Saturday, October 4, 2008

The downfall of MDeities

Perhaps it happened in the 80's when the drug companies started rolling out antibiotics as if they were the next best thing to sliced bread, and, by intimidation perhaps, doctors bought into the hype.

Remember when undercover cameras were the hottest thing in tv journalism? There was a 20/20 story, I still recall, where a reporter went into 3 different doctor's offices as a new"patient" with a sore throat. All 3 doctors gave the "patient" antibiotics; no lab tests were run, no fever was present, no throat scrapings, etc.. When asked why, a female doctor replied "It's about customer satisfaction, I want my patient to come back." At the time I was blown away, patients are customers in the eyes of doctors? Holy Hippocrates since when? I had always seen doctors as highly intelligent people gifted with the humility to help others, or even intermediaries of the Gods from an ancient Greek perspective, and here this female doc was talking customer service.

A new day dawning wasn't until 10 years later when I was eating a ribeye steak at the most expensive hotel in town listening to a doctor "expert" talk about the virtues of Prozac, and how patients will feel the doctor is really making cure happen. The enormous bill graciously paid for by Eli Lilly. In retrospect, I think the antibiotic drug reps must have been convincing in their sales terms: keep your patients coming back, give them this. Convincing, indeed, drug pushers, in fact, for the pharmaceutical industry has a phenomenal profit margin. As for M.D.'s, in a way, who can blame them? Especially female doctors at that time- it was the new wave, just think of the pressure to perform.

Medicine is surely an art, for sometimes our best thought out plans don't always work and seeing a patient's condition stagnate, or worse decline, under our care would instigate doubt in anyone. Put that together with a patient's lawyer's willingness to sue your doctor and you have a winning combination for mediocre if not dismally uninspired care. Where there's no inspiration how can there be curiousity and creativity?

Though, N.D.'s have been trained in the modern medical methods of diagnosis, our treatment approaches have mostly remained holistic and rooted in antecdotal methods. Modern medicine and science refer to any treatments or trials as antecdotal if they've not been studied in a randomly controlled double blind study. Which I must add, here, is designed for the express purpose of comparing a placebo pill with an active ingredient pill; it's hard to use this template for any other type of clinical investigation, and near impossible when dealing with psychological or emotional treatments that are not encapsulated.

Thus, N.D.'s see a lot of "hopeless" cases, it is our credo that we can do something no matter how small to help patients, and we usually help them quite a bit. It's not that we are curing them, per se, but that we are relying on their body's inherent ability to effect cure. With this in mind, how can one test for an individual's ability to move itself into balance? Does this mean that the ancient observation of the body's power to get healthy is a figment of imagination? I'd love to hear any and all proposals for a double blind randomly controlled study of this dynamic healing power inherent in the human body. Because at this point if it can't be bottled and/or tested it aint gonna work, much less be covered by insurance. 'Til next time, keep it simple, fresh and full of grace.

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