A New State of Reliability & Trust

Initially when searching the internet for health information, I used to ask the question of “How can I find reliable sources of information that I trust?” Now I am continually redefining my concept of reliable, because it does not truly exist in the concrete sense I had previously thought.  The ability to judge whether information is truly reliable depends entirely on your perspective of what reliable truly means.  It also leads me to a deeper question – what is my role as a physician and as healer? How can I be that reliable source of information that people can trust?

Information becomes simple to sort through when you have a set of criteria that define ‘reliable’.  Let’s look at allopathic medicine.  A peer-reviewed meta-analysis of randomized controlled trials (RCTs) is the strongest evidence one can find.  Allopathic medicine is based on the scientific method, which proves or disproves theories within a set of parameters.  Modern medical and health research have evolved ways of rating evidence.  Evidence-based medicine is the fundamental core of any medical teaching program and is the foundation of clinical guidelines.

In certain situations, such as emergencies, medical/surgical oncology, infertility, and palliative care, among many others, modern medicine is fantastic.  In primary and preventative care, allopathic medicine falls short of making a difference in people’s lives.  One limitation of allopathic medicine is that it depends entirely on the research that has been published.  For example, if there are 50 trials showing that Therapy A is beneficial and only 5 showing that it has no benefit, Therapy A will be considered beneficial for the given population.  But what about the unpublished research, if there is any? Another limitation is that a Therapy has to be easily defined with controlled factors in order to have the strongest evidence.  Many health therapies are unable to fit such a rigid standard, therefore they are unable to be studied in this fashion.

In all of this, oddly enough, research has found that people are most likely to trust family members and close friends regarding health information.  So here we are as a society spending billions of dollars looking at health strategies as objectively as possible (taking the swayable human interpretation out of events), yet this information matters very little in our day-to-day decision-making.  What matters is our loved ones’ experience and opinion.

Then we have holistic medicine, which seems to have a smattering of all types of evidence.  From well-researched studies to passionate testimonials, this large area of health is everything in between.  Many therapies in Chinese medicine have been proven over thousands of years of use, but not studied.  Many holistic therapies fail to show any difference in people’s health outcomes when studied.  Some therapies are harmful and are shams.  But many may have benefit, but because they are too difficult and too costly to study, the question remains as to whether they are helpful or not (according to evidence-based criteria).

Then there is the trust factor.  If a health practitioner is selling his own brand of supplements for which they receive financial incentives and kickbacks, how do you know if he is reliable? If a doctor is sponsored by a drug company, can you trust her with your health decisions?  Many purists would say this is unethical.  Yet no one health practitioner is truly objective despite what western physicians may think.  In short, no one practices truly unbiased medicine, including allopathic doctors.  We all have a certain bias (perspective) from which we operate.  Once we all begin to see that perspective from which we are operating, we can be honest about what we can offer.

Mental health is a fundamental key in the wellbeing of people that is often addressed but not explored by all health practitioners.  Addictions, relationship difficulties, low self-esteem/self-worth, career stress, financial problems – all of these areas of life directly impact a person’s state of health, yet they are left to the realm of friends, counsellors and religious/spiritual pastors.  It’s an area all practitioners ask about if they have the time, but it’s not really addressed as a causative factor in the active health problem.  If someone is under serious financial strain or has a toxic home environment, any lifestyle changes they make will not yield the results that will shift the underlying source of illness in his or her life.

Now we move into deeper aspects of human life.  As health providers, we love to fix.  We feel good when we can fix.  When we start looking at the whole person, we get into unfixable areas with people.  We cannot change people’s circumstances, but we can give them a remedy for their headaches that will help them feel better.  In our attempts to feel good about helping, we actually hinder the process of healing by slapping on band-aid approaches with health problems.  If we were to take a longer look at our patients, we would see much more that would be contributing to the health issue at hand.

I believe our paradigm of health needs to change.  We need to appreciate and use evidence-based medicine in context.  We need to give some value and meaning to the personal stories of people who have been helped by a certain practitioner, technique or remedy.  Yes it may be only a placebo effect, but at the end of the day, does it matter?  We need to move away from quick-fixes and into using common sense principles such as mental/emotional wellbeing, healthy food, and positive lifestyle choices as fundamentals of health.  We need to take less responsibility for people’s health and instead empower people to choose to help themselves.

What matters at the end of the day is empowering people to make healthful, positive, live-sustaining choices in their lives.  THIS is what people are searching for in a health practitioner, but haven’t yet found.  There are millions of different types of practitioners out there, each with their own biases, their own set of beliefs and their own criteria of ‘reliable’.  I personally feel we need more “health brokers” in this world.  Allopathic and naturopathic physicians alike need to understand and appreciate that they only represent one method of healing respectively, not the only method of healing.

We need un-biased physicians who can see the big picture and address all health issues needed.   This will be challenging, as the diagnosis and treatment plan are completely different depending on which health paradigm one chooses.  A block in one’s chi needing acupuncture or migraines without aura needing prophylaxis have different endpoints.  However, the outcome is the same – a healthy, happy individual.

For this to happen, everyone needs to be responsible for their part.  People will need to take the onus put on health providers to make them feel better or solve their health problems and put it back on themselves.  Health providers will need to recognize their contribution as merely that, a contribution to a person’s health.  Health providers also need to be specific and transparent about what type of medicine they are offering.  In this way, the general public will know what medical paradigm he or she is operating from, while allowing the patient and practitioner to build a trusting connecting within a therapeutic context.

Not every health care practitioner needs to change their modus of operandi, but for those of us up to challenge, we can create a new authentic space for primary care.  We can become genuine health providers that are reliable and trustworthy – that alone will mean the world to our patients.