HEALTHCARE: Reform the PARADIGM

From an article in the Pittsburgh Post-Gazette 10/11/2009. Sunday Forum: Suck it up, America: We have become a nation of whining hypochondriacs, and the only way to fix a broken health-care system is for all of us to get a grip, says DR. THOMAS A. DOYLE

The human body is exquisitely talented at healing. If bodies didn’t heal by themselves, we’d be up the creek. Even in an intensive care unit, with our most advanced techniques applied, all we’re really doing is optimizing the conditions under which natural healing can occur.

“Our best medicines are Tincture of Time and Elixir of Neglect.” Taking drugs for things that go away on their own is rarely helpful and often harmful.

We’ve become a nation of hypochondriacs. Every sneeze is swine flu, every headache a tumor. And at great expense, we deliver fantastically prompt, thorough and largely unnecessary care.

Read more:

http://www.post-gazette.com/pg/09284/1004304-109.stm#ixzz0UzeQAZNR

Although I agree with the good Dr.’s points, I want to chime in with a broader perspective from someone who is no longer part of the industry.

I resent the tone of his article. He is critical of his patients for choosing to follow precisely the dictates of the industry that cripples them. It is the same industry to which he is indebted — in more ways than one.

If you take his reflections one level deeper you will see the source of his complaint; the shift of medical empowerment from the individual to the institution. This reflects a larger trend which is the demise of Community and the ascendancy of the Corporation. We are a society quickly being molded to depend less and less upon each other.

Not too long ago, the primary source of advice on medical matters was people with whom you had connection. In order to generate money, that focus had to shift away from people and on to a product. The winner was the corporation that could best package and sell the cure. Your neighbor and Aunt were replaced by “commercials”.

Once medicine became Big Business, economic forces dictated that anecdotal, traditional, native, and folk medicine, all including natural remedies, be pushed to the side, and most importantly, debunked and derided as “non-scientific”. This, in fact, occurred.

In that vacuum, campaigns were undertaken to “educate” the public on just how many little things can go wrong with these fragile bodies. Fortunately, science has a cure, and here’s where you can buy it!

Corporatized, institutionalized medical care became a primary income source for millions of people in thousands of spin-offs. It spawned a tiered system that  the medical “consumer” could explore from product to  procedure for the rest of their lives.

Economics stepped in to make sure each level of illness you attained, or “cure” made available to you had with it a corresponding product or procedure, commensurate in expense with the percieved complexity of it and its handler.

Many, many people have been helped. But today, it’s all breaking down under its own weight. Something…MANY things are not working.

Doctor Doyle says:  “Health care costs too much in our country because we deliver too much health care. We deliver too much because we demand too much. And we demand it for all the wrong reasons. We’re turning into a nation of anxious wimps.”

The “we” who are demanding on the doctor are obviously the patients.  It’s not about “Follow the Patient” Doctor, it’s “Follow the Money.”

We’re only about 50 years from the time when hospitals were considered places you go to when you died. I’m 58 and when I was a kid, growing up in Brooklyn in the 1950’s the last resort was the doctor (who made HOUSE CALLS!); the Final resort was the Hospital and the Conclusion, the newly emerging Funeral Home!

How were medical problems handled? First, by the family and then, the extended family. Every folk remedy in the book was used BEFORE a Dr. was contacted. The primary, time-tested and NATURAL methods were completely exhausted before a trained professional was called (and paid!). Preliminary care had $0 associated with it, only time and concern. Though a very big factor in the effectiveness of this approach was proximity — relatives were geographically available, which is not the case today.

And then SCIENCE took control. Granted, it could have been partially in response to the societal trend of the fragmentation of the extended family. Still, science costs money. That means investors. Investors require a return on their investment. That means profit, and profit comes from getting people to buy something. This is the American Way.

In order to do that you had to shift the source of health care from the family to the institution, which now was housing all those Paid Scientists. You had to raise the funds to keep them going.

Naturally, you wanted them to be in comfort.  And yourself, of course, so a market had to be created, the size of which was determined by the level of comfort you wished to attain.

Sometimes it’s hard to discern for whose comfort our self-perpetuating  health care system is designed.

Did you know the when the image of the hospital as a place people went to die changed? Right around the time the AMA mandated newborn deliveries to be taken out of the home or doctor’s office and into the hospital. All of a sudden, hospitals became places where people were born. In marketing, perception is everything!

