Many patients today complain that the doctor doesn’t listen to them. They may have a lot of vague complaints, but are hesitant to say anything to the physician because these complaints have been ignored in the past. When physicians are faced with too many complaints from a patient, they probably believe there isn’t anything really wrong with the patient and that it has to be something psychosomatic and their problems can be addressed with the antidepressant du ‘Jour.
A term that gets thrown around a lot these days is gaslighting medicine, which comes from the title of a 1938 play Gaslight, later turned into a movie starring Ingrid Bergman, Charles Boyer and Joseph Cotton. A great black and white movie. The premise of the movie is that the husband tries to convince his wife that she’s going insane by manipulating her perception of reality. Though physicians are not being malicious in disregarding a patients symptoms, in many instances physicians disregard the patient’s symptoms because it may not fit the medical school accepted presentation.
One criticism of medicine today is that many studies in the past had been conducted only on white men and that other patients, non-white males, may have different presentations to similar illnesses. In the late eighties and the early nineties cardiologists realized that the presentation for myocardial infarctions were different between men and women. Several years ago, I had a female patient who was diagnosed with ankylosing spondylitis (AS), confirmed by an Xray that showed the classic bamboo spine. The rheumatologist I referred her to said it couldn’t be AS because it only affected men. Wrong! There is a male predominance, but AS can affect women. The problem here was that the rheumatologist approached the patient as a board question, not as a human being.
This is where, unfortunately, medicine is going. More and more, the medical industry (Big Pharma, Health Insurance and The Medical Education Institutes) are leading us to generalized medicine with its one-size-fits-all approach. They want medicine and medical decisions to fit into a nice, neat little package. In 2023, this isn’t going to work. The reason being is that there are over eight billion of us on this planet and no two are the same. Consider the amount of travel and relocation that has occurred in the last fifty years and you come to realize that there is more genetic diversity than ever before. A one- size-fits-all approach to medicine cannot, and will not, work.
In previous posts, I’ve discussed how clinical trials are sterile in that they only like to look for patients with the one particular illness. The same goes for clinical trials on new medications. Patients with multiple chronic conditions (MCC) are usually excluded from these studies. For many physicians, their patients haven’t read these clinical trials and aren’t aware that they’ve been excluded. More and more, clinicians are asked to treat by the numbers. You can’t use this protocol until the patient’s hemoglobin is this or the oxygen saturation is that. Who makes up these scales, anyway?
The more we treat by the numbers, the more medicine loses its sense of humanity. Instead of becoming more generalized, medicine needs to become more customized. If medicine continues on its current path, the machines will win.
