Wednesday, August 9, 2017

Yes, Change Is Happening And You Are Part of It

The medical profession has changed slowly for centuries, and then a very rapid change has nearly left us in the dust. Scientists are finding causes and cures for illnesses that in the past were always fatal, even with treatment. Vaccines and medicines are making some illnesses obsolete.

For hundreds of years illness was thought to be caused by divine, or evil, spirits. The first "doctors" were priests or shamans, who could intercede for the person suffering with an illness. The most important figure in ancient Egyptian medicine was Imhotep, way back in 2600 BC, a high priest.  It wasn't until Hippocrates, considered the father of medicine, in ancient Greece that anyone described many diseases as due to natural circumstances rather than a supernatural force. ( The Patient Will See You Now, The future of Medicine is in Your Hands, by Eric Topol)

Hippocrates is considered the father of medicine and his philosophy shapes the medical culture to this day as paternalistic and somewhat secretive. He believed that the patient should not be told what treatment entailed and the science of medicine should be held as above the understanding of the common man. The Hippocratic Oath states that "the precepts and oral instruction and all the other learning of medicine be shared only with those who have taken an oath according to the medical law, but to no one else."

Eons later that same oath and philosophy has led to the culture of medicine that puts the patient in a subordinate role in his or her own healing. Doctors are still often treated like gods and, in turn, they treat patients like children by withholding information and making life and death decisions for the patient without the patient's input.

While the medical profession insists that they must be given respect, all to often the patient is not treated with respect. The patient does not have all the information available to them when they are told they must make decisions about possible treatments, making informed consent a misnomer. The patient is treated like a child when they ask for more information or when they are resistant to the doctor's treatment decisions.

An informed patient who insists on the doctor's respect is all to often labeled a "difficult patient" and shunted off to the side. When a patient is insistent the doctors label them difficult. That label in a patient's record can have longstanding consequences with any medical professional reading those notes.

Now, however, patients more and more often have access to information about illness and medicine that was never before available to the layperson. We can go online and find research results and reports about all sorts of illnesses. We can look up or symptoms and learn possibilities even before we see a doctor. We are more informed than ever before. And we are demanding medical professionals hear us and respect what we know about our own bodies.

And this is changing the culture of medicine. With the proliferation of smart phones we can have access to doctors, research, test results, and be part of the conversation about our health. As this trend grows medical professionals will be forced to change the way they treat patients. We will insist that be become Individual, Active Participants (IAPs) rather than patients. Because we know our bodies better than anyone else can, our input is vital. And with better information we can make better choices, we can have true informed consent.

Just think of that word "consent". What other profession demands its clients give consent to leave a relationship. But to leave a hospital without the doctor's consent is the same as being a defiant revolutionary! The doctor is assumed to have ownership over our lives when we agree to their treatment. When our decisions are made as a result of intimidation are they truly informed consent?

In the new medical culture the doctors will work for us as equal partners. Yes, the professional has more education and training in medicine. We don't dispute that. Yet they don't have the right to decide for us what we want to do about our health, unless we give up that right and go back to the paternalistic philosophy of Hippocrates.

The new generations of doctors will listen to and respect their patients as partners in their healthcare. I feel truly blessed to have a doctor like that now. My doctor knows that I am the expert on my body and what does or doesn't work for me. She listens and agrees to try what I think will work best. I get lab results with the values for each test given, not a rubber stamped "all tests were within the normal range" or a brief "good". When I have questions or concerns I am attended to.

But the changes in medicine are not stopping there. In the future of medicine our professionals will be more accessible than ever before, thanks to technology. More about that in my next post.

*The facts in this post come from the book The Patient Will See You Now by Eric Topol.

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