The Growing War Between Modern Medicine and the Public

Across the country, trust in institutions that were established to guard our health has fallen to an all-time low. According to an article in 2004 in the Harvard Public Health Review, this country is having a “crisis of confidence.”

Patients don’t trust insurance companies, pharmaceutical companies, or their physicians. Physicians, in turn, are skeptical of clinic and hospital administrators. I am certain that the situation has not improved in the past four years and has probably further deteriorated.

The Matter of Trust

Why does trust matter?

“Trust is an important lubricant of the social system,” Kenneth Arrow writes in the Harvard article. “Without it, the gears of the nation’s health system will continue grinding down.”

But here is an interesting thought; maybe this system should grind down as it has been dysfunctional for so many years.

One of the “side effects” of a dissatisfied populous is that people take matters into their own hands. This has had a beneficial effect in the United States as people have begun to investigate other ways to achieve health—alternative and complementary medicine. Not only have they dipped their toes into the water, they have jumped in.

As the featured article states, Americans are embracing alternative medicine for its focus on health versus illness, prevention versus cure. People are hungry for a holistic alternative in which they feel treated like people, rather than diseases.

Natural medicine not only provides a less expensive and safer alternative to conventional medicine, but an empowering one, since many of the health techniques are done at home, by you, the patient. It often involves simple lifestyle changes, nutrition, exercise, etc., and emphasizes something I have long advocated--taking charge of your own health.

Repairing Damaged Relationships, or Moving On

Does this new paradigm really mean that modern medicine has to be at war with the public? Do you have to sacrifice your relationship with your physician in order to embrace new forms of health care?

I say no.

In fact, there is nothing to be gained by being at war with anyone. The relationship is the cornerstone of the medical system--nobody can be helped if physicians and patients aren’t getting along.

But increasingly, research and anecdotal reports suggest that many patients don’t trust their physicians.

About one in four patients thinks his physician sometimes exposes him to unnecessary risk, according to a study published this year in the journal Medicine (cited in an article in the New York Times). And two recent studies show that patients’ trust in their doctors strongly influences their medication compliance.

Many studies have documented that the quality of the interaction between physician and patient can strongly influence patient outcomes. As long ago as 400 BC, Hippocrates wrote about how “the patient, though conscious that his condition is perilous, may recover his health simply through his contentment with the goodness of his physician.”

Dr. Newman, author of the book Hippocrates’ Shadow: Secrets from the House of Medicine, said studies of the placebo effect suggest Hippocrates was right when he claimed that faith in physicians can help healing. “It adds misery and suffering to any condition to not have a source of care that you trust,” Dr. Newman writes.

The Placebo Effect is Real and Can Be Used for Good

Many physicians have enormous potential to positively influence outcomes and behavior just by the way they interact.

In 2001, Blasi Z et al. did a systematic review of 25 clinical trials (Lancet 2001 Mar 10;357(9258):757-62) to determine if doctor-patient relationships had any measurable therapeutic effect. They concluded that physicians who were “warm, friendly and reassuring” were more effective than those who were more formal and less nurturing in their approach.

Unfortunately, physicians today are working in settings where they are usually expected to funnel patients through every 7-12 minutes, which churns out a tall stack of invoices by the end of the day but leaves no time for relationship building.

As the public demand for complementary and alternative medicine grows, a new and different type of provider will emerge.

This is already happening!

If you find that you have philosophic differences with your health care provider that seem irreconcilable, perhaps it’s time to make a change.

There will always be some physicians who are behind the times, some who are on the cutting edge, some who want to learn from their mistakes, and some who don’t. It is your job as a proactive individual to evaluate what is moving you toward better health, and what isn’t—and that includes your relationship with your doctor.