I am indebted to the moderately well known irrational American physician Dr Frank Lipman for drawing together most of the commonly held misconceptions about real medicine. He writes regularly for a generally ethical and altrustic website, which naturally tends to attract a very wide range of views, sadly rather more irrational ones than I would like. Anyway, Lipman gives me the opportunity to address all of his strange claims in one place. Here are the 18 things he says are wrong with modern medicine, with my answers.
1. Modern Western Medicine is based on a narrow “scientific” model, and arrogantly ignores and rejects therapies and entire medical systems that don’t fit this model.
Science is not just a model, it is the only reliable method we have of discovering the truth about the universe. It is underpinned by evidence. Scientists do not arrogantly reject anything that doesn’t fit the model, they simply ask for evidence. If evidence is not available, we can’t accept the claim. Science is not narrow, it is broad enough for the entire universe. It works for everything else. If it doesn’t work for certain “medical systems”, does that not tell us something?
2. Doctors are trained in hospitals in “crisis care” medicine, not to take care of the “walking wounded,” which is the majority of people. They need to be trained to take of (sic) the “walking wounded” as well.
What does he mean by the “walking wounded”? What is “crisis care”? Are there no doctors who specialise in chronic diseases? I can’t speak for the US medical system, but I do know that the biggest worry over there is long term care of the chronically ill – hardly the “walking wounded”. Perhaps he means the “worried well”.
3. Instead of treating the underlying causes or imbalances, Doctors often merely manage symptoms.
So we don’t bother to learn about cell surface receptors, immune abnormalities, bacterial sensitivities and a host of other fundamental components of disease? Molecular biology tells us that many diseases are caused by genetic mutations. All these sound like underlying causes to me. But perhaps Lipman’s `causes’ are imaginary concepts such `yin’ and `yang’. I wonder what he thinks is out of balance. How does he measure it? Is it reproducible?
4. Symptoms are seen as something to be suppressed rather than a pointer to some underlying imbalance.
Not true. Symptoms are signposts to what has gone wrong. Doctors are trained in diagnosis, not simply to get rid of symptoms. In reality the homeopaths are the ones who are obsessed with symptoms. Again, what is out of balance? Show it to me. But ah, I am not admitted to the fold of those who are granted the wisdom to see.
5. Doctors see the human body as a machine with separate parts that can be treated independently rather than as an integrated whole. In addition the mind and body are also seen as separate independent entities and emotions are often ignored.
This is incredibly out of date. If doctors treated the body like this they would not do a full physical examination or take a full history – they would only look at the current disease. The mind-body dichotomy has been found to be a non-problem, as the mind is an emergent property of the brain.
6. Man is not seen as part of nature, and how what happens in nature effects (sic) humans.
What on earth does this mean? Of course doctors look for environmental causes of disease. That is a major focus in immunology and respiratory medicine, for example.
7. We look for a magic bullet instead of all the possible factors that make up the total load which are causing the underlying imbalance. There is no understanding of the total load.
Not true. See my comments in 5 above. What does `total load’ mean? Without explanation it is meaningless.
8. No belief that the body has a self-healing capacity and no ways to boost that capacity.
Not true. Doctors know that a great many diseases are self-limiting, so in such cases they just make the patient comfortable and wait for nature to take its course. There are many examples of “boosting self-healing capacity”, such as immunomodulation. What do antibiotics do? They do not repair any tissue damage, they stop more damage happening and the body takes over.
9. Everyone with the same disease gets treated the same way, patient uniqueness ignored.
This is really iniquitous rubbish. See my comment in 5 above about taking histories and doing physical exams.
10. We treat the disease, not the patient.
Rubbish again – see 5 above. Even highly specialised doctors collect information on all possible health factors for each patient. In any case if the patient has no disease would you still treat them? Obviously the disease is the reason for treatment.
11. There is a reliance on numbers and tests rather than how the patient is feeling and what is found on examination.
Hmm…. so all that work on rating scales in psychology, and multitudinous quality of life questionnaires, never happened?
12. We don’t take into account the importance of diet and lifestyle on health. How could we? We get a total of 6-8 hours of nutrition lectures in medical school.
Well again I can’t speak for the US system, and I would be interested in readers’ comments on the truth of this statement. But I do know that UK medical training includes substantial modules on nutrition. Otherwise I am not sure why we would have professors of nutrition and so many nutritionists and dieticians in the NHS.
13. We don’t recognize or understand the correct use of supplements to optimize health.
Here speaks a dupe of the multi-billion dollar supplements industry. Any qualified medical biochemist and nutritionist will tell you that supplements are unnecessary for normal people taking a healthy diet.
14. We don’t recognize the importance of toxicity on our bodies nor know how to boost the body’s own detoxification systems.
So toxicology as a specialism doesn’t exist? We know nothing about clearance pathways? Pull the other one.
15. The Doctor patient relationship is not emphasized and the role of the patient as a partner in their own health care not encouraged.
This is the first one with a grain of truth in it. However the old days of paternalistic medicine employed the worst of relationships, and that is now changing. Many studies have shown that spending time with patients gets them to comply with their treatment much better, and they have better health outcomes and lower health care costs. But the important thing is that this works even if the person spending the time is not the doctor, but someone else such as the pharmacist.
16. The placebo has a negative connotation and ignored. The placebo is really the body healing itself and should be encouraged.
Wrong. There have never been any decent studies to show a healing effect of placebo. It is only an effect of perception, which is why it works best for pain.
17. The Drug Industry is too enmeshed in the medical system The Pharmaceutical Industry has WAY TOO MUCH power and is “bribing” Doctors to use their drugs and researchers to produce positive results for their drugs.
Partly true – but again this is from a US perspective. Yes, there is a problem of bias in the reporting of clinical trials, but bribery is a serious allegation that needs evidence. Lipman obviously has no idea at all of the level of regulatory scrutiny exercised by the FDA.
18. More than 80 percent of all medical treatments used have been untested by rigorous peer reviewed study, yet the Medical establishment insists that alternative health treatments must undergo these before they can be used. The system of evaluation needs to be changed.
He doesn’t say where he is getting the 80% figure from, and it may not be true. However, the first point is that, where the outcome is not in doubt, you don’t need to do any rigorous studies. Would you do them for splinting broken legs, or for tying off a severed femoral artery? The second point is that alternative medicine is called that because all of it is in doubt. Well I should qualify that. The National Center for Complementary and Alternative Medicine (NCCAM), operated by the NIH, spent over a billion dollars on rigorously researching CAM and came up with no clearly beneficial treatments. So it isn’t quite the case that CAM is waiting to be tested. It has been tested and has mostly been found to be ineffective. Presumably Lipman wants the evaluation system to be changed until it gives him the result he wants.
Well overall, this is the litany of the pseudo-medicine fraternity. We see it continuously, yet there is never any real evidence to underly any of it. The idea seems to be that the more times it is said, the truer it will be. Someone else thought something rather like that. Well not quite like it, because he declared that the bigger the lie, and the more it was repeated, the more people would believe it. He never said that he believed it himself, so maybe he wasn’t as self-deluded as the likes of Dr Lipman seem to be. His name was Joseph Goebbels.