Over at Lance Mannion's shop, he's musing on the many weirdnesses in the voting last night for the imperfect House health reform bill. Imperfect, indeed. Anyone who thought it could be otherwise is a magical thinker of the first order. The fact is our approach to health and medicine - two waaay different things, by the way; genuine health may be further from what most people call medicine than Russia is from Sarah Palin's porch - is a mess almost beyond measure. Some kind of government health reform is a necessary step; but without a shift in consciousness it's just an insufficient finger in the dike. Some examples:
Today's Sunday Times Magazine features Dr. Brent James and "The Theory of Evidence-Based Care", a completely rational approach to bringing down health care costs:
PROBLEM : For any given diagnosis, a doctor can consider a number of ways to treat a patient. But how does a doctor know which treatment to use?
SOLUTION: Committees of doctors and others track treatments and their outcomes by medical specialty, developing treatment protocols based on the data.
RESULT: A doctor may choose to ignore the protocol. But patient care should improve as doctors see evidence for the most successful treatments.
Yay-Rah for Dr. James. Thanks for helping, and it's not enough.
In part, because there is this block quote in the Times article:
"It is possible to rely too heavily on numbers and patterns when treating patients but the BIGGER RISK - the one we are now taking - is relying too heavily on intuition."
May I just step in here to mention that I would prefer to have a physician WITH intuition? Not just some intuition, but I want a doc with major, mind-boggling intuition! The problem is not so much that we are "relying too heavily on intuition", it is that we are relying on faulty intuitions, because our current medical education is designed to thump the intuition out of these people, when it should be actively nurturing just the opposite.
I'm remembering a conversation I once had with a family physician who had been practicing for about ten years. He told me that he'd recently heard at a seminar that, while examining a patient, it would be good to place his free hand on said patient in such a way as to establish more human connection, and that he had found this to be true. To quote SNL, "REALLY?!" Here was a guy supposedly "called to healing" who couldn't figure this out on his own in ten years of practice... with kids, mothers... "REALLY??" - I asked him how he'd come to medicine. Answer: "Well, I could have gone into law or engineering or medicine and it just happened to go this way." In other words, income was the call. I'm okay with income being the call to to law or engineering. With medicine, I'd like a little something more. But I can tell you from having attended a top pre-med school, income is primarily the call. So when people fret that government health reform will lower doctor salaries and drive people away from medicine, I smile and say, "Bring it on. Alter the damn universe. Up the proportion of actual healers in the ranks. It can only improve the system in the long run."
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If the physician attending me cannot be an intuitive genius, then I want him or her to at least have some deeper awareness of subtle energies. In Chopra's latest book, he tells the story of a patient with a pulled muscle that grew more and more painful.
"I knew from doing this kind of thing before that it was tendinitis... I was given the name of a really good acupuncturist and made an appointment... he stuck needles in a few places. not just in the afflicted muscle. When the treatment was over and I was about to leave, (he) surprised me by asking if I was depressed. My mother had died the year before, and I told him that I had been feeling down, though I didn't think I was still grieving. He told me that he had detected weak energy around me. That was how he recognized that I was depressed, and he suggested that I let him do a few things...he pressed a few points along my spine, very gently... The whole thing took no more than ten minutes, and he didn't charge me... As I was walking back to my car...I felt very good. I was buoyant, my footsteps lighter. Only then, when the gray cloud over me had lifted, did I realize I had been feeling down for quite a while. The next day I was still in a good mood, almost elated...The visit stands out for receiving a healing I never expected."
How many doctors today spend enough time with each patient to make or cure such discoveries, or for that matter know you as a human being?
Findings have estimated that on average, patients can expect to spend no more than 10 to 16 minutes with their doctor, depending on the negotiations that doctor has made with that patient's insurance company.
Sixteen minutes once or twice a year.... Now, there's a meaningful relationship. With pressures to move 'em through as quickly as possible, physicians need to become extraordinarily perceptive and sensitive. How many do you know like that? Name one required med school course that addresses this need.
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Another example of "off" thinking: The Placebo Effect. As Dr. Andrew Weil points out every time he speaks at medical schools, the placebo effect is the most interesting thing in drug studies, it's the place of power and potential: How exactly did those patients heal without drugs? That's what we should be looking into - not to the exclusion of all else, but certainly we should be giving it more respect than it gets.
Meanwhile, we're all drowning in TV pharmaceutical ads... Ugh. Or should I say glug?
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For some people, the decision to not buy health insurance is based on a desire to commit to prevention: "I can either spend $600/month on coverage, and have nothing left over for personal maintenance or I can use that $600 to buy better food and have regular acupuncture, massage, Ayurveda, etc. to keep my body in the best possible shape." Some people might call them irresponsible. Really? At least they are consciously applying themselves to health. How many health plans make room for that? It will be interesting when those people have to - by law - put that $600 into insurance. We should all hope that they - who know whereof they speak - will start demanding a health care system that allows for a much more flexible and intuitive approach to prevention.
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In short, yada-yada-yada - reform the system, change the system. Yes, do what you can and as soon as possible. But until we fundamentally transform the works through a shift in consciousness, the current beat will go on and on and...