There is a better way to help people recover their health

The current medical model is responsible for more deaths in the United States than all of the major wars of the last century combined! Estimates of 250,00 up to 440,000 people die each year from medical mistakes.1,2,3 Medical mistakes, termed iatrogenic in the medical world, are now the 3rd leading cause of death in the US behind heart disease and cancer.2,3 While we hear advertisements and pleas to fund research for cures for cancer and heart disease, we don’t see charities asking for money to study the epidemic of medical harm or death caused by the system. These medical errors have been found to be underreported and actually benefit the hospitals and physicians who caused them as they receive increased revenue to improve safety.4 This is the same system that is continually defended and relied upon by countless Americans as the way to health. Unfortunately, it seems more likely it is a road to injury, illness, and death. 

We can all accept some level of mistakes from our coworkers, friends, and loved ones. To err is human, so the saying goes. Even in the medical world, we term the work physicians and doctors do as “practice,” however the deaths of one-quarter to half a million deaths each year is unacceptable. For perspective, we shut the world down in 2020 due to Covid. Covid deaths in the US accounted for roughly 345,000 deaths, still less than iatrogenic causes.4 Still, we are not shutting the country down because many, many poor physicians are making mistakes and killing our loved ones. Or is the cause even deeper than doctors making mistakes because of poor training or lack of skills and knowledge? Is the medical system, as we currently understand it in the US, deeply flawed to the point where doctors make mistakes because they lack resources and time to make the right decisions?

So, how might this mighty system become so inefficient? As the magnitude of the current medical system is expansive, so too the answer to this question is multi-layered and complex. Perhaps a good starting point would be to focus on the foundation of this system and gather a better understanding of the bedrock of this model. From a historical perspective, an article entitled Medical Education in the United States and Canada: a Report to the Carnegie Foundation for the Advancement of Teaching (1910), otherwise known as The Flexner Report is universally understood to be a pivotal moment in the emergence of medical school curricula.5 While cited as the report that underpins our modern medical model6, it is fraught with faulty scientific inquiry and rampant racism, resulting of the shuttering of 82 of the 148 medical schools at the time, including 5 of the 7 schools for African-Americans.7,8 

Flexner advocated for decreasing the amount of heterogeneity (or differences) in the medical students to create a more uniform and standardized practitioner.7 This thought process has formed the foundation of the medical model and practitioners ever since, and has perpetuated and exacerbated health and societal problems. Calling for essentially a “one-size-fits-all” approach to medicine is not only ignorant, it’s incredibly dangerous. Yet this is how the current model functions. If you have high cholesterol, you are prescribed a statin. If you have diabetes, you get metformin. If you have high blood pressure, your doctor has the choice between a beta-blocker, an ACE inhibitor, or a diuretic! Regardless of the disease, they have either created or are in development of a pharmaceutical to address it. This is the true result of the Flexner Report. The introduction to a narrow therapeutic window which focuses solely on the biomedical model to address symptoms and ignore root cause of disease. If this model worked, we wouldn’t have 250-440,000 people dying each year in the hands of “competent” doctors. 

The Flexner Report also established medical programs lasting 4 years with both laboratory and clinical education. With this amount of schooling, you could assume that these doctors and physicians are smart. They learn all about the body, how it works and how it doesn’t work. They are required to study cadavers and differentiate tissue types, understand immunology and biochemistry. The sheer complexity of these fields must mean they have a full understanding of the workings of an individual, right? Next time you go to the doctor, ask them how much education they have on dietary recommendations. Ask them if they were given proper training on how to prescribe movement therapy. See if they understand the hormesis curve which determines the benefit or toxicity of a given substance. Undoubtedly, their response will be very little to none. Then ask them how much training they received on pharmaceutical medications and their mechanisms of action. If they laugh and explain that’s basically all they did, you may have to question if you have a doctor or a drug dealer. Doctors are supposed to be educating and teaching their patients about health, not just prescribing drugs for symptoms. 

