Modern Medicine: The "alternative" that was destined to fail.
It's just a matter of when.
Recently, I announced a couple of new goals on the horizon for this online publication.
One of these is the composition of a book.
The primary objective of this book is to show people how to lead a life that breeds vitality, resilience, and joy for life.
Why else would you want to be healthy, or free of illness?
In the years spent writing online, one of the things I’ve learned from readers is a misapprehension of where the problems in modern medicine lie.
Some believe it’s because of “big pharma.” Others blame insurance companies.
There’s this idea that if we just solve this one problem, or reform this one organization…the modern allopathic industry will be good for the population.
This is a mistake.
A big mistake.
In fact, the propagation of this idea by talking-heads, online commentators, and newly appointed officials into our health regulatory apparatus…is a trap.
A trap designed to lull you into a sense of security and complacency. The reality, however, remains the same.
Nobody will care more about your health than you.
Anyone pretending to, must draw your suspicion.
It seems to me that for this book to be maximally effective, people must first understand where the real problems in medicine lie. With this approach, I hope I can help people avoid falling into these traps.
Define Some Terms
To avoid arguing over definitions, let’s set some things clear.
Modern medicine is the current Western allopathic medical model that continues to be exported to the rest of the world.
Although we commonly include surgery in this industry, in my opinion surgery is a separate field.
Often times, surgical interventions do not fall within the scope of allopathy. Allopathy is the practice of medicine by which illness is treated with opposites.
This is in contrast to homeopathy, which is the practice of medicine by which illness is treated with similars.
Surgery, more often than not, is concerned with taking things out of the body or removing body parts. I don’t think this neatly fits into either mode of medicine.
Furthermore, according to the Hippocratic Oath, surgery is not the concern of the physician.
Further, I will comport myself and use my knowledge in a godly manner.I will not cut for the stone, but will commit that affair entirely to the surgeons.
What’s Wrong With Medicine
People often talk about incentives as the unseen factors contributing to the rot in many organizations and institutions. Everyone I talk to in my day job knows this.
Observers from within and outside the industry are prepared to lay the blame at the feet of incentives.
Show me the incentive, and I will show you the outcome.
-Charlie Munger
So, to understand what’s wrong with medicine…maybe we should start talking about the incentive structures that permeate the industry?
What if we ask a question like…
What is Western Allopathic Medicine Optimized for?
As I’ve written about before, I believe the path to optimal health is through an understanding of one’s self (via temperament and heart), as well as optimization of habitat, activity and consumption.
Unfortunately, this is not what modern medicine is optimized for.
Modern medicine is optimized for revenue generation, risk mitigation, and product utilization.
This optimization manifests in the interaction of four distinct industries.
Insurance: centralized determination of medical practice through billing codes and risk pooling.
Pharmaceuticals (and biotech): product creation and packaging to optimize revenue.
Academia: production of information that aligns with financial incentives of benefactors.
Law: shielding and reinforcing of industry practices codified by the above, and punishing deviation from the centralized dogma.
Let’s dig a little deeper into all of these.
Insurance Companies
When people discuss “insurance” they often refer to health insurance companies, and sometimes the publicly funded equivalents (like CMS in the US).
However, there are other insurance companies which influence healthcare decisions, such as life insurance. In fact, life insurance companies may be masterminds behind much of the grief in our industry.
After all, they are the underwriters of not just health, but life itself. I would be surprised if they play no role in how “healthcare” is defined and practiced.
But, let’s set that aside for now and discuss the commonly referred to “insurance companies.” What is their role?
In short, insurance companies determine how medicine is practiced.
If you as a hospital or doctor would like to be reimbursed for your efforts, you must get along with the people who pay you. Otherwise, good luck getting paid.
Insurance companies reimburse based on diagnostic and billing codes (e.g. CPT and ICD-10 codes). If you do not make diagnostic or therapeutic efforts aligned with these codes and their pre-requisites, chances of appropriate reimbursement is low. This practice alone is responsible for many of the incentive games that healthcare providers and entities have to play.
These coding practices generate additional games of their own.
For example, one of the things we’ve observed in recent decades is the creation and expansion of diagnostic criteria. Or, the moving of diagnostic goalposts.
e.g. the diagnostic criteria for hypertension has gotten lower and lower over the years (systolic blood pressure > 140 vs > 120).
Pharmaceuticals
Drugs are expensive to develop, mass-produce and distribute.
Once they are created, they must be used as widely as possible to generate revenue. Otherwise, the manufacturer goes broke and probably sells their patent for pennies on the dollar to another company who will then try to market this product for their own gains.
