Peter Gzosky was a much loved journalist turned host of the national Canadian radio show Morningside. Peter’s guests were not limited to stars, celebrities, and politicians. Listeners of the popular morning magazine were frequently introduced to the everyman and woman: a young Saskatchewan woman who recovered from childhood sexual abuse, a street person, a soldier who was in the 1944 D-day landing on Omaha Beach, France. Peter asked the type of questions you always wished you had asked as an after-thought but could never think of at the time.
One such guest, a retired village physician, had spent his life in the service of a small Canadian town. Many of Peter’s questions explored this doctor’s approach to treating his patients comparing them to the modern physician’s approach.
The doctor recalled that when he entered a patient’s bedroom, he would first smell the room, then the patient, sometimes audibly sniffing over-top and around the patient like a bloodhound.
“A patient’s body smell,” he told us, “Tells you a lot about what was going on inside the body. My routine, and the routine of most of my colleagues, was to touch the skin, feel its quality and temperature, look at the tongue, pull down the folds of the eyes, and ask questions about the patient’s lifestyle and stresses – historic and current.”
He bemoaned the loss of the physician’s hands-on approach. He felt physicians had become overly dependent upon machines and laboratory analysis for diagnosis. The personal touch, for him, had diminished.
It wasn’t that he was fully against this newer approach – he did see it as progress towards a greater accuracy in diagnosis – but he worried it was leading to a kind of de-humanizing of the patient-doctor relationship. That, in an endeavour to overcome or reduce the effects of the symptom, the physician’s approach has become too simplified and predictable. The patient tells the doctor about the problem. If the doctor is unable to reliably diagnosis, she orders tests. Once tests identify the issue, the doctor prescribes treatment – usually drugs.
The old-time physician wondered where the days had gone when the doctor had the time to take interest in the potential contributing causes to the symptom: lifestyle, stresses, foods we eat.
Western medicine approaches health almost exclusively from a physical perspective. We are brought up with the premise that if we have an ache, pain, or an incongruent symptom, we go to the doctor in the hope that they will give us something to take for it or do something to fix it. Whether the treatment is successful or not, the doctor is paid for his or her work, effort, and expertise.
Yet in China of old, the physician was paid only for as long as the patient remained well. If the patient became unhealthy in any way while under his treatment the physician did not get paid.
The Chinese approach therefore leaned towards prevention. Prevention involved concentrating on the maintenance and upkeep of the client’s health, keeping the body’s defenses strong so that there is greater likelihood of precursors such as viruses, bacteria, and cancers being dealt naturally by the body’s innate troubleshooting systems before they emerge as symptoms.
In the treatment of his patient, the same Chinese practitioner would take every aspect of the person’s life into account, getting to know his patient intimately. He would want to know about his patient’s diet, his physical and emotional history, the stressful components of his life, how he or she relaxes, the health of the parents and siblings, his spiritual life. He would palpitate pulse points on the wrist for diagnosis, listen to his breathing, smell the patient.
The practitioner considered all aspects of a person’s life, physically, emotionally, and spiritually, as being potential contributors or causes to the person’s health imbalance, seeing the relationship between the physical, emotional, and spiritual elements as inter-changeable. The old Chinese approach was holistic in that it took into account the whole of the patient’s lifestyle as a potential contributor to the symptom.
The holistic approach changes the fabric of the practitioner-client relationship. The practitioner takes a few steps away from an authoritarian “you must do” approach, to one of companion on the patient’s journey, where the practitioner offers observation and advice, which may include suggestions on a treatment and a change in the patient’s lifestyle. The patient’s willingness (or unwillingness) to change lifestyle then becomes a contributing factor towards the improvement of the presented condition.
The old Chinese approach being outlined seems a world away from what has become the traditional western approach to medicine. It may be true that in the old physician’s day the approach was more holistic. But times are different today. Doctors have to cope with larger populations the world over. There are significant financial demands in the running of a doctor’s office Property rent often in a centrally located area of a city or town and wages for skilled nurses and administrators, to name but two, have sky-rocketed over recent decades.
To cover their costs doctors are obligated to cram in more patients into their day. This factor alone accounts for less time with the patient. Many of the medical doctors I see in my own private practice understandably struggle with exhaustion and burn-out.
I recently heard a doctor speak on a television interview about the demands doctors have to shoulder today and his own struggle with burn-out. He described times when his exhaustion is so intense that he finds himself feeling angry and intolerant with his patients. Sometimes, in those moments, he wants them to just leave so he can have some free time. He told us how he has to monitor that urge and override it whenever he is at that level of burnout, because if it were allowed to take over, he would skim over his patients’ treatments depriving them of the quality of service they require.
We tend to forget that the medical profession is a business. The doctor’s office is interested in profit as well as providing a service. The commitment to service is more important and prevalent than say the service of a plumber, because it involves the health and often the life and death of human beings. All businesses are to a greater and lesser extent governed by the laws of supply and demand. Economic theory states that the demands of the consumer are an important and necessary factor in determining the nature and quality of supply. An important question to ask is, how our demand, as consumers of our medical system has influenced or contributed to the nature of the supply being provided.
To read more on how emotions and stresses effect physical conditions such as illness and pain, click on:
Are you happy with the medical services you receive? In what areas could they be improved?
Do you believe emotions and stresses contribute or influence physical symptoms, illness, or disease – or not?
Should doctors be trained to give more consideration to our emotional well-being?
Do the demands we as consumers make influence the politics, policies, and choices our medical personnel make? For example, are we demanding physical care, and is this demand influencing the type of care we receive?
Let us know what you think – leave a comment in the box below.
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