Which Path?

A medical doctor on "automatic pilot" did not take the time to listen to his patient's primary complaint. The patient grew frustrated and irritated that the physician was not taking her health condition seriously. I observed this as I sat across the room, leaning against a pastel-colored wall. Why is it that many of us in acupuncture and Oriental medicine (AOM) want so badly to be accepted and be a part of a health care system that is collapsing beneath us?

The physician inquired about the patient's condition, but to my surprise, I noticed the doctor frequently finished the patient's sentences. From my observation, the patient's body language and change in respiration suggested she was quite irritated. When the patient attempted to shed some light on her condition, the physician would insert his rationale and his conclusion to the diagnosis. After the doctor left the room, the patient responded aloud, "He has the wrong diagnosis!" It seemed to me that the physician had made a diagnosis that fit his likening long before he had all of the patient's medical information.

To be fair, I don't believe that the physician is incompetent in his diagnostic skills, but rather a victim (for lack of a better term) of the managed care system. The pressure on physicians to increase productivity by seeing more patients in less time is phenomenal! I believe this is a major cause of the failure of physicians to hear their patients out. As managed care organizations find it increasingly difficult to compete on costs, they will have to compete on satisfaction - and at the current rate, it does not look so alluring.

Studies have shown that, because they are so intent on saving time, medical doctors in the United States usually interrupt their patients after only 22 seconds of history taking. Evidence has also illustrated that patients of doctors who listen well have better clinical outcomes. Doctors often steer the discussion onto familiar technical ground, depriving many patients of the chance to tell their whole story, including the importance of psychosocial factors (something AOM tends to embrace). This is why AOM diagnostic methods are so rich: They encourage patients to share their conditions - physical, mental and emotional.

I would like to see AOM stand independently as a profession, as opposed to being under the wings of the American Medical Association (AMA). I do not want to see our profession so eager to be accepted that we sell ourselves short. Science has a place in AOM - but will its essence be dismantled in the process? I truly hope not. I believe that if AOM remains independent and out from under the AMA, a better-constructed health care system will flourish, integrating the best of both worlds. As I see it, once AOM is under the guidance of the AMA, it will direct our advancement and how we fit into its paradigm. The AMA's interest is self-interest - not the benefit of medicine and the people as a whole. The AMA has a lot of power, and if we are to direct our own future, we as a profession need to remain unified and organized. Let's learn from the mistakes and progress of other professions; let's not repeat history where other professions have failed. Integrating the two health care systems fills the gaps.