2 Questions to Ask That Are More Important Than A Diagnosis

Originally posted at The Huffington Post entitled 2 Questions To Ask That Are More Important Than A Diagnosis

After 30 years of practicing Medicine, I have learned that for any chronic illness or problem, making a diagnosis and naming a disease is not as important as treating the underlying imbalances and dysfunctions. Asking the right questions is more important than giving a label to a set of observations or getting the diagnosis right.

For most if not all chronic problems and illnesses, there are usually multiple factors that need to be addressed… it is called the total load. The total load is the sum of the factors that influence a person’s life and health. Individually, each of these elements might not normally cause a problem, but their cumulative effect and the fact that they all act on us simultaneously can overload our normal functioning and cause harm. In addition, everyone’s tipping point is different and each of us present in a different way when over-loaded or overwhelmed.

To understand the concept of total load, think of yourself as a ship floating in the water. Depending on the load you’re carrying, you are either riding high above the waterline or sinking beneath the waves. And just as you can save a sinking ship by tossing some ballast overboard to lighten the load, health can be improved by reducing the overall number of factors that cause stress in your system. The good news is that frequently you may only need to identify two or three factors to toss overboard in order to feel better.

When working with patients, I always try to reduce the total load by slowly removing the factors that could cause harm. At the same time, I add the factors that nourish them in order to enhance the healing process.

Some examples of what may need to be removed are the amount of sugar, junk food, chemicals, caffeine or alcohol in your diet. Or the burden of responsibilities you have, how hard you work and how much tension you carry in your muscles.

Examples of what factors may be lacking and need to be added are nutrients, sunlight, sleep, down time, play time, love or joy.

Unfortunately, I, like all Doctors never got taught to think like this at medical school. We got taught to name it, blame it and tame it. That is to look at the symptoms, signs and test results, make a diagnosis, name the “disease” and then treat the “disease.”

This model works well for acute or short-lived illnesses which were the common problems Doctors had to treat until about 70 or 80 years ago. There is no better model for crisis care management, for example, if you are having a heart attack or your appendix bursts. Or if you break a bone, we can fix it and if you have an acute bacterial infection like pneumonia, antibiotics kill the bacteria and the infection resolves. And due to the success of antibiotics in treating most infectious diseases, we have extrapolated that model, looking for an isolated single cause with a “magic bullet” treatment, and adapted it to most diseases today.

But this name-it, blame-it and tame-it medical paradigm is not effective for chronic problems. This process of giving a set of observations a name and treating the named problem does not help us understand the origin of the problem and its causes, which are usually multi-factorial. We are now finding that most chronic diseases today are not served well by this model in which complex disease processes are reduced to a diagnosis.

A label or descriptive name for a problem is not a bad thing–it is often reassuring to know what we have. I do not want to under-estimate the significance of this. But we have been brainwashed to think that if we know the diagnosis or if we know the name of our disease we will know how to not only treat it, but fix it. Unfortunately, this is not true. Doctors are increasingly practicing from the vantage point of an outdated and ineffective model and are not addressing the needs of the millions of patients who come to them with complicated chronic problems. They give them drugs to suppress symptoms and do not address the underlying physiological imbalances that produce these symptoms. Therefore we do not change the course of the disease and often end up causing more harm than good because the underlying problem has not been addressed. And to make matters worse, many people develop side effects from those drugs.

Luckily for all of us, there is a new little known science-based health care model for chronic diseases, called Functional Medicine, that deals with the underlying causes instead of just suppressing symptoms. It is a true mix of Chinese and Western Medicine. This new medicine is systems based biology rather than disease focused. It redefines chronic disease as a functional alteration in the physiological network that requires a systems biology approach to its management, which improves both the safety and effectiveness of treatments.

This model helps us understand how the disruptions of molecular pathways cause dysfunctions in various body systems and then result in disease. It is less concerned with a diagnosis and more concerned with the underlying dysfunctions that lead to the symptoms and the disease.

My Chinese Medicine teachers taught me to think of myself as a gardener when I see patients. When a plant or tree is not growing well, when the leaves are drooping and turning yellow, we do not call it yellow leaf syndrome and paint the leaves green or cut off the “sick part.” The gardener evaluates why the plant is not growing well. He determines whether the plant is getting enough or too much sunlight, enough or too much water, is the soil rich and balanced in order to nourish the plant? And he looks to see if the roots are being impinged upon, and if so, what needs to be removed.

Even though you may have been given a diagnosis, always ask yourself these two questions with any chronic problem:

  1. What is harming you and needs to be removed to permit the body to heal?
  2. What is lacking or what does your body need to promote healing?

I would like to thank Sidney Baker and Jeffrey Bland, two of the “fathers” of Functional Medicine and Efrem Korngold and Harriet Beinfield, my Chinese Medicine teachers, for teaching me to think critically about these issues and for creating a model that has helped thousands of patients with chronic problems.

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