Guiding Principles

My Guiding Principles in Helping You Find Your Health Path

(Or … how being curious is a foundational skill for health )

(A) The Point – Your Freedom and Capability

The role of a physician – it’s all about your freedom and capability:

As a doctor, what I am all “about” is people having fulfilling, enjoyable lives. Capability and freedom are central to this, and health has a major role in these two things.

As a doctor, this is where I can hope to contribute. I want to see ill health interfere as little as possible in a person’s freedom to undertake and enjoy their life as they see fit. On the other hand, I want to see medical interventions and health-related strategies interfere as little as possible also. This is a balancing act.

As I see it, the role of a doctor and of health care in general is to support a person attaining and keeping the full use of their capacities and their potential for personal development, in the service of as much personal freedom as possible.

Part of this is to support that person in being as free as possible from unwanted or unnecessary burdens and limitations. This includes pain and other distressing or distracting or function-limiting or time-consuming “ill-health”.

Less obvious is that this also includes endeavoring to find and use those medical interventions and health practices that are the least burdensome – interfering as little as possible in a person’s freedom to undertake and enjoy their life as they see fit.

All of health care practice, research and policy is subservient to the above at all times.

(B) Always Seek the Cause(s)

When you are having symptoms of any sort or something has happened to make you concerned about your health, there can be many explanations. It is vitally important to look for the real cause(s) and not jump to conclusions or settle for just doing things that help the symptoms without doing everything possible to understand what is really going on with your health.

Many people feel that your doctor’s main job is to treat your medical problems.

In fact, your doctor’s first job (after emergency care, if needed) is to diagnose the cause of your health symptoms or signs. You want to avoid the situation of having some unknown medical problem get worse while you are getting relief of symptoms by some means that does take care of the cause of the symptoms.

Be sure to talk to your doctor about any symptoms or medical problems or concerns you have.

If you just try various things to see what is helpful, you may miss out on effective help and, worse, you may suffer real harm from delay in finding out what is really going on with your health.

(C) It’s a Balancing Act – It’s All About What You Decide Is Worthwhile

  • The goal is to find the health strategies and interventions that are worthwhile for you.
  • Your response to any health strategy or intervention can only be determined by trying it.
  • Your personal experiences with trial and error will not by itself provide you with enough information to be able to fully make your evaluation.

(D) Every Intervention is a “Trial 0f Therapy” 

I have spent massive amounts of my time reading medical educational materials and research papers. There is always something new. Medical research answers important questions and points the way to new possibilities.

Yet, each person and each person’s circumstances are unique. Although research findings are indispensable to good care, in the end they cannot conclusively answer the question of how you as an individual will respond to any particular medical intervention or health strategy. So, each time any medical intervention is tried, it is an experiment of one. This is called a “trial of therapy” – that is, try an intervention and see the result. This is always true, but often it is forgotten.

Sadly, it’s not as simple as that may sound. No matter what, there is just no way to get as much information as you need from an experiment like that. Was your apparent response actually due to something else? Were you just about to feel better anyway? Are there hidden harms or harms that only show up slowly over time?  Are there benefits that are not obvious or benefits that only show up over time? Research on groups of people is vital to shed light on those questions.

We are stuck with the reality that, when we consider one specific person in their specific situation,  we will never have as much information as we need to feel fully confident about which interventions are worthwhile and which are not. It is important to remember this and not fall into complacency or habit. Every intervention should always be up for re-consideration and re-evaluation. Particularly, theoretical benefits are often confused for demonstrated benefits.

(E) Every Intervention is Provisional Always

Medical knowledge is increasingly-rapidly rapidly progressing. New insights and new options arrive all the time. At present, your treatment options may include some interventions that are particularly difficult or challenging. Long gone are the days of saying something like “you’ll need this treatment for the rest of your life – get used to it”. We have no idea what options tomorrow may bring.

Remember, by definition improved treatment means treatment options that are more beneficial, less burdensome, or both.

If you find yourself discouraged about your present health options, or you are feeling burdened by the idea that some difficult treatment may be too much to bear over the long term, consider this:

  • the better your over-all state of health, the better position you will be in to take advantage of tomorrow’s improved care options. This may make it worthwhile to keep up a more difficult treatment now, to arrive at that future date in better shape.
  • more and more we are recognizing the interplay of all aspects of your health with all other aspects of your health. You may need less medical intervention and be able to ditch that burdensome treatment by doing all you can for your health in total. For example, by getting adequate restorative sleep, using mind-body interventions, reducing exposure to toxins like smoke and alcohol, reducing inflammation by being kind to your metabolism, and so on, your may be able to have a much more powerful effect on your health than you imagine.

(F) Attending to Your Total Health Situation and “Lifestyle” is Powerful

For decades, the importance of nutrition, the mind-body connection, our balance with our internal and external environment, etc., received scant attention. Now, nutrition-related problems dominate our medical world. Mind-Body interventions have surged in recognition of their vital place in health. The gut microbial population has become a red-hot topic research topic. Major institutions and governments are coming on board with this now (finally playing catch-up to the public’s lead).

Integrative Medicine might be expressed as: combining what is available for the investigation, diagnosis and care of specific injury and disease, with a broad approach to and emphasis on the foundations of wellness and resiliency, in a way that is attuned to and respects the individual person’s needs, responses, choices and over-all wellbeing. (Any sentence like that is inadequate and could include dozens of words, but you get the general picture.)

(G)   … this list isn’t complete, it’s just what I can think of for now.