Have you ever met a person who was diagnosed with diabetes, or an autoimmune condition, or high blood pressure?
I’m sure the answer is probably sure.
Now, have you ever met someone who said, “My doctor helped me reverse my diabetes without any prescription drugs!”
I bet you haven’t.
But why not? Why, despite how hard working and smart doctors are, do they struggle to help patients get the outcomes they desire?
This is a question I’ve asked myself for YEARS. It just doesn’t make sense to me how, as a nation, we can spend $3.5 trillion on healthcare annually and yet chronic disease rates are higher than ever.
Throughout the years, I’ve come to realize that the problem is a multi-faceted, convoluted mess and I’m going to simplify it as best I can into 3 main problems.
Problem #1: The US is a sick care system, not a healthcare system
Modern medicine was created in a time when infectious disease was the main cause of death. Because of this, doctors focused their education on the treatment of these diseases, which makes sense. By the 1940’s, antibiotics like penicillin were discovered and they revolutionized the treatment of acute infections.
It is this model — a pill for an ill — that has been the focus of mainstream medicine ever since.
And prescription medications like antibiotics certainly have a lot of positive attributes. They are easy to study, reasonably predictable, and an intervention that nearly all patients can follow without much, if any, supervision. Even to this day medications like antibiotics are life-saving. Make no doubt about it.
But, the problem is we now manage ALL diseases with medications, including chronic diseases. And the issue with that is these medications only treat the symptoms of chronic disease, not the underlying causes.
For instance, if someone has diabetes they will be prescribed a drug like metformin or insulin to lower their elevated blood sugar, but that does not address WHY the person has elevated blood sugars in the first place. Without addressing that issue, these patients will always have to be on these types of medications and they will undoubtedly worsen over time because they root causes has not been addressed.
So why does your doctor prescribe long-term medications when you can reverse chronic diseases without them?
Problem #2: Your doctor is a slave to insurance companies
For the vast majority of doctors, they make their money by getting reimbursed by insurance companies. This means that most are going to act in a way that maximizes their reimbursements.
Because doctors don’t get paid for the amount of time they spend with you, the goal is to get in and out of the room as quickly as possible while making sure to ask the necessary questions and perform the required exams. Even though many people can reverse their type 2 diabetes with some simple lifestyle interventions, doctors do not have the 60-90 minutes it would take to really educate their patients on how to do this.
So what do doctors do instead? They make a few dietary recommendations and then pull out their prescription pad and hand you a script for metformin. What could be easier for the both of you? You can continue with the way you are living and your doctor can move on to the next patient. It’s a win-win.
That is, until your metformin stops working as well because you continue to do the same things that caused your diabetes in the first place.
Unfortunately, insurance companies do not incentivize doctors to help their patients get healthy, even though it’s way more cost-effective in the long term. Just think about it. What would be more effective? Doctors getting reimbursed to spend an hour with a patient now or a $760,000 hospital bill in the future because their patient had a heart attack?
Problem #3: Your doctor isn’t trained to reverse chronic disease (because of problem #2)
Medical school trains doctors to operate within the current medical system. This means the main focus of medical school is in the understanding of a disease process, diagnosis of said disease, and the pharmaceutical or surgical approaches to managing that disease.
Despite heart disease being the #1 cause of death in the US and the clear ties to diet, the amount of education on nutrition for doctors is astoundingly poor. The average amount of nutrition education is 24 hours, which is just way to little given how important it is to maintaining health.
In my own medical training, I received a total of 2 hours of nutrition education and the lecture was given by a professor who was obese. And this was from a well-respected medical school!
So no wonder clinicians are so poorly equipped to educate their patients on nutrition.
An even larger issue is that medical schools teach doctors that you cannot reverse chronic disease, that some people simply need to be on medications long term. Ask any person who has an autoimmune condition like rheumatoid arthritis or inflammatory bowel disease and they will verify this.
But the truth is, you can reverse autoimmune conditions. I’ve seen it with many patients. But it takes an experienced clinician and a patient who is willing to put in the work.
The take home
The point of this article is not to bash mainstream medicine. I truly believe doctors, nurse practitioners, and physician assistants are doing the best they can and genuinely want what is best for their patients. They just aren’t taught the skills to get their patients the clinical outcomes they are looking for because that is not the game they are playing.
They are playing the name it, blame it, tame it game. They want to put a name to your symptoms in the form of a disease, blame it for how you feel, and tame it with a medication. And the reason they are playing this game is because insurance companies are dictating how they should practice.
And this is why doctors are flocking to fields like functional medicine and operating outside of insurance, because it is the only way they can give the clinical care chronically ill patients require to get better.