The Self-Referral Paradigm
“Only one who devotes himself to a cause with his whole strength and soul can be a true master. For this reason, mastery demands all of a person” – ALBERT EINSTEIN
Do paradigms and paradigm shifts matter? Author and performance expert Stephen Covey argues that paradigms are critical.
“Paradigms are powerful because they create the lens through which we see the world. The power of a paradigm shift is the essential power of quantum change, whether the shift is instantaneous or a slow and deliberate process. “
I suggest that the paradigm of medical practice shifted sometime between the General Practitioner era and now. The assumptions of doctors and patients alike changed, and it was not for the better. The resulting dissatisfaction continues to cause severe deterioration of the doctor-patient relationship – and degrades the medical system.
Political or economic measures will not deliver what patients really want: doctors who meet their deepest needs. Politics and economics will not bring what doctors want: the ability to heal the patient. The ineffective medical paradigm that now exists takes a terrible toll in dissatisfaction - from patients and doctors alike. This negative impact interferes with the positive emotions needed to heal. This is why patients and doctors are estranged from each other.
I suggest the problem is deeper than meeting patient and doctor expectations. The field of medicine is ripe for a paradigm shift of monumental proportions. Just as physics went through a paradigm shift from the science of Isaac Newton to that of Albert Einstein, medicine also must change. This paradigm shift will change our assumptions about the body, health, and disease – and how we practice medicine.
The Self-Referral Paradigm
What are today’s doctors and patients about to discover? What new perceptions are on the horizon of medical progress? We may glimpse this new paradigm by reexamining the object of all medical care - the human body, and our assumptions about it.
The human body is healthy for most of the average lifetime. This hardy biological creation somehow survives a poisoned ecology, bad diet, insufficient exercise, and the stress and craziness of modern life. How does the body do it all? The body is resilient because of excellent design. The body is self-correcting and capable of adapting to any number of noxious influences – and stays mostly healthy. How does this happen?
The human body dynamically responds to challenges it encounters by adapting to the challenges. Self-Referral is the body's ability to regulate itself - by itself. This is how the human body maintains health throughout life.
Today’s disease-focused medical care largely ignores Self-Referral, instead seeking ways to neutralize disease or irritating symptoms. By ignoring Self-Referral, today’s medical care is ignoring the best road to health. Rather than ignoring Self-Referral, doctors must seek Self-Referral and work with it. The Self-Referral Paradigm will focus on how the human body works through Self-Referral – and restoring Self-Referral whenever possible.
Many in business now want to understand Eastern philosophy. This interest partly stems from the need to compete with Japan, China, and other Pacific Basin countries. Seekers of business wisdom have made best-sellers of formerly obscure books. These unexpected hot sellers have included Miyamoto Musashi's martial arts classic A Book of Five Rings an excellent source of strategy useful to business. Another example of this phenomenon is Sun Tzu's Art of War. This venerable teaching also has sold well - in several editions – and even inspired some best-selling computer war games.
Doctors and patients can glimpse the new Self-Referral Paradigm in these sources of wisdom. Thomas Cleary writes in the introduction to his translation and commentary of Sun Tzu’s Art of War:
“According to an old story, a lord of ancient China once asked his physician, a member of a family of healers, which of them was most skilled in the art.
The physician, whose reputation was such that his name became synonymous with medical science in China, replied, "My eldest brother sees the spirit of sickness and removes it before it takes shape, so his name does not get out of the house. My elder brother cures sickness when it is still extremely minute, so his name does not get out of the neighborhood. As for me, I puncture veins, prescribe potions, and massage skin, so from time to time my name gets out and is heard among the lords."
Modesty is not the point here. The ancient physician tells us that prevention of disease requires much more thought, planning, and skill than treating it after the fact. Sun Tzu states the same idea in terms of the martial arts:
“To overcome others' armies without fighting is the best of skills. “
In today's climate of spiraling medical costs, prevention is more important than ever to doctors, patients, and budget planners. Looking for ways to defeat disease in earlier stages - or even preventing disease completely – is of great interest. We see here that Sun Tzu’s insight could be a path to both reducing patient suffering and reducing medical expenses.
Implementing the Self-Referral Paradigm
Health care experts know that prevention of disease is far more cost-effective than treating disease after it occurs. Screening patients often identifies health problems early. When doctors treat disease in its early stages, they prevent the devastating effects of undetected long-term disease. This is why working to prevent disease prevents suffering and yields big savings.
Today’s medical care does not focus on prevention; people usually see the doctor if they are sick – or after they are miserable from symptoms of advanced disease. The focus is now on disease – after it is diagnosed, often in advanced stages. Promoting health will require a reorientation of the entire medical system. The Self-Referral Paradigm will focus on promoting health and catching disease early for effective treatment.
Healthy lifestyle choices produce healthy patients. Everyone knows this, but a major challenge lies in changing deeply entrenched patient behavior. The constant flurry of confusing advice from media accomplishes precious little – and passing out stock pamphlets at the doctor’s office seldom helps. Tailoring effective lifestyle recommendations to the individual must become a high priority. The Self-Referral Paradigm will focus on comprehensive lifestyle intervention to optimize health.
Considering disease prevention, we must turn to the problem of stress. Medical research shows that stress creates body wear and tear - and causes many diseases. This may be true, but how can a stressful experience translate into disease? Even if we answer this question, how can we avoid the negative effects of stress? A better understanding of stress and disease will benefit both physicians and patients. The Self-Referral Paradigm will focus on new ways to reverse the effects of stress.
Stay with me as we explore all of this in greater depth.