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Where's My Medicine?!?!?

The Response-Ability Paradox

Do doctors even care? Do patients even listen?

The doctor speaks.

"You have hypo-hyper-scoli-medi-osoriasis."

(scribble, scribble)

"Here's your prescription. Maggie will schedule an appointment for your lab work.

Take care."

OK, maybe your diagnosis is shorter. Maybe you were told you have high cholesterol, or high blood pressure. Maybe you were told your age is responsible for bringing you insulin resistance or metabolic syndrome.

Perhaps you were told that many moms your age deal with thyroid issues, or arthritis is common among former athletes when they hit their 40's. Whatever the specific diagnosis, the process is often the same. The doctor gives you a label that correlates with a code. With that code your insurance will cover your prescription.

That seems to be the paradigm for the not-sick-but-not-well. Lots of people fall into that category.

This is a difficult article to write. It's lengthy. It crosses boundaries. It will raise eyebrows and emotions. It's written for the individual seeking physical improvement, but it will be reviewed by medical professionals and fitness professionals, many of whom might have strong opinions contradictory to my own. Know in advance . . . everything you read here is grounded in sincerity, and my future, as I move through my third decade as a fitness professional, is stacked upon the passionate want to empower people to find mastery over their own health and well being. With that said, I'll step forward by further delving into how and where the population at large interacts with those who we refer to as, "doctor."

Where Do You Go To Get "Better?"

If you're near-dying you go to the hospital. If you have a minor trauma like a broken finger, a nagging fever, or an erupting blue blister where you accidentally whacked yourself with a hammer, you go to the Urgent Care center. If you just don't feel well, you need a check-up, or you're dealing with a chronic annoyance you make an appointment to see the doctor. You can prepare to wait in a waiting room, get weighed and questioned by a nurse or nurse practitioner, and you can expect, within the hour you spend in the office, to see the doc or a physician's assistant for all of six minutes. That's enough to get you the label and the scribble.

If you're a doctor and you're reading this, you're heating up a bit. I know you are, and I've barely even gotten started.

You've heard the slams recently aimed at your esteemed profession. I've heard them as well. Here are some actual quotes from people I've spoken with very recently.

"Doctors suck."

OK, that's brash. It's global, it's insulting and it doesn't pretend to pull any punches. When I heard it, it came from the mouth of a former football player dealing with arthritic pain and a growing waistline.

Here's another . . .

"I’m done with doctors.  My chiropractor is the only one I trust."

That's from a 36-year old police officer with high cholesterol and chronic low back pain.

As I consult with individuals seeking betterment, individuals frustrated by changes taking place in their mirrors and in their lab results, there seems to be a want to point a finger at conventional medicine and throw a quick dart.

The momentary affront is often followed by a comparison.

A 63-year old woman spent 20 minutes in a consultation with me going through her medication list. She then, paused, eased into her own imagination, and expressed a memory that she wished she didn't have to detach from.

"I remember when I was a little girl, Dr. Schaefer would see my whole family for check ups.  We knew him, we knew his wife, we knew his kids, and he really cared.  Doctors aren’t like that anymore." 

I understand the perspectives.  I’ve met the frustrated patients and, although I couldn't have made the following statement before the age of 45, I can now, at 49, say . . . I’ve been on the patient end. 

New Perspective From The Impatient Patient Side of Things

I not only understand the expressed sentiments because within my professional consultations I hear them so frequently, but I also understand them because I've felt the emotions that prompt them. I have felt the "doctors suck" emotion, although it was less of a rational affirmation than a reactional prompt to the sense of hitting the wall, running into a dead end without resolve.

Yes, I have felt the emotion that leads to the words, "doctors suck." Conversely, I have several doctors as close friends and I hold extreme admiration for every one of them. I am also connected professionally with a handful of doctors I feel deserve extreme recognition for their talents and abilities, and I’ve met enough doctors over the past year to recognize, they all have deep knowledge, they all are committed to their professions, and despite individual differences, they ALL maintain good intentions. 

