Have empathy for your doctor.

Regular readers will know that I’m a fan of active engagement in our health-related decisions. To do this effectively, it helps to know several things about the healthcare system. This understanding will relieve your frustration with the way things are, and it may also make you more empathetic toward the doctor who doesn’t listen when you try to participate.

1. The healthcare system is a product of the consumer culture, and is designed around money.

Doctors are paid for a very short appointment time with each patient, usually about 10 minutes. That means appointments are booked close together and the doctor is invariably running late by the time the first patient leaves.

From the patient point of view, this means a long wait after arriving at your scheduled time. It also means your doctor may seem rushed, harried, and unwilling to listen to your explanation of what’s going on with your health. And, if you have the impression that doctors only want to hear about one issue at the appointment, that’s true. Ten minutes doesn’t allow enough time to sort out even one problem, never mind a complex health issue.

Sanity strategies…

  • Take a book, listen to your iPod, or decide to enjoy leafing through magazines you don’t normally read.
  • Book your appointment far enough in advance so that you can get the first slot in the morning or after lunch.
  • Don’t plan your next activity for the day based on the time you would be free if you got in to see the doctor as scheduled. You know it isn’t going to happen, so be realistic and save yourself the stress.

2. Physicians are the product of a system that has trained them to think a certain way.

Conventional medicine is based on the fix-it principle: diagnose (i.e. label) the condition and prescribe something to relieve symptoms. Conventionally trained  physicians do some things very well. They are the people you want when you have a medical emergency. They know how to swing into action to stop bleeding, stitch up wounds, fix broken bones no matter how severe the damage, and generally put Humpty Dumpty back together again. They also have access to state-of-the-art equipment to do advanced tests and complicated procedures.

Humpty Dumpty needs to be put back together

Image via ClipartFest.com

But it’s another story when you have a chronic illness. Their abilities to put you back together don’t help when lifestyle changes are the best prescription. Sadly, there are major gaps in conventional medical training. Unless doctors have taken extra courses, they know next to nothing about nutrition. When it comes to exercise, they wouldn’t know what to recommend beyond the basics unless they have studied it for themselves. When you have a crick in your neck, they can give you something for the pain, but they aren’t trained in how to adjust your spine.

In essence, medical doctors have been schooled to see health issues as individual problems that require medicine to get rid of the symptoms. They do not have holistic training that looks at the function of body systems and how they interact with each other.

Conventional doctors are schooled in using pharmaceuticals but not herbals, homeopathics, or other forms of more gentle treatment. The cynical part of me would refer back to point #1 about the monetary basis of healthcare. Pharmaceutical companies have huge amounts of profit at stake and put a lot of attention on promoting their products to both patients and doctors. They position pharmaceutical drugs as the only solution to health problems.

Sanity strategies…

  • Be clear about your health biases and preferences. This helps you find the most suitable practitioners for you. For example, if you prefer prescription drugs only as a last resort, ask questions to find out if that is your doctor’s philosophy. If it isn’t, you can decide how you’ll manage that with your doctor or if you’ll look for another who’s a better match. It’s not a question of right or wrong, but whether there’s a fit or not.
  • Assemble a team of practitioners. A family physician is a must. He or she has a unique knowledge base, is able to prescribe pharmaceuticals if you need them, and is your access to the system including hospitals and labs. Other possibilities for your team include a medical doctor with functional training, a naturopathic doctor, Ayurvedic doctor, chiropractor, nutritionist, physiotherapist, Chinese medicine doctor, acupuncturist, massage therapist, psychologist, and energy practitioner.
  • Seek out practitioners before you are in a health crisis, if possible. Consult friends with similar values and preferences for recommendations. You can also find on-line reviews in some cases.
  • Arrange for an introductory meeting. My current GP booked a “meet and greet” appointment with me when I enquired about becoming a patient in her practice. These days there is more emphasis on the patient-doctor relationship. I think it’s fair on both sides to meet before diving in so there is the space to develop rapport.

3. Your doctor is confined by the system – e.g. office policies and constraints of the insurance plan that covers your care.

This system can be a brutal workplace for your doctor. In the following video, a family physician shares her experience. This was filmed at Dr. Pamela Wible’s physician retreat. Pamela Wible is a medical doctor who has humanized her medical practice and is on a mission to reduce physician suicide. For more, check out her TED talks.

This doctor is not alone in her experience. In 2014, Atlantic Magazine investigated the issue of disillusioned doctors. According to “Doctors Tell All—and It’s Bad”

…students (like the doctors they will become) are overworked and overtired, and they realize that there is too much work to be done in too little time. And because the medical-education system largely ignores the emotional side of health care…doctors end up distancing themselves unthinkingly from what they are seeing.

Dr. Daniel Friedland is addressing the issue by providing conscious leadership and resiliency training for healthcare providers. He, like Dr. Wible, is doing his best to help his colleagues navigate the broken system without being broken by it. The question is, just who is fixing the system?

Only time will tell the whole story.

I welcome reader comments on my blog. They get me thinking. Here’s one, in response to my post, written after I tripped and gave myself a black eye.

Great blog today. I love how an unfortunate event becomes blog fodder. 😊

It made me aware that I hadn’t actually thought of my black eye as unfortunate. And with that awareness, I remembered the story that first shifted my thinking about good and bad fortune.

