How do I select a practitioner? (Part 3)

My decision of moving to Arizona to become a Naturopath was made after I grew frustrated with our current health care system. I believe that prevention of disease is the best way to combat morbidity, but once disease settles in, you have to remove obstacles to health rather than suppress symptoms to achieve true cure.

The focus of this series of articles is to help my family and friends sort through the murky waters of our current health care system, and to help them find a practitioner that will provide the best preventative care, but most importantly, that will help them find real cures when they are afflicted with an acute condition like a cold, or a chronic condition like diabetes.

In my first post I discussed strategies to find a practitioner, in the follow-up, I talked about the qualities and intangibles your practitioner should have. In this third post, I will discuss the concept of removing obstacles to health.

Imagine driving your car and that pesky “check engine light” turns on. You are worried, since your car has been pretty reliable, and you’ve made the oil changes every three thousand miles, you check your coolant and have your tires aligned. You know whatever is going on under the hood is probably minor, and you take it in for a checkup. The mechanic takes in your vehicle and tells you “yes, I’ve seen this before”, and he promptly disconnects the light behind the dashboard. The symptom is gone, you no longer have a “Check Engine” light on your dashboard, but you know that there must be something wrong. The mechanic just deactivated the alarm that tells you to check your car.

Would you pay your mechanic? Most importantly, maybe the problem with your car was simple, but disabling the annoying light and not correcting the actual problem will most likely create a bigger problem. 

Now imagine you have a headache. You’ve been working outside all day long and forgot your water bottle. You have two options, you could go inside and take some aspirin and get rid of the headache, or you could drink some water. Both options will remove your symptom. But only one will fix the problem. The problem that created the headache was a water deficiency.  There is even a medical term for it: dehydration.  I have never heard of anyone having an aspirin deficiency. Both options will get rid of the pain. Taking a medication that suppresses symptoms is like that mechanic disabling the check engine light. Now imagine all of the different symptoms that are suppressed in our conventional medical model. Fatigue, blood sugar dysregulation, pain. The list is endless. Every time a practitioner dismisses or suppresses symptoms (such as fatigue, headaches, chronic pain) they are silencing your internal alarm, and thus maybe creating a bigger problem.

Why do we settle for a system of medicine that is not correcting the actual problem? You should select a practitioner that focuses on removing the obstacles to health, and not just suppression of symptoms.

Sometimes suppression of symptoms is necessary. Have you ever broken a bone? If you have a bone fracture, your body will tell your brain there is a problem with localized pain. The course of treatment for a broken bone is simple. Pain (the symptom) is controlled with pain medication,  and a doctor will set the bone fracture (the underlying cause for the symptom) using a splint, a cast or even surgery. The pain will be present until complete resolution; but the pain medication will not fix the broken bone. Pain medication is given to help the patient deal with the symptom, because no one should suffer through pain.  The suppression of the symptom (in this case pain) will help the patient heal faster, but the patient will only heal if the obstacle to health (in this case the fracture) is removed. Most importantly, no practitioner would ever recommend to be on pain medication long term, in fact, we should encourage the patient to reduce pain medication as quickly as possible. In this case, the obstacle to health is so clear, that our current system of practice works perfectly.

What happens when the obstacle to health is not clear? Let's talk about a common chronic disease: diabetes. Diabetes is a common disease, either you or someone you know suffers from diabetes. Type II diabetes (DMII) affects blood glucose regulation (actual problem), and presents with very clear symptoms polydipsia, polyurea and polyphagia. What causes DMII is not so clear, and if you are reading this blog, you are probably in the camp that believes that DMII is caused by lifestyle choices and genetics and not just dumb luck. How do we treat diabetes? If someone suffers from DMII, they might need an insulin sensitizer in order to get the blood sugar back under control, but medication should never be used as a crutch to allow patients to continue eating a high sugar diet. Medications should be prescribed with the goal of amelioration of symptoms - in the short term, until homeostasis is reached. In this case, the real culprit is lifestyle, and correcting lifestyle choices is the real problem, no amount of metformin or insulin will ever replace the need for a proper diet coupled with optimized lifestyle decisions.

In our current system of healthcare, the symptoms of DMII are treated with insulin sensitizers. When the insulin sensitizer stops working and the symptoms come back, we add insulin to the problem. When that stops working, we increase the dose. How many people do you know that have cured themselves from DMII? And of those people, how many did it by losing weight vs. adding more medications? 

Beware, you could also fall into a trap with holistic practitioners that might want to treat using more "natural alternatives". One example comes to mind: one of my friends told me “My doctor is very natural, before he prescribed anything to help reduce my blood sugar, he recommended a cinnamon supplement”. Substituting a natural product for a medication does not make a better practitioner. My friend did not have a cinnamon deficiency, my friend needed lifestyle modifications to fix his “check engine light”. Your practitioner should be able to identify when medications, supplements and lifestyle modifications are appropriate, and be able to recognize the patterns and obstacles to your health.

If your practitioner is prescribing a medication or a supplement for a condition that could be avoided with a lifestyle modification, the practitioner is focusing on symptoms not disease. If your practitioner tells you “you will have to be on this medication for the rest of your life” you should ask for clear clarification. This is not to say that “health” means not taking any medications or supplements. Some diseases such as genetic conditions, surgeries, viral infections, hormonal problems, cancer and many might be incurable or they might have to be constantly managed with medications. In other words, some medications have to be taken forever, because we might not have cures for certain diseases. For all the other disease processes, we should focus on correcting the problem, rather than the elimination of symptoms in order to prevent an acute illness from becoming chronic or even worse, incurable.

In summary, find a practitioner that has clear goals to health, that has ideas on how to measure true health outside of the numbers on your lab report. Look for a practitioner that is practicing with a focus on preventative medicine, well within their scope of practice. Your practitioner should keep up with research and most importantly change the approach to disease as the evidence changes. Your practitioner should focus on removing obstacles to health, not just symptom suppression. And finally, your practitioner should be your ally, not your boss. They should show compassion and they should be open minded. It might take you some time to find a good practitioner, but once you find your practitioner, you will have an indispensable ally in your journey to health.   

There are many reasons this article could be helpful to you or your friends; maybe you feel that there is room for improvement in your health, maybe you have an acute condition that needs to be checked or maybe you were diagnosed with a chronic disease. In any case, you should never settle for cookie-cutter healthcare. You should empower yourself to find a practitioner that will work with you to bring true cure.