Today, it is of the ultimate importance that healthcare professionals have an overview of medicine as practiced internationally − not just as it is practiced in Canada. Around the world, it has been demonstrated that governments and medicine seldom mix. Accordingly, all healthcare professionals, particularly physicians, must be independent practitioners who have only the best interests of the patient at heart and must therefore focus their efforts on this objective.
Unfortunately, system administrators seem to sprout ever enlarging bureaucracies often advised by physicians who are motivated by exercising political clout and their own pecuniary interest, rather than the welfare of patients.
Pharmaceutical companies, with their extensive lobbies and the support of government bureaucracies, are primarily driven to generate profits but nevertheless exert an excessive and unwarranted degree of influence in formulating healthcare policies, extending even to the educational process.
Insurance companies, as is increasingly evident, again are economically oriented and pose one of the most pernicious influences in healthcare today. Claims adjusters and low-level administrators frequently impose incredible hardship on patients desperately in need of funds to pay for both their specialized and routine health care, for which they have contributed premiums over many years.
The combination of gatekeepers consisting of governments, HMOs, Wall Street corporations, etc., further muddy the waters. There is no clarity existing with all the vested economic interests that at this point almost totally control healthcare delivery systems, whether in England, Cuba, Canada or Sweden.
In many instances, unfortunately, no healthcare at all may be preferable to what is actually provided. For example, wounds secondary to diabetes, atherosclerosis, and other etiological factors often show rapid improvement with simple elevation of the extremity and saline compresses to the wound 24/7, as compared to the utilization of multiple dressings, antibiotics and analgesics that are provided in such abundance, accompanied by rising costs. All too often, the latter approach leads to the eventual amputation of the afflicted limb.
Does anyone really care about these issues? Not as long as the care provided is perceived to be ‘free’. And what of the latter fact? A perfect excuse to levy more taxes, to expand the bureaucracy and order more diagnostics and consumables, all excluding the most important item – the correct therapy designed to cure the patient’s problem.
To elaborate on the insurance situation: each day, we see new patients at our clinics and invariably, at least initially, the priority item they wish to discuss is their insurance plight – rather than their medical condition. These patients rant on about how the insurance companies keep reneging on the promise to pay for their care. How can you blame them? This premise, after all, is why they bought insurance in the first place.
I recently uploaded on my blog the story of one particular family which serves as an excellent example of this growing problem. The husband was severely injured in an automobile accident over five years ago and has been unable to work since. The couple went broke paying their medical bills and were recently evicted from their home. Several insurance policies had been purchased by this individual, who owned a number of businesses that were thriving prior to the accident. Financial failure ensued after the trauma as the wife was busy taking care of her husband and two children and could not continue to manage their affairs.
Over five years later, the insurance companies are still fighting about who should pay for what. Anyone familiar with this paradigm knows that it can go on for many years, or at least until the patient expires.
At the same time, insurance companies spend considerable funds on diagnostics and these are seldom questioned, no matter how expensive they may be. They also spend unlimited funds carrying out assessments, investigations, etc., which allow them to renege on claims, aided and abetted by a hoard of assessors, bought and paid for by the carrier. The latter almost invariably find that there is no objective evidence to substantiate the disputed claim.
As for pharmaceuticals, these in many instances confer significant benefit. For example, insulin, thyroxin, cortisone, and analgesics, along with many other drugs, provide viable solutions – primarily in the short term, although often only by masking symptoms. Furthermore, drugs do have limitations and can produce adverse effects. In some instances, the latter may be significant. However, because the pressing need for these medications may override the objection to prolonged use, dependence becomes ‘justifiable’. That is certainly the case with diabetes and insulin, ACTH for adrenal insufficiency, thyroxin for hypothyroidism and a number of similar situations.
On the other hand, alternative therapies can and do provide highly effective solutions in the treatment of a plethora of medical conditions and do not produce adverse effects, either long or short-term, particularly in the treatment of arthritis, back problems and most conditions with the common factor of inflammation, a major component in most disease processes.
I first learned about Laser Therapy in 1988, having injured my right shoulder in a skiing accident in 1986. The injury included a complete tear of the supraspinatus tendon and a fracture of the humeral head generating chronic inflammation of the shoulder joint. Subsequent to this episode, I consulted a number of orthopedic surgeons and the general consensus was to perform an arthrogram to be followed by immediate surgery. Being a trained surgeon, I resisted the temptation to follow this approach, based on past experience, notwithstanding the fact that both orthopedic surgeons I consulted were highly competent and had the best of intentions. My conclusion was that this intervention, fully approved by the regulatory bodies, would not substantially benefit me and I therefore pursued an alternative course. Above all, I did not wish to be subjected to an additional trauma.
Unfortunately, prior to Laser Therapy, from 1986-1989 I was unable to play golf or swim on a regular basis, secondary to the discomfort and pain. Analgesics and anti-inflammatory medications produced undesirable side effects; moreover, I objected to them on basic principles. Periodically, when the symptoms became unbearable, I submitted to cortisone injections which, when properly placed, provided temporary relief. A permanent cure proved elusive.