Here’s a charming version, narrated by philosopher, writer, and speaker, Alan Watts. Born in England, he moved to the US in 1938 and began Zen training in New York. Watts, who died in 1973, is best known as an early interpreter and popularizer of Eastern philosophy for a Western audience.

So what can we make of this ancient teaching?

Continue reading

Simplify. Use your whole brain.

Making decisions about health can be complex and frustrating. How can you possibly know what is the right thing to do?

The complicating factor is that most of us make decisions with only one-half of our brain. For example, suppose you want to know what is the best diet. Your left brain will have a field day. You can listen to interviews, read blogs and books, ask family and friends. You’ll find masses of eating rules, opinions, and theories—many of them conflicting.

With all of that to consider, your left brain may be driven to distraction trying to determine the pros and cons of these various approaches. It may seize on something and make a plan with great enthusiasm, only to have it fail shortly after you implement the plan. That makes no sense to you because the idea or theory was such a logical conclusion from the information you found. Frustrating? No doubt!

Here’s the missing piece…

Continue reading

Tyranny of the Test

As I mentioned recently, testing is one of the hallmarks of personalized medicine. These days there are so many tests to help zero in on what’s really happening in your body. When used judiciously, test results can provide comprehensive information which helps your doctor or health coach develop an individualized plan for you.

Lab testing

Image via NPR

Thanks to technology, doctors are able to see images of your heart and carotid arteries in action, graphs showing a heart under the stress of walking up an incline, and more graphs of your heart beats and blood pressure during daily activities. They can see your brain in glorious colour and your body in three dimensions. They’re able to monitor the level of all manner of things in your blood. They can measure good and bad bugs in your gut, and find out if you have genes that predispose you to certain conditions you’d rather not know about.

Sounds like a good thing? Continue reading

Do your assumptions trip you up?

Mine did. Literally. Tripped me up.

Here’s the evidence. In full colour, an unretouched photo.

Me with blackened eye

So…how did I get a black eye, and how does it relate to assumptions?

I tripped on a curb. Well, not a curb exactly. I was stepping onto the accessibility ramp that transitions the pavement to the sidewalk.

There was no snow or ice. I was not in a hurry. I was not distracted by my phone or iPod. I did not faint and then fall. I was wearing flat shoes that are old friends. There was no obvious reason for this to happen.  Continue reading

Personalized Medicine

Whether it’s called personalized medicine, precision medicine, or individualized medicine, it means you are being treated on the basis of your uniqueness. A study-of-one approach allows for comparison of different treatments in the same person. You get feedback by observing your condition before and after a particular treatment. It allows you to determine whether that particular treatment is effective in your case.

This is different from conventional research, which uses many subjects who are divided into two or three groups. each group is given a different treatment and then the average responses of the groups are compared. This is known as a randomized controlled trial, and study results are reported as a statistical average.

Truth is, this does not provide helpful information for us as individuals. Just because a research study found that a particular treatment works on average, it may not work for you in particular. Or it may even make your condition worse even though it worked for most people. Continue reading

Psychologist Barry Schwartz (#4 in a series: I Couldn’t Have Said It Better)

The Paradox of Choice

Last week I wrote about the dilemmas of too much information. It strikes me that too much information is like having too much choice. It complicates things, even though there’s a good side as well.

The paradox of choice caught my attention when I was teaching college classes about consumer issues. In the TED Talk below, researcher Barry Schwartz speaks about choosing consumer goods, but his findings can also be applied to health and wellness decisions. Continue reading

What if…Type 2 diabetes can be reversed?

We are typically told that once a diabetic, always a diabetic—that is, diabetes can be managed but it is not reversible once you have it. Dr Sarah Hallberg challenges this viewpoint, based on her clinical experience using a high-fat diet. Her program has been highly successful in reversing diabetes and other metabolic diseases. Continue reading

Emily Fletcher (#3 in a series: I Couldn’t Have Said It Better)

Be present to yourself.

This is being posted on Valentine’s Day, when it’s traditional to acknowledge those you love. If you aren’t on your list of people you know and love, this is a good time to think about how to change that.

Meditation is a time-honoured means of learning to be present with yourself, to get to know and appreciate who you really are.

If you’ve ever had even an inkling of interest in meditation, this video is for you. Emily Fletcher started her career in theatre. When she refers to being able to dance, that relates to her 10-year career on Broadway, which included roles in Chicago, The Producers, and A Chorus Line. Continue reading

What if…we can eat to starve cancer?

In this TED-Ed talk, William Li, MD presents a new way to think about treating cancer and other diseases. It is anti-angiogenesis, which means preventing the growth of blood vessels that feed a tumour. He says the crucial first (and best) step is eating cancer-fighting foods that cut off the supply lines and beat cancer at its own game.

Watching this reminds me of three things that are important and easily forgotten:

  1. Just because conventional wisdom has not yet embraced a new idea, that does not make the new idea untrue.
  2. What we eat does make a difference and it’s worth paying attention.
  3. As Dr. Li says (at 19:00 minutes on the video), we can empower ourselves to do the things that doctors can’t do for us, which is to use knowledge and take action.

Continue reading