Streicher 1

Nadya Streicher

Professor Thomas Cherry

English 2089- Intermediate Composition

3 August 2017

A Disregard for Categorizing Medicine

The most celebrated member of the healthcare team, our physicians, may also be the root

of some of our healthcare issues as of late. The price to be healthy seems to be growing daily

regardless of the new scientific advances our nation is making. The National Center of Chronic

Disease Prevention reports the average American must pay $7000 annually on healthcare; this

doubles most other developed nations. Chronic diseases are rampant in our country, including

arthritis, diabetes, and obesity (Anderson). We have focused too much on the celebration of

research and lost sight of the true definition of do no harm and proper social skills. Our doctors

are first scientist and second humanitarian. Our broken system arises from a broken discourse

community; with a comparison of the mindset between Medical Doctors (MDs) and Doctors of

Osteopathic Medicine (DOs), we are best able to see the flaws in the way medicine is practiced

in our society today.

At the core, Medical Doctors and Doctors of Osteopathic Medicine are the same. Each

endure a rigorous education, beginning with a four year bachelors degree, followed by four

years of medical school, and either a residency or clinical rotation. Both MDs and DOs must pass

a certification exam before they can begin their practice, be it the USMLE or COMLEX

respectively (Gray). In practice, these doctors approach patient care vastly different, allowing the

community of patients to see the flaws in our system.

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Our standard internal medicine doctors appear to be a well-oiled machine. They rely

heavily on a team of professionals to best cover all bases of patient care. However, this reliance

gives rise to the biggest critique of our MDs: their overall discourse. Doctors are almost

emergency responders like fire or police. Patients have little to no interaction with them on a

regular basis; however, when something goes wrong, doctors are the first to call. Patients are

often initially asked, What is the problem? instead of a more general how are you feeling?.

Critics of allopathic medicine claim that there is an apparent disconnect between health and

wellness. Doctors are focused on physical ailments when recent studies point to a need to include

the treatment and care of mind, body, and spirit. A healthy mind truly does yield a healthy body.

Doctors who have adopted more psychological questions have an increased rate of patient

satisfaction (Frederic). Doctors need to be inviting that conversation more frequently to prevent

the onset of chronic disease rather than waiting for a patient to call.

MDs are applauded for their professionalism and shine as icons for white collared

workers. This strength also proves as a weakness and a great division in patient care. A

superiority complex often surrounds our brightest physicians. Dr. Silverman defines

professionalism as, not an attempt to protect physicians' power and status, he noted, but a

call to practice medicine in patients' best interests. (Silverman). With such a prestigious and

intense education, physicians do deserve utmost respect, however, they still are a servant to the

patients health and wellness. Sir William Osler, a physician at the beginning of the 20th century,

broke through this barrier by introducing bedside manner. He proposed the most credible

physician is first a gentleman and performs his duties as such (Silverman). Doctors who sit eye

level with their patient, rather than stand and look down, or collect personal data and engage in

some small talk are noted to be much less sterile and more approachable than a standard
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physician (Silverman). A charismatic doctor is a promising draw for patients. They reduce the

amount of fear and anxiety surrounding medicine and bring comfort to patients; this allows them

to feel confident to visit their physician more often than when something goes amiss.

This elitist attitude does not only yield a personal separation between patient and MD but

also a misunderstanding. Doctors are not often relatable to their patients as they are often marked

as too financially well off or of a high status. They often are stuck with their own personal ideas

of treatments with little regard to what the patient is actually capable of accomplishing. Dr.

Robin Selzer leads a powerful course on healthcare disparity at the University of Cincinnati. She

speaks on the issue that doctors are recommending preventative measures to people who do not

have the funds or environment in their reach. For example, a doctor may advise diet and exercise

to a patient who is pre-diabetic and hypertensive. However, if that individual is residing in a food

desert--an area with a lack of access to fresh food or grocery stores--they would be unable to

properly diet. These food deserts are often located in poor, crime ridden areas of town with lack

of access to fitness centers or safe parks to exercise. This makes the doctors plan of action futile

(Selzer).

Our MDs are pioneers in innovative, top level care. Where they lack in discourse, they

gain in overall practice and research. The US holds about 40% of the biomedical research pages

published in the past 10 years. We house top facilities such as John Hopkins. While other

countries are catching up, the United States still leads in sought-after, innovative care provided

by our MDs. (Herber)

In contrast, Doctors of Osteopathic Medicine are vastly more thorough in the area of

patient care. An initial visit with a DO tends to last one to two hours with follow up visits

between 30 and 60 minutes. They take an in-depth history, asking detailed questions about levels
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and sources of stress, area of town they live in, access to food and exercise, as well as the family

health history. Even from the visit, the DO may request diagnostic testing. They often operate

on a solo basis with smaller practices allowing for a more personalized approach with more time

with the doctor (AANP).

DOs are often applauded for their ideals in the empowerment of the individual. They

communicate to their patients as they are in charge and responsible for their own health and

wellness. Rather than the doctor having the power, they shift it onto the individual by utilizing

their personal strengths to better improve their health. They give more options and ask about the

comfort level with procedures. It is more of a request or invitation rather than a demand to

partake in medical examination and care. Instead of just prescribing a medication, they often turn

to therapies that allow the patient to participate in treatment. As noted by the in depth first visit,

DOs recognize lifestyle issue. Many physical issues arise from mental issues such as stress,

inadequate rest, or spiritual imbalance (Hart). They see a whole person rather than a physical

ailment. This is a more tender, love, and care, family approach in contrast to the more sterile, A

to B approach of Medical Doctors.

With all this proper, humane communications, DOs should be more popular than MDs.

