Women’s health articles

The truth about modern health care — it’s in your capable hands

by Marcelle Pick, OB/GYN NP

There was a time not so long ago when many women went to their healthcare providers and simply followed instructions. Years ago, our mothers and grandmothers didn’t have the internet as an information resource, but they did have physicians who had more time for research and getting to know their patients as people. And for the most part, practitioners have always had their patients’ best interests at heart. Though many patients (and healthcare practitioners) still subscribe to the creed that “doctor knows best,” the framework for practicing medicine has changed dramatically. The fact is, health care has become a very big industry, one that often puts profits before the individual’s health — and that’s putting all of us at risk in the process.

Assembly-line medicine affords practitioners very little freedom to tailor a patient’s care to the individual. As this happens, I talk to more and more women who find themselves taking medications or undergoing procedures without truly understanding their practitioners’ reasons for prescribing them. Protocols are set forth, studies released, and one-size-fits-all treatments are presented, but lost in the mix are the unique needs and circumstances of each person. Sadly, very few women or practitioners are stopping to ask questions or really understand the implications of these so-called “best practices.”

With headlines about states mandating the new HPV vaccine Gardasil for young girls without long-term research, widespread use of cholesterol drugs even among children, and the countless women who have come to me thinking they had no choice but to have a hysterectomy, I think it’s time to remind women who is steering the ship when it comes their health care. I know that health issues can instill a lot of fear in women, especially today, but making fear-based decisions is never as safe or effective as making informed ones.

Let’s take a closer look at where modern medicine falls short, and how you can safely navigate through the system to stay healthy naturally.

Prescription drugs — how good is the evidence?

So many women I see have been told they need a pill to maintain health. From Fosamax to Lipitor, pharmaceutical companies do wonders with marketing and public relations. Not only are practitioners prescribing drugs as solutions, but patients are actually steered toward certain medications by advertisements on television, the internet, or in magazines.

The problem is that good marketing doesn’t always mean good medicine. One recent advertisement from Lipitor claims that the medication “reduces the risk of heart attack by 36%...in patients with multiple risk factors for heart disease.” But if you take a closer look at where that number comes from, the benefits don’t measure up. First of all, this figure comes from a study funded by Pfizer, the pharmaceutical giant that sells Lipitor, and if you read the fine print you’ll see that 2% of patients in the Lipitor group of the study had a heart attack, while 3% of patients taking a placebo had one. This means that two out of every 100 people in the Lipitor group had a heart attack, compared to three out of every 100 in the placebo group. The reality is that Lipitor reduced risk of heart attack by 1%.

What many women — and even healthcare providers — don’t realize is that researchers and reporters often present relative differences instead of absolute differences. This is how Pfizer came up with 36% instead of 1%. It isn’t a dishonest figure, it’s just a different way to present the numbers so the effects “feel” bigger. But when we break it down, the benefits aren’t that great. You have a one in a hundred chance of being helped by this drug, not one in three. Pfizer isn’t the only corporation that uses statistics to exaggerate drug benefits. Most pharmaceutical companies manipulate statistics to their products’ advantage, because it generates sales. We see a similar situation with the reported benefits of osteoporosis drugs like Fosamax and Actonel.

It’s really important for you as a patient to understand what the study actually determined and what the real benefits are, but when research is funded by pharmaceutical giants, even the scientists themselves are compelled to spin the numbers. Squeezed by the need to spend less time on more patients, does the average healthcare provider today have time to scrutinize the data?

Don’t get me wrong — prescription drugs can be lifesaving for certain groups of people under certain conditions. But they aren’t necessarily the first or even the best treatment for every health condition. And more than 20% of all prescriptions today — some experts say as much as 60% — are written “off label,” meaning they’re being given in situations that were not approved by the FDA. This practice can walk a tricky ethical line — some off-label uses are lifesaving, but others amount to little more than using a patient as a guinea pig.

The good news is that for many symptoms, chronic and degenerative conditions, more often than not there are effective natural alternatives to consider. Even better, more rigorous scientific research is being conducted on nutraceuticals and plant-based medicine — and that means that conventional practitioners are beginning to lose their skepticism. The one drawback is that natural disease treatment and prevention can take longer and may require more effort on the part of the patient and her provider, but with far fewer side effects and often a more complete improvement. (For further discussion on how natural medicine compares to prescription drugs, see my article on phytotherapy.)

Good medicine requires patience

We all know the old adage, “Good things come to those who wait.” And it’s as true in health as it is for any other area of life. Sadly, our modern obsession with quick answers and solutions has not spared the medical world. A good example is the release of the new HPV vaccine Gardasil, being marketed as protection from cervical cancer. Though intentions may be good, healthcare practitioners, policy makers, and drug companies are quick to make this vaccine a requirement before we’ve even seen its long-term effects. In essence, they’re conducting a huge, uncontrolled experiment on women and girls as young as nine to find out whether this vaccine works and whether it has side effects — and they have no real idea what its long-term impact on health will be.