A great example of this is the hepatitis B vaccine. Here was an injection that was designed to “help” drug abusers and promiscuous people from contracting hepatitis B. After the drug was developed, uptake within this target population was low.
So, the companies lobbied regulators to include this injection in the childhood immunization schedule. Now, it is offered to newborns on day one of life. All the while, the bill is covered by taxpayers and the harms by children and their parents.
But, it’s not just vaccines.
Diabetic medications being prescribed to people who are “pre-diabetic.” Blood pressure medication offered to people who were technically “normotensive” just a couple of years ago. But, the diagnostic goalposts were moved and now they are considered “hypertensive.”
Statins, one of the most widely used class of lipid-lowering drugs, are now given out like candy. Despite the fact that they have only ever been justifiable for secondary prevention (repeat) of heart attacks.
The list goes on.
But, the incentive pattern is the same.
Make drug. Find use.
If, you cannot find a use…expand the definition of diagnosis to include more people.
If that still doesn’t work, invent a new use.
E.g. using anti-depressants or anti-psychotics as sleep aids.
If all else fails, create surrogate markers of disease to chase with drugs and expensive lab tests. E.g. you have no history of heart disease, but your LDL number is “high” and so you must be put on a statin.
Academia
Medical research and education should seek the truth. In reality, it chases funding.
Most research money comes from:
Government grants (with stipulations and priorities)
Industry (pharma or biotech who fund studies to market their products)
Private foundations (which often also have their own agendas).
Clinical science is very expensive to execute. But, the people who can provide the money usually want specific answers or outcomes.
Whether you want to believe it or not, this creates the perfect storm for motivated reasoning and research within academic medicine. The results are rather obvious:
Study the same ideas over and over
Avoid exploring new or holistic approaches
Create medical “knowledge” that fits inside the industry’s business model
It doesn’t stop there.
Because, doctors-in-training learn from this limited pool of research. Medical schools, textbooks, and treatment guidelines are shaped by what gets funded. Not by what works best for the patient.
Legal Infrastructure
The final frontier.
The source of “cover your ass” medicine. The reason why doctors increasingly just “follow the guidelines.”
Medical malpractice. Sounds like a great thing. Protects patients. Right?
Not entirely.
Now that you understand how poorly informed these guidelines, algorithms, and billing codes are…you can start to see the problem.
What role does the legal system play in this Hydra?
For starters, it provides protection for those who adhere to the mal-incentivized healthcare practices we just discussed above.
More importantly, it often aligns with corrupt regulators (like the FDA) to protect medical entities from the consequences of bad outcomes associated with their practice. Whilst punishing those who take unorthodox approaches. Whether or not these approaches are beneficial or less harmful than the standard practice.
What happened to doctors who were helping their patients through COVID with things like vitamin C, ivermectin, or hydroxychloroquine?
Alternatively, what happened to the doctors who contributed to the demise of their patients by administering experimental drugs, vaccines, and inappropriate intervention?
Exactly.
Guidelines become the legal armor of the industry, while its inversion becomes the spear by which alternative practices are destroyed.
What Gets Left Behind?
Patient autonomy and individualized health.
Prevention, lifestyle modification and holistic approaches to vitality.
These things aren’t codified in billing.
They are not “measurable” or “testable.” Thus, they are left out of the logic of this system.
Healthcare centered on the patient, on living, and vitality help people in ways that eclipse “management” of disease and surrogate biomarkers.
Unfortunately, modern allopathic medicine does not support this.
There is no test for vitality.
There is no prescription for nature, community and sleep.
Nor are these things profitable.
“Alternative” Medicine
One of the great scams of the 20th century has been making the population believe that “conventional” or “traditional” medicine is that which is practiced in the current allopathic industry.
This could not be further from the truth.
Modern allopathy is the odd one out.
Traditional medical arts from all around the world have far more in common with one another, than any of them do with modern allopathic medicine.
In reality, modern medicine is the “alternative” to the traditional medical arts which have survived for millenia.
As a pharmacist, once I realized drugs were petrochemicals, I changed my whole outlook on health.
True health is a responsibility that the individual MUST take on. If not, those four agencies will play a role in that decision
I am on a FB group for dogs with seizures. A lot of dogs with this problem now, sometimes from vaccines or flea meds. The woman that started it lost one dog to seizures. For her other dog, she wound up using homeopathy. Dog was seizure free for two years (recently died from cancer). You would see people join the group asking for advice about the pills the vet gave that weren't helping or wantingto do an MRI. None of them seemed willing to try homeopathy. It's a shame because it is effective in many cases and certainly won't harm you.