What happened then was simply the compounding effect of the Very Human trait of protecting one’s territory. In this case, profits. This was not an accident. The guiding philosophy of the Industry now was to get control of every aspect of an individual’s care so profits would accrue so more things could be devised to keep health care out of the control of the individual, thereby generating even more profit. It’s a form of mystery building.

Even Obama’s best efforts are based on perpetuating the system as it stands. That system is literally killing us by killing our health-care providers.

Doctor  Doyle is basically sharing that he expends a significant amount of  his life energies  taking action against those innumerable ills that befall the human being whose health is, in medical parlance, WNL; within normal limits.

These ailments once were handled by their peers in the community, with inexpensive remedies, easily obtained. Now, they’re in this Doctor’s ER.

Perhaps the Doctor doesn’t see that he’s fulfilling the role he was meant to play: He’s there to service the market that was created to support the industry that helps him to act like an ER Physician. He is fulfilling his role as “Holder of the Mystery”, but it’s not his only role.

The grave both the Doctor and the common folk are being herded into is not one they dug themselves. Here’s how it works. Going back to the problem’s Genesis, let’s visit the American Medical Association (from: http://www.alternet.org/story/81659/)

When George H. Simmons began in 1899 what became a twenty-five-year reign as head of the AMA, it was a weak organization with little money and little respect from the general public. The advertising revenue from the medical journal was a paltry $34,000 per year. Simmons came up with the idea to transform the AMA into a big business by granting the AMA’s “seal of approval” to certain drug companies that placed large and frequent ads in JAMA and its various affiliate publications. By 1903, advertising revenue increased substantially, to $89,000, and by 1909, JAMA was making $150,000 per year. In 1900, the AMA had only 8,000 members, but by 1910, it had more than 70,000. This substantial increase in advertising revenue and membership was not the result of new effective medical treatments, for there were virtually no medical treatments from this era that were effective enough to be used by doctors today or even just a couple of decades later.

(Emphasis mine)

The economic tie-in is unavoidable, even if you choose to think the industry has regulated itself in the years that have passed out of altruism.  We’ve eliminated “Quack Cures” haven’t we?

Not if you define them as treatments/medicines that do no more than provide the illusion you’re doing something when all that’s happening is time passes. That’s a point of the Dr.’s article, is it not? I interpreted that as what he was saying about Intensive Care Units.

American industry is defined by innovation – whether you need it or not. Innovation is nothing without marketing. You’ve got to find your niche because it IS a competitive world out there. If you don’t find your niche – a vehicle to help sell what you have to offer – then create one. That, too is the American way and it applies to Doctors as well.

Doctors must perpetuate the illusion that they are the final arbiters when it comes to that which ails you. In order to do that, they have to support the illusion that the over-the-counter drugs sold you to relieve your pain and suffering actually work; to a point. From that point on their job is to bring you up to the next tier of therapies.

Most typically, that involves pharmaceuticals. An MD in private practice the other day told me he sees about 40 patients each ten hour day, and that’s not packed. When I asked what do you do, he answered me in one word, “Prescribe.”

If you get worse, it’s up to the next tier you go. Typically that involves some sort of diagnostic process which then leads to the next tier, invasive procedures.

Essentially, Doctor Doyle sharing his frustration about his other role, that of Gatekeeper. In the absence of Aunt Lucy to advise, in the failure of the OTC meds to take care of ALL those nagging little symptoms, and not being able to plan the timing of her freak-out, the woman seeks out the nearest next tier, which is him.

So much of it is about the need for human contact.  Study after study shows most ER visits are driven by the need for human advice and caring. But the health care providers can’t do that; because the system asks them to find something to cure that is curable by something that generates money because those are the tools they’re given and trained to use.

These tools fall in to the broad categories of drugs and surgery; the primary approaches embraced by the AMA over Homeopathic, Chiropractic or Osteopathic philosophies. Is it too hard to see how those competitors to Allopathic Medicine may never have gained traction because they simply didn’t have the marketing power behind them the AMA did?

This is not out of step with history. Christianity as a religion was circling the drain until Paul of Tarsus, Master Promoter, came along.

Perhaps the saddest part of the whole dynamic is that Physicians enter their profession mired in debt. There’s only one way to get out of it and that’s to become even more deeply entrenched in the system. Of course Physicians are still altruistic but because the industry that trained them was molded by economics, without even realizing it, that thread runs through everything they do. For some, it’s more like a cable.

