The chronic epidemic of the acute mind-cage

[ygolo]

I have noticed that all industries are trapped in a way of not thinking systemically.

I am speaking from personal experience of most doctors only being able to think about point problems and not being able to process that a system of issues can cause unusual cases-even many Primary Care Providers. I have been listening to a lot of people's stories (from people dealing with chronic conditions) and while it is clear that good doctors exists, most have an assembly-line mindset to fix a particular problem and want to just give a pill and be done. Yes, the healthcare system does the pill pushing. It is not the patients demanding a simple-pill solution. The excuse that patients just want a pill to fix everything is a lie. Why else would we have so much bunk around "holistic medicine" that people are so easily willing to fall-for? The demand is for total solutions to healthcare, not single pills.

We know the same thing is happening in engineering with similar disastrous results. McDonald Douglass, now "Boeing" is great at creating point solutions that fit together sort of (maybe missing bolts) that make all the metrics (especially stock price) go in the right direction(by their logic), but maybe not airplanes. How long before we, as humanity, can't even make bridges and buildings that function as a whole?

I have also recently been talking to a lot people pushing for change in the way things work. The same things happens. We are guided systematically by many knowledgeable and well meaning mentors to give point solutions. Yes, I understand we need to start small and expand. But what if THE PROBLEM is that there are too many point solutions to manage?

 

[The Cat]

We know the same thing is happening in engineering with similar disastrous results. McDonald Douglass, now "Boeing" is great at creating point solutions that fit together sort of (maybe missing bolts) that make all the metrics (especially stock price) go in the right direction(by their logic), but maybe not airplanes. How long before we, as humanity, can't even make bridges and buildings that function as a whole?

I have also recently been talking to a lot people pushing for change in the way things work. The same things happens. We are guided systematically by many knowledgeable and well meaning mentors to give point solutions. Yes, I understand we need to start small and expand. But what if THE PROBLEM is that there are too many point solutions to manage?

The Lithium Age Collapse. Not quite as mysterious as the Bronze Age Collapse, but the dark age that follows promises to be rather...apocalyptic. But yes I wonder this also.

 

[SensEye]

The excuse that patients just want a pill to fix everything is a lie. Why else would we have so much bunk around "holistic medicine" that people are so easily willing to fall-for? The demand is for total solutions to healthcare, not single pills.

I'm not sure I agree with you here. Semaglutide (active ingredient in Ozempic et. al.) sure seems popular. And in general, a healthy (even moderately healthy) diet and exercise are the best preventative cures for most chronic conditions. That is not news to anyone but people don't seem to care for the prescription.

Isn't 'holistic' medicine mostly a marketing ploy for all sorts of natural remedies (herbal products in pill form) and the like. Those 'natural' remedies are produced by wall street companies no different from big pharma except they are completely unregulated (i.e. there is no requirement to prove your snake oil actually works) and yet they are big business. A few holistic medicine fans might might take up meditation and yoga but most of them still want a quick fix near as I can tell.

 

[ygolo]

I'm not sure I agree with you here. Semaglutide (active ingredient in Ozempic et. al.) sure seems popular. And in general, a healthy (even moderately healthy) diet and exercise are the best preventative cures for most chronic conditions. That is not news to anyone but people don't seem to care for the prescription.

Isn't 'holistic' medicine mostly a marketing ploy for all sorts of natural remedies (herbal products in pill form) and the like. Those 'natural' remedies are produced by wall street companies no different from big pharma except they are completely unregulated (i.e. there is no requirement to prove your snake oil actually works) and yet they are big business. A few holistic medicine fans might might take up meditation and yoga but most of them still want a quick fix near as I can tell.

Are moderately healthy diet and exercise preventative for congenital defects, for Chron's, for traumatic brain injury, for autism spectrum "disorder', hypothyroidism, Hasimotos, is spinal cord injury, Parkinson's, Huntington's, ...?

