Why medicine is not health


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 the age of 35 do you know that are not on any medicines? Why is it that our patients now come to us asking for specific medicines? And why are we as a society spending so much money on healthcare?

I believe that the core principle behind these questions and the medicalization of our society is the pharmaceutical pill. And while I certainly am a fan of modern technology, I believe that now more than ever we need to pause and reflect upon this notion. We have made the medicine synonymous with health, when in fact, these are two separate entities.

Before antibiotics, we as physicians had to rely on many different healing practices: mercury ingestion, blood letting, herbal botanicals, surgery, and countless other healing modalities including song, dance and even 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 blood letting. Antibiotics truly helped our society transition into the Industrial age. After antibiotics we were introduced to hormones and blood pressure medicine and diabetes medicine and antipsychotic medicine. The pill became our greatest ally in helping fight disease and improving 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–just think about your medical training and the focus of today’s evidence based medicine. Nearly all of it is defined and literally financed by the 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 disease? There is more heart disease and cancer and autoimmune disease than ever before. If medicines truly defined health, than 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. I think many of you would even argue that we do not see lower rates of disease because patients are not as compliant with their pills as they could and should be.

But I think differently. By defining health by the 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 model of medicine, we have to see more patients everyday, thus allowing us only a brief few moments with each patient. In this type of 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, though, is that patients don’t want more prescriptions, they want to feel better. But because we have medicalized the very essence of health, we, oftentimes, misunderstand our roles as doctors.

Medicine itself is a wonderful tool, a powerful one. But as we move forward in trying to determine what the next landscape of medicine will look like, 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.

Craig Koniver practices integrative medicine and consults with physicians at The New Rules of Medicine.

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