most chronic diseases that are bankrupting our society is ultimately driven by poor diet and lifestyle choices, and making healthier choices could significantly decrease the rates of chronic health issues and could prevent them from occurring in the first place.
Because of this, it is the government’s duty to start investing money into legitimizing and educating alternative health practitioners who can help coach people to facilitate sustainable behavior change around their diet and lifestyle via one on one or even group consultations that can last up to an hour and are not spaced out over a few months. People don’t often struggle to change their diet and lifestyle habits because they don’t know what to do, they struggle because they don’t know how to do it, which is why longer and more frequent consultations are important to coach people to change their habits, as is it no easy task. These consults will involve the patient/s and practitioner working together to improve the patient’s health. The practitioner is not there to fix the patient, rather to facilitate behaviour change around their diet and lifestyle in a slow, incremental, habit based manner with sustainable, measurable and achievable changes. This is very different to saying these changes in passing without any coaching.
Not every patient will want this, as some people rather their chronic diseases get managed with drugs, however it at least should be an option within the medical model that is government funded due to its necessity. This is so people use these facilities. It must also be an option that is well communicated to patients so they understand the benefits/importance of treating the underlying cause of their health issue. It may not be a cure for some people but it can increase their quality of life, their health, their longevity and ageing process, as well as improve uncomfortable symptoms, slow disease progression, decrease future disease risk and help lower medication doses/amounts, as well as mitigate their side effects.
Although the upfront costs may be more, it will significantly decrease costs over the long term, because if a person’s receives treatment before a chronic disease manifests, they will not have to be managed with a life long treatment of drugs, doctors, hospitalizations and surgeries.
This will also mean that there will have to be open lines of communication between alternative medicine practitioners and medical professionals. Both sides will have to drop their stigma’s of one another and engage in cross referrals to ensure the best care of patients.
Medical professionals will also need to be given permission/encouraged by Medicare to screen patients who may be at risk for chronic diseases and refer them for lifestyle coaching, before chronic disease has manifested. This will also decrease the all to common story of a patient who has a chronic health issue for many years and becomes frustrated from being treated using drugs (that don’t fix them), which is why only then they turn to alternative medicine practitioners.
At the moment, there is a lot of alternative medicine practitioners who help coach people to change their diet and lifestyle, however they lack legitimacy within the eyes of the government and medical professionals, therefore they operate on the fringes of the medical model and are often coined as “quacks,” which is why their services/medicines are not covered by Medicare, making it inaccessible to those that sometimes need it the most. Their prices are high in order to cover the overheads of their practices, keep their businesses alive, as well as make a living. This would not occur if they were integrated into the medicine model as primary health care practitioners.
In all health modalities, it is important to use the best scientific evidence possible to guide treatments whether this be administering a drug, herbal/nutritional supplement or advocating for a certain dietary/lifestyle change. There is a growing amount of research that is starting to legitimise the efficacy of diet and lifestyle medicine, as well as herbal/nutritional supplementation for treating and preventing chronic health issues.
There are many alternative medicine practitioners out there who are practicing based on this evidence base, practicing safely within their scope of practice and using high quality, practitioner only supplements while taking into consideration drug-supplement interactions for patients who are also taking pharmaceuticals. These supplements are manufactured scientifically by companies such as mediherb and metagenics, with manufacturing practices as good as any pharmaceutical company and above and beyond TGA requirements.
Moreover, because natural medicine natural practitioners make a profit from the supplements they sell in their practices, they often come under a lot of scrutiny because there is invested interests in every prescription.
There is no denying that some practitioners abuse this system for profit and some practitioners use supplements in the same way as pharmaceuticals are used, without addressing diet and lifestyle changes (i.e. supplements for symptoms). Which is usually due to a lack of knowledge in how to coach people to change their diet and lifestyle in a sustainable manner, therefore they turn to supplementation as treatment. However, if the government subsidised the cost of good quality practitioner only supplements, it would help to remove the invested interests around prescribing and increase the likelihood of treatment being focussed around diet and lifestyle.
Furthermore, for those practitioners who already use supplementation in an evidence based way as a therapeutic adjunct to diet and lifestyle modification, government subsidies would remove the cost barrier for patients who could benefit from this type of medicine, but can’t afford it.
