Doctors, Dictators, And The Medical Autocracy

Authored by Amy Denney via The Epoch Times (emphasis ours),

Jean Wendrick acknowledges that she’s been mostly unhealthy her whole life—suffering from diabetes since she was in her 20s and overcoming breast cancer more recently.

(Illustration by The Epoch Times, Shutterstock)

At a doctor’s appointment last year, Ms. Wendrick learned she has osteopenia, a condition in which her body isn’t making new bone cells quickly enough, which often leads to osteoporosis. Her doctor suggested medication—the same type her mother has been taking.

“It was devastating to me,” she said. “My mom is hunched over with osteoporosis and can only look at the floor. She’s in so much pain, and she took all the meds. It was all for nothing.”

While Ms. Wendrick can see her potential future when looking at her 86-year-old mother, she also finds reasons, when thinking of her 18-year-old daughter, Victoria, whom she had at age 47, to make the changes that can restore her health.

Thus, Ms. Wendrick became determined six months ago that she would live out her years in the best possible health. She knew it would demand real change and a true return to a healthy lifestyle—something her doctor’s prescriptions could never give her.

The Doctor’s Dilemma

Ms. Wendrick’s experience is common. Facing devastating illness, patients are offered drugs that have little effect and create problems that patients may never be told about.

It is common for doctors to suggest only two types of treatment options: drugs or surgery. (Daria Serdtseva/Shutterstock)

While some doctors will do little beyond suggesting surgery or a new prescription, many others do recommend their patients make lifestyle changes to fundamentally resolve the cause of chronic conditions.

However, all too often, these recommendations come as brief commands to “lose weight,” “exercise more,” or “eat better” and are often served with a sprinkle of judgment.

Health care providers may then blame patients for their inability to follow such orders.

A study in Finland echoes findings in other settings where physicians and nurses say patients with obesity, Type 2 diabetes, high blood pressure, and who smoke, just won’t do what they are told.

“A majority [of both physicians and nurses] agreed that a major barrier to the treatment of lifestyle-related conditions is patients’ unwillingness to change their habits,” the study states.

And all too often this is true. However, research also suggests doctors and nurses dispense such advice in ineffective ways. Giving orders in brief and hurried appointments is not an effective way to get patients to address long-standing habits, like eating certain foods, advised Dr. Ann Lindsay, a physician and clinical professor in medicine at Stanford, in an article in Stanford Medicine’s Scope magazine.

“Everybody basically wants to lead a healthy life,” Dr. Lindsay told Scope, “but there are different beliefs and obstacles that contribute to ambivalence.”

Helping patients overcome those beliefs and navigate those obstacles simply isn’t in the job description for many health care practitioners.

Many doctors have hundreds of patients and spend too little time building a genuine connection with or an understanding of them. (peterfactors/Shutterstock)

One part of the issue is a lack of time. Another part of the issue is that physicians simply don’t know how to help patients or communicate these issues well. Many doctors have no meaningful relationship with the people whose lives depend on them.

Physicians who learn how to communicate well are more than twice as effective in getting patients to make lifestyle changes, said Dr. Lindsay.

One of the reasons for the rise of functional medicine is a desire from both patients and physicians to focus on the systemic lifestyle factors behind disease.

A Different Approach to Medicine

Making changes requires patients to take responsibility—and health care practitioners to effectively support that change, say experts.

“Before I had excuses. I ate what I wanted when I wanted, and I was eating for emotions. I always had symptoms. I didn’t do any exercise. It was awful,” Ms. Wendrick recalled. “Now, there is a reason for me to get up in the morning and finally take care of me. I know it takes discipline and determination to get results.”

Ms. Wendrick is on a mission to get her diabetes under control, lose weight, and strengthen her bones. She hired a new doctor to help her succeed, Dr. Scott Doughty, a family doctor at U.P. Holistic Medicine in Michigan. Ms. Wendrick calls him “the boss.” She’s lost 30 pounds so far and said she feels like she’s in her 20s.

For the first time in her health care experience, Ms. Wendrick felt listened to and that she had suitable options and a support system that would allow her to avoid the poor prognosis she was facing. It became easier for her to comply because she felt in control and supported by Dr. Doughty, she said.

Ms. Wendrick isn’t an exception. Patient engagement, motivation, and support are vital ingredients for healing disease from the standpoint of functional medicine and research studies.

The American Medical Association (AMA) says doctors need to help patients find their motivation and give them small but meaningful targets for improvement—like a 5 percent weight reduction.

The AMA also raises the need for an engaging coach, someone capable of getting patients to participate in lifestyle programs.

People often need the support of a health coach, nutritionist, or personal trainer to make meaningful changes in their daily habits. (The Good Brigade/Getty Images)

Unfortunately, these programs are still hard to come by in many areas and physicians may not even be aware they exist. All too often, doctors simply tell patients they need to take a new drug or have surgery, with little in the way of discussion.

Medicinal Commands

A 2019 study revealed that a shared power balance between patients and health care providers was critical to active patient participation and adherence to treatment in chronic illnesses.

“Patients cannot be forced to follow a lifestyle dictated by others,” notes the study published in the International Journal of Community Based Nursing and Midwifery. “The finding suggests that adherence is facilitated by empowerment that includes competence in self-care, adaptability, and persistence in treatment.”

Telling people they need to “stop this or stop that” almost universally fails, Dr. Joel Evans, founder and director of the Center for Functional Medicine, told The Epoch Times. It’s more effective, he said, to find beneficial things to add to behavior such as eating more fruits and vegetables.

“By talking to patients this way, they feel more cared for, and they’re more likely to participate in the creation of a plan … and they’re more likely to follow the plan,” Dr. Evans said. “The doctor dictator doesn’t work.”

While it can be frustrating to encounter doctors who don’t offer options or support, patients can voice concerns, ask for more resources, or find help elsewhere as Ms. Wendrick did.

Doctors As Dictators

Physicians find themselves in an impossible bind. They often believe they must convey a sense of certainty and authority to give their patients confidence in prescribed treatments—and yet there is little certainty in medicine. This can lead to issuing orders rather than engaging patients in more meaningful conversations.

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