Our current medical model needs a makeover

Modern medicine continues to amaze me in so many ways. The growing sophistication of diagnostic techniques, life saving surgery, pharmaceutical drugs and emergency 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 and antibiotics has saved countless human lives. 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 healthcare 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 go to a doctor with 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 diet, lifestyle and environmental factors that may be 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 symptom relief is necessary in the treatment of a patient as these symptoms can be debilitating and medication can sometimes be necessary. However, the problem occurs when symptom suppression with drugs takes the place of other approaches (such as nutritional, lifestyle and environmental changes) that address the root of the condition.

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.

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. 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. We wait until people get sick, until we decide to treat a person. Then we treat them with lifelong medications, 15-minute check ups and surgery.

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 event 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 are not addressed, it is usually only a matter of time before the drugs become obsolete.

Furthermore, many individuals present with common health issues like digestive problems and fatigue before their chronic disease manifests itself clinically, however the current medical model fails to provide adequate solutions to these issues because they treat the symptoms, without finding the underlying cause. The doctor may run some tests and many of the tests will not be seen as abnormal unless the person being tested is already sick and has clear pathology. If the tests come back “normal” or “within range”, the patient is told that there’s nothing wrong with them! Then, because the underlying malfunction is still manifesting, the person ends up developing a disease eventually. Doctors may only decide to treat a patient when their test values are “out of range.” However, 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 a reference range and it was only a matter of time before they went out.

Test values 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. Being within the range is not enough and we know that even within the reference ranges but not within the optimal ranges, symptoms can occur. This is because reference ranges are set around disease states, being out of the range indicates frank pathology. Therefore, if your are within the reference ranges, you can still feel unwell but will not be considered to have a disease as of yet and therefore will not be treated.

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 specialize (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.

Moreover, many doctors fail to recognize the connection between diet/lifestyle factors and health issues, 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, so a drug can be administered. 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.

Also, some doctors may refer a patient to a dietician. 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.

Lastly, the government nutrition 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 nutrient needed to prevent disease, rather than thrive.

Drugs are harmful and not always effective.

Pharmaceutical drugs are not harmless and carry some very harsh side effects and potential long-term risks. Yes they are necessary in some cases and do serve a valuable purpose in the treatment of patients, especially in acute cases for relieving unpleasant symptoms. However, I believe we turn to them far too quickly and overuse them, before we try other less invasive forms of treatment.

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 body’s 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 bred 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 lead them to ill health. 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.

The overuse of pharmaceuticals is having a profoundly negative impact on people’s 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. 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. 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 drug 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. antidepressants, ant-acids and statins), they are still allowed on the market.

Why is there a growing need for “alternative” medicine practitioners like Naturopaths?

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 are 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 legitimising and educating practitioners who can help coach people to change their diet and lifestyle via 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 change people’s habits. These consults will involve the patient and practitioner working together to improve the patient’s health. Although the upfront costs may be more, it will significantly decrease costs over the long term, because if a person receives treatment before a chronic disease manifests, they will not have to be managed with a life long treatment of drugs, doctors, hospitalisations 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 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 too common story of a patient who has a chronic health issue for many years and becomes frustrated from being treated using drugs, which is why only then they turn to alternative medicine practitioners.

At the moment, a lot of alternative medicine practitioners like Naturopaths exist, 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. Research is booming in the nutrition and herbal/nutritional supplementation world. And there are many alternative medicine practitioners out there who are practicing safely within their scope of practice and using high quality, practitioner only supplements (not over the counter supplements), that 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.

These practitioners are using these supplements based on scientific evidence, are very careful around drug-supplement interaction and are working closely with medical professionals to ensure the best care of their patient’s.

The whole alternative medicine industry should not have to suffer for the mistakes of others. Just like there are bad natural health practitioners, there are also bad doctors out there who do harm, it is in any profession. More than often, the reason why some people actually come under the care of an “unsafe” alternative medical professional 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 credibility, which will weed out the bad eggs.

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, 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. Prevention is the best cure.

Final note.

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 15-30 minute consultation before the next patient comes in. This means there is not enough time to take a full case history, understand the underlying drivers of the presenting complaint, build a meaningful therapeutic relationship and talk about complex diet and lifestyle issues with a patient.

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 affects 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 people’s 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.