more doctor solve the healthcare crisis?
Dr. Martin Wang, MD (China),
R. Acupuncturist, Chinese herbalist
People in Alberta have being talking about healthcare
crisis for a long time. They complain the long time waiting time
to see a doctor. They complain that they have to have various
lab tests, CT, or MRI, again and again. They feel disappointed
after see a “specialist” without any useful solution to their
A hot discussion is also going on (up to June, 2008), for why
there is no enough number of doctor in the province. People
question the medical education authority if the medical
education should be expanded to meet the need for the number of
doctors, if the standard for license to doctor practice is too
high, and if more Canadian doctor has moved to
or other countries for higher salary, so and so on.
Will more doctors
really solve the healthcare crisis?
An ideal healthcare system should be, as most of us wish, that
doctor solves our health problem after we visit him once, twice
or three times, no matter what therapy he used, drugs, or
surgery. In practice, this is not always realistic or true.
Conventional medicine depends heavily on various lab tests and
physical exam (X-ray, CT, MRI, etc.) for diagnosis. So often,
the vigorous exams appear useful for a doctor make “their”
diagnosis, but no use for him to solve the problem (see below).
Health problem is still there.
Before establishing the diagnosis, doctor cannot do almost
anything except a symptomatic therapy, such as using
painkillers, fever reducing drugs, sleeping pills, etc. Even if
a cortisone injection is used, it only works for several months.
Health problem is still there after the months and months of
such symptomatic treatments. It is very dangerous that a
treatment depends on a clear diagnosis, when a large scale
epidemiologic disease occurs, such as during the SARS, in which
the spread of the disease is very fast, and the death rate is
extremely high, but the doctor still cannot start effective
treatment before knowing the exact reason for the SARS.
If the doctor is lucky to find the reason for the disease, he
may not be lucky to have proper medication to solve it.
If the disease is diagnosed as bacteria related, its treatment
still depends on if there is effective drugs available. If the
illness is bacteria related, the doctors give us antibiotics. It
is found that some drugs that work before, not now, such as the
drugs for the treatment of tuberculosis. The occurrence of
drug-resistance bacteria has become a very big problem for the
conventional medicine (one of the doctor created health
problems). If the antibiotics does not work, they start to use
cortisone like hormones (it is dangerous too for many reasons).
If the disease is virus-related, they almost cannot do any
radical treatment – no effective drug for virus exit yet so far
– from hepatitis to AIDS. The treatment of virus diseases is
still a heavy challenge to the conventional medical doctors.
If the illness is no-bacteria related inflammation (we call is
non-specific inflammation), such as rhomatoid arthritis, heart
disease, they use aspirin-like drugs. It may work well when the
disease is in early and acute stage, but not so good if it is in
chronic stage. Such drugs usually do not really solve the
problem (this is true for any disease that belongs to the
disorder of our immune system) and they also cause lots of side
effects (another kind of doctor-created health problem). A final
replace surgery (if they can perform the surgery – such as a
knee replacement) is quite commonly recommended because the
failure of the non-surgical treatment.
If the disease is hormone deficiency, say, a hypothyroidism,
type I diabetes, for instance, they use hormone replacement
therapy. We may feel “normal” after the treatment, but in most
cases, we have to take the hormone for ever. We become permanent
client to a doctor.
If it is because the hormone production is too much in the body,
such as a hyperthyroidism, a surgical treatment is highly
recommended. If a proper amount of the hormone producing organ
is removed, everyone is happy. If too much such organ tissue is
removed, patient turns into the hormone deficiency – hormone
replacement is then needed, as above. A permanent visiting to
doctor turns to be new life style of the patient. This is
because they cannot tell the reason for the reason for the less
or over production of hormones in the body. Similar to the
treatment of a cancer, they treat the symptom rather than the
If the diagnosis is cancer, they are eager to start
chemotherapy, radiation therapy or surgical therapy. Except for
early stage cancer, or some hormone-related cancer, the overall
five-year survival rate of the treatments is still not so
satisfied. It means that most of cancer patients, especially if
the cancer is in middle-later stage, they cannot avoid die
earlier than ordinary people, even after vigorous treatment.