Pharmaceutical medications do a great job of suppressing symptoms. The problem with that is suppression drives the disease deeper into the body where it manifests into chronic disease. This is another path to illness and death. Your symptoms are your body's way of telling you something isn’t working correctly. For whatever reason, it is not strong enough to maintain necessary pathways and it has had to find a new way to survive. This is called adaptation. When this happens it is crucial to restore normal physiological function to the system or systems involved. If we only suppress the symptoms and ignore the adapted pathway, we soon find ourselves in chronic disease. This disease is seen as the root cause in the eyes of the current medical model, and it’s unsurprising that there is a pharmaceutical available to treat it. However, this misses the point entirely, and again, drives disease deeper into the body to manifest as cancer, heart problems, metabolic dysfunction, etc. Seems like we may be able to lump all this together to see the true impact of the medical model.

While this medical model may be promoted and advertised as the only model available, there are other options. One of the main causes of iatrogenic deaths is doctors unwilling or unable to spend time discussing options and potential complications with patients. They aren’t given the resources (either time or knowledge) to provide their patients with an adequate education about their own health. Stepping away from this model requires some basic health literacy. If your doctor cannot provide that, why do you see him or her? There are other models that exist to empower patients to take control of their own health choices with a full understanding of what is happening within their body.

This is what was lost after the Flexner Report. The idea that the body can be strengthened by promoting the idea that we need to live in patterns that reflect our natural bodies. We can understand that there are bugs (bacteria, viral, and fungal) that exist, but we can also rely on our body’s strength to overcome those invaders. We strengthen our body by eating foods our ancestors ate, which didn’t come in a box. We move our bodies as our ancestors did, which usually wasn’t off the couch. And, when we have ailments, we can look to the natural world and explore herbal botanicals, just like our ancestors did. They didn’t have all the fancy designer drugs we have now, and somehow they thrived. 

We have to look for other options to the model that is accidentally killing tens of thousands of people a year. We have to explore the claims of agencies that are ultimately trying to take our money. We have to demand autonomy as patients and better practice from our doctors. We have within us the medicine we need, we need to have access to it. In the light of day that time provides us, we have seen past misdeeds that have been done to further the medical industry, to improve our training, and even to individually remedy our diseases. This failure is only compounded by the inability or unwillingness of the medical model to be reflective and see how it continues to perpetuate disease. Demand more from your practitioner ; demand more from yourself. Take responsibility for your body and lives. Each day provides you with the opportunity to be your strongest, most optimized self. Why wait til tomorrow?

References

1) James JT. A new, evidence-based estimate of patient harms associated with hospital care. Journal of Patient Safety. 2013;9(3):122-128. doi:10.1097/pts.0b013e3182948a69

2) Ray Sipherd special to CNBC. The third-leading cause of death in us most doctors don't want you to know about. CNBC. https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html. Published February 28, 2018. Accessed August 24, 2022.

3) Makary MA, Daniel M. Medical error—the third leading cause of death in the US. BMJ. 2016:i2139. doi:10.1136/bmj.i2139

4) Anderson JG, Abrahamson K. Your Health Care May Kill You: Medical Errors. Stud Health Technol Inform. 2017;234:13-17.

5) Varughese H, Shin P. The Flexner report: commemoration and reconsideration. Yale J Biol Med. 2010;83(3):149-150.

6) Nachman RL, Marzuk PM. Flexner Redux. Perspectives in Biology and Medicine. 2011;54(1):55-60. doi:10.1353/pbm.2011.0006

7) Bailey M. The flexner report: Standardizing medical students through region-, gender-, and race-based hierarchies. American Journal of Law & Medicine. 2017;43(2-3):209-223. doi:10.1177/0098858817723660

8) The 1910 report that disadvantaged minority doctors - JSTOR DAILY. JSTOR Daily. https://daily.jstor.org/the-1910-report-that-unintentionally-disadvantaged-minority-doctors/. Published May 3, 2019. Accessed August 25, 2022.