We Need Nicer Medicine

Anyone who knows me knows that snake oil peddlers rank close to the top on the list of things I despise. When someone is suffering from an illness, taking their money in exchange for false hope is among the worst things one human can possibly do to another. Evidence based medicine is the best medicine we have, and I wouldn’t let myself, or anyone I care about, receive any other kind of treatment. However, evidence based medicine has one major problem in that is is very unpleasant for the patient.

Even as a kid, going to a doctor’s office is typically unpleasant. Most people hate getting pricked with needles, drinking nasty liquids, or swallowing strange pills. People hate being in hospitals more than anything. They never want to go there, and they want to leave as soon as possible. People hate real medicine so much, they will avoid going for as long as possible, until they are very ill and have no other choice.

Yet, when it comes to snake oil, people love it. In fact, people love it so much, they will take it even if they aren’t sick. Going to phony healers is so fun, people go when they are in perfect health. People who are genuinely ill will avoid getting real help. People who are just fine will seek out completely fake help. What is going on here?

Some of it is just that reality sucks. Snake oil is usually very pleasant when compared to real medicine. Surgery, radiation, chemotherapy, injections, strong medications, etc. are all very unpleasant things. They have lots of side effects, and pain is only the first one. Most, but not all, snake oils have no effects whatsoever other than placebo. You can’t have a side effect if you don’t have a primary effect. The only way to make medicine more pleasant is with scientific advancement. More investment in medical research is the only way to solve any of these problems.

There is another side of this problem that we can solve. You see, real medicine isn’t nice. When you’re in the hospital, you rarely see the doctor. Nurses don’t come immediately when you push the call button, if at all. Emergency rooms have long waits. You never really get to spend a lot of time talking with your doctors. They can’t sit around for an hour chatting with you. They have a lot of patients to see, and not enough hours in the day to see them all.

Not only that, but because of ethical concerns, doctors will only talk to you in a certain way. They don’t talk like a normal person. They are often cold and clinical. There are many things they can not, or will not, say. Even a doctor who has what most would consider excellent bed-side manner does not speak in a way that is as reassuring and comforting as is possible.

On the other hand, a snake oil practitioner is the exact opposite. They will sit and talk with you all day. Most of them actually aren’t scam artists, but actually believe in the snake oil they are peddling. They are well-meaning normal folk, who want to, and believe they are, healing their fellow humans. They really do care about you. They don’t have ethical qualms because they don’t know ethics. They engage you in warm environments like living rooms and local shops, as opposed to sterile offices. They also speak in the most reassuring manner possible, with lies. Nothing is more comforting than someone guaranteeing a perfect recovery with no side effects, no pain, and trivial treatments.

Obviously there is a limit to how much nicer doctors can be. I am not suggesting in any way that we should give up the aforementioned ethical concerns doctors have when speaking with patients. In fact, I think that many doctors need to be more ethically conscious than they are. I obviously don’t think doctors should start lying to patients, as the scammers do, just to make them happy.

What I do think is that we need a new profession. We need someone whose only job is to talk with patients and doctors. It should be someone who is knowledgeable in the areas of medicine and psychology. They should be able to speak with patients, both to assess the patient’s situation and to make sure the patient fully understands their conditions and treatment. They should also be able to efficiently communicate to doctors the information they need to treat the patient, of course without actually practicing any medicine.

Let me use my own hospital experiences as some examples. Personally, I have only been to a hospital because of myself twice. Once was for a broken bone, which needed no treatment, and once was a quick emergency room trip to get stitches. However, I have been to the hospital quite a few times to visit friends and relatives.

Let’s begin with the time my roommate cut his finger while making dinner. It definitely needed stitches. We drove to the nearest emergency room, and of course we expected to wait, but they took him in right away. Time passed, and nothing happened. It was late at night, and the people at the desk could not offer any information. We also could not leave the waiting room. There was no communication with my roommate whatsoever. Eventually hotel staff starting leaving, and there was nobody to talk to at all. Waiting was not a problem. What was the problem was there was nobody to talk to. All we needed was someone to estimate the waiting time, keep us informed, maybe predict what the doctors would do. We couldn’t even get some assurance that care would actually be provided. I guess its fitting that there was no assurance, as no care was provided. My roommate left without treatment after an ungodly wait, and no communication from the staff. He went to the clinic the next day for treatment, and part of his finger is still numb to this day.

Let’s talk about my grandparents. When they go to the hospital, they have many doctors. Cardiologists, internists, gastroenterologists, and more. I’ve been to these hospitals on successive days, and you never see these doctors. You can spend a week there, and you’re lucky if you see a doctor once. You’re lucky if they call you more than once every few days. Any non-nurse who comes to see you tends to ask the same questions, even though you know that information is on the chart. It’s a miracle if they stay more than a few minutes.

There’s also no way to know that your multiple doctors are communicating with each other. You want to be assured that all the doctors are discussing your case together, and they all have up to date information. Yet, never have I seen such a thing. You talk to one doctor, then the next one won’t even ask what the previous doctor did. You have to make the initiative to tell them. And even when you do tell them, they don’t indicate in any way that they care, are paying attention, or are taking that information into consideration.

If you are a doctor, and a patient tells you something, even if it is stupid and useless information, you have to at least pretend that what they are saying is the most important thing in the world. Lying to the patient about their condition or treatment is unacceptable. But a doctor lying about their own feelings has the potential to decrease the stress and anxiety of the patient, and therefore smooth the path to recovery. Based on that, I can make the case that doctors are obligated to do this, otherwise they are being negligent in their treatments.

If the profession I suggested actually existed, that person could solve these problems. They could make sure both the patient and doctors are all up to date with the latest information. They could reassure the patient that they are receiving the best treatment possible, and they could save doctors a lot of time dealing with inefficiencies. They could even fill the role of translating complex medical knowledge into terms that patients can understand.

We need medical care in this country, and around the world, to be nicer. Anyone who engages the medical system as, or with, a patient, has a very strong possibility of meeting with a very stressful, unpleasant, and anxiety-ridden scenario. It’s no mystery at all as to why people are flocking to fake medicine. It’s so warm and welcoming. If fake medicine worked, nobody would ever use evidence based medicine.

While I fully support evidence based medicine, we need to realize that there is more to medicine than the medicine itself. The experience is just as important as the product. The great experience is why people go to Starbucks instead of making something in their kitchen. Doctor’s offices and hospitals really need to work on providing this better patient experience, and having a person to sit and talk with can go a long way towards achieving that.