Value at any Price
As you leave college, you will go out into the world of ‘real’ medicine. There are three (at least!) obstacles that you will meet.
Firstly, there is the general ignorance of what we do – but don’t assume that because TCM makes perfect sense to you, it will to everyone else. There will always be a large proportion of the population that will never see past the needle. Also, don’t assume that speaking to every WI who will listen to you will educate and otherwise spread the word; I’ve tried it but with only minimal success (but hey, maybe that’s me!).
Secondly, there are the other complementary therapists. These range from the credible to (let’s face it) the somewhat ‘flakey’. Again, it depends where you want to be positioned; don’t forget, you are judged on the friends you keep – the same applies to the professional colleagues you keep.
Thirdly, there is ‘conventional’ medicine. The term ‘conventional’ always amuses me for a system that’s really only a few hundred years old, is science-only validated and, essentially, only considers the physical world. However, it is this society’s medicine of preference, and so we have to live with/in it.
The National Health Service, in the 60 years it has existed, has prided itself on the fact that it is ‘free’ at point of delivery. With the exception of some small things like dental, prescription and hospital car park charges, this is the case. It strives to address all illness but NICE is continuously having difficulties allocating resources, especially as some of the modern drugs are so expensive.
Which brings us to the cost of this ‘free’ service. I understand that twice as much of the expenditure of the pharmaceutical industry goes on marketing (some 31%) as goes on research (14%) (did you think these companies were altruistic in what they did?), yet the cost of drugs to its customers (the NHS included) has raised it to the third largest industry in the UK – after Tourism and Finance. 15% of the NHS budget (some £7000m) is spent on prescribed drugs, 80% of which are patented. And the total cost of the NHS budget represents some 7.2% pa of the national wealth – not surprising when you see the above spending on drugs, the recent average doctors’ pay rising to £100K pa, etc.
And this, because the costs of it are removed from us at source, is considered to be a ‘free’ service.
Like all bureaucracies, it is inflexible and very expensive to administrate. Fixed in it’s ways, politically, administratively and clinically, it has great difficulty in accepting that there is another way to do things – this then rubs off on its patients who are channelled into thinking that the NHS is the only way to go; like Edward Bear in AA Milne’s ‘Winnie The Pooh’ they don’t know any different.
“Here is Edward Bear, coming downstairs now, bump, bump, bump, on the back of his head, behind Christopher Robin.
It is, as far as he knows, the only way of coming downstairs, but sometimes he feels that there really is another way, if only he could stop bumping for a moment and think of it.”
But let’s step back a pace and see the ‘essence’ within this framework.
There is a symbiosis between large industry and the political structure – so that each supports the other to exist. This was seen very clearly during the years of the ‘Cold War’ when both Western and Eastern political systems were supported by enormous weapons industries. When the Berlin Wall fell, so did this mutual dependence, and both parties returned to a more realistic footing. The language of the Cold War was interesting – anyone who argued against it was seen as a traitor and, indeed, in the latest ‘War’, that on terrorism, the USA said that whoever wasn’t with them, was against them.
The same can be seen with the Pharmaceutical Industry, the NHS and Government – pity the career of a politician who dares talk of introducing part of the medical cost to the individual, and there are enough drugs industry-funded research conclusions that indicate that even more should be spent on their products (witness the latest report on non-mainstream cancer research).
So because we live in a society that is told it has no option, and that the service is ‘free’, we can take advantage of it willy-nilly. Therefore:
WE CAN ‘AFFORD’ TO BE ILL
I see it daily – so many complaints would not exist if people had to pay directly for their healthcare. Low-cost or free solutions would be found to many complaints. Exercising, eating sensibly, self-sufficiency would all become popular if it avoided spending money on medicine. Old Wives’ Tales would be listened to and acted upon (they didn’t come about by accident).
Instead we have a medical system that, AT ‘NO COST’, supports the unfit, the overweight, the self-indulgent and those suffering from ‘imaginary illnesses’ by pumping them full of chemicals that suppress their symptoms, and coming up with even further excuses like the recently announced ‘fat gene’, and so on.
So, in creating a universal and ‘free’ health service, we have effectively made the nation unwell. And who said that Chinese culture was full of paradoxes?
Clients come to me waving sheets of prescription, sometimes almost like a badge of honour, telling me that they feel unwell and what can I do about it. More often than not the majority of the items listed are there simply to counteract the effects of the others (don’t get me started on the efficacy or otherwise of drugs testing, the high level of major side-effects or the number of prescriptions that are wrongly prescribed!).
So I have people who come because: “I don’t want to take drugs”, “I don’t want to go into hospital (for fear of Hospital Acquired Infections)”, “the doctor’s can’t do any more for me” or, the old favourite, “you’re my last resort”.
AND ANOTHER THING ……..
Despite spending approximately £500 million per year on treating back-pain (not to mention the cost of absence from work to the employers), the NHS still does not go for the preferred option. I was reminded of this on hearing the news today that Alexander techniques achieved a better sustained benefit than either massage or exercise; a year ago the BMJ published a study which concluded that acupuncture is the cheapest way of treating lower back pain – despite higher initial costs, the long-term improvement in patients’ condition mean it works out cheaper in the long run than conventional Western Medicine. And yet neither sufferers nor taxpayers are getting what they want, namely pain relief and economy respectively – if the NHS does not provide what is wanted by those who fund the service or those who receive the service, then it does beg the question ……..!
…………….
So if, in your first few years of practice, you feel you are swimming uphill, then that’s because you are. But, after all of that, the incredible sense of achievement you will get in fixing someone’s ailment, I believe, beats anything you’d get from working in a ‘conventional’ environment (judging by the low levels of morale and the high levels of stress that I see there). And the encouraging thing is that people are prepared to pay us to do it; they ‘value’ what we do.
Those who empathise with the above may like to read Kevin Baker’s “Empowering the Patient: Perspectives from Western, Psychological and Oriental Medicine” at: www.acupuncture.org.uk/student/articles/empowerment.asp
Metta