Rationally I know better than to believe any global statement condemning medical professionals stems from anything other than pure emotion. Every doctor deserves admiration for the discipline, commitment, and perseverance summoned up to manage the progression through medical school, internship, and the practice that follows. Doctors don't suck. It does appear, however, based upon scores of personal discussions with doctors of all levels, the current medical system limits them, pigeonholes them, and unfortunately, comes with a rift between their ability and their ability to manage a patient load.

Are there doctors who have found their footing and stayed with their early aspirations despite the overwhelming tendency to cave to the present paradigm? Of course there are, but the 21st century is not an embracing place for the man or woman who had those aspirations of being “the good old family doctor” my 63-year-old client longed for.

I will share what I believe the be the paradox, the enigmatic puzzle that seeks to pull the pieces of patient need together with medical treatment, but first. . . . I mentioned I have felt the emotions that come with a sense of being disheartened by conventional medicine. While I realize it adds length to an already heavily worded article, I feel it vital to inject a glimpse into some of the experiences that helped to shape my present perspectives.

Here’s the short version of my journey into the patient side of the medical field. 

In 2005 my office was destroyed and flooded by a hurricane.  I spent 3 months inside the four walls, paying contractors to tear out rotting drywall, bust open tattered A/C ducts, tear up mildew-ridden carpet, rebuild, repaint, reglue, and repaste.  Shortly thereafter, as the office began to take shape, as my fitness center and personal training studio began to look as good as new, I had trouble breathing.  Through a series of doctor visits I was directed to an allergist. After a series of tests he told me I was allergic to cats, grasses and dust.  He referred me to a pulmonologist where I was diagnosed with emphysema, given prescriptions for inhalers, corticosteriods, and sent for albuterol nebulizer treatments whenever I couldn’t breathe, which was often.  As time went on I developed problems with my vision and the eye doctor said I had erratic function of the optic nerve.  I lost my ability to distinguish colors and 2 weeks later I developed numbness in my hands and feet followed by the rapid onset of tremors.  On the day that I couldn’t tie my shoes because my fingers didn’t work, I went to the ER.  Subsequently I saw neurologists, went for MRI's, cat scans, brains scans, and electro-everything tests, and at the end of the testing process sat in front of a neurologist who handed me prescriptions sheets as he diagnosed me with Parkinson’s Disease.  That was the moment I hated the medical field.  It wasn’t the diagnosis as much as the calloused way the diagnosis was delivered, and then it was “fill your prescriptions and move on, I have someone else's life I have to destroy.”  No, that isn’t exactly what was said, but put yourself in my position and you’ll understand why I heard it that way.  I had never been sick a day in my life and in a matter of months I went from emphysema to Parkinson's with no mention of hope beyond, "with medication you can have a good quality of life for many years." That moment began what proved to be the worst 24 hours of my life. Then something clicked. I decided I wasn't going to be victimized by one man's diagnosis and I continued to explore. 

I’ll make the long story short.  I didn’t have emphysema, nor do I have Parkinson's  I had inhaled super high levels of toxic mold and with it, a host of chemicals used in construction materials.  The end result was a neurotoxic reaction that threw the systems of my body into mayhem.  I thankfully found three wonderful doctors in three different parts of the country who helped me understand what had happened, and helped me get back to normal function.  Today I'm left with some residual compromise, but not a one I'd be willing to complain about. Emotional roller coaster aside, I can honestly say at this point I treasure the entire experience.  It allowed me to be the patient, to feel the helplessness, to be viewed as a puzzle that needed to be solved with a prescription, and to be lost in a sea of patients reaching out to the medical field for answers. 

I better understand the plight of those diagnosed with hypothyroidism who are given a prescription for synthroid and told to accept it as a normal part of aging.  I empathize fully with young fathers who fear illness when the doctor tells them they have metabolic syndrome, syndrome X, or type 2 diabetes, and hands them prescription sheets as they’re ushered out the door.  I wonder how many who are living their lives as if they have incurable autoimmune diseases, Parkinson's, MS, lupus, or a host of other non-specific conditions were wrongly diagnosed. 

