Limitations of Medical Practice
Each person has some control over their life course and
some ability to prevent injury and disease. Often, diseases emerge because of
ignorance or careless disregard for risky behaviors. On the other hand, some
people become overly concerned about unseen health risks and focus on small
issues, using casually gathered misinformation. Although their intentions are
admirable, their methods fail to achieve the right results.
Medical practice overall treats emerging diseases with
drugs and is less concerned with self-responsible actions that could prevent
disease and mitigate the consequences of diseases. Affluent countries tend to
create dependent citizens who may fail to act responsibly and instead, dependent
people expect that MDs and hospitals will rescue them from all misadventures.
Denial of Food Allergy
I continue to champion the idea of delayed pattern food allergy as
the cause of common dysfunction and disease. I join an illustrious group of
physicians who have recognized this possibility for over 2500 years, starting
with Hippocrates in ancient Greece. The problem for patients is that most MDs
remain ignorant of this possibility and do not guide patients toward a
solution. Medical care insurers should notice that this oversight leads to
expensive prolonged investigations and futile treatments. No-one knows the cost
of the oversight, but it must in the hundreds of millions of dollar per year in
the USA and Canada alone.
Another problem is that medicine promotes a
passive, dependent attitude and patients are discouraged from seeking their own
solutions for dysfunction and disease. I promote self-managed health care and
believe that intelligent, well motivated people can solve the most prevalent
health problems without medical resources.
I have abandoned the idea of neatly packaged diseases.
Health problems tend to cluster in groups and evolve over time. Many factors
contribute to the final end-stage disease, listed as diagnoses in medical
records. Non-specific illnesses may be misunderstood by physicians who have been
taught to make diagnoses of specific disorders. Often patients with mild
symptoms are proceeding toward a major illness, but they may suffer in an
ill-defined state for months or years.
As illnesses progress, more specific features tend to
emerge-dysfunction and tissue changes become more obvious, and medical diagnoses
become more useful. A heart attack or stroke, both calamitous events with
obvious features, fit the medical model well and tend to be diagnosed reliably
and treated in a standard fashion. These are end-point events - the underlying
pathology takes years to develop and increasing dysfunction is often ignored as
the pathology progresses toward a dramatic conclusion. Other processes may
remain ill defined; chronic fatigue, muscle pains, headaches and cognitive
dysfunction may make life miserable for many years before a more definable
disease such as arthritis becomes apparent.
One missing ingredient is self-responsibility. Since
everyone is blameless, any and all misadventures and environmental degradations
are tolerated . The supply of medical problems increases. Some injuries and some diseases are indeed blameless and any
good person will want to help the victims. But more than half of all diseases and injury are
self-inflicted and are preventable by well-informed self-responsibility.
Even if prevention fails, diseases such as diabetes require well-informed self-management. The American Diabetes Association
published revised Standards of Care for diabetes emphasizing that high-quality
diabetes care must be individualized to reflect the needs, interests, and
abilities of each patient. Patient education and motivation must be a central
component of quality diabetes care because the patient must provide daily
self-care such eating properly, monitoring blood sugar levels and fulfilling
exercise requirements.
Food Quality
A steady flow of molecules from the
environment enters the body of each individual through the air breathed and
the food and liquids ingested. This body-input determines health and disease
in whole populations over the long-term and the moment to moment functional
capacity of the individual. A person's performance can change dramatically
with changes in this molecular stream. The quality and composition of air,
food, and water changes continuously. The illusion of food continuity in the
supermarket conceals changes in the growth, contamination, storage,
spoiling, transportation, and merchandising of food products. To understand
environmental reactivity we must deal with changes, variability and
inconsistencies, and we must seek adaptive, flexible responses to changing
circumstances.
The improvement in the diversity and availability
of foods has been a mixed blessing with major problems emerging to negate the
potential benefits. Food is the most intimate part of the environment because we
ingest it. When something goes wrong, it makes good sense to look at the flow of
substances through the mouth for the source of the problem. We look not only at
the composition of the food but also, and more importantly, at the interaction
of the ingested molecules with body. Adverse reactions to food are common and
produce many disturbances by a variety of mechanisms. Diagnosing adverse
reactions to food is an important task of clinical medicine, despite the fact
that it is not currently taught in medical schools.
Stephen Gislason MD
Learn More
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