Disease Care versus Health Care

by Caroline von Fluegge-Chen

Disease Care versus Health Care

Now that health care reform has been put on the back burner, maybe it is time to discuss what health care reform should really look like. Although we talk about a “health care” system and health care reform, what we’re actually talking about is a “disease care” system and disease care reform. Doctors of modern western medicine are trained to treat disease with drugs and surgery. They are not trained to keep people healthy.

At medical school, we doctors are taught how to treat the symptoms of disease, rather than how to prevent disease in the first place. For example, throughout our training we receive very few lectures on nutrition, despite the fact that diet is fundamental to good health. Nor are we trained in other lifestyle modalities that help keep people well, such as exercise and relaxation therapies. We are taught nothing about the wisdoms of alternative medical systems that have been helping other cultures for centuries.

I will be the first to acknowledge that modern western medicine and science have made phenomenal advances. These improvements alleviate pain and suffering and save lives every day. Better treatment of trauma and burns for example, or the management of acute medical and surgical emergencies, are among the miracles of modern life. We have drugs today that, when used appropriately, work wonders. We are indeed blessed to have modern western medicine in our arsenal, and for disasters like the Haiti earthquake, this kind of medicine is life saving.

The problem is that although most of us are not permanently in a health “crisis”, this crisis care model is being used to treat our every health problem or symptom – as if it is the only health care model we have. Most of us are not sick enough to be in hospital, and by far the majority of people who visit their doctor, do so for ongoing chronic problems like diabetes, heart disease and obesity – or less-defined ailments like joint pains, back pains, fatigue and headaches. Western medicine’s solutions to these problems are drugs and surgery.

But apart from antibiotics, which can kill the bug causing the problem, most drugs treat symptoms and not causes. Similarly, surgery usually addresses the symptoms and not the causes. For instance, bypass surgery, although often life saving, does not address the underlying reasons for why one’s arteries are getting blocked in the first place. And in the case of both drugs and surgery there are often significant side effects, which are then addressed with even more drugs, resulting in many patients being on multiple drugs at the same time. But these drugs are powerful agents interacting with very complex systems. Often the first one or two drugs have been prescribed to treat the original problem and the other five to 10 are treating the side effects caused by the first two drugs or the interactions of the other drugs. Clearly this understanding of how to actually cure disease is incomplete.

The tragedy is that most of the chronic problems that most people endure can so often be cured with diet, lifestyle and behavior changes and supplements. Drugs – along with their potentially-unpleasant or even lethal side effects – are often not necessary. Unfortunately it does not suit the drug industry to give patients a drug that cures or eliminates the problem. It is much more lucrative to use drugs to simply manage a patient’s symptoms, ensuring that he or she stays on them for life, instead of eliminating the disease. Examples of this would be statins and anti-hypertensives.

What we should now really strive for is a health care system that shows patients how to stay well with a properly preventive approach. In fact what we call “preventive medicine” in the modern western model – pap smears, breast exams and certain blood tests – are really “early detection” measures. I am not saying these tests are unnecessary, but they are not teaching patients how to stay healthy or prevent the diseases they are being screened for. We need a complete rethink and overhaul of what early detection really means and implies.

A true health care system would incorporate the “disease care” model as part of the system. I most certainly would not encourage a patient with a medical emergency to see a nutritionist or acupuncturist. But by the same token, these modalities need to be seen as an important part of a much more comprehensive health care system.

My 30 years of experience as a doctor have shown me that in the areas where western medicine is weak – such as chronic disease and disease prevention – a combination of other modalities and systems actually excel; and where western medicine is particularly helpful, these other modalities are not as effective. It’s about taking the best of both and going beyond the limitations of each and melding them into a new combination that works.

This means that western medicine should be used for crisis care, but for chronic disease we should find the root cause of the problem and uproot it – instead of merely suppressing the symptoms. We should look for the underlying metabolic processes that have gone awry or the underlying dysfunctions present. We then need to try to correct these safely, effectively and without side effects.

We must use the objective information we get from blood tests, X rays, MRIs and so on. But we need to consider the actual patient or person as well, by taking into account subjective information too: feelings, intuition, attitudes, belief systems and relationships.

In a true health care system, we must use modern western medicine for what it is good at – crisis care, acute medical and surgical emergencies – and natural, non-toxic and non-invasive therapies whenever possible. The most effective ways of preventing and treating most chronic diseases are diet, supplements, exercise, stress management and other benign modalities. And herein lies the rub. Although guidance may be helpful, lifestyle changes can’t be imposed from above – they have to come from you. There is no greater reward than being the master of your own health.

Frank Lipman MD, is the founder and director of the Eleven Eleven Wellness Center in NYC a center whose emphasis is on preventive health care and patient education. His personal blend of Western and Eastern Medicine combined with the many other complimentary modalities he has studied, has helped thousands of people recover their energy and zest for life. He is the author of the recent REVIVE: Stop Feeling Spent and Start Living Again (2009) and Total Renewal; 7 key steps to Resilience, Vitality and Long-Term Health (2003)