This sent me on my most recent mission and led me to develop the ALIVE protocol, now in use with select clients as a vehicle to lead to physical betterment. (continued below)  


Here’s what I now understand . . .  

The pulmonologist who sent me the way of inhalers and corticosteroids is a very nice, very well educated, very committed man. He has a family.  He’s in his 50’s.  He’s been practicing medicine for decades.  He has a patient load beyond what is comfortable, a staff beyond anything he ever wished for, a need to keep records that falls way outside of what he ever imagined he’d have to do professionally, and, although he makes a good living, he isn’t “wealthy” at the level others think he is.  He has kids in college, has a home to maintain, an ex-wife who did well in the divorce, and lots of headaches he’d love to trade for days on the golf course.  He works hard, he does what he has to do, and he doesn’t have enough of him to go around.  He follows protocol, stays within his specialty, bills within the insurance paradigms, prescribes labs and meds as he’s supposed to, and he’s entertained by drug reps who make prescription easy.  I’m simply one of thousands who have passed through his revolving door. 

The neurologist is a surgeon and spends more time with his unconscious patients than he does with the conscious ones.  Every one of his patients is dealing with extreme emotion, uncertainty, and fear, and if he were to get sucked into even 1/10th of their emotional concerns, he’d become emotional mush, and nobody wants an emotional mush to operate on their brains. 

That understanding wouldn’t have made it any easier for me on the patient end, but as an observer seeking to help the unwell part of our population, the perspective I’ve gained brings immense new power. I applaud the amazing advances of medicine. I've gained insights into genetic research and the possibilities are staggering. The Human Genome Project brough great minds to find belief in the "anything is possible" axiom. While the actual science is stunning, and the potential for halting or reversing many of the symptoms and conditions we've come to mistakenly accept as realities of aging is real, there's a gaping chasm between scientific discoveries and the availability of promising treatment options.

While I'm awed by science, I also acknowledge the impact of money-driven pharmaceutical giants, litigious attorneys finding jackpots in malpractice suits, understaffed overloaded hospitals, private practice groups capitalizing on doctor's talents without respecting their contributions, a population in want of a miracle fix, and a system of HMO's and PPO's that has run so out of control I feel for whatever powers seek to find resolve.

My emotions and perspectives aside, here’s the huge paradox I'd ask you to consider.  

Doctors cannot be responsible, and patients cannot be accountable.

That's a problem. Allow me to explain.

We, who wish to rely upon doctors when we have health concerns, believe there should be professional responsibility. 

There’s little that can questioned about the morality behind the statement, “you’re highly educated, you’re an expert in your field, you’ve been trained to treat the patient’s condition, and in that you should accept full responsibility for the outcome.” 

The family doctor or surgeon in 1972 might have accepted the responsibility with a nod, a handshake, or a simple smile signifying, "of course I'm responsible." 

That was before malpractice insurance ate up 1/3 of the doctor’s income.  That was before society became so litigious that lawyers can find riches hunting down clients who have the weaponry to sue medical firms for damages. 

It was a time before foods contained hydrogenated fats and high fructose corn syrup, a time before formaldehyde was used in carpet and furniture, a time before drug companies put out drugs faster than those releases could be proven safe.

It was a time before people sat at their kitchen tables and accessed a mix of science and bunk on their laptop computers trying to determine whether they have a pimple, a fatty tumor, a tick bite, or a cutaneous eruption indicating the presence of a killer flesh eating bacteria. 

The lines of medical need, medical care, and medical alternative have become blurry, and with an uncertain, litigiously hungry, unwell population, even the most talented physician has to be able to find protection from risk, error, and external forces playing against the intended outcome.

The doctors agree that they are catalysts, diagnosticians, and practitioners, but can they really be fully responsible?

