The Role Of The Doctor: Pharmacist Or Therapist?

Recently, I led a teleclass with Dr. Bruce Lipton, author of The Biology Of Belief  and The Honeymoon Effect, as part of my Whole Health Medicine Institute MD training. During the class, we talked about the role of the doctor, and Bruce told the Whole Health Medicine Institute doctors a story about a physician who claimed that his job was to help his patients maintain the status quo in their lifestyles- even if that lifestyle was, for the most part, unhealthy. In other words, he was willing to address diet and exercise lifestyle issues if he felt it would benefit the patient, but he believed it wasn’t the physician’s job to get involved in whether a toxic relationship might be making the patient sick- or whether a soul-sucking job might be causing symptoms in the body- or whether an illness might be the result of a thwarted dream or a financial worry.

The doctor believed this his job was to medicate the symptoms so the patient could stay in the bad marriage or the unhappy job, so they could keep thwarting dreams and worrying about their finances- symptom-free. He believed his role was more that of pharmacist than therapist, and that the role of intruding into the personal life of the patient belonged more to the therapist than to the physician.

The Doctor As Mirror

Bruce and I both blatantly disagree. In fact, the nature of the doctor-patient relationship is at the core of what I’m teaching to both patients and health care providers in Mind Over Medicine. I believe it is ESSENTIAL that the health care provider hold up a loving mirror to help the patient address lifestyle issues that may be causing or exacerbating physical symptoms. To view the body as solely a biochemical organism, separate from its environment and the factors that threaten its homeostasis is careless and ultimately ineffective. The body’s biochemistry may be important to address, but the mind and the soul and the context of how they interact with the world are just as important.

The Body Is Equipped To Heal Itself

The medical literature is full of scientific evidence that the body is equipped with natural self-repair mechanisms that can be flipped on or off with the power of our thoughts, feelings, and beliefs. As doctors, I believe it is our responsibility to dig into the lives of our patients so we can help them figure out what might be activating disease-causing stress responses in the body and what they might do to facilitate healing relaxation responses in the body.

That doesn’t mean we shouldn’t use pharmaceuticals or surgical interventions when appropriate. But it does mean that medicating a symptom so the patient can maintain the status quo of an unhealthy lifestyle is not the solution. Consider the patient who gets severe migraines every time her boss yells at her- which is every day. Is she better off getting Imitrex? Or should she either set boundaries with her boss or find a new job?

Should the patient who is shouldering the responsibility of caring for her abusive, aging mother take Percocet for the disabling back pain she started experiencing right after her mother moved into her house? Or should she put her mother in a nursing home?

I’m not suggesting that Imitrex and Percocet won’t help the patient in the interim, as they muster up the moxy to make lifestyle modifications that will support better health.  But I am saying that treating the symptom with drugs and surgeries without examining what stressor might underlie the symptom is simply practicing bad medicine.

Symptom Relief Vs. Symptom Prevention

As Dr. Andrew Weil says in the documentary Escape Fire, “We have a disease management system, not a health care system.” Our health care system is badly broken because we are in the business of symptom relief, not symptom prevention.

The way our system is set up, most doctors are treating patients the way doctors treat injured football players- do whatever you can to set that bone, wrap that ankle, inject that joint, and get the star player back in the game. Nobody’s really thinking about the fact that the best way to help the injured football player is to get him out of the game- for good. And look what happens to pro football players down the road. Their bodies are wrecked. Most of them are getting knee replacements by the time they’re in their fifties.

We do the same thing to patients. We medicate them so they can get back into the game of an unhealthy life that is out of alignment with their Inner Pilot Light. And the consequences of such behavior are dire. As doctors, we promise to first, do no harm. But by slapping Band-aids on symptoms rather than helping patients get at the root of why the symptoms are there in the first place, we put our patients at risk of more disease and even premature death.

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