As a woman “of a certain age” married to someone of an even higher “certain” age, I find that galloping entropy has taken over our lives. Since entropy (that unrelenting decreasing functioning of just about every body part), has reared its ugly head, we spend more time than we would like in various doctors’ offices. I use the word “various” to highlight the way medical care is delivered in the United States. I believe in some ways the rise of medical specialties can lead to a reductionist approach to health care that adds to already rising costs.
Then and Now
Do you remember when we called our family doctor a “general practitioner?” The GP handled almost everything. When I cut a three inch gash in my leg from a fall from my bicycle, my mother took me to Doc, who stitched it up in his office, while calling me a “chowder head” to take my mind off that horrible needle. (It didn’t work.)
Today our family Docs are called Primary Care Providers. PCPs, more often than not, send people to the emergency rooms for a leg injury like mine. Sometimes, it seems they are traffic control experts, rather than hands-on care experts. With aging, we acquire more and more referrals to specialists who (hopefully) know all about whatever body parts are causing our symptoms. In the case of chronic disease, as in “you will have this condition forever,” the current name of the game is controlling it and reducing those symptoms that interfere with your life. Specialists are highly trained to treat specific body parts, and only those body parts.
Case in Point
Take the “alimentary canal” — better known as the digestive system, which runs from the mouth to the anus. Here are all its parts and their matching medical specialists.
- MOUTH – includes lips, gums, teeth, tongue, inside of the cheeks – DENTISTS
- THROAT – is part of the expertise of your ENT (ear, nose, and throat doctor). Actually, the nose plays a part in eating because without a sense of smell, we would not taste our food. As disappointing as that would be, smell helps us recognize spoiled or non-edible food too.
- STOMACH AND SMALL INTESTINE – The name of this specialist comes from the root for the word stomach (gastr) and the root for small intestine (enter). And there you have the GASTROENTEROLOGIST.
- Moving along, we arrive at the large intestine or the colon, that prepares the food waste for excretion through the rectum. So, this doctor is your COLORECTAL specialist.
- Not done yet. Finally, we have the PROCTOLOGIST whose specialty is, you guessed it, the anus.
The irony I see in this is that not one of these specialists were educated in how food (the reason for the alimentary canal in the first place), can prevent illness and even cure what we call chronic diseases. Their focus is on the one body part —the particular tree in your body’s forest—that they believe is the culprit. (Fortunately that is beginning to change, and med students now take nutrition courses in more enlightened hospitals/universities.)
This reductionist approach to medical care is beginning to irritate me more and more every time I hear one of my doctors proclaim something I know to be false. I left a PCP after he informed me, with great authority, that what happens in one endocrine system cannot affect the other endocrine systems. Then too, I hear things like “that’s common in old age.” No it isn’t! I want to shout— not if you eat a healthy diet, and regularly exercise your mind and body.
I buy every issue of Forks Over Knives magazines because of the great recipes, instructive articles, and inspiring personal testimonies. One doctor wrote that, after watching, the Forks over Knives documentary, she hoped the doctors in the film were crazy. If they weren’t, she and her fellow docs had been practicing medicine all wrong. She wrote that after trying the whole food plant-based diet for a while, her doubts, as well as her, hypertension, pre-diabetes, and depression, left. I would bet this doctor now takes a holistic approach to her medical practice.
Frequently, physicians order medications to address troubling symptoms. With the best of intentions, this reductionist approach does not consider how the treatment may affect the rest of the body. For example, acid-blocking drugs to treat stomach upset can lead to more serious conditions throughout the body. https://nutritionfacts.org/video/are-acid-blocking-drugs-safe/
I am convinced if our health care paradigm in America shifted from reductionist to holistic, it would not matter what type of health care is available to consumers. Any payment mechanism would be sufficient to provide adequate health care to all because the cost of health care would plummet with less need for medications, expensive treatments, or surgeries.
If you are skeptical, buy or rent Forks Over Knives (for starters) and please watch Dr. Caldwell Esselstyn’s short video. It was an eye opener for me. https://www.youtube.com/watch?v=oOcyuLGXd0s