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?

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The Woman Who Changed Her Brain

I found Barbara’s story particularly poignant because so many people experience variations of what she described. And it happens all the way along the age continuum…from children with learning disabilities of varying degrees to adults with dementia of various types and severity.

Barbara Arrowsmith Young’s vision is a lofty one—that cognitive exercises become a normal part of curriculum, and that school becomes a place that we go to strengthen our brains. The good news is, she has done something about it. The Arrowsmith Program is offered at schools throughout North America, Australia, New Zealand and Asia.

And what can we do?

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Engaging Your Whole Brain

Last week I wrote about using your whole brain when making decisions. That post included a TED talk by a practitioner of Psych-K (psychological kinesiology). As the name suggests, Psych-K uses body movement (kinesiology) to assist the brain in working as it’s meant to.

Psych-K was my introduction to energy psychology many years ago. Psychologist Rob Williams had blended principles of psychology with body movement from Edu-K (educational kinesiology), also known as Brain Gym.

Braqin Gym book

Brain Gym is a set of 26 movements aimed at integrating the two halves of your brain. It was developed by Paul Dennison to help himself with learning challenges when he was a post-secondary student. Seeing the potential to help others, he and his wife, Gail Dennison, developed the Brain Gym program. They found that people doing these movements experienced improvement in a number of areas, including concentration and focus, memory, physical coordination, and organization skills. The photo is my copy of the original book. It is still available on the Brain Gym Bookstore. 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…

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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

You’re a “study of one”…and the director of it.

Last week I wrote that we are complex organic systems, each with a unique combination of inherent constitution and life experiences. Under such conditions, the best way to address health issues is with an individualized plan.

In this model of achieving wellness, you are the subject in the study of you. Of course, a study also needs someone to direct it, and that is you too, since the medical system hasn’t yet embraced this approach beyond trying one prescription and then something else if that didn’t work.

How you think makes a difference to the process.

To handle your role as the study director, it helps if you will:

  1. adopt an experimental mindset,
  2. recognize that it’s a zig-zag path to where you want to be,
  3. look for clues,
  4. experiment judiciously, and
  5. think creatively.

Adopt an experimental mindset.

An experimental mindset is a huge asset because it keeps you from being trapped in the mode of doing things as they’ve always been done. It allows you to think, “There has to be another way.” This is not the typical medical approach, so you inject fresh energy into the situation when you approach an issue with an inquiring mind.

An experimental attitude allows you to be curious, to see what happens when you make a particular choice. It opens up possibilities and gives you a chance to learn what works and what doesn’t. It’s the attitude that has been behind many innovators and inventors, including Thomas Edison.

Recognize that it’s a zig-zag path to where you want to be.

In the search for another way, you’ll be reading, listening to interviews, and asking questions. As you do that, it will become apparent that there are very few definitive answers about solutions to health issues.

One expert advocates a certain approach, another takes an opposing position that is equally convincing. Both are quoting research that supports their position. How does that make sense?!

Because there isn’t just one perfect answer. Each of those contradictory protocols has worked for some people. The main variable in solving your particular issue is your specific symphony of information, as Dr. Kelly Brogan said so eloquently at the beginning of this post.

Your job, as the director of your study of one, is to find what works in your particular case. By judiciously trying things, you can gain information that will help you determine how to proceed. Then it’s a case of “rinse and repeat” as you apply your learnings from one stage of the experiment to determine what to do next. In doing so, you’ll almost certainly find yourself taking a zig-zag path.

This is not the typical approach In our culture, which is goal-oriented and success-driven. We don’t appreciate trial and error. Instead we look for a direct path to the right and perfect solution, and consider ourselves failures when our chosen solution doesn’t work the way we expected.

However, the search for the perfect and correct answer can be a handicap because it sometimes prevents any action at all. As psychologist Barry Schwartz found in his research, this occurs because you can never be really sure you’ve chosen the perfect resolution from among an over-abundance of possibilities. This is true whether you are buying a pair of jeans or trying to figure out how to bring down high blood pressure.

Look for clues.

Self Help visual

Over the past three years, I’ve had ample opportunity to observe my process as I worked my way toward wellness. I notice that I’m always alert for clues when I read or listen to expert interviews. I watch for things that stand out, catch my attention, ring bells for me. I make note of those ideas and often end up experimenting with them.

Let me be clear—I’m not implementing every idea that crosses my path. That would be a recipe for disaster, as Aesop pointed out in his cautionary tale of The Man, the Boy, and the Donkey. The old man and his son adopted every suggestion made by people along the road to market, instead of doing what made sense to them. In the end, they unintentionally drowned their donkey, losing something of great value in their lives.

Experiment judiciously.

When experimenting judiciously, we consider the inputs from others, including the experts, without blindly following them. All inputs need to be filtered through our own inner knowing to determine the best course of action in any given situation.

Clues can come from many places. Experts are an obvious source. But something might come up in conversation with a friend that unexpectedly catches your attention. Or a relative may mention something about one of your parents that gives you new insight into your current condition.

Your body is also a rich source of feedback and clues. Be alert. What does it seem to be asking for? How does it respond when you try something, whether it’s a new supplement, a medication, a different type of exercise, or regular meditation?. What makes it feel worse? …better? Why is there a knot in your stomach whenever your cousin walks into the room? Why do you sleep better when you’re on holiday?

These are all rich sources of information that become “grist for the mill,” as my grandma used to say.

Think creatively.

Clues provide information and ideas. Combining ideas in unusual ways is the hallmark of creativity. And it’s the key to finding solutions that work. Psychologist Keith Sawyer studies creativity and innovation in business, but the same principles apply to creating wellness for yourself.

Last fall, Dr. Sawyer spoke to a gathering of tech visionaries and experts in human flourishing. He began with this description of creativity:

Creativity is not mysterious. Creativity is not a rare insight, that comes to you suddenly, once in a lifetime, to change the world. It’s just the opposite. Creativity is a way of life. It’s a process. The process starts with an idea. But it’s not a big insight–it’s a small idea. And that small idea can’t change the world by itself. In the creative life, you have small ideas every week, every day, even every hour. The key is to learn how to bring those ideas together, over time, and that’s the essence of the creative process.

More next week about personalized medicine. In the meantime, here’s Dr. Sawyer’s short talk about creativity.

We are organic systems. Not mechanical.

Organic. Not mechanical. That means we need to think differently when trying to fix problems in the system. Repairing a mechanical system is usually a straightforward, clear-cut, logical process.

Not so with living systems, which are elegantly complex and sometimes incomprehensible. We have a capacity for emotion, interconnected body systems, and strong survival instincts. No wonder it’s challenging to zero in on one correct thing to do when you have a health issue.

Integrative Health Approach

Institute for Functional Medicine Clinical Matrix for Core Imbalance. From the Institute for Functional Medicine: Textbook of Functional Medicine. Gig Harbor, Wash: The Institute for Functional Medicine, 2005, p 100. © 2005 The Institute of Functional Medicine. Via the Cleveland Clinic

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