What Clinicians can learn from Mechanics
As an Osteopath it is my duty and purpose to help people resolve the underlying causes of musculoskeletal pain and poor health. This process starts by assessing the foundations upon which strong health and wellness rest upon. These foundations include our diet, movement, sleep, mental and emotional health. I liken this healthcare approach to that of a car mechanic, who starts the repair process by checking the fundamentals of a car’s function such as the oil, spark plugs, engine compression etc.
Although I’ve never felt comfortable drawing comparisons between people and cars, If our healthcare followed the logic and process of a mechanic when fixing a car, We would surely have better healthcare and better health!
As obvious as the car mechanic analogy may sound, it is a far cry from how we currently engage with healthcare. We tend to pay little attention to the ABC’s or pillars of health, while expecting some prescribed panacea or procedure to rid us of pain and disease. This is akin to a mechanic trying to fix a car without doing the basic routine checks of the oil, spark plugs and engine compression!
How can we hope to effectively resolve pain and disease without bolstering the foundations upon which our health is built, and from where most of our poor health stems? It’s as ludicrous as attempting to build a castle on quick sand! Just as an engine will not ‘purr’ unless it has the basics of fuel, oil, spark plugs and adequate compression, we can’t expect to feel or heal well with hindrances such as a poor diet, lack of movement, and poor sleep.
It is becoming increasingly more apparent that our lifestyles are the biggest driver behind the most prevalent diseases of modern life. However, in clinical practice, there seems to be a lack of appreciation of how diet, sleep and movement contributes to pain and poor health. In my clinical experience, when I ask patients about their lifestyle habits, I am often politely reminded that they have come for treatment of their pain, not an assessment of their lifestyle! 🙄
Unfortunately, this reductionist mentality around health is perpetuated by our medical culture and subsequently the expectations and demands of patients.
Over-Medicalised & Paternalistic Healthcare
Medical healthcare has created a paternalistic culture, in which pharmaceutical drugs have been embraced as a panacea, and doctors are perceived as the arbiters of healthcare- The Doctor tells us what to do (or take), and we do it! The rise of this pharmaceutically driven paternalistic medical model has its roots in the early 20th century, when the more ‘patient-centered’ and holistic practices such as osteopathy and naturopathy were systematically attacked and demonized (in the Flexner Report), by the rising behemoth of biomedical science.
This paternal pill popping paradigm has contributed to a culture of passivity amongst recipients of healthcare. Until very recently, the current biomedical model of healthcare has placed little emphasis on the critical role of the patient within their own treatment, and the power inherent in them to eradicate disease. Although we have seen a ‘tip of the hat’ towards patient centered care in recent years, the harsh truth is, that the profit-driven culture of paternalism within healthcare still prevails.
The last year has been a shining example of hard medical paternalism at work, with the prevailing narrative from both public and world health authorities being little more than stay at home, wear masks, and take emergency use experimental drugs. In fact, under the recommendation of Global Health Authorities, many countries around the world are actively coercing thousands of people into taking experimental drugs, that will confer little to no benefit to many of the recipients. Person centered advice, focusing on naturally improving health status and immune function hasn’t even been an after-thought amongst Public and World Health Authorities. This blatant reluctance to empower people and prioritize self-care is apparent, even in the face of robust evidence for some very simple and effective protective therapies such as vitamin D supplementation.
This paternalism has contributed to the passive culture in healthcare that is causing and prolonging so much unnecessary pain and disease. As patients, we have been conditioned to believe that a therapist or doctor can do something to us, or give us a drug to solve our problem, when in reality, the overwhelming majority of pain and disease we see in clinics and hospitals is most effectively treated through our own self-care. Unfortunately, the sad fact is that money talks, and the ethical line between Healthcare and Wealth care has been well and truly breached.
Healthy and empowered people do not make good customers!
As a practitioner who has only worked in private practice, this passive mindset places pressure on healthcare professionals to provide patient satisfaction, and ultimately get results in the quickest time possible. Of course, we need to manage our patients expectations with sound clinical reasoning and conservative time frames, however we prioritize patient satisfaction, and ease of engagement for patients. This often means skipping some of the most fundamental components of their overall health ( diet, movement, sleep, etc) and providing symptomatic treatments that scratch the surface of the underlying problem. This is like the car mechanic skipping the basic routine checks and just putting some air in the tyres!
People in Pain want Panaceas
As important as it is to reinforce our foundations of health in order to thoroughly resolve pain and disease, we as practitioners often feel a pressure to get quick changes and results. The reality is that most patients want results quickly and with as little effort as possible from themselves.
For example, I frequently encounter severely overweight patients with knee pain, who believe that there must be some form passive manual treatment that can resolve their pain. When I explain that weight loss is one of the most effective ways of reducing degenerative knee pain, and that I can help with that process, it is frequently met with resistance and reluctance, as if there must be a quicker and easier solution.
I do not judge patients for feeling this way because I would probably feel the same if I had severe knee pain, however my genuine desire to help these people, not only reduce pain, but significantly improve their overall health is made more challenging by a healthcare culture that has conditioned us to believe that there must be a pill, procedure or external intervention that will fix the problem.
With this mindset, we are not psychologically prepared or empowered to take ownership of our health, and be active participants in our treatments. We are more geared towards the expectation that something or someone else can fix us. For this reason (amongst others), the majority of overweight patients with knee pain that I encounter, will favour invasive surgery over a sustained attempt to lose weight.
Time for a New Healthcare Paradigm
If we want to fix our patients like a mechanic fixes a car, we need a paradigm change within healthcare, and within the minds of our patients. This paradigm change has to focus more on preventative/proactive medicine, instead of reactive medicine, teaching instead of administering, and ultimately treating every patient as an active participant rather than a passive recipient of healthcare. This paradigm change will resolve the blatant mismatch we currently have between the evergrowing burden of modifiable non-communicable disease and the overmedicalized model that treats them.
Many inspiring healthcare professionals are pioneering this paradigm by focusing on treating the pillars of health. Functional Medicine Practitioners, Nutritionists, Naturopaths, Lifestyle Medicine focused GP’s, Health Coaches and Osteopaths and are now the most important healthcare professionals in the fight against our most prevalent aches, pains and diseases. The irony here is that the biomedical model still views our evidence-based approaches as either complimentary or alternative!
Amongst a predominantly passive and ‘quick fix’ healthcare culture, our patient centered and holistic approach to health presents many challenges, such as patient adherence and motivation. However, the lack of ability of the conventional medical model to cope with modern disease, coupled with the despondency of people being failed by it, is fueling an organic growth and reliance upon more holistic medicine, where the patient is leading the way.
You are always an Active Participant not a Passive Recipient
We are the car mechanics of healthcare because we focus on the pillars upon which your health rests. We are also doctors who embody the root meaning of the word, which is ‘to teach’. As the car mechanics of healthcare our results speak for themselves, and with each success story, another mindset is transformed from being a passive recipient of healthcare, to an active participant within their own healthcare.
I hope this blog helps to inspire people to seek root cause healthcare with mentors, teachers and coaches, as an adjunct to, or in favour of symptomatic healthcare from pharmaceutical drug dispensers. By entrusting your wellness with the ‘car mechanics’ of healthcare, you will be working with professionals dedicated to empowering you with the health and wellness you deserve.
Judge your doctor by how hard they try to get you off your medications