The bottom line in most 21st century conditions is patient accountability. After all, the doctor can control cholesterol, blood pressure, or blood sugar through meds, but that doesn't alleviate the patient from having to exert some level of self-care. If a patient is prescribed medication to preserve a compromised heart, and feasts on deep fried artery cloggers day after day, the doctor can't be blamed.

In that lies the paradox; professional responsibility vs. patient accountability. 

Who is to blame for treatable illness advancing?

The advancement of treatable illness is a pervading reality. Type 2 diabetes, which has arguably reached epidemic proportions, is perhaps fully preventable and in many cases reversible. Most of the risk factors of heart disease and perhaps of cancer are outcomes brought about by individual choice. Nobody wants to be an overweight smoker . . . or an overeater seeking tranquility with antidepressants, but we all know many such individuals.

If you agree that even some of these statements are representative of the real world, it’s clear that the physician cannot be wholly responsible.  To further move the blame scope away from the doctor, we can acknowledge that when confronting a patient with a fixable condition, or a controllable progression, any sound physician will advise a patient to "eat right and exercise."  If the patient comes back months later with advancement of symptoms, it’s clearly the patients fault.  Right? 

Not necessarily (continued below). 

Eat Right and What?

The doctor knows the patient should eat right and exercise.  The patient knows he or she should eat right and exercise.  If everyone listened to their doctors, there wouldn’t be an overweight smoker anywhere in the world.  The first glance tendency is to therefore throw the blame over to the patient side . . . until you spend some time interviewing overweight smokers. I've met them. I've spoken with them. I've coached them. I understand them . . . at least some of them, and the ones I understand needed more than advice, more than prescription, and more than a new menu and a bit of willpower. They needed a system mixing clear direction, coaching, appropriate treatment, and the gradual and long-term instilling of new supportive habits.They needed support, empowerment, education, and evidence. They needed a proven protocol that respects both medical science and personal accountability.

I know this is beginning to resemble a ping pong match, with blame shifting from side to side, and it should. That's a perfect metaphor for the paradoxical question of blame in this regard.

Overweight smokers try.  They really try.  I'm sure you can find an exception, but in my professional pursuits, I meet smokers who detest their habits, and of those who are overweight,not a one of them defends the condition. The problem in most cases isn’t a death wish or a lack of innate willpower.  The problem is, misinformation.  The patient, even with good intentions, doesn’t know how to eat and exercise in a manner that moves him or her along the continuum back toward health.  An extended walking program combined with caloric deprivation is likely to slow metabolism, lead to unintentionally self-induced cravings, affect neurotransmission and mood, bring about endocrine shifts primarily in thyroid and pancreatic function, and leave the patient, despite a valiant attempt, worse off.

The first cigarette offers a familiar and oddly comfortable resignation. Whatever prescriptions are accessible allow for a soft landing and justification of the abandonment of the flawed effort.

Ask a non-pilot to take the controls at 20,000 feet and you're pretty certain to crash. Ask someone who hasn't been given the user's manual for the human machine to take the controls and the same is true. Some believe eat right means eat less, others believe it means eat natural. Some will opt for organic, others will throw away carbohydrates, and the only unifying trait they all share is movement toward failure resulting from misinformation.

The doctor isn’t to blame, nor is the patient  A technologically-addicted, undereducated, overindulgent society needs a more aggressive educational and instructional intervention. 

There is a platform between medicine and fitness that must be developed and populated, and that’s the platform upon which I built the ALIVE protocol. 

Patient, know this. 

Your doctor wants to help.  If you aren't seriously ill, if you aren't on the brink of physical crisis, the medical paradigm limits the doctor's ability to assist you at the level you’d like.   

Doctor, your patient wants to follow your advice, but he or she has to understand precisely what that entails, not at a macro level, but at a micro level. 

Meet me on that platform and I’ll move patients back toward health.  I’ll show you how shifts in eating and movement can improve lymphatic cleansing of the body. I'll demonstrate how anyone who wishes to return to a prior condition can restore movement and strength. I'll demonstrate how anyone can bolster energy stores until there's a reacquaintance with that “on top of the world” feeling. 