If no any concrete pathological reason can be found, they either
do not admit that you have a disease (they may say that you have
a mental problem) and give you nothing for treatment but refer
you to a mental specialist, or just let you take some
symptomatic treatment: feel pain? Pain killer. Poor sleeping?
Sleeping pills. Chronic cough? Cough suppressing medication,
etc. After weeks, months, even years, you find that you still
have the same problem no matter how many times of visit to a
doctor. Then the dose of the drugs might have to be increased,
so the side effect becomes serious too. Then you need other drug
to solve the side effect. You link to the doctor permanently
(doctor-created problem again).
After trying for a long time, when there is no way to go and
your problem comes into the very late stage, such as heart
failure, kidney failure, liver failure, they will let you to
have a surgery, such as heart transplantation, kidney
transplantation, liver transplantation…. We admit that the
transplantation technique is super in the conventional medicine
than other medical system. But, why not to prevent the disease
into so late stage?
Many times, a surgery is recommended even without vigorous
treatment, such as hysterectomy for long time uterus bleeding or
uterine fibroid. If the ovaries are also removed during the
hysterectomy, people have to have hormone replacement from then
on – a new permanent client to doctor too. Another example is
the knee replacement. We found that doctors here are so eager to
have knee replacement surgery. If the surgery success, every one
is happy of course. However, our experience is that if the
surgery fails, alternative treatment by acupuncture or a TCM
treatment becomes also very difficult – surgical operation has
changed the structure of the knee.
Now a days, the treatment by the conventional medicine tends to
shift more from drugs to surgery, from natural therapy to a
non-natural therapy. The surgical therapy might be simply “cut”
of the diseased tissue or organ, or a transplantation with an
artificial organ. This shift suggests the weakness of the
western medicine system in the treatment of a disease with drugs
and a failure to prevent a disease towards later stage.
If you have no any bad feelings physically or emotionally, but
your doctor find that you have mild increase in your blood
cholesterol, blood sugar or blood pressure, you are recommended
to take drugs as soon as possible. For what? For prevention.
According to the western medicine, they found that some people
(Here I say, some, not most, or all of the people) with an
increase in blood cholesterol, blood glucose level, or blood
pressure may develop into arthrosclerosis or heart disease. Your
doctor will give you some drugs to reduce the cholesterol, some
for reduce the glucose, and some others, for blood pressure. You
become a “patient”, or a permanent client to doctor, from the
movement they see the lab test report. For such prevention
melody, all of the people with increased cholesterol, glucose,
or blood pressure have to take artificial drugs. All become
“patients”, though theoretically only part, or small part of
them may suffer from heart disease in later their lives, due to
the inability of the conventional medical system that cannot
tell exactly who will develop the heart disease.
Once the patient has been recommended for a surgical operation,
as we mentioned above, it is good if it works. Otherwise, the
side effect due to the operation, such as pain, swelling,
numbness, is hardly solved with conventional drugs or even with
acupuncture or TCM therapies. In practice, it has been reported
that large portion of hysterectomy are not necessary actually.
In summary, the more doctor (physician or surgeon), the more
healthcare resources are needed without guarantee that the
number of patients will reduce and the waiting list will be
shorten. Our medical system is also a reason for health problem,
e.g. the doctor-created health problem, beside the bacteria,
virus, genetic disorder, psychological influence, etc..
We, especially the doctors in the conventional medicine, have to
admit that no any medical system in the world currently is
perfect. Various medical systems, no matter it is the
conventional medicine, or TCM system, have to be used in a rang
of clinic conditions that they works best. We should try to
solve health problem with a remedy that works as soon as
possible but cause as less as possible side effects. We should
be hesitated to apply a surgical therapy, if it is not yet
mature to solve the problem, or if it does not work, or if it
makes other medical therapy hardly work if the surgery per se
If we admit that our healthcare policy is “patient first” and
“solve the health problem first”, we should allow any therapy to
try. Not care too much, at this movement, why it works. Not care
too much if it has “scientific” evidence. Science is a course of
searching the reason. It is not at all a conclusion. Clinic
evidence is more importance than the scientific evidence, if we
really put the “patient first” as our healthcare policy.