Dec 5, 2011



Sometimes I get discouraged when I think about our Health Care System. It seems to me the emphasis is on Sick Care. You are encouraged to see the doctor because you are SICK. Can you imagine seeing your doctor saying, “I feel good most all the time, but I want to know how to stay this way until I die.” Your doctor may very well say, “I have a waiting room full of sick people. Come back to see me when you are SICK.”


I believe we need a new paradigm in medicine, one in which physicians are concerned about keeping our patients well instead of just treating disease. Just because one is healthy is not the same as absence of disease. We need to think about upstream medicine, looking for the reasons we get sick. When we see dead fish in the river or poisons or trash or other pollutants, we go up river and look for the source of the problem. We need to do the same in medicine. Doctors need to be asking the question, “Why did this patient get sick? Why did he have a heart attack at 48 or 58? What could have been done to prevent this from happening?”


But we are so involved with caring for this medical emergency now we forget to ask, “Why did this happen?” Doctors are not paid to figure out WHY they are paid to get us well when we are sick.


I believe we have adolescent diseases that cause adult / geriatric results. Some adolescent diseases are: eating too much fast food, not exercising, obesity, computer games, smoking, and drugs. And the consequences are seen 30 or 40 years later.


The evolution of our medical care system can be understood when we consider the history of medicine. In the late 1800’s it was discovered that a certain germ caused a certain disease. The tuberculosis germ caused TB. The pneumococcal germ caused pneumococcal pneumonia. In 1865 Louis Pasture discovered that microbes (germs) can cause infectious disease. Infectious disease can spread by the spread of microbes. This was followed by Sir Alexander Fleming’s discovery of penicillin. One may call this, “The single bullet concept. I found a germ… a problem, and there is a pill that will treat that problem. There is an external invader and we have to kill that invader.”


The problem is that usually the problem (the illness) is not one dimensional….there are multiple causes for why the patient is sick today. It all started 30 or 40 years ago. We cannot limit our thinking to just one cause. The patient may have pneumonia but the reason is he has smoked for 30 years. He may have heart disease but the problem started 40 years ago with too many fast food hamburgers. We need to treat diseases before they occur.


I will discuss next week the first step in prevention. It begins with hormone balance.