Being a physician certainly biases how I view the world around me. I can’t help but think in terms of problem-solving and healing. But have you noticed how medicalized our society has become? The other night watching television, we watched at least four drug commercials and one health insurance commercial — during a half-hour show! I believe we are in the middle of the medicalization of America, and I don’t think this is a good thing.
Let me ask you three questions: How many people over 35 do you know that are not on any medicines? Why do our patients now come to us asking for specific medicines? And why are we spending so much on health care as a society?
The pharmaceutical pill is the core principle behind these questions and the medicalization of our society. And while I certainly am a fan of modern technology, I believe that we need to pause and reflect upon this notion now more than ever. We have made medicine synonymous with health when these are two separate entities.
Before antibiotics, we as physicians had to rely on many different healing practices: mercury ingestion, bloodletting, herbal botanicals, surgery, and countless other healing modalities, including song, dance, and prayer. But antibiotics changed everything.
Now patients could take a pill and get predictable healing without the many unwanted side effects that came along with the harsher treatments of mercury and bloodletting. Antibiotics truly helped our society transition into the Industrial age. After antibiotics, we were introduced to hormones, blood pressure medicine, diabetes medicine, and antipsychotic medicine. The pill became our greatest ally in helping fight disease and improve health.
But, as we grew accustomed to the medicines, we could not escape being changed by the medicines. As a physician, you know this is true–think about your medical training and the focus of today’s evidence-based medicine. Nearly all of it is defined and financed by pharmaceutical companies. And as a society, we know this is true when we see how many of us are taking medicines and how much money we spend on these medicines.
But medicine is not health. Why is it that today we have more people taking medicines yet have more diseases? There is more heart disease, cancer, and autoimmune disease than ever. If medicines truly define health, we should see greater reductions in morbidity and mortality.
The pill is not the panacea of health. Yet, our patients expect us to write for them, and we have been trained to intervene with them. Many of you would even argue that we do not see lower disease rates because patients are not as compliant with their pills as they could and should be.
But I think differently. By defining health by medicine, we have neglected our greatest ally in medicine itself: the doctor/ patient relationship. We have traded in our interactions with patients for the myriad of medicines we prescribe them. This is not all of our fault by any means. In our pressured insurance-based medicine model, we have to see more patients every day, thus allowing us only a few brief moments with each patient. In this environment, it is no wonder that we are quick to fire our prescription writing off, giving the patient something to get “better” with.
The reality is that patients don’t want more prescriptions; they want to feel better. But because we have medicalized the very essence of health, we often misunderstand our roles as doctors.
Medicine itself is a wonderful tool, a powerful one. But as we determine the next landscape of medicine, let us not continue defining health by the medicine itself. Next time you go into the exam room with your patient, try putting the prescription pad away and see what happens.
The author is an anonymous physician.