Doctor knows best

In the beginning, learning and practicing a new type of treatment, homeopathy, I felt I had undertaken a revolutionary change. It was a confession to myself and my patients that my training as a psychiatrist and child psychiatrist was inadequate to the task I had taken up so many years before. After 8 years of practicing and studying in my chosen field, I had essentially given up on my long nurtured hope that the field could provide the necessary tools to a successful practice. By successful, I mean having successful outcomes, not having financial success. It was also an admission to my colleagues that I had found the practice of medicine wanting. Although I certainly was not the first to reject the calling I had once embraced, there was a very personal sense of guilt in effectively criticizing what had been given to me with what had appeared, for the most part, to be a sincere and honest effort to develop my professional capabilities.

Now 10 years after my personal peripety, my questions have turned to other matters, although there is still some lingering discomfort over what in some manner, still feels a little bit like a betrayal. As my skills in homeopathy developed, it slowly became apparant to me that homeopathy, much as I love to practice it and broadly applicable as it is, still is unable to touch many of my patients. Thanks to the inspiration of some of my homeopathic mentors, I've undertaken to learn yet another modality, Bowenwork. This type of body work, named for the late Australian Tom Bowen, is perhaps somewhat more narrow in its scope of action than homeopathy, but quite inspired, and sometimes able to produce results where homeopathy (and allopathy) have failed. It has all the hallmarks of what I consider a good treatment to be: high success rate, gentle, with low morbidity (and no mortality), quick results (at least measured by the standards of modern medicine), low expense, and broad salutary effects, not merely to the symptoms or illness of clinical focus, but, above and beyond that localized problem to the patient's overall health.

As the power of Bowenwork has opened up to me, it has come into my awareness that these both Bowenwork and homeopathy are but two of many unconventional approaches to treating illness which have as a primary goal improving the individuals' overall health. Indeed, I can now see that it is possible to divide health care into two broad categories: the health-promoting and the illness-managing. Conventional medicine, for the most part falls into the illness managing category. In spite of its greater status, conventional medicine is relatively bereft of tools to improve health. All of the conventional research and treatment that is done in the great social/medical problems of our times --smoking, drug abuse, nutritional problems, lack of exercise, and iatrogenic illness, has yielded little to medical treatment. Although many fine people in ancillary services, such as dieticians, respiratory therapists, physical therapists, social workers do commendable jobs, often exhausting themselves in the process, the medical acumen they bring all too often leads to rather disappointing results. The limitations of the drug-oriented and surgery-oriented physician's services are well-reported in the scientific journals and in the many books available in the popular press on the pharmaceutical industry. Ultimately, while much good does occur, little is accomplished to make people healthier. The diseases are being well-managed, but the diseases persist, and now often are complemented by new drug-induced illnesses, which have to be managed themselves.

The implications of this are profound. In promoting health, a good deal of illness may be ameliorated if not eliminated. This leads not only to happier outcomes (who doesn't want to get better?), but also to fewer consumption of resources in those who do experience broad health improvements from their treatments. If you are healthier, it stands to reason you need fewer health-maintaining resources. What conventional medicine calls health is in fact a misnomer: it refers to the illusion of health created by a menagerie of pharmaceuticals that keep illness out of awareness by suppressing the symptoms of illness. Why doctors and in fact a whole health care industry would prefer to maintain this illusion of health rather than deliver the real thing should not be much of a mystery. Physicians want the best for their patients: they simply have no training in health. The modern health care worker (of the conventional stripe) is an expert on illness, but severely challenged when it comes to understanding and improving health. Modern health care is expert at removing the symptoms of illness, but not in making us healthier. And when we can't make you better, we sometimes just take out what is ill and replace part of you with a machine or other device, as in hip replacements or valve replacements.

Physicians are thought of as experts in health. In fact they know less about it than many lay persons. It was only after I learned about health for myself that I realized how little I had known about it. The public at large, the media, and most of the health care world will continue to believe that the high cost, high intervention, high risk approach to health care that our current medical system has become is the supreme wisdom as long as the illusion that the doctor knows best prevails.