Finally, I found a therapist equipped with a primitive European Laser device and in a short period of time, my shoulder pain subsided significantly. Inspired by this turn of events, I began my pursuit of self-education in the emerging technology of Laser Therapy. Over the course of two years, I read over 300 articles and 13 texts on this topic and participated in many national and international meetings exploring the subject.
Here are some observations noted on this journey:
• How little was really known about this therapeutic medium at that time.
• How much remained to be learned.
• How we must open our minds to new ideas, thoughts and solutions.
• How we must question tradition and “the way things have always been done”.
• How we must be critical of the massive amount of information and disinformation coursing through the net. This is extremely challenging and reminds me of my mother who often said, “I read the following in the newspaper.” My usual response would be, “I know that this is not true.” Her invariable retort was that “It would not be in the newspaper if it were not true!” She also believed in the infallibility of physicians, with the exclusion of myself. Unfortunately, that was the cause of her demise at the age of 93. Had it not been for a series of hospital blunders, she might still be alive today.
• We must always be aware of how the internet disseminates a mountain of data, all of which is of course documented by humans, many of whom have a vested interest in benefiting the propagator of the information provided.
• Creativity and independent thought must be encouraged. In a civilized world, these qualities inevitably lead to progress.
• Never be afraid to question or criticize authoritarianism in its varied forms.
• Do not permit economic conventions, inappropriate regulations, and other obstructions to get in the way of implementing better therapeutic solutions.
To cite some recent advances, I refer to:
o Stem Cell Therapy
o Genetic Modification (gene splicing)
o Robotic Surgery
o Laser Therapy, etc.
• All healthcare professionals should be encouraged to make the patient’s clinical status the focus of their endeavors.
• Most significant of all, are the advances in Laser Medicine over the past decade and the wide impact this should have on the quality of medical care, now and in the future.
When asked how he conducted research surveys indicating what product the company should build, Steve Jobs, the late departed CEO of Apple, stated, “Surveys of that type have no interest to me. I know what people need and that is what I give them.” To me, this represents a greater wisdom than the many aphorisms espoused daily by the leaders of the corporate world.
Steve Jobs may have been, in the eyes of some, a “son of a bitch” but he is one of the few who had the vision and courage to nurture his original concepts and ideas and translate them into reality. All of us should adopt this type of guidance to a greater degree. Personally, I like to think that in many ways Laser technology is developing along a similar trend.
At our clinics, the most significant results produced are in the treatment of arthritis, musculoskeletal problems, particularly the spine, dermatological conditions including wound healing, along with the all too common soft tissue and sports injuries, many of which have acquired the characteristics of chronicity.
In addition, we have discovered and are learning that Laser Therapy has the potential to treat more complex systemic conditions, particularly in situations where conventional methods have been ineffective.
In the past several years, stimulated by several neurological researchers, we have developed and refined some exciting new applications in the field of neurology, particularly with regard to the following conditions:
• Multiple Sclerosis
• Anxiety Disorders
• Nerve Regeneration
• Spinal Cord Injuries
• Demyelinating Diseases (Gene 7 Paresis)
While only a relatively small number of these conditions have been treated, it must be noted that we have achieved a greater degree of success than anticipated. In keeping with the conventional one-line disclaimer so common in academic circles, “more studies are indicated”. At the same time, I must emphasize that we continue to meet, if not exceed, our expectations.
The constant road block? Insurance companies. They may be willing to pay for diagnostic services, but refuse to pay for actual therapy that may not yet be “authorized”. Again, this is one of the regressive forms of behaviour dictated by managed healthcare systems in the interest of economic considerations. While the focus is on diagnostics, there is a clear lack of enthusiasm for selecting and applying therapies designed to actually benefit the patient. This is commonly described as “risk management”.
Another problem I mentioned is that pharmaceuticals are generally paid for by the management systems in place. Whereas prescriptions are often written under the mystique of providing instant benefit, the reality is that an undetermined number of prescriptions are never filled, which may be a blessing in disguise. Two-hundred and ninety patient deaths are reported daily in North America – the result of pharmaceutical utilization. In reality there are probably thousands!
In 1998 an article in the Journal of the American Medical Association concluded that prescriptions legally written by physicians are the 4th leading cause of death.
In his 2012 book, Unaccountable, Dr. M Makary, a Johns Hopkins School of Medicine researcher, shows how “mining sickness for profit” makes everybody “unaccountable” – hence the book’s title. The book illuminates a description of how hospitals are a major cause of death and how at least 30% of conventional “healthcare” is unnecessary and leads to deadly results.
From my personal perspective, effective therapeutic solutions have always been integral to the agenda of any ethical medical practice. Again, instituting immediate treatment when the disease process begins, circumvents the obstructive process of bureaucracies in the treatment of both routine and complex medical conditions, while substantially reducing the cost of healthcare.
