by Marcelle Pick, OB/GYN NP
The healthcare industry changes quickly. With advances in medical technology, enhanced scientific research, improvement in treatments, and the ability to have so much information at our fingertips, the healthcare industry is an ever-evolving universe of numbers, research and changing practices.
The fact is, because healthcare changes so rapidly, it often does not leave room for the basics in patient care, establishing intimate doctor-patient relationships, time for trials and testing, and sometimes even the development of confidence in the whole system. Healthcare has become a very big industry, focusing on profits before patients’ health, which leaves us all at risk.
Clinicians, for the most part, have always had their patients’ best interests at heart. But the framework has changed. We have become a culture of “assembly-line medicine”, making it very difficult to tailor care to the individual. Practices deemed “best”, may simply mean the most accepted. Studies are released, protocols are quickly set forth, and “one size fits all” treatments are established. But sadly the unique circumstances and needs of each person are lost in the process.
Another huge building block in this new foundation is the Internet. This valuable resource has pros and cons. There is so much medical information out there – material that can range from completely accurate to totally nonsensical. It is hard to decipher what is real, what is important, and what to do with any of it!
I talk with so many women who want to understand how to manage all of these factors. Health issues instill fear, and women want to make informed decisions, but are not sure how. They may find themselves taking medications or undergoing procedures recommended by their doctors without understanding the implications. They read headlines revealing new medical research and treatment plans claiming to work, but without time to back them up. They consult the Internet for one thing, only to find many other things of concern.
Modern medicine can be very confusing. So let’s take a look at how to navigate through the system with confidence.
There are pills to treat nearly everything now, and taking medication is common practice to maintain health. But many providers automatically prescribe medication to treat a symptom, without even investigating what is actually causing the symptom. They are aided by pharmaceutical companies who tempt us with “cure all” solutions through advertisements and marketing. The problem is that this information is not always clear or accurate.
Here’s an example. One of the recent advertisements for Lipitor claimed this medication “reduces the risk for heart attack by 36%…in patients with multiple risk factors for heart disease”. But there are a few problems with this claim. First of all, when looking closely at the study, the numbers indicate a reduction of heart attack risk by only 1% based on the reporting of both those patients on Lipitor, and those taking a placebo. Furthermore, the study in which they base this information was funded by the pharmaceutical company that sells Lipitor, creating a potential for bias.
What many patients and their healthcare providers fail to realize, is that these reports often only present relative differences as opposed to absolute differences. What this means is that the numbers are not necessarily dishonest, they are just presented in a way to appear better. But when it’s broken down, the benefits are not what they appear to be. With Lipitor, the absolute difference indicates you have a one in 100 chance of being helped by this drug, not a one in three chance.
Sadly, most pharmaceutical companies manipulate statistics because it helps generate sales. If a product appears to be more advantageous than it is, they use that in their marketing so that doctors and their patients will buy the drug. Also, when the drug studies are funded by giant pharmaceutical companies, even the researchers are compelled to ensure positive results. Combined with the patient overload for the average healthcare provider, who may not have time to scrutinize the numbers from a drug study, we do not always have complete information about our medications.
It is very important for patients to understand the real benefits of a drug. In certain circumstances, prescription drugs can be lifesaving for many conditions. But they should not automatically be the first line of defense for every health issue. More than 20 percent of all prescriptions today are being prescribed for situations they were not intended for or approved for use for by the FDA. Off-label use of a drug can be lifesaving, but it also carries the risk of complications for people who may not truly need it.
The good news is that there are many effective natural alternatives to consider when treating health issues. Nutraceutical and plant-based medicine is beginning to come to the forefront in both research and usage. Natural disease treatment looks to a bigger picture, offering more complete improvement, and also offers fewer side effects than prescription drugs.
Patience pays off
Part of the problem with the changes in modern medicine is the demand for speedy solutions and quick remedies to fix our problems. We live in a culture obsessed with immediate gratification, and we want no less for our medical needs. And just as quickly as we want answers, drug companies want to be able to deliver the solution. So much so, that they often find ways to expedite their medications through the FDA review and approval process, which could jeopardize quality and lead to issues down the line with safety.
Richard Deyo, MD, from the University of Washington recently wrote an article for the Journal of the American Board of Family Medicine cautioning providers:
“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”.
One such example is the release of the HPV vaccine Gardasil, marketed to protect against cervical cancer. I have a particular interest in this as a women’s healthcare practitioner. Although we have not seen the long term effects of this vaccine, healthcare practitioners, drug companies, and policy makers have quickly made this vaccine a requirement, after conducting studies on girls as young as age 9.
There have been thousands of reports of adverse effects with Gardasil, many of them very serious. Some reported side effects of this vaccine include nausea, infections, joint pain and weakness, and other side effects may include blood clotting, anaphylactic shock, coma, paralysis, foaming at the mouth, grand mal convulsions, and death. There have been 21 deaths to date from this vaccine, and we don’t even have all of the facts about the vaccine itself. It is irresponsible of policy makers to mandate a vaccine offering women and girl’s protection for only two out of more than 20 cancer-associated strains of the human papilloma virus (HPV), plus two of multiple strains associated with genital warts for which it is supposed to protect.
I am not suggesting to not get this vaccine. I am suggesting that parents be given the opportunity to make an informed decision based on realistic and proven information about the benefits and the risk, rather than mandating the vaccine’s use without accurate data on the long term effects.