However, while MDs fell short when it came to discourse, DOs often lack in practice.

Alternative medicine often has a bad reputation. It is smudged by sensationalism and the

infamous placebo effect. The American Medical Association upholds traditional, Western

medicine too very strict standards. Each treatment must go through rigorous testing in order for it

to be palatable to the patient consumers. Alternative medicine treatments and therapies are not as

strongly tested. With this lack of oversight, these methods of DOs are often less trusted as they

do not have the scientifically sound backings of traditional medicine. Critics claim if it was
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tested well enough, there would be no need to add the word alternative; it would just be called

medicine. Another argument against the DOs is the heavy price tag they have. Such

personalized care has to have a price as it requires more one on one time. The therapies as well

are often more expensive, and these are often out of pocket. It is reported that over $34 billion

per year in the US is spent on alternative methods with little research to the actual outcome

(Herman).

At the heart of a discourse community is true participation. With such a strong division of

alternative and traditional methods, it becomes hard to dub doctors as such a community. This

may be the root of some of the healthcare issues are nation has been facing today. Emergency

rooms are often flooded and have a long waiting list. There is a high rate of burn out for

healthcare professionals. The price tag for pharmaceuticals and alternative therapies is rising

each day. New scientific discoveries are affecting our bodies. We are in need of a sleek and

strong team of medical professionals in our nation today.

Medical doctors need to adopt the Doctors of Osteopathic Medicines discourse and

incorporate the openness to alternative methods while retaining the stability and efficiency of

tried and true pharmaceuticals. This blend can create one unified community of just doctors. No

separate distinct titles needed Medical schools should begin to teach the thorough, almost

neighborly bedside manner to their students. By truly understanding the environment patients

live in, proper preventative care can be given which can dramatically reduce emergency

department visits. What is born is called integrative medicine, a happy blend of East and West. It

is the middle ground needed by our healthcare system.

Integrative medicine is still based on science. However, it acknowledges that certain

therapies are more effective. For example, self-guided meditation for cancer patients or at home
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spa treatments for Parkinsons patients are much cheaper than some of the options offered

currently. Harnessing the communication of DOs is also key. Using key phrases and knowledge

of their social surroundings allows patients to feel more involved in their care. Physical

therapists work hard to adapt this communicative shift. They remind their patients of important

things in their life in order for them to abide to therapy. For example, speaking to a man with a

broken leg, a therapist might remark he might not get to go golfing again if he doesnt suffer

through some of this pain now.

Intervention is the heart of this new realm of integrative medicine. Doctors must act way

before health issues set in. For example setting up a fitness plan for a prediabetes or finding

financially reasonable nicotine replacements for a smoker are intervention methods.

For this to be truly effective, medical doctors must change their discourse. Trust has to be

established between patient and doctors. They need to begin to distance themselves from a

superiority complex and become more of a regular blue collared worker. We trust people who

understand our background. Medical schools need to teach more of a coaching aspect to doctors

to put the responsibility to the patient. They must discuss the full spectrum of the individual:

mind, body, and spirit and how they are currently interacting. This means the doctor must be

attune and care to ask what is going on in the patients life rather than just how they are feeling.

They must remove the historical power structure that arises to put the patient at ease and in more

control. Bedside manner is a main and high priority goal.

Finally to complete this shift, doctors must work closer with each other. Within in a

discourse community, there lies a common goal. Rather than just serving an individual, doctors

should strive to a goal of improved medicine. Their egos must be removed to be more accepting

of the variety of methods produced by different practices. However, education needs to be kept
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uniform and just as rigorous for all doctors. An openness and fearlessness to put a reputation at

risk to try an alternative method must be developed as well.

The human body and its health is a beautiful, intricate machine that is best trusted to our

doctors. With a growing population, the nation is need of this stream-lined integrative care with a

disregard to labeling medicine. Without titles such as allopathic or alternative, doctors reach a

highly respected, efficient discourse community.

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Works Cited

Anderson, G. The Power of Prevention . www.cdc.gov/chronicdisease/pdf/2009-power-of-

prevention.pdf.

Frederic Luskin. The Journal of Alternative and Complementary Medicine. October 2004,

10(supplement 1): S-15-S-22. https://doi.org/10.1089/acm.2004.10.S-15

Gray, Ryan, MD. "MD vs DO What Are the Differences (and Similarities)?" The Medical

School Headquarters. N.p., n.d. Web. 25 July 2017.

Hart, Jackie, MD. "Alternative vs. Traditional Medicine." Health Library. Willis-Knighton

Health System, n.d. Web. 25 July 2017.

Herman, Patricia M., et al. "Are complementary therapies and integrative care cost-effective? A

systematic review of economic evaluations." BMJ open2.5 (2012): e001046.

Herper, Matthew. The Most Innovative Countries In Biology And Medicine. Forbes, Forbes

Magazine, 11 Aug. 2011, www.forbes.com/sites/matthewherper/2011/03/23/the-most-

innovative-countries-in-biology-and-medicine/#e4a70701a714.

"Preventive Health Care Helps Everyone." WRF: World Research Foundation. WRF, Feb. 2015.

Web. 25 July 2017.

Selzer, Robin. Healthcare Disparity. Exploring Health Professions. Sept. 2016, Cincinnati,

OH.

Silverman, Barry D. Physician Behavior and Bedside Manners: The Influence of William Osler

and The Johns Hopkins School of Medicine. Proceedings (Baylor University. Medical

Center) 25.1 (2012): 5861. Print.

"What Is a Naturopathic Doctor?" American Association of Naturopathic Physicians: Natural

Medicine. Real Solutions. AANP, 2016. Web. 25 July 2017.