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Dr Shoshana Scott

My Lunch with Dr Daniel: Insights into Medical Culture

Friday, Nov 20 - 2015

As an alternative medicine practitioner, as I was termed in the old medical clinic where I used to work for the past five years, I was privy to insights into the lives and challenges of medical doctors. What is particular about that clinic is it is staffed by dedicated physicians who are educated to a degree on alternative medicine and interested in an interdisciplinary approach.

 

My office was often party central in the good fun times but often also  a bit of a confessional/complaint centre for a bunch of the “docs”, as we affectionately called them. Mostly due to the bureaucracy in the clinic in which they found themselves, frustration, tears, a sense of failure and general unease were not uncommon.

 

They were physicians who openly admitted that they cannot successfully give what they wish to give to their clients in the ten minutes allotted. Some choose to spend more time each client, for less money, but because they work on a percentage basis are under pressure from the clinic itself to make more money. That kind of practice is not healthy they say woefully, ruefully. And some of them leave the profession, others have retired, another wanted to choose a related form of work, others went to work in a walk in setting or in emerg.

 

Yesterday I had lunch with one of my favourite doctors from my old clinic. This lunch came about one month after my move to my new clinic setting. (Also multidisciplinary but not conventionally medical). 

 

Daniel is my favourite doctor because he cares deeply about people,medicine and how medical culture. as he terms it, has gone astray. He is a brilliant diagnostician and clinician who never failed to bring satisfaction to the clients we saw together. Daniel retired recently due mostly to what medical culture has become. I find his insights on medicine interesting and of course useful.I hope you do too.

 

The first thing Daniel did was to present me with a gift. He passed along a book from Holland called Minor Ailments in Primary care, about all the little things you see in practice. Daniel  said he was giving this to me because diagnosis, reassurance and follow up, are always the first steps. 

 

I thanked him profusely because he is absolutely right. I used to send people to the doctor because I could rely on the doctor to diagnose and tell the client what was wrong. Small things from ear lobe inflammation to threadworms to croup, so I could properly prescribe by obtaining a second opinion and at the same time ensuring nothing more serious was occurring. But as I told Daniel, I can’t always rely on their ability to diagnose any more. For example I had a patient with a skin eruption that looked like scabies. I sent them to her GP for a diagnosis. To properly diagnose scabies, to differentiate it from bed bugs for example, you need to do a little test and observation. The test wasn’t done. She was told it looked like bed bugs and was given a referral to a dermatologist.

 

Daniel calls this common situation, this “clinical ambiguity”. It unwittingly produces unintended anxiety for clients. He basically said it is about what a wishy washy diagnosis does to people. He mentioned for example that bed bugs come with all sorts on implications including possibilities of infidelity even. Other times it produces worry, anxiety and searches on the Internet that may lead to erroneous conclusions that are more serious than what people actually have, or solutions that are less than effective.

 

The other thing Daniel told me is that it is time to speak out about about the culture of over prescribing and over unnecessary testing which at great health and monetary cost. Daniel referred me to an evidence based text written by a medical advocate who describes which  tests are being over performed, and what medicines are being over prescribed and when and why. Just to be clear, the tests and medications are of course often useful and valuable when performed and prescribed at the right time. Daniel called it “wise-use”. Homeopaths call it judicious use,

 

For example, there is the  overuse of anti-chosterol drugs such as Lipitor and Crestor. While they have their place, there are scales of measurement to ascertain people’s risk of a cardiac incident that need to be taken into consideration in addition to lab work ups such as family history, medical history, history of smoking and blood pressure. The blood work itself also has to be closely examined. A high cholesterol level in and off itself is meaningless. It is the cholesterol ratio that is important along with the type of cholsterol, HDL versus LDL (HDL is the good one).

 

These drugs have side effects. Wrong use results in unnecessary problems that people over time come to regard as part of their disease itself such as joint and muscle pain.

 

One of the controversial  issues that also falls into this category  is protocol for dealing with prostate biopsies and prostate cancer diagnoses.. It is important to get the right information at the right time rather than jumping the gun on treatment and to know when to treat and how.

 

We also briefly discussed the over use of antibiotics and its ramifications such as superbugs and antibtioic resistance.

 

As I told Daniel, I am quite sure that antibiotics will no longer be very useful by about 2025. This was told to me years ago by Dr Leelamma Nielsen, a Homeopathic doctor working in Winnipeg who essentially revived Homeopathy in Manitoba during the years I lived there. 

 

Daniel agreed and described the latest trend in medicine to me that he hopes will help to deal with it, ecological medicine. 

 

Ninety percent of the Staph bacteria are good he told me (referring to MRSA or methyl resistant staphylococcus aureus bacteria which as the name implies are already resistant to many antibiotics). This concept is the idea of replacing the 90% rendering the other 10% less toxic.

 

My answer comes from experience with Homeopathic medicine in the treatment of infection. The immune system within our own body is far more intelligent that too many cooks who can spoil the broth, so to speak. Pouring in a bunch of ingredients that we hypothesize might be the right balance is far less efficient than providing Homeopathic medicines that are targeted to bring each individuals immune system into peak efficiency, letting it sort out its own internal balance of good bacteria, yeast, protozoa and so on most of which are “good”.  Then we provide the nutrition and environmental conditions to foster this. And voila, the infection resolves and the person’s immune system is working better at the same time. Obviously this is harder in countries where poverty prevents this. Tragic in fact. But in Canada where we live, it is a good, strategy and sound ecological medicine in my opinion. Then we reserve antibiotics for more extreme emergencies so they can still work too.

 

But at least the concept of ecological medicine coming into vogue means that scientists and  doctors are recognizing  that when you wipe out most of the fauna and flora with a broad spectrum antibiotics in the body, or with pesticides in a farmer’s field, it makes the body or the field totally vulnerable to invasive pathogens. That without its natural predators present to spot to defeat them, bad bacteria will land and grow unfettered.

 

Daniel consults with me on my clients cases where the right protocol is controversial.  Each case is different and requires a unique homeopathic prescription as well as a plan of action that is right for them. I love working with Daniel in this way. He reviews the whole case with me and is then able  to comment on the surgery, investigations, and treatment options that might be the best. Not the homeopathic ones of course, that is my department. He will ask if I have a treatment for this part or that part, and what will be the outcome and together we work out a plan each within the scope of our limitations.

 

Just as when different cultures can come together and work wonders, so too can multidisciplinary medicine be greater than the sum of its parts.

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