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The Medical Paradigm Is Fatally Flawed

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We live in a society based on a fatally flawed paradigm, a fact that is becoming apparent as we face a collapsing economic system in a collapsing environment. Even so, many who recognize the flaws of these systems still hold tightly to the concept of a medical system that exists for their benefit. It is, though, part of the same flawed paradigm.

 

Where Is Common Sense in Medicine?

Why is a child who gets bored in class labeled with a psychiatric disorder, and then drugged for it?  Why are there so many new mental diagnoses: oppositional defiant disorder, conduct disorder? Any child who acts up can be labeled with a psychiatric disease, and much the same is true of adults.

Ultrasound is used to determine a baby's position during childbirth, when palpation can do the trick just fine. Why use expensive technology with no long term independent studies that document its safety on the fetus?

Just as other corporations have raped the earth of its resources and people of their economic freedom, medical corporations are raping people of their health and finances. Have you noticed all the "pre" conditions that are being defined? No longer must you worry about getting diabetes, you must also be concerned if your doctor says that you're prediabetic. After convincing us that osteoporosis is a disease that women can virtually expect to get, we now learn that you can also suffer from osteopenia, pre-osteoporosis. Of course, that diagnosis wasn't invented until a drug to treat it was in the process of being developed: a drug that, by the way, probably causes more cases of genuine osteoporosis than it prevents.

Normal life processes are now defined as diseases. Pregnancy is a condition that requires treatment, let's not even talk about what's happened to childbirth. Menopause is a disease, and attempts have been made to convince men that they have andropause. Suggestions that nearly everyone should be taking statins to prevent heart disease are starting to pop up—in spite of the fact that statins don't prevent heart disease.

If you've ever had an MRI, you probably know that the radiologist always wants to see previous films before examining a new one. Does this make sense? When examining films of severe pathology, about one-fourth of radiologists' diagnoses vary from the rest, and 31% disagree with their own results on second examination of the same films. Could it be that the radiologists want to make sure that they don't contradict each other—or themselves?

Thyroid cancer and dysfunction is becoming commonplace. About 20 to 30 years ago, dentists started to insist on x-rays as routine parts of examinations, in spite of the fact that radiation exposure is linked to genetic damage. Are common medical diagnostic procedures, such as dental x-rays and mammograms, putting future generations at risk?

Dr. Robert S. Mendelsohn, author of Confessions of a Medical Heretic, enjoys telling of the study that documented 197 out of 200 people being cured of so-called abnormalities simply by retaking the diagnostic tests. So much for the accuracy of modern medical tests.

The Culprit

What's the real cause of all this? Mendelsohn tells a story that leads us to the heart of the issue:

One of the common dangers of going in for an exam is that you'll be used for purposes other than your own. Years ago, after becoming director of an outpatient clinic I found out that one of the routine questions asked of mothers was "Is your child toilet trained?" Every boy who was not toilet trained by the age of four was separated out and referred for a urological workup, which included, among other things, a cytoscopy. All these four-year-old kids were being cytoscoped! I immediately eliminated the question about toilet training. It didn't take long before I got a call from the chairman of the urology department…He was very angry…He said it was important to do this kind of examination in order to find the rare cases in which there might be something organically wrong. Well, of course that was nonsense, because all the rare cases can be identified by measures that are far less dangerous than a cytoscopy.

Then he told me more about what was going on. The real problem was that I was destroying his residency program because in order for a residency to be approved by the accrediting authorities, the residents have to perform a certain number of cytoscopies every year. In this case it was around 150. I was taking away his source of cytoscopies, and I got into trouble over it.

An Allegory
In a brilliant article, "John Deere and the Bereavement Counselor," John L. McKnight tells the story of a prairie town where bereavement counselors move in. They take over the local means of dealing with grief, in which loved ones and community members mourn together and support each other, with a new bereavement technology, for which they provide the support system to process grief. They convince the local government to provide their services to those who aren't able to afford it. Of course, those who trust in new technologies take advantage of this new and wonderful technique. The former grief infrastructure, such as clergy and family members, avail themselves of the wonderful new tools provided. It isn't long before the new technology replaces the old methods.