There have already been thousands of reports of adverse effects, many of them serious (including 21 deaths to date), in women and girls after receiving the Gardasil vaccine. One of our Personal Program Members wrote to tell us about how her previously active daughters, ages 12 and 16, have suffered for months after receiving the vaccine. Stomachaches, infections, joint pain and weakness have kept them in bed most days. It has been devastating for the whole family, and there are some families who are dealing with even more. Other side effects of this new vaccine may include blood clotting, anaphylactic shock, coma, paralysis, foaming at the mouth, grand mal convulsions, and death.

All this, and the vaccine offers women and girls protection from only two out of more than 20 cancer-associated strains of human papilloma virus (HPV), plus two of multiple strains associated with genital warts. What’s more, we don’t even know how long the vaccine provides such “protection” — it may be for only a few years. I realize that in order to make progress, there have to be people willing to take risks with a new drug, vaccine, or procedure. But legally mandating an expensive vaccine for young girls when we don’t even have long-term data seems irresponsible from my perspective.

It’s particularly outrageous that this vaccine is being pushed hard at women and girls when annual Pap smears and pelvic exams have a proven, safe track record in screening for cervical cancer. Government programs offer free pelvic exams for those women and girls who can’t afford them, so here in the US, screening for cervical cancer is affordable for most women. So why not let women and parents make up their own minds about this new vaccine when the data on long-term effects become available? Many women may still choose to get the vaccine for themselves and their daughters anyway, and I support that! What matters most is that women are able to make an informed choice based on realistic information about risks and benefits, rather than being told they must vaccinate and given a marketing pitch when they ask questions. (For more in-depth discussion, see our page concerning these and other questions regarding HPV vaccines.)

Just as we want answers to quickly solve our health woes, drug companies want to be the fastest to deliver the solution. In many cases, companies find ways to expedite their drugs and vaccines through the FDA review and approval process, which may compromise quality and safety. As University of Washington’s Richard Deyo, MD, recently cautioned in an article for the Journal of the American Board of Family Medicine:

FDA review serves a critical function, but physicians should be aware that new drugs may not be as effective as old ones; that new drugs are likely to have undiscovered side effects at the time of marketing; that direct-to-consumer ads are sometimes misleading; that new devices generally have less rigorous evidence of efficacy than new drugs; and that value for money is not considered in approval.

From my perspective as a practitioner, it sometimes seems as though the business of health care is spiraling out of control. And one factor contributing to this is how the commonsense concept of preventive medicine is being distorted by fear.

Preventive medicine — how far is too far?

I think everyone would agree that preventive medicine is the best way to keep people healthier and save money in the long run. But this term means different things to different people along the healthcare delivery pathway. In my background of functional medicine, we’ve looked at the overwhelming data to support natural therapies and find that prevention works best when it is tailored to unique needs of the individual, and involves high quality nutrition, targeted natural supplements, regular exercise, and stress relief. But to others, particularly those in a more conventional model, preventive medicine might mean multiple vaccines, prophylactic medications, screening tests, and surgeries.

Let’s look at hysterectomies for a moment. About one-third of women in the United States have a hysterectomy by the age of 60, and gynecologists, hospitals, and drug companies make billions of dollars per year on them. In many cases, women have other options that providers don’t recommend or even mention, such as uterine artery embolization or myomectomy (for fibroids), uterine ablation (for bleeding), dietary changes, progesterone treatment, or even less invasive variations of the surgery that leave more of the uterus and ovaries intact. (See our articles on hysterectomy alternatives for more info.)

I can’t tell you the number of women who come to see me, having had a hysterectomy, who say they had their ovaries removed because their practitioner was worried about ovarian cancer — even when they have no family history of ovarian cancer or cancer of any kind. Some practitioners call this preventive medicine, but women use their ovaries and uterus throughout their lives — they don’t just become expendable when we’re done with childbirth. Removing organs to prevent a disease that isn’t likely to occur will only cause health problems later in life — it simply doesn’t make sense to remove internal organs for a disease that might occur (and most likely won’t).

We’re seeing the same kind of “preventive” medicine in children as well. Infants are now getting more than double the number of vaccines they received in 1985, and the American Academy of Pediatrics has just approved the use of cholesterol drugs, known as statins, in kids as young as eight! We know there are negative side effects of statin drugs in adults, and now it’s okay to give them to children, whose bodies haven’t had the chance to finish developing yet?

The bottom line is that there are other options when it comes to vaccine schedules and preventing heart disease in children, but modern medicine tends to paint all individuals with the same broad brush. Prescription medications and vaccines can save lives, but to me it’s sad that we’ve taken something that can be a good thing for certain groups and applied it across the board without thinking about the possible consequences.

But great medicine is still being practiced everyday — I promise! Especially if you as a patient are willing to look at things a bit differently from what the cultural norm dictates. I tell so many of my patients that if they are willing to do their own research, ask questions of their practitioners, and get informed now, they stand to benefit enormously in terms of better health today and in the future. Otherwise, we’ll all be stuck with protocols geared for assembly-line medicine, which values profits over our health.

