What Does ‘DOCTOR’ Mean To You?
My perception of ‘Doctor’ began with my debut to the world. It was straight into the hands of a doctor. The first person to ever touch me.
That one action was a signal to me of the amount of trust my parents and American society have for doctors.
For most of my life, I did whatever the white coat said to do. Allergy shots, braces, and birth control encompassed most of our interactions.
It wasn’t until I let my OB-GYN cut out a tumor that I experienced negative repercussions for going along with a doctor’s recommendation.
Today, I’d like to explore the authority most of us have been conditioned to hand over to doctors and invite us all to take a look at the culmination of influence the doctor brand has amassed. I use brand here because there is a commercial interest in our not asking too many questions and instead, just having the test, the surgery, the prescription.
The White in White Coat
A few cultural signals demonstrate the powerful entanglement among the color white with the concepts of morality, purity, health, doctors, the sacredness of the body, and force.
Hieronymus Bosch was the Creative Director who responded to the Catholic Church’s brief to tell the world what was important in the Gutenberg Bible.
“Paradise: Ascent of the Blessed” is the first Western reference of white being the place you want to go and the color of the blessed.
Cut to the bubonic plague, which is estimated to have killed 30-50% of all the people of Europe from 1347-1351. Doctors wore a white mask to signal they were treating a person who might recover, and a black one for escorting the dying and dead. They mistakenly believed these creepy masks could purify the air, while embedding this image of horror as arbiter of death into the collective consciousness.
The color of Spanish inquisition tunics of Spain and Portugal? Yup, white.
The pandemic recently resurrected many images from The Spanish Flu, with rows of nurses and doctors wearing white.
Doctors now enter the treatment or zoom room wearing their white coat and spend a quick five to ten minutes with each patient. Despite the speed of the interactions, each one is heavily weighted with the doctor’s tacit right to authority and righteousness.
Even with exposés of doctors like Dr. Death, the surgeon who paralyzed or killed most of his patients, or those who colluded in the opioid epidemic, we still tend to trust them. Society acts as if “health insurance” which provides access to doctors is worthy and necessary for all citizens.
The Doctor’s Job To Be Done: Diagnose
When we hire a doctor, we are often outsourcing any need to understand the inner workings of the human body.
We generally hire doctors to respond to our symptoms by diagnosing us so that we can undo the symptoms with pills and procedures. We also hire doctors to give us exams and diagnose things, hopefully, before they become real problems. And we hire doctors for emergencies, to treat us for acute injuries and accidents.
As a bodyworker, my “scope of practice” is clearly not in the area of diagnosis and I could loose my certification if I were to overstep.
Diagnosing disease and injury is the scope of doctors.
It turns out, we can feel really good about emergency care keeping us alive after an accident or health crisis.
But to “First, do no harm” among all the other doctor/patient interactions turns out to be a mine field of ever-evolving knowledge that is not evenly distributed.
I learned of these cancer related examples in Barbara Ehrenreich’s book, Natural Causes: An Epidemic of Wellness, The Certainty of Dying, and Killing Ourselves to Live Longer.
In 2012, an article shared that treating pre-cancers with surgery, chemotherapy, and radiation have real risks. For example, breast biopsies can plant cancer cells in new spots via adjacent tissue, making them a risk factor for cancer themselves. (“Do Biopsies Spread Cancer” PR Newswire August 23, 2012)
In 2014, Stephanie O’Neill reported in “Too Many Are Getting Unnecessary Prostate Treatment, UCLA Study Says.” This article shared how over-diagnoses of prostate cancers lead to unnecessary treatments with the very real possibilities of incontinence, impotence, and cardiovascular disease.
In 2016, Gina Kolata wrote an article for The New York Times where she uncovered that an estimated 70 to 80 percent of thyroid cancer surgeries performed on US, French, and Italian women in 1900-1950 are now judged to have been unnecessary. In South Korea where they have a culture of being even more meticulous with thyroid screening, that percent rose to 90. Men were also overdiagnosed, but in fewer numbers. The article was titled “Got a Thyroid Tumor? Most Should Be Left Alone.”
One more infuriating example: the $10,000+ colonoscopy screenings turn out to be no more accurate than examining the feces for blood. Which you might imagine is cheaper and noninvasive. (“The $2.7 Trillion Medical Bill” The New York Times, June 1, 2013, Elizabeth Rosenthal.)
We live with a medical system that makes money by subjecting healthy, relatively wealthy, subjects to as many tests and examinations as possible. And the results of the tests almost always lead to procedures and pills.
Consider that even the most basic service, the “annual physical,” has no standard elements. If you’re a wealthy exec, it can include a five day stay at the Mayo Clinic, full of tests.
End of life for many people is full of doctors appointments and tests.
Most doctors and dentists I’ve met over the past three years have never heard of CranioSacral therapy, let alone recommended their patients seek it out.
And what of movement and the things we eat and drink? Oh those have so little to do with human health that doctors don’t get trained in them nor do they then discuss such things in any detail with their patients!
Ultimately, I believe it’s important to learn a term that conveys the domain of doctors: pathogenesis, or the origins of disease. Yes, sometimes we want and deeply need help in this domain.
Ever Heard of Saludogenesis?
I assert that the modern human has another Job To Be Done.
Rather than merely seeking the roots of disease, it is valuable to know and support the origins of human health.
Functional Medicine doctors and Naturopathic doctors are doctors who have expanded beyond pathogenesis. Yes, they too often also wear white coats to benefit from the halo of authority as they swim against the mainstream. And yes, I’m finding they often push supplements they earn money from selling, but they also have more coaching programs to really help change behavior. Something humans need and that just won’t happen in a five minute visit to check on a mole or persistently painful ankle.
Beyond the evolution of the role of doctor, the things I’ve written about on Project 100 are in the saludogenesis category: CranioSacral therapy, pilates and other movement modalities, moving the lymph, maintaining good air quality, making sure to breathe while you sleep. These things help the body do what it does naturally, well.
Today, I’d like you to consider the sizable amount of time and money that is spent on pathogenesis. As one example, the average individual in the US is spending $7900 a year on “health insurance” and a family is spending over $22,000.
This in turn results in 70% of Americans taking one prescription. 50% are taking at least two.
I simply imagine how our culture would shift if we spent anywhere near as much on saludogenesis. Imagine if you had $7900 to spend on wellness activities. How would you spend it? A portfolio of visits for acupuncture, massage, fitness training, wellness coaching, and a cryo/sauna/floating membership sound like privileged luxuries before you stack them against access to pills and surgeries.
What would it feel like to live in our bodies if we had access to emergency care along with access to nutrition and movement care? What would happen if it were normal to have an agent working on our behalf who studied methods of saludogenesis and helped us find what worked best for each of us? That is a future I’m eager to create.
Spot on! Love your mission!