The Gray or Plaid Approach to Health Care

All or nothing, black or white — I just don’t get it.  In the past few days I’ve had this conversation a few times, so now I’ll share it with you.

My friend and neighbor (I’ll call him Ted) suffers from a very slow-growing brain tumor.  He asked me to watch a DVD with him that is one of a dozen or so developed by Dr. Lorraine Day (his wife calls her Doris!)  Prior to my visit, I checked her out online — and at QuackWatch.com.  I have very mixed feelings about her work — which you’ll understand in a minute. 

In a nutshell, Dr. Day, who lists her medical credentials to provide credibility (assuming they are bona fide, they are impressive), mixes her medical expertise, with nutrition, with the Bible and word of God, to provide a message that healing is all about the immune system and having faith — and that medicine doesn’t cure anything.  She bases this on her own experience with breast cancer (which QuackWatch disputes). In the DVD Ted and I watched, she makes great pronunciations about the perils of eating any kind of meat or dairy because ALL animals are diseased or are too fatty or have mad cow disease or deadly salmonella — she describes a litany of animal based ills.  And she provides evidence to back up her claims.

OK — now remember those statements for a moment.  Consider the ALL or NOTHINGness of them.

Very separately, a couple of links have arrived in my mailbox to news stories that follow up on the stent vs. medicine study I wrote about a couple of days agoOne article regards the reactions on the parts of insurance companies who will now re-examine how they reimburse the interventionalists, those cardiologists who do angioplasties and implant the stents.  In effect, it has been surmised that insurance will stop paying for stent implantations based on the study.

Once again — an ALL or NOTHING answer.

These are just two examples of dozens and dozens of instances where individuals or groups are applying EVIDENCE to create black and white. Only they seem to be turning the evidence into something that (in my not-so-humble opinion) it isn’t.

I just don’t get this.  I don’t get it because I don’t think that all human beings are the same. I don’t think our bodies are identical.  I don’t think our brains work the same way.  I don’t think we comply identically, I don’t think our attitudes are the same, and I don’t think that any study can produce results that can be applied to EVERYBODY or NOBODY.

I do understand the concept of evidence-based medicine.  A drug, for example, is tested, and in X% of the people it gets tested on, it works — or it doesn’t work.  Medicine — and insurance companies — and patients — then want to say “it works” or “it doesn’t work” — when, in fact, the EVIDENCE was that there isn’t one consistent answer!

On occasion I listen to Dr. Dean Edell on the radio.  He has the ability to wax poetic on all kinds of answers to questions from patients — but one thing he says all the time is that evidence isn’t always as it appears.  Amen!  You’ll love this: “if a study is done of everyone who has been in a car accident in the past two weeks, and it determines that 100% of them ate carrots in the prior month — we can’t necessarily conclude that eating carrots caused their accidents!”  (or something like that — sorry if I messed it up Dr. Dean!)

Dr. Day suggests that medicine can’t cure disease — only nutrition and faith (which will boost the immune system) can. Well, Dr. Day — I believe you are giving good advice about boosting the immune system. But I believe you are depriving your followers (some of whom are real lemmings — although Ted isn’t!) — of medicine that can work for them. Your ALL or NOTHING approach doesn’t work for everyone.

Insurance Companies — to take this stent vs medicine study and apply it to everyone (no stents for YOU, Mr. Heart Patient!) is depriving some people of the very treatment they need to prevent some heart attacks. Don’t try to apply black and white answers to all human bodies!

As a teacher many moons ago, I learned to account for individual differences.  I would ask the science and medicine and health insurance to do the same.  This shouldn’t be a difficult concept.  We are all different, and different approaches to our treatments will work differently. 

Black and white?  No.  Let’s try shades of gray — or even plaid.  ALL patients are different and NOTHING will consistently work for them all!

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