Participate in your health care — the Women to Women approach

The relationship between women and their providers is a partnership, but we often forget that a partnership takes effort on both parts. Healthcare practitioners are only human — they can’t know everything and anything about your health concerns. And they certainly don’t know what it feels like to live in your body. But they will help you to find the answers you’re looking for, if you hold up your end of the bargain. Often that means doing your own research, asking good questions, and allowing time for an informed answer.

Here are some thoughts on how you can take a lead role in your health care and get the most out of your visits to your healthcare practitioner:

Engage in your own research. We are living in extraordinary times, where a wealth of information lies at our fingertips. Though the internet offers both great information and some not-so-great information, I encourage you to read from multiple sources to gain a better understanding of the concerns around your health issues — whether in the conventional arena in terms of a new prescription, a vaccine, or a procedure; or in the realm of integrative health. Understand that there is a lot of information out there designed to sell you something — which may or may not be good for you — and always consider the source. Most of the articles on this website have a link to references and further reading at the base of the base, and if you’re curious, we encourage you to explore and satisfy your desire to learn.

Be a prepared, proactive patient. You probably wouldn’t go to an appointment at a hair salon without at least some idea of what you hope to walk out with — so it’s worth taking a little time before an appointment with your healthcare provider to determine what you hope to get out of the visit. Even if you’re just going in for a yearly physical, think about what your goals are for your health, and decide what you want to bring up to your practitioner. If you have several concerns in mind, take a few minutes before the appointment to make a list so you don’t overlook anything. You can also bring in your reading material or simply say, “These are the things I was thinking I could do. What do you think?”

Consider your alternatives. From nutraceuticals and phytotherapy to massage therapy and acupuncture, there are so many ways to create better health — and nowadays, we have strong scientific evidence that the functional medical approach can be just as powerful when it comes to healing as pharmaceutical drugs. More and more conventional practitioners are educated about functional medicine options as well, so don’t be afraid to ask about your options and do your own investigation. For more information, see my article on making women’s alternative health care work for you.

Ask for copies of your reports and lab results, keep them on file, and track your progress. I try not to focus on numbers too much, but it does help to follow your results over time, to see if anything such as blood sugars, cholesterol levels, thyroid hormones, vitamin D levels, bone density, or mammography are changing. Often healthcare practitioners won’t mention these changes or respond until you are already in the abnormal range. If you can spot trends before this happens, you’ll have a better chance of preventing the problem on your own, and possibly avoid a prescription or procedure down the line.

Communicate your health needs and philosophy. We all know our healthcare providers don’t have the time to sit over tea with us and discuss our philosophy on health! But there are ways to communicate with your practitioner about your personal health preferences. For example, if your practitioner suggests a prescription for a health concern like high cholesterol or osteoporosis, you might use this as an opportunity to say you’d rather not take prescription drugs and ask if there is an alternative. Or take some time as you answer routine questions during a yearly physical exam to explain your perspective. Don’t be shy to seek a second opinion, especially for anything requiring invasive surgery or a lifetime prescription. But most of all, you should not hesitate to make a follow-up appointment with your practitioner if you feel you need to further discuss test results, ask questions, or express further concerns about your health. In fact, you should expect to do this if your questions aren’t fully answered in your initial visit.

Find ways to create better health on your own. When you’ve established what you want for your health, you shouldn’t settle for less. In my experience, nutrition and lifestyle habits make all the difference in our health. Do your best to nourish your body with fresh whole foods, including plenty of fruits and vegetables, healthy fats, and unrefined or unprocessed carbohydrates. Every system in the body requires micronutrients for survival, so be sure to add a high-quality multivitamin–mineral complex like the one offered in our Personal Program to cover all your bases. Our bodies were meant to move, so include some form of exercise in your daily routine as well. Research shows us that exercise can be extremely helpful in preventing or reversing most of our common chronic and degenerative health concerns. For more on healthy eating, see our articles on nutrition.

Shed the traditional doctor–patient roles

Many women in their 50’s come in to see me expecting that aches and pains, fatigue and low energy, or prescription drugs are just normal for someone their age. Many say their other practitioners have already set this bar for them. But I tell them, just as I’m telling you: Don’t settle! If that’s not what you want, it’s not what you should have. Create your own glowing health picture, and find out what you can do to achieve it.

I know it can seem overwhelming to take charge of your health, especially without a medical background and so many pressing daily responsibilities. But believe me, a little reading and a lot of intuition will have you well on your way to making good decisions about your health care. It’s time to shed the traditional doctor-patient roles and bring your own wisdom to the partnership! You can start here — we’ve helped millions of women navigate a natural path to good health.

Related to this article:

References and further reading on the truth about health care

 

Original Publication Date: 09/02/2008
Last Modified: 02/16/2010
Principal Author: by Marcelle Pick, OB/GYN NP