The old methods were part of the commons, that is, no single person or group owned them; they were owned by everyone and shared equally. No one would have thought of owning grief. The new methods, though, are held by a new elite, the ones who own the new bereavement technology. The "community of mourners" disappears, replaced by an impersonal service, owned and controlled by an elite group. As McKnight says, "The counselor's new tool will cut through the social fabric, throwing aside kinship, care, neighborly obligations, and community ways of coming together and going on."

McKnight goes on to discuss how such a service technology creates "counterproductive constructions." He points out that these constructions become so costly, they distort a society's economics.They result in "sickening medicine, stupid-making schools, and crime-making correctional systems." And, they result in loss of knowledge, as the old ways of the commons are lost.

The Medical System

The medical system is equivalent to McKnight's bereavement counselors; health care has been monopolized and pressed into a crushing hierarchical system. What were once elements of the commons, health and treatment for illness, have been co-opted by an establishment that may have started with the best of intentions, but has evolved into a multiple-limbed monster. The consent of those it rules is presumed. When one of the nonelite resists, that person is assumed to be deranged, and often treated without his consent — for his own good, of course.

The medical system has helped to destroy community. The dying are treated technologically, while the needs of the person leaving the world are unmet, along with those of loved ones, neighbors, and community. The process of death itself, rather than acknowledged as the final act of life, is lost in a pointless fight that degrades everyone. The person whose health has suffered is likewise treated as the object of technology.

The medical system has lost its purpose. Healing is no longer its goal, gaining more customers is. Thus, we have the medicalization of normal life processes. The focus on symptoms, rather than their cause, is the issue, so the actual disease is merely masked. Perspective is lost in using drugs with a wide range of deleterious effects in the hope that one might be beneficial in suppressing one symptom. Its practitioners wear blinders, refusing to see the harm they're doing, and often refusing to provide the desired care.

The medical system has molded itself into the modern paradigm of a corporation. Just as we find it virtually impossible to even imagine any part of our needs being supplied by anything other than a corporation, our medical needs are also supplied in that manner. If it wasn't manufactured by a corporation, the system is trying to create suspicion of it. Vitamins are treated as dangerous. The FDA states that any health claim made for anything — even soup! — makes that thing a drug. Only recently, the maker of Cheerios was informed that its health claims magically turned a breakfast cereal into a drug.

The medical system tells us what they will give us, packaging it into a profitable product. You want to be left alone to deal with the pain of your iatrogenic illness, just given narcotics to ease your suffering? Good luck finding that product for sale. We'll send you to the latest and greatest pain management; that'll teach you how to live with your pain. It doesn't resolve your pain? Well then, you must be mentally ill. Certainly, you're depressed and need the latest and greatest pharmaceutical designed just for depression-induced unmanageable pain. And if that doesn't work, we have…

The medical system has transformed itself into the ultimate modern paradigm, corporate business, and corporations are at the heart of the ill-designed modern paradigm. Just as other corporations have raped the earth of its resources and people of their economic freedom, medical corporations are raping people of their health and finances.

The Corporate World

When any business entity transforms itself into a corporation, it almost certainly takes on the characteristics of a sociopath. Watch the documentary, The Corporation, which explains that a sociopath exists for his own benefit and has no empathy for others, and that a corporation fits all the traits attributed to such a person. By law, a corporation is beholden to only one thing: profits. By making itself into corporations, the health industry has truly made itself into an industry, a structure designed to make profits by selling goods. The image of its purpose as being for the good of people is relegated to the status of marketing, something designed to convince people to purchase their products.

So, the medical corporation distorts its original objective of healing. It subtly redefines. Rather than healing, it focuses on symptoms. If it can define a health problem in terms of a symptom, then it can focus on suppressing that symptom. If it can suppress that symptom, it can claim success. Medical corporations package products to treat symptoms. So, by the technique of redirection, convincing people that the problem is a symptom rather than what caused the symptom, products are developed and marketed. The medical corporation is a structure for profits. The original goal of healing is lost.

The Bottom Line

If one takes a step back, it becomes obvious that there is something very very wrong with the medical system. It not only condones concepts that make no sense, it advocates for them.

It's obvious that it's irrational to routinely use radiation to detect breast cancer, when the means of detection actually causes the disease it's supposed to find. It should be obvious that this is a flawed approach, unless and until it can be conclusively documented that the benefits outweigh the risks. Instead, the opposite happens: if a technique is profitable, it's used and vigorously promoted and defended. When someone manages to prove that harm outweighs risks, that person is condemned. It's abandoned only when there's an overwhelming case against it, when the cost of defending is greater than the profits. The bottom line must be served.

