“Cookbook Medicine”: Is This the Future of Medicine?

"Cookbook medicine." That's what my doctor described the medicine of the future after health care reform. Because my daughter is entering college and thinking about a career in physical therapy, I had just asked the doctor about where she sees medicine going. She bases her opinions on what is already beginning to happen, not on theory.

"Politicians are addressing something that was never a problem," she explained. "They say it will give more people access to health care, but access was never really the problem. I should know. I worked in 21 different hospitals in my career, many of them in poor areas. We always saw people. They may have had to wait 24 hours for their sore big toe because someone else came in who was bleeding, but we always saw them."

The real issue is not access, but cost. To keep costs down, doctors will be required to practice medicine "by the book." The doctor explained: "We are given certain procedurs for, say, a stroke. And that's all that will be paid for. But there are all different kinds of strokes. Good medicine treats the individual as an individual. That kind of approach won't be reimbursed. The patients will suffer as a result of the new approaches."

In answer to my question about physical therapy in particular, she said that would be one of the areas that will likely be squeezed the most. "The money will go to the hospital or clinic, and the administrator controls it. The administrators will get their cut, then the doctor, then the physician's assistants and nurses. The one at the end of the line, like the physical therapist, is likely to get squeezed out. Rehab will likely be hit hard. Too bad, because that is important."

She told me how government has been pressuring independent physicians like her to join large medicial practices that will better comply with the cookbook medicine approach. Doctors are to be managers of the physician assistants and nurse practitioners, who of course can be paid less. And why not? Anyone can consult the cookbook, right?

So far my doctor is able to resist. (Click the image or here to get to an interesting article on what some doctors are doing, called "direct-pay medicine.")

But I as a patient bear the cost of that, too. For instance, a recent hormone test I had to pay for myself, and now it may not be reimbursed by insurance as it might have been had the lab billed her and she submitted the claim. "The people rowing the boat are having more people added to the boat. But are those people rowing the boat? No….."

I could go on with our conversation, but I don't want to get too political here. She did pose a question that any of us would do well to think about: "What has the government run well? The postal service? Medicare? Teachers' pensions?"

The only thing we can really do, she said, is be very proactive with our own health. The best thing for us to do is try to stay out of the medical care system altogether. Somewhere close to 70 percent of people in the US are on pharmaceuticals, with side effects that are often treated with more pharmaceuticals. "You have acid reflux? Take this drug." Too often doctors don't even ask what other meds you might be taking that can cause the acid reflux. The cookbook approach is to treat the symptom, period.

Being proactive about your health means educating yourself about health issues from reputable sources that are open to alternative as well as allopathic medicine. It's about doing as much as you can with lifestyle and using approaches that reduce stress (since stress is the major factor in up to 95% of diseases and illnesses). That's why I do what I do with The Healing Codes. I know that is helping people deal with the source of so many issues by healing the unconscious stress from unhealed memories.

Too bad the stress of the upcoming changes in health care is yet another thing we'll have to address. I echo the words of many of my clients, and my own mother: "I don't know where I'd be without The Healing Codes."