From: f1221-AT-cc.nagasaki-u.ac.jp
Date: Thu, 7 Jan 1999 15:10:04 +0900
Subject: Re: Bruce Hagoods 2 c


At 5:28 AM 99.1.6, Bruce Hagood wrote:

> My two cents' worth, FWIW:  MD's, especially in the United States (I
>can't speak
> too well for MD's in other countries, and I am not an MD myself,
>understand) do a
> good job of giving catastrophic care and care for trauma.  Routine health
> situations seem to be a problematic area now.

Though I do not have first-hand experience with the situation in the United
States,
your observation certainly holds for many other countries, too. Due to
specialization,
the >family physician< is an endagered species. There is a tendency to have
health
care centers with specialists, which are usually more efficient than the general
practitioners, who by necessety have to be >jacks of all trades<. As higher
efficiency
usually means better pay, many medical students are drawn into specialize,
less want
to become general practitioners. This can lead to problems in routine
health care,
especially as health care centers are univiting enough to have people avoid
going
there if at all possible.

> My grandparents' generation saw doctors as gods walking on earth, and the
>doctors,
> by and large, were happy to concur with this opinion.  As I see it,
>people of my
> generation and younger generations are seeing the clay feet on the MD's,
>but the
> MD's (as a general rule, note) still insist on being treated as gods
>walking on
> earth.  [...]

Hmm, yes that is true. Though it is getting better.

> Understand, I think that on the whole, it is better to have MD's in our
>society
> than not.  As I say, MD's do a good job with trauma and catastrophic
>care, and many
> MD's do a pretty good job with routine health care.  But as I see it, the
>problem
> is that MD's have a tendency to want to treat the symptoms rather than the
> underlying causes.  It is much easier to wait until the problem starts
>getting out
> of hand, and then prescribe some medication for the problem.  It is much
>tougher to
> recommend and supervise fundamental lifestyle changes which will avoid
>potential
> problems.

There is also the problem, that many people simply do not want to have their
lifestyle changed, left alone have these changes supervised. It is sometimes
difficult enough to persuade someone to comply with a therapy if he does have
symptoms. It is even harder to reduce weight or quit smoking if one is still
healthy. But preventive medicine has to rely on compliance. It cannot be
good to go to the different extreme: recommend lifestyle changes is ok, but
supervising them is questionable [at least supervising them strictly] -who
wants
a health police ?

One of my beloved examples: one of my colleagues practises shiatsu for
>minor diseases< like stiff shoulder. [If you are intersted: it means
>pressing with
your fingers onto a point on the patient`s body to elicit a response like
easing pain
or relaxing muscles. For stiff shoulder you should press with your thumbs both
[backs of the] hands of the >patient< at the point between the thumb and
the index finger.
As you press pretty hard, it is not entirely pleasant, it may actually hurt
a bit.
Yet many people like it. I cannot say it works for me, but some people say their
shoulders get better.] Once I asked my colleague, why he did not recommend
to his
patients to go swimming. He answered, >I tried, but they want something,
they do not
have to work for.<

 > An ounce of prevention is worth a pound of cure, but MD's tend to go with the
> latter because it is easier for them.  That is a human impulse, but not
>necessarily
> best for our long-term health.  Hence the rise in popularity of
>alternative health
> strategies.

Alternative health strategies usually do the same: treat symptoms once they
are there.

I believe, the popularity of alterative medicine has to do with the
abovementioned
specialization. People feel treated as >cases of this-or-that disease< by a
health-care
machinery that has taken on the form of an industry. In alternative
medicine this is
usually different. For example, in homeopathy determinig the patient`s type or
>constitution< plays a major role in the diagnostic process. [Therefore, a
>homeopathic
interview takes a long time.] Though I do believe, >conventional< medicine
is by far
superior to homeopathy, I can understand why the latter rises in popularity.

sY
-Yamazaki