Women have gone through menopause ever since there were women. It's simply a stage in life, not something to be cured. Now, though, it's a disease, one that must be fixed by replacing hormones that are no longer required. The fact that these drugs increase death from heart disease and cancer? Oh well, the bottom line must be served.

The child who can't hold still in school is a nuisance. That child disrupts a part the corporate system — providing fodder for its economic maw. The medical system defines that child as having attention deficit disorder, and then it drugs the child, without any consideration for permanent damage done by the drugs. It profits while strengthening the corporate paradigm. The bottom line must be served.

The bottom line is the paradigm. Everything we require to live is twisted to serve the corporate purpose of profits. Energy. Transportation. Food. Health care. Grieving. It makes no difference. Where one corporate function can out-compete another, as in grabbing as much of a person's property during the dying process as possible leaving less for burial and grieving; well, that's part of the corporate game.

Health care has become one of the corporate world's most successful products. In 2008, it was 17% of the US's GDP, about $7,900 per person, and the rate of growth continues to escalate at double the rate of inflation. It's expected to reach 20% of GDP by 2017.

In the world of corporations, few businesses have had the success of Big Med. In 2002, Big Pharma topped the Fortune 500 list. Since then, the energy crunch has launched oil company profits ahead. However, in 2008, the profits of the top eight pharmaceutical firms were in the billions, and all but one of the next 11 were in the hundreds of millions.  In a corporate world, the bottom line is the bottom line. Profits are the raison d'être.

The Flawed Paradigm

Once a product or service has been corporatized, every aspect of it is addressed for its ability to exact profits; medicine is no different. By joining the corporate paradigm, medicine has ceased to be primarily a force for wellbeing. Any flaw found, such as a drug's side effects, is turned into yet another profit center. McKnight likens this process to pyramid building, saying:

They [medical corporations] envision a landscape scattered with pyramids of new technologies and techniques, each designed to correct the error of its predecessor but none without its own error to be corrected. In building these pyramids they will also recognize the unlimited opportunities for research, development, and badly needed employment. Many will even name this pyramiding process "progress" and will note its positive effect upon the gross national product.

Damage is turned into a profit center. The leaders and profiteers of the corporate paradigm see that as good.

The result is distortion of resource use and how we view the world. McKnight tells of Medicaid, wherein the child of a grindingly poor woman is provided with medical care at a cost that's 1½ times what is provided for food and shelter. That child's health would almost certainly be better served by providing better food and shelter, but the lens of appropriateness is distorted.

The same may be said for drives to provide vaccinations and medical care to the desperately poor in Africa, when they would be far better served with adequate food, clean water, and a stable environment, their lack being the real source of their misery. That, though, wouldn't serve the corporate medical juggernaut.

Society itself is distorted. Mere humans take on the stature of gods. A person is thrilled when her doctor pays attention to her. She feels special, and even brags about it. What does this say about her view of reality? A mere human is looked upon as a god, whose word must be accepted as truth, and whose every utterance must be obeyed. A class of demigods has been created.

These distortions cannot go on, and what cannot continue won't. We're seeing that in the environment, where pollution of every possible sort is destroying the ecosystem on which we depend. We're seeing it in our economic system, which gets patched over and over, each new patch providing a new source of profits and increasing the risk of the whole system catastrophically coming apart. And we see the same thing in the medical system. It absorbs an insanely large portion of the economic resources. It has changed the focus from healing to suppression of symptoms. It invents diseases. It profits from the damage it creates. It distorts society. It has removed most of the individual's ability to treat illness, causing a massive loss of healing knowledge. It has infiltrated the most private areas of our lives. It presumes to define mental health, and forces those on whom it's placed a mental illness diagnosis to ingest its poisonous drugs.

From birth to death, the corporate medical system has productized and profitized every aspect of health. Modern medicine serves up every stage and aspect of life to Profit. After destroying the methods and knowledge of the old ways, what will be left to replace them? In the end, we'll lose not only the social structures and old knowledge around health, we'll also lose the knowledge and skills of the new. As with a collapsed economy or environment, in the end, we all lose.