Just like any profession, there are good alternative medicine practitioners and there are bad ones. More than often, the reason why some people actually come under the care of an “unsafe” and “bad” alternative medical professionals who is not university trained and registered with a association, is because of the lack of government regulation over the industry, which is why the government needs to start legitimising the industry. The registration of alternative medicine practitioners, like Naturopaths, will hold the entire industry up to a certain level of creditability and it will lead to a certain standard of practice that practitioners will follow. Creating a standard of practice for diet and lifestyle medicine is quite hard due to its variability, however some kind of government regulation and legitimisation will hopefully decrease the over-prescription of unnecessary and unsafe supplements, as well as the prescription of dangerous, unsafe and unsustainable diet and lifestyle habits. It will also protect the name of Naturopath’s, in order to prevent any joe shmo without formal education calling themselves a Naturopath.
Education is also the key to disease prevention.
Lastly, there is also a desperate need for there to be a better form of education system around health, diet and lifestyle for younger generations. School fails to teach us many of the life lessons we will need to function in the real world, such as saving money and cooking a healthy meal. These subjects are available in some schools but are not compulsory and can often be seen as the “dumb” subjects. If we educate the youth about how to cook healthy meals, exersize, good sleep habits and ways to manage stress levels, we will have the next generation coming through who are more health conscious, leading to lower rates of disease. It is also just as important to educate adults. Rather than the health practitioner being seen as the expert and telling the patient what to do, the patient should be educated on their health issue and how to go about fixing it via diet and lifestyle coaching. Prevention is the best cure.
Healthy diet and lifestyle programs can also be implemented into workplaces with adults, which have been shown to decrease sick days, increase productivity and decrease disease rates. Also, health cover and health insurance companies need to start working with the government to financially incentivise people to buy healthy food, sign up at gyms etc. (e.g. decrease costs of healthy food or every whole-food bought will decrease medical cover costs. The same can be done for exercise and joining gyms).
Furthermore, as a recent article in the New York Times points out, the return on investment from spending on public health is often much higher than it is from treating disease.
Benjamin Franklin famously said, “An ounce of prevention is worth a pound of cure.”
There’s nowhere this is more true than in medicine and healthcare.
And yet, we continue to spend the majority of our time, money, and efforts on treating disease after it has already occurred, which is a losing battle.
So, what’s the solution?
- Spending more money up front to detect and prevent disease, rather than waiting until it’s too late.
- Teaming up licensed clinicians with nutritionists, health coaches, and other allied providers that can support people in making the diet, lifestyle, and behavior changes that will move the needle. This is where a collaborative practice model comes in.
I want to emphasise that in many cases I am making generalisations here. I know there are many doctors who emphasise the importance of preventative care, and prescribe nutritional and lifestyle changes to their patients. I also know that our hospitals and doctors rooms are overflowing with patients suffering from complex health issues, who sometimes just want a quick fix, therefore the doctors have to supply the demand.
Also, I know that in many practices, especially in the public health system, a doctor only has a 10-15 minute consult before the next patient comes in. This means there is not enough time to take a full case history (including diet and lifestyle), understand the underlying drivers of the presenting complaint, build a meaningful therapeutic relationship and talk about complex diet and lifestyle issues with a patient. Lastly, due to limited government funding, doctors are sometimes restricted in certain tests they can order and need to justify to the healthcare system their reasons for ordering certain tests. This means they may only order certain tests when something is overtly wrong with a patient and “disease” has already occurred, rather than ordering a test for preventative measures.
Therefore, doctors are working within a broken healthcare model and treating in a way that they were trained, which was to prescribe when needed. I also know doctors are under a lot of pressure and stress and are scared of malpractice, which is sometimes why they may come across very clinical and may prescribe certain things that are sometimes unnecessary.
Ultimately, our current medical model sets up doctors for eventual burn out. Burnout is a multifactorial problem stemming from physicians’ high patient volume, financial pressure, extremely long work hours, poor work–life balance (causing mental health issues), and the increasingly litigious work environment that has become characteristic of our modern medical system. This ultimately effects doctor’s job performance, job satisfaction, the way they engage with patients (e.g. empathy and communication). It also increases the risk of medical errors, putting peoples lives and health at risk.
This article was not made to bash doctors, however it was written to point out some key issues that I believe are worth talking about and to merely advocate a paradigm shift. We drastically need it because we are getting sicker.