It’s no different for you  Dr. Doyle, so quit your own whining, and please don’t try to lay the blame at the patient’s feet. That is taking a superior attitude. Remember, you’re just a Gatekeeper.

I was a Paramedic, a Gatekeeper as well. I know the biz. The only way I got to use my monitors, defibrillators, drugs and therapies (and occasionally save a life!) was to haul Gramma Grinch from the hospital to the nursing home, respond Code 3 to pediatric fevers, and even put drunks in the back of the ambulance to avoid a crowd attacking me for prejudicial treatment: I was commanded to do my job, which more often than not was merely a horizontal taxi service.

That’s the price you pay for being a part of a system that has forced medical care out of the hands of the people and into the computers of the  accountants of the corporations. You are the manifestation of profit, and are beholden to it.

If you’re going to be an activist, Dr. Doyle,I suggest you begin the work there. How can YOU change the paradigm to serve both you and your patients? It’s the paradigm that needs fixing, and you’re in a great position to help do it.

I wish you well!

James Ray’s Lawyer Makes Marcia Clark Look Like Clarence Darrow

In the case of the tragic deaths of three participants in a sweat lodge during James Ray’s mega-bucks seminar in Sedona, how easy it would be to say, “That’s what you get for messing with spirit.”

But it had nothing to do with spirit of any kind except the spirit of responsibility. In this case, to simple common sense.

Ray knows he’s involving people in a seminar that puts the physical body under a significant amount of strain. By his own admission, that’s how he designed it. As a seminar leader who places high value on the power of individuality, he must recognize each person’s constitution is different.

The physical aspects of the sweat lodge process involves filing people into a confined, light-tight space with super-heated rocks in a central pit. The rocks get doused with water, producing, in some cases,  scalding steam. This was not Ray’s first lodge. He knows what happens and what CAN happen.

Logic dictates, given that the people had just come from highly physically-stressful environments, there would be some person being designated as Gatekeeper to assure, in each round, no one is too distressed to enter.

No mention was made of anyone designated as watchdog of some type for any reason. Reports said people were passing out and vomiting and no effort was made to attend to them. Their care was even discouraged by Ray.

Fifty (+) people are a lot of people thrown in together, but when each person is disempowered to take lifesaving action, either for others OR themselves, now we have a SERIOUS breakdown in logic.

If no one else in the process is aware of the physical safety of each and every person involved, it MUST be the Sweat Leader, because he has control of the amount of added stress he imposes on his charges. In Ray’s case, it could not be more clear: he neglected his responsibilities and it had fatal consequences.

Of course, all this is hindsight. Who’s expected to predict the future?  I’ll tell you who, the Lawyers.

James Ray is head of a machine influencing millions of people and generating millions of dollars.  Where there’s money there’s lawyers. Where there’s that much money, more Lawyers. Every lawyer is charged to act like a Gatekeeper by troubleshooting to save his/her client from areas of potential liability.

Maybe the life lesson for James Ray is to get Gatekeepers.

Where would anybody’s client be most vulnerable? In ANY area where he puts another human being in physical stress! Just like situations that could lead to a charge of sexual harassment, anything that could remotely be construed as assault would be a red flag the size of Texas.

How many Lawyers must you have to spot that kind of vulnerability?

I guess in James Ray’s case it only took one; the guy who advised Ray that once the Release from Liability form was signed, he could play God.

(Video: Third Person Dies in Sweat Lodge Case)

Contemplating Suicide

I just got through threatening my life by swimming around in YouTube. I ended up drowning in despair in the plastic soup that our  — that’s you, me and EVERYONE’S! — sea is becoming.

Maybe I don’t really want to know what’s going on in the big impersonal world out there today; it’s much too personal.

I’m 58 years old now, and death prowls around in my consciousness every day of my life. It gets continually renewed by the passage of my peers, one after another in a relentless,  procession. Their numbers now are swelling, but too soon will run out.

My life has been lived much closer to death than most. In 1969  I started working in a nursing home  and then went on to become one of the first paramedics in the US. I left allopathic medicine in 1985, and behind it participation in hundreds of deaths, most all of them right in my hands.

There’s no one who understands better that I’m going to die than me.

Combining this experience with what I’ve seen in my lifetime and done with my own life, I’ve come to a conclusion about my species: We defy life in hatred of its impermanence. Each of us, and we as a whole, seem to court suicide.