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About Heidi Stevenson

  • http://drdreadful.blogspot.com Dr Dreadful

    Good article, although I detect a fair degree of Luddism.

    In particular, I would have liked to see citations for some of your claims, such as that:
    – the drug used to treat osteoporosis may actually increase the risk of developing OP
    – statins do not prevent heart disease
    – the radiation levels used to detect breast cancer may actually cause it.

  • http://gaia-health.com Heidi Stevenson

    Actually, I love science. It’s twisted pseudo-science that troubles me. Sadly, the bulk of medical research is twisted by the sources of funding. By the time the truth comes out – usually in genuine university research untouched by Big Pharma – millions have been harmed. That’s the case with statins, bisphosphonates, and x-rays for diagnostics.

    I was a computer programmer who has worked in rocket testing – hardly a Luddite’s profession!

    Citations: Statins (First of 4 articles with several citations) The Lancet (Just the beginning of this issue, but enough to start.) Bisphosphonates (Bisphosphonates are the class of drugs used to supposedly prevent osteoporosis. This is another beginning point.)

  • Clavos

    Heidi,

    Sources offered on our comment threads should be presented as HTML links, rather than raw.

    One of the Comments Editors will correct the ones above for you, but we would appreciate your coding them in the future.

    Thanks!

  • http://gaia-health.com Heidi Stevenson

    Thanks, Clavos.

  • robert matthews

    Heidi – just a friendly note before other less friendly voices wade in to rubbish your entire article for the egregious flaw it currently contains: radiation is not used to check on babies in utero (let alone “in childbirth”, where it’s not exactly hard to tell): it’s ultrasound. Even MRI scanning, which involves electromagnetic radiation, does not involve the kind of radiation that causes leukaemias – that’s “ionising” radiation, such as X-rays. Cheers!

  • http://gaia-health.com Heidi Stevenson

    Thank you, Robert. X-rays were originally used for pregnancy scans, in spite of being known to cause cancer and teratogenic effects. X-rays didn’t go until ultrasound was available to replace them. I was stuck in a bit of a timewarp when writing! Of course, ultrasound may not be as harmless as generally thought…but that’s a different issue.

    In any case, you are correct. I’ll see if the article can be corrected.

  • satish chawla

    I am a retired physician and I agree with the gist and the sense of your article. I feel helpless in the face of the over whelming forces that are driving our delivery of medicine and rue the loss of the humanity in medicine.

  • Baronius

    A good portion of this article is about the methods of seeing inside a person. No doubt these techniques are overused. But they are excellent diagnostic tools. Doctors don’t have to open you up to find out what’s going on – not that exploratory surgery was ever that common, because it was so dangerous. Doctors can more easily find the problem and perform a minimally invasive procedure to fix it. It’s not fair to look at the drawbacks of increased radiology and other methods without looking at its non-financial benefits.

  • http://gaia-health.com Heidi Stevenson

    Baronius, I think your point is valid – to a point. Certainly, many of these tools have good uses—I’d be the last to suggest otherwise. However, the point of the article is that they are abused more than used, that profits have become the primary goal of the medical system, that the very paradigm of medicine has been warped by capitalism.

  • http://gaia-health.com Heidi Stevenson

    Comment #5 from Robert Matthews made the point that ultrasound is used for pregnancy scans, rather than x-rays, as I’d originally written. The article has been modified (under Where Is Common Sense in Medicine on page 1) to reflect that.

    Thank you, Robert, for bringing it to my attention.

  • Clavos

    However, the point of the article is that they are abused more than used, that profits have become the primary goal of the medical system, that the very paradigm of medicine has been warped by capitalism.

    While I don’t doubt that some tests are administered for profit reasons, the research I’ve done, and the experiences I’ve had as my chronically ill wife’s caregiver and patient advocate (I’m writing this at her bedside in the ICU, in which she’s been for the last two weeks of what is so far a sixteen week hospital stay), is that the vast majority of tests are ordered by one physician and performed by the radiology group, which is who gets paid for them, not the ordering physician.

    That said, it is unquestionable that we over test in this country, but my research indicates that the primary reason for this is the widespread practice of “defensive medicine,” which is defined as medicine ordered to protect the physician from liability in the event of a lawsuit.

    It’s for this reason that I think that any proposal that does not include provisions for tort reform is a recipe for disaster, with the likelihood of not stemming the ever-rising cost of medicine in this country at all.