It's true hypertension and diabetes are the most common chronic conditions, but they are not the only ones.

Even Type II diabetes is known to be much more genetic than previously thought. There are extended families (distributed over multiple countries and generations) where practically every member of that family over 40 has type 2 diabetes.

The blame-the-patient mentality is a holdover from when exorcists and witch doctors believed that evil in the patients leads to their problems.

Diet and exercise will of course help for most things. But which diet and which from of exercise? HITT, cardio, Meditrranian diets, whole-food plant based, Nutrisystem, weight-watchers? The are all sorts of fad diets and exercises that are supposed to be healthy that plenty of people use. Some people swear by some, some people swear by others.

There are plenty of people who exercise and eat much better and have conditions when compared to couch potatoes who eat like crap who are perfectly fine.

The whole point is that things are not that simple. But the healthcare system doesn't collectively look at the complexity outside of some exceptional people.

I think most professionals want to think systemically, but they are pushed into the assembly line, 15 minute sessions with patients where over half the time is spent typing into EPIC, and if the patient is lucky, some listening is done.

The pills, even ozempic, comes about because that's how the solutions are developed and packaged by the healthcare industry because that's how solution are conceived. That's how they are studied. That's how companies are formed to solve problems.

That's the trend -the more medically backed the solution brought to market, the less systemic it is, while the more systemic a solution claims the more fadish and gimmicky the solution is.

I don't believe this trend needs to be the case-at least not when you dig into the science by itself. It's when you get to the marketing and distribution chanels where it happens.

Most importantly, there's a domino like way that chronic conditions work.

Hypothyroidism, Chron's, and congenital intestinal defects (often not detected till very late in life) for instance can lead to accumulating one condition after another. As can mood disorders, schizophrenia, and other non nuerotypical ways of going through the world.

 

[ceecee]

I'm not sure I agree with you here. Semaglutide (active ingredient in Ozempic et. al.) sure seems popular. And in general, a healthy (even moderately healthy) diet and exercise are the best preventative cures for most chronic conditions. That is not news to anyone but people don't seem to care for the prescription.

Isn't 'holistic' medicine mostly a marketing ploy for all sorts of natural remedies (herbal products in pill form) and the like. Those 'natural' remedies are produced by wall street companies no different from big pharma except they are completely unregulated (i.e. there is no requirement to prove your snake oil actually works) and yet they are big business. A few holistic medicine fans might might take up meditation and yoga but most of them still want a quick fix near as I can tell.

Give me a break. Birth defects, spinal injury, Parkinson's, dementia and Alzheimer's.... are not going to be prevented by diet and exercise and are likely caused or exacerbated by environment and pollution. How are the microplastics they are finding in placenta samples going to be fixed by your prescription? Simplifying things and using terms like "most" just makes you look like the most ridiculous libertarian. Things like diabetes, hypertension and high cholesterol can be controlled by meds and mostly resolved with diet and exercise although you may want to have a look at North American agriculture and see why there are so many with these diseases to begin with.

 

[ceecee]

We know the same thing is happening in engineering with similar disastrous results. McDonald Douglass, now "Boeing" is great at creating point solutions that fit together sort of (maybe missing bolts) that make all the metrics (especially stock price) go in the right direction(by their logic), but maybe not airplanes. How long before we, as humanity, can't even make bridges and buildings that function as a whole?

I have also recently been talking to a lot people pushing for change in the way things work. The same things happens. We are guided systematically by many knowledgeable and well meaning mentors to give point solutions. Yes, I understand we need to start small and expand. But what if THE PROBLEM is that there are too many point solutions to manage?

I think point solution fatigue is a very real thing, as is so many options and choices for anything you can think of. But my feeling is that corps or companies that offer point solutions often seem to feel that the offering should be the extent of what they have to do. Not deal with anything beyond - not their problem. Johnson & Johnson is being sued by their employees for mismanagement of their drug benefits. Which is what strengthens that argument of - we offer "something". That should be enough. On top of that, most of these benefits aren't used. Perhaps asking employees what they want would be a better idea. Perhaps some sort of contract or bargaining arrangement for more workers, including white collar and management, might help.