If you struggle with dis-ease or chronic conditions that limit you, I’ll provide you a vehicle for true accountability, for optimizing the systems and structures of your body, and you’ll do it in a way that is harmonious with any intentions your doctors have.

Fitness, true fitness, may very well be the missing piece of the puzzle. It facilitates enhanced neurtransmission, restores comprosmied endocrine function, and instills a sense of power that begets adherence and follow through. Yes, you can be response-able with the proper guidance and the necessary follow-through.

Does Your Personal Trainer Have the Solution?

Are all fitness professionals and personal trainers able to stand upon the platform I'm describing? Are they all capable or restoring the unwell to health?

Absolutely not.

I'm ready for the argument, the criticism, and the skepticism. I'm ready for the personal training discussion boards to attack my arrogance and insist I'm blowing smoke. Here's one more dose of reality. Nobody oversees the fitness field. Anyone can become a personal trainer in a matter of weeks, or days in some cases, and competence is not a requirement. Unfortunately, many personal trainers who sat for exams, and received credentials associated with those exams, believe they're competent and those trainers may be offended by my words. I hope they'll consider there may be some truth to my assertions.

The platform I'm describing, the area that melds patient responsibility with guidance, consideration of the synergistic relationship between ingestion and output, the gray area that can serve as the vehicle to move the unwell back toward health, requires a skill set not required in the field of personal training. It requires a multi-faceted protocol, one that has been reviewed by experts, one that has been proven sound, and one that has a body of evidence to support it. 

It’s time to recognize the platform that bridges the gap, the platform upon which medicine and individuals meet, where responsibility joins accountability.

If you're a medical professional or someone seeking physical change, contact me with your present interests, needs, and concerns to open up further dialogue related to my ALIVE protocol. Read my Seven Letters and evaluate whether, with a better understanding of the information I share, you are ready to believe you can take control.

If you are a fitness professional, and you feel there may be some validity to my heartfelt statements, I ask you to recognize that conventional personal training curriculum is only a first step toward standing upon the platform I'm spotlighting.

Fitness professionals, with the proper education and skill set, can empower.  We can aggressively intervene.  We can recognize dis-ease as a continuum, and while we cannot make illness vanish, we can move our clients back along the continuum, back toward health.

The few personal fitness trainers who respect the level of commitment required to stand upon the platform should take steps to work alongside medicine, taking a place as part of the allied health care team. If you agree, consider my Be Better program for fitness professionals, and if you want to share your views, I'm listening.

I've covered lots of ground in an article that mixed perspective and emotion. My intention is simple.

I want anyone seeking betterment to know, there are solutions, and limiting attempts at betterment to wishing the doctor presents salvation is going to leave you short of optimal health.

Fitness and well being do require responsibility, but you don't have to be on your own. Be proactive, take responsiblity for learning to manage your own physical condition, and if the concept of follow-through in the past has left you compromised, find a better resource for empowerment. Find a fitness professional who works with your doctor, who aligns with any health professionals you have come to trust, and who has worked with others like you to achieve the betterment you seek. 

The iconic representation of medicine is a serpent and staff. This is the staff of the Greek God Asclepius, a physican who was revered as a healer thousands of years ago. Asclepius, according to Greek mythology, had two daughters, Hygeia, and Panacea. Hygeia represented wellness, the avoidance of excess, sprituality, poses, tranquility, and natural healing. Panacea represented treatment with herbs and surgery. The solutions for a population in need of health lie not on one side, but somewhere in the middle.

Conventional medicine has mastery of the evolving science of Panacea.

The platform of fitness professionals maintaining a high degree of competence and excellence can empower people to employ the preachings of Hygeia.

The outcome? Health, well being, and a joyous state of physical excellence.

I invite all feedback.

Be Better. Always Better,

Phil Kaplan


Read the Seven Letters


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