  • http://gaia-health.com Heidi Stevenson

    Hi Clavos,

    I’m so sorry to hear of your wife’s chronic illness, and dearly hope that she will be able to recover.

    My best to both of you,
    Heidi

  • Clavos

    Thanks, Heidi. She has too many things wrong with her to ever “recover” in the fullest sense, but we’ll both be happy if she can just come home again soon.

  • http://joannehuspek.wordpress.com Joanne Huspek

    Great article.

    I know of physicians who try to buck the system (insurance) but it’s tough. They do so at their own peril.

    Good parallel to “corporations.” All customers (patients) should realize this before going in for anything. I have insurance but it’s very costly and I’m careful with it. Patients have to take some of the responsibility. They can’t look at doctors like gods and they have to be sensible. But we are indoctrinated to this way of health, so it’ll be a tough sell to the masses.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    You might add this to your collection, Heidi – the Pfeizer story.

  • http://gaia-health.com Heidi Stevenson

    Hi Roger,

    Funny you should say that. The article above was my first for BlogCritics, and my second is What the Pfizer Settlement Really Tells Us, or “Why the Pfizer Settlement Doesn’t Give Me a Warm Fuzzy”.

  • Clavos

    Um, Heidi,

    Why do you think he gave you the link?

  • http://gaia-health.com Heidi Stevenson

    Um, Clavos,

    The comment is on the Medical Paradigm article, and the link is to something outside Blogcritics. Naturally, I assumed that he was trying to add information that helps support Medical Paradigm. Why would I think he’d read my Pfizer article?

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    I haven’t, Heidi. But the Pfeitzer story is breaking news.

  • http://gaia-health.com Heidi Stevenson

    Hi Roger,

    Yeah,that’s what I’d figured – that you were letting me know about the Pfizer settlement (which I do appreciate – thanks). You wouldn’t have known that I’d written about it – was in a mad rush to do so. Mine is an opinion piece, not rehashing the facts.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    I’m sorry, Heidi, but I don’t read every article posted here, and I didn’t read your, yet. I just thought it would be a good idea to piggyback it to yours.

    In fact, George Noory’s Coast-to-Coast AM show last night features John Abramson (Overdosed or Overdosing America), and he was very informative about those issues. It made an impression, consequently I decided to post.)

    You might look him up, BTW. He’s been an articulate critic of that pharmaceuticals for quite some time and quite knowledgeable. It is really a pity that the present healthcare reforms aren’t doing enough on this subject. He’d voiced some excellent ideas on the subject yesterday, and perhaps I’ll be able to find a synopsis of the show. Most important, was the fact that the purchasers of the insurance products – consumers such as the unions or the employers – do not exercise their responsibility in the market place, in demanding that the big companies like Pfeizer shape up. If I find anything meaty, I’ll post it here.

    Roger

  • http://gaia-health.com Heidi Stevenson

    Roger, you don’t owe me an apology – hardly! And I certainly don’t mind you posting a related link. That’s a big part of what this is all about.

    No way can any of us read everything – I was trying to let you know that I took your post as a compliment.

    My primary problem with healthcare reform is that it really isn’t that – it’s reform of how it’s paid for. The healthcare system itself isn’t changed in the least, and I think that’s tragic.

    I just started checking up on John Abramson, and found this link, an interview with him – interesting.

  • María

    Heidi has a point- medicine is certainly becoming not only a for profit enterprise, but also appalingly dehumanizing.

  • steve

    I fear you are throwing out the baby with the bath water. Most particularly in this country medicine has been corrupted by the capitalist system — an economic system that has the imperative of maximizing short term profits for the benefit of stockholders rather than long term planning for the benefit of society. This shows up in the ways our food is produced, how are children are fed, the long hours we work with little vacation time so family time is destroyed, etc. But, there are many very fine doctors who are devoted to their patients and who dislike or hate the present medical system. I know quite a few of them. Ultrasound is more expensive than a doctor’s touch, but it also reveals far more. There are situations where a baby’s breech birth can be avoided by manipulation by a doctor or mid-wife, but still C sections are needed. I think you tend to write without balance showing the reasons and benefits of allopathic care. By the way, I am a supporter of the intelligent use of chiropractic and am open to some alternative therapies. steve