Remember that administrators and other gatekeepers have no real interest in finding the best possible medical solutions but focus instead on cost controls and their primary interest remains the bottom line.
For a good clinician, defining the correct diagnosis does not require a major effort. In most instances, it can be accurately determined by taking a detailed history and performing an equally thorough physical examination. This aspect of medical practice, unfortunately, is no longer de rigeur.
Diagnostic studies, which can be expensive and harmful, should only be employed when the practitioner is unable to arrive at a working diagnosis or to confirm the clinical diagnosis, if this is essential.
All too frequently, prolonged diagnostic studies, the prescription of inappropriate pharmaceuticals, cross consultations, and other non-relevant assessments delay the initiation of therapy and therefore the healing process. This approach is wasteful and one must remember that no pathology can be cured without initiating appropriate treatment, preferably immediately.
It is therefore paramount that Laser Therapy, which can be easily administered by therapists with a modicum of medical training, can and should be more widely implemented, particularly in situations where urgent and effective treatment is essential.
Today, evidence-based medicine is all too often related to double-blind studies, peer reviews and the literature. Sometimes these imply or provide automatic approval of therapies that may have minimal benefit at best. In view of this, one must always ask:
• Who finances these studies?
• How relevant are they?
• Who conducts them?
• And for what purpose?
My personal view is that when a patient presents with a problem and has undergone many studies and treatments without any measurable improvement that is clear evidence of failure. Unfortunately, in healthcare systems today there is no real accountability and supervision of progress may be spurious or even non-existent.
Confusion surrounding terminologies such as “evidence-based”, “scientific”, “double blind”, etc. may often be categorized as time based illusions. Healthcare professionals must adopt therapies that cure the problem rather than focusing on the modulation of symptoms and physician compensation codes. The latter is comparable to following a road leading to nowhere.
In our clinics, the problems that we treat most frequently include multi-level degenerative disc disease and single disc herniations, often accompanied by stenosis, radiculitis, etc. The success rate in these situations is over 90% and no adverse effects are produced. In a select number of cases we have performed follow-up MRIs and were not surprised to see that the problem had been resolved (i.e. the disc herniation could no longer be visualized).
Contrary to current concepts, we frequently encounter young athletes with dysfunctional knees. The basis of these pathologies consists of varying degrees of disruption of the anterior cruciate and/or other ligaments, meniscal tears, contusions, etc. Currently, these are almost invariably treated with surgical intervention, which can lead to complications and permanent dysfunction.
As the number of patients presenting at our clinic with these types of injuries has increased over the past several years, we have again been able to conduct follow-up MRI studies and complete healing has been reported most notably in cases where the original MRI read complete anterior cruciate ligament tear. It is my belief that in these instances, a portion of the anterior cruciate ligament remains intact, perhaps only 10%. Again, further studies are indicated and we are conducting these on an ongoing basis.
Without question, if my knee were injured I would use the conservative Laser Therapy approach and surgery could always be instituted at a later date if necessary; this is rarely the case.
It should be noted that frequently patients are successfully treated with Laser Therapy for conditions that have not improved with traditional therapies. Nevertheless, some physicians will comment that they do not believe in this therapy, and this often repeated statement stimulates some reflection on my part.
I believe that our planet sustains approximately 7 billion people and that over 90% of the entire population, I am informed, believes in some God, religious power or tradition. Without invoking blasphemy at any level, I have never been informed that anyone has actually had a conversation, discussion or meeting with a God. Nevertheless, a God of some form exists in almost everyone’s mind and historically the belief in a Dogma survives, particularly in the face of political repression attempting to dissuade citizens from maintaining this practice.
Obviously some remediation of the medical profession is indicated. It should be noted that in all cultures ignorance and non-believers exist. These have always been a mainstay of the human condition and the effort to maintain this status is sacrosanct to many. It feeds their ego, as they have established an opinion – right or wrong – and free-choice philosophy dictates that individuals can choose to be ignorant and incompetent if they wish and there is really nothing that can be done about that. Eventually, these non-believers may become extinct, hopefully replaced by those with more open and educable minds.
Needless to say, progress will require some leadership from educational institutions and governments. Hopefully this process will stimulate further reflection on our ethical and moral values. And then there is always the matter of mass conditioning. For instance, several years ago when a flu epidemic was rampant in Canada, people dealt with infinite lines to obtain the vaccine. Individuals lined up day and night to receive the shots and information was rapidly circulated about the clinics that had the shortest wait times. This persisted for several weeks. As soon as the flu vaccine became widely available, the lines almost instantly evaporated.
• My vision is to exchange a Laser Therapy Unit for every prescription pad in existence.
• To take control of healthcare away from governments and other vested interests and return it to properly educated and trained healthcare professionals who possess and understand quality medical care.
• All healthcare professionals who review this article should strive to integrate Laser Therapy into their practice.
• Embracing these concepts globally will improve every citizen’s health status immeasurably and wider application will reduce costs of delivery by billions of dollars.