 

[SensEye]

I think most professionals want to think systemically, but they are pushed into the assembly line, 15 minute sessions with patients where over half the time is spent typing into EPIC, and if the patient is lucky, some listening is done.

Well, I do agree with you here. I'm not sure what to do about it though. There seems to be too few doctors/health care providers to spend the necessary time with patients and the cost to get more seems rather high as it seems to be an issue in just about every country. And yes, big pharma certainly is more motivated by profit than outcomes (this is the inherent nature of corporations regardless of industry). On the bright side, effective medications make big bucks, so that is a good movtivator.

As far as some genetic diseases and the like go, there's not much that can be done about them period, although some of the degenerative diseases like Alzheimer's or Parkinson's could possible be cured some day with drug treatments.

 

[The Cat]

I think point solution fatigue is a very real thing, as is so many options and choices for anything you can think of. But my feeling is that corps or companies that offer point solutions often seem to feel that the offering should be the extent of what they have to do. Not deal with anything beyond - not their problem. Johnson & Johnson is being sued by their employees for mismanagement of their drug benefits. Which is what strengthens that argument of - we offer "something". That should be enough. On top of that, most of these benefits aren't used. Perhaps asking employees what they want would be a better idea. Perhaps some sort of contract or bargaining arrangement for more workers, including white collar and management, might help.

If only there were something. Some thing that existed so that laborers could come together and stand up to management. Something to organize and unionize...for the purposes of bargaining. Collectively even. And yet I know people who whenever I mention union to them, they react like they're stung, or they sensed man returning to the forest. It boggles my mind. Growing up the union was the reason we had food on the table regularly.

 

[ceecee]

If only there were something. Some thing that existed so that laborers could come together and stand up to management. Something to organize and unionize...for the purposes of bargaining. Collectively even. And yet I know people who whenever I mention union to them, they react like they're stung, or they sensed man returning to the forest. It boggles my mind. Growing up the union was the reason we had food on the table regularly.

Add it seems like more and more people realize that hey- having something in my corner is better than not having anything at all. The un-unionizable industries have organized and unionized (Starbucks, fast food) and the non organized unionized industries are treating the 21st century like the 1930's. As they should be.

 

[ygolo]

Well, I do agree with you here. I'm not sure what to do about it though. There seems to be too few doctors/health care providers to spend the necessary time with patients and the cost to get more seems rather high as it seems to be an issue in just about every country. And yes, big pharma certainly is more motivated by profit than outcomes (this is the inherent nature of corporations regardless of industry). On the bright side, effective medications make big bucks, so that is a good movtivator.

As far as some genetic diseases and the like go, there's not much that can be done about them period, although some of the degenerative diseases like Alzheimer's or Parkinson's could possible be cured some day with drug treatments.

Firstly, I want to commend you for engaging in discussion when you disagree. I think it should be possible to discuss disagreements and improve each other's understanding.

The bolded part is the reason I say the healthcare system is the pill pusher. The industry is organized around this model.

I can see why people can be resigned to things as the way they are. There are possible solutions, however. The system was less biased towards this pill pushing nature in the past. The family doctor and the town doctor are good examples in the past. The whole healthcare team really understood each patient's history deeply. There are still stories about people who have doctors offices like that. I think, most doctors offices want to be doctors offices like that.

Influential people are pushing for moving back into this direction- Eric Topol for instance. A couple of books worth reading from him are:
1) Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again
2) The Patient Will See You Now: The Future of Medicine Is in Your Hands
There are probably a lot more.

Personalized medicine, improvements in gene sequencing, and understanding neurogenerative diseases all have been making steady progress.

What I am saying is that the business models of bringing medicine to the patients are in themselves causing a lot of the problems.