I had an interesting conversation with a savvy patient the other day. She has experience in the healthcare industry, and we were having a lively discussion about the present state of American healthcare especially in light of the coming changes. We were discussing Western vs. Eastern models of health. In the West, we follow a Cartesian model which is disease oriented. In medical school we teach students to diagnose and treat these diseases. The orientation is largely aimed at identifying what is broken and what can be fixed. Eastern models take a holistic whole systems approach which tends to view the person as generally well; there is more right with the person's system than wrong. Our Western disease-laden approach creates dis-ease. Western doctors tend to see patients as their diagnoses. We are uncomfortable looking truly at the whole person. We are taught this from the start; as a student you are told,"Go check the labs on the post-op appy in room 205." (Appy is short for appendectomy.) You are your disease and/or your procedure. This extends all the way through to the insurance industry, which requires a diagnostic code and procedural code for billing and reimbursement. No, "worried well" (an actual code) will not get your doctor reimbursed, and you will likely get the bill for that visit. Does this make sense? Not to me. It's a big part of why I'm doing what I'm doing.
Anyway, back to my smart patient. She had an interesting take on one reason why modern Western healthcare keeps going down this path despite it being obvious that it doesn't work and will bankrupt us. Cancer. The Big C. We are all afraid of this, including doctors. Cancer is very real and no one wants to have it. She feels that one reason we are still running down the disease/dis-ease path is that we are all scared of cancer and need to keep spending more and more to test for it, treat it and cure it. Preventing it is not as sexy unless it involves a screening test like a PSA or colonoscopy. Now I'm not saying that screening tests have no value. On the contrary, they save many lives. But the crux of our healthcare situation is that we segment people up into their parts and the disease risk to those parts. We don't look at the whole being and try to prevent the problem adequately in the first place. I could just as well substitute obesity for cancer and discuss all the ways we could prevent this problem and all it's subsequent disease processes and diagnoses.
So now you can see why I put the word "whole" in my practice name. Wholeness is the thing we humans seek, need, crave. We are not the sum of our parts. We are not a list of diagnoses. We are whole beings from the time we are born until we die, and we should be treated that way.
Dr. Heather's musings about medicine, mindfulness and life.
Heather Krantz, M.D.
Mailing Address: P.O. Box 6913 Office Address: 1012 SW Emkay Drive
Bend, OR 97708 Bend, OR 97702
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