The modern American medical system, and particularly its education, was crystallized into being following a Carnegie Foundation funded report in 1910, put together by Abraham Flexner. It sought to raise the bar for medical standards and changed the landscape of medicine in this country almost overnight.
The report and subsequent education recommendations focused on the key issues of the time, namely acute and infectious conditions that were both rampant and relevant. Underpinning these policy changes were some of the prevailing assumptions of the time, specifically the Germ Theory.
These changes were very successful and thrust America towards a healthcare system that by the middle of the century was the envy of the rest of the world, technologically and educationally. The obvious causes of acute and emergent issues had been identified, drugs and surgical procedures and protocols refined.
However, fast forward to 2010 and the US is 46th in infant mortality even though its health spending per capita is several times higher than any other country. The landscape of disease has changed considerably, with chronic and degenerative disease driving both numbers and costs.
Scientific inquiry into these more complex diseases continues to struggle to identify single, clear causes for contemporary issues ranging from cancer to diabetes. More and more, however, the research points to diet, lifestyle and in particular toxicity factors that, over time, contribute significantly to those conditions. As the now famous saying goes ‘The genes load the gun, the environment pulls the trigger.’
Breast cancer has been particularly relevant to me this year, with a member of my close family being diagnosed, and as a result, I have spent a lot of time investigating the latest research. Anything from underwired bras to soy products have been fingered as potential causes, but the overall trend is one that points towards multiple potential causes being able to produce the same symptoms, and this is not only in cancer but in other growing degenerative dis-ease categories from autism to MS.
Once source of hope is that such lifestyle and environmental factors rarely induce these dis-eases overnight. It is unlikely that anyone would develop bowel cancer without a history of significant bowel sluggishness, yet currently these potential causes are not being caught early enough to be able to change behavior to avoid potential pitfalls.
These factors combined have created a ‘perfect storm’ of market and clinical conditions whereby holistic practitioners and holistic medicine can take its rightful place in an optimal, integrated medical system. You can argue until you are blue in the face about the relative value of traditional and ‘alternative’ medicine, but two things that holistic practitioners objectively do better than their allopathic counterparts are listening and educating, two key parts of ‘Empowerment Medicine’
If the cheapest and most easily leveraged area of improving these chronic conditions is lifestyle factors, then empowerment towards consistent behavior is crucial to a sustainable system. This will take changes not only clinically but also in patient flow and office visit structure, and it is encouraging to see the green shoots of empowerment medicine taking root in the integrative practices across the country.