This is when the old adage, “Good things come to those who wait”, could make a tremendous difference.
When “well visits” became part of routine care in our society, I think we all agreed that this is a good way to keep people healthier in the long run. But preventative medicine means different things to different people in the world of modern medicine. For some it is about saving money by helping people stay well as opposed to treating illness. For others, it means providing prophylactic medications, multiple vaccines, screening tests, and even surgeries.
A good example of that is the use of hysterectomies to correct many, if not benign, gynecological problems. About one-third of women in the US have a hysterectomy by the age of 60. Who benefits most from that? Doctors, hospitals, and drug companies make billions of dollars annually from this procedure. In many cases, women can have other less invasive options that doctors do not even consider, let alone offer. The same held true for cesarean section births until a few years ago when the numbers of unnecessary c-sections was so high, that people started to notice and made a case for returning to vaginal births in appropriate situations.
There are many practices considered to be valuable in modern medicine that may still raise questions. For example, infants today receive twice the amount of vaccines they received in 1985. Also, the American Academy of Pediatrics approved the use of cholesterol drugs known as statins in children as young as 8. The negative side effects for adults on statins are quite documented, but they are now approved for children who still have many years to develop. While vaccines and medications can save lives, they are not always appropriate for every single person. It is important to think about the possible consequences of this type of preventative medicine.
In functional medicine we look at preventative medicine in the form of natural therapies involving high quality nutrition, natural supplements, regular exercise, and stress relief. This type of medicine works best when it is tailored to the unique circumstances and needs of the individual. That does not mean conventional medicine is better or worse than functional medicine. It simply means that from a patient-perspective, you might want to consider looking at things differently from only what the current accepted norm dictates. I encourage my patients to become informed, do their own research, ask a lot of questions, and learn alternatives to assembly-line medicine and protocols dictating what may be the standard practice, but may not be the best one.
Participate in your own healthcare
Taking a lead role in your health care can help both you and your practitioner form a strong partnership leading to the right solutions for your personal health goals. The relationship between you and your provider requires both people to actively participate in the process. Remember, you know best how what you are feeling inside of your own body! Here are some ways to get the most out of your visits to your healthcare practitioner:
- Be prepared and proactive. First determine what you want and need to achieve in the visit. Make a list of your concerns, even if you do not think they are important. Evaluate your personal goals for your health and how you want your provider to help facilitate them. Be sure to ask lots of questions and do not leave until you feel you have gotten the answers you need.
- Do your own research. Explore all of the possible resources offering you information to gain a better understanding of your own health situation. Whether you want to learn about a medication or procedure, alternatives in treatment, or simply expand your knowledge about a particular topic, feel empowered to research and have a deeper discussion with your healthcare provider during your visit.
- Consider alternatives. There are so many ways to approach healthcare today. From conventional medicine offering standard practices – to integrative medicine offering a whole person approach (body, mind and spirit) – to Ayurveda practices, acupuncture, nutraceuticals, and homeopathy – to functional medicine, offering holistic and natural medicine focusing on the underlying causes of disease that lead to patient-centered therapies. There is strong scientific evidence now supporting the functional medicine approach to healing to be as effective, or even more effective in healing than pharmaceutical drugs. There are many avenues to better health. Don’t be afraid to investigate all of your options.
- Keep copies of your lab results, reports, and keep track of your progress. As a functional medicine practitioner, I try not to focus on testing and numbers as much as I do how my patients feel. But it does help to have this information to see if things are changing. Keep track with your provider of blood sugars, cholesterol levels, thyroid hormones, vitamin D levels, bone density, or mammography, and when shifts occur, you can address them appropriately.
- Communicate your healthcare philosophy. We all have personal preferences about what we feel comfortable with when tending to our health. Some people like to let their doctors make all of the decisions and allow them to initiate protocols. Others prefer to steer away from medications and follow a more natural approach. Some patients like to know every detail about what is going on with their bodies and others prefer to let their doctor manage that information. It does not matter what your preferences are, it matters that you discuss them with your practitioner so that you can receive the care that feels most comfortable. After all, feeling good about your care will help you have a successful outcome!
- Practice good health habits. Nutrition and lifestyle can help make – or break – our health. Nourish your body with fresh, whole foods – lots of fresh fruits and vegetables, healthy fats, unrefined or unprocessed carbohydrates, and a high-quality multivitamin can change your body’s functioning all the way to the cellular level. Exercise is another important way to not just prevent, but also reverse many common, chronic and degenerative health conditions and maintain good health. And of course get plenty of sleep, which helps regulate all of the systems in the body.
Change the traditional doctor-patient roles
I have many women who come to me in mid-life, when shifts in their bodies become evident. They often believe that any pains, fatigue or chronic complaints are normal for their age, as well as the need for medication or even procedures. I have good news! That is not true! I tell them to think about the health they would like to have, and to not settle for anything less. Creating a healthy and vibrant health picture in our minds is important for achieving that in our bodies.
It may seem overwhelming to navigate a complicated medical system offering so many alternatives. But optimal health is possible, no matter the path. You do not have to be a medical provider to know what is best for you – that is what our intuition (or our gut instinct) is for. When we tap into our own inner wisdom about what we need to feel good, and we trust that, we can walk with our healthcare provider on our personal path to good health.