Even as a child I knew — not suspected, but knew — it wasn’t a matter of if humans would wipe themselves off this planet it was a matter of when. This would have to have been the conclusion drawn by any child of my generation living near any of the primary targets of the USSR’s nuclear missiles. The futility of “Duck and cover exercises” every day at noontime sirens (in my case, Brooklyn, NY)  gets wired into your DNA.

On my TV screen were images of Nikita Khrushchev, leader of the country pointing its arsenal at us, beating his shoe on the UN podium looking as if Michelangelo himself had taken a stab at portraying our vicious id. Though debated about, and today better understood, all of my classmates still talked about that madman who swore “We will bury your children!” That is what we heard; that is what got in. The Dude was Serious!

And, even as a child, nothing you could have told me would have lessened the fact that there is no such a thing as a Good Guy because WE were the ones to first annihilate and torture fellow human beings with the evil handiwork pointed at us.

So I’ve not been surprised at all by the incredible amount of pollution in the air during the Seventies, the AIDS panic of the Eighties, Global Warming and the Middle East debacle in the 90’s and up to this very day when incredibly huge areas of the Pacific Ocean occupying over 30% of the earth, have six times the weight of plastic particles in them than plankton and there are 90% less fish in the sea now than in the 1800’s!

My biggest surprises have been the significant reduction in air pollution and the lessening impact of AIDS here in the US, but all that’s really happened is the rest of the world, in a rush to be like us, is picking up the ball and heading us all to the goalpost.

Some day, it’s all going to catch up with us and we’ll be, as we say here in Hawaii, “Pau!” Finished.

And that’s where it all gets personal. Right now I am more aware of the ways in my life I’m killing myself or have “tried” to kill myself than I’ve ever been before. I have to look at every accusatory sentence I’ve ever laid on anyone about killing themselves and apply it to myself.

To me, their attempts have always looked blatant. With me, of course, it’s been more subtle!

I’ve always considered myself to be a lightweight in suicidal behavior in everything except food. My eating habits will ultimately take me down. In terms of alcohol, drugs, cigarettes and all the typically self-destructive behaviors of my generation, at worst I was a periodic. I did smoke cigarettes for 30 years, but quit. Yet, in how many moments during such indulging did I put my life in danger knowingly?

Still, looking through the eyes of other people, I’m sure they said about me what I say about them, “Look at how that idiot persists in pursuing suicide!”

As a paramedic in all sorts of environments, my life was continually on the line, and often I totally disregarded the fact. If I found myself in a moment where something immediate needed to be done to interfere with death’s grasp, I barely considered my own safety and took action. I’ve pushed gun holding murderers away from their victims, jumped into canals to hold someone stable with an amputated leg when I’m a lousy swimmer, entered rooms to “talk down” violent psycho patients as police stood behind me, guns drawn, covering my back.

Lookit that Idiot! Is that not courting death?

For more than 30 years I rode motorcycles and toured all over the mainland US and into Canada. I’ve raced old growth log-carrying tractor-trailers on mud roads in Oregon, drafted Semi’s within four feet of their bumpers to be in a wind-pocket saving me from freezing rain in Georgia, hit a VW bug at 70 MPH, totalling it and landing 116 feet from the point of impact (spraining my foot!). In fact, the only time I ever had a motorcycle seriously break down on the road, it saved my life! I was on the 1st Mt. St. Helen’s eruption Missing List because I was scheduled to be camped out on a neighboring mountain’s slopes (up a closed Forest Service road) photographing the volcano’s activity the very day it blew.  I was delayed by the breakdown for twelve hours!

This very day I make my living driving the Hana Road, on Maui. That’s driving about 200 miles each work day, 100 of which include 1,234 curves and 108 one-lane bridges through a tropical rainforest known for flash floods, landslides and disorientated tourists.

Suicidal food, jobs and movement are just a few categories whose volumes don’t come close to the pile of individual moments powered by death-defying choices I’ve made. Along the way, I’ve learned of others doing similar things — hauntingly similar things — but they got killed in the process.

It is not my fastidiousness that keeps me alive, and I know it. I cannot count the opportunities I have given death to claim me.

That leads me to suspect even more that death and I are in a sacred alliance. We are meant to meet. My job is to provide the occasion and Death’s job is to decide the time.

From within my own very human skin, I wonder if this is not the arc of our collective reality.