After recently catching up on reading my blogs, a friend commented that doctors must have found me intimidating. That got me thinking. Was I? Certainly not deliberately. But perhaps there’s an inherent element of intimidation when I arrive with notes in hand. It’s quite possible they feel I’m challenging their authority.
Who is the authority?
An authority is someone who’s an expert on a subject. Merriam-Webster defines being an expert as having special skill or knowledge because of what you’ve been taught or have experienced. We live in a culture where people gain the status of expert through years of specialized training. This is particularly obvious in medicine, where doctors have been through a dozen years of post-secondary education to qualify to practise.
This has created an uneven playing field which fosters the view that doctors are the authority and patients should acquiesce to what doctors tell them to do. In its extreme, this attitude backfired for patients like my mother-in-law, who withheld necessary information because she expected the doctor to know everything (including the unknowable). This didn’t work well for her, and I can’t imagine it was satisfying for the doctor either.
So where was I coming from?
I was not posturing to assert myself in a system where I was the lesser authority. I was trying to ensure that the doctors had enough of the backstory so they could make decisions in context.
In the early stages of my post-thyroidectomy treatment, I wondered how long I’d be able to function in the world. Finding the right combination of thyroid replacement medications literally saved my life and livelihood. So there’s a lot at stake when I meet with a doctor. I have very specific thyroid replacement needs and I’m completely reliant on the doctor’s prescription because there is no alternative I can buy over the counter.
It’s no surprise that I am highly motivated to make sure doctors understand my situation. Putting my history on paper, and leaving a copy with the doctor, seemed my best hope. Admittedly, I knew that most of them would never find time to read it. But I trusted its existence would emphasize that this was crucial information.
More flies with honey than with vinegar…
When there’s a lot at stake, it’s a challenge to be assertive rather than aggressive or passive. I hope my manner and presentation helped to soften the intensity I felt about my precarious situation. And I did make a conscious effort to respect the doctor’s limited time by being succinct and bringing written backup material.
I also kept the discussion to areas that I knew were “safe.” I did not want to have them discount everything I said because I’d mentioned an alternative like muscle testing or homeopathy. As in many instances in life, discretion is sometimes the better part of valour.
In these ways, I coped as best I could within the limitations of the traditional system. It wasn’t ideal, but we all survived—including me!
What if we viewed things differently?
Perhaps another scenario would create a better experience for everyone—one where we could thrive instead of just surviving the experience. What if we saw the doctor-patient relationship as a partnership in which both parties are on equal footing?
What if we recognized that we all have expertise in some subjects, and no one can be an expert in everything? I like this quote, attributed to mixed martial artist Conor McGregor: “I don’t look at a man who’s expert in one area as a specialist. I look at him as a rookie in ten other areas.”
So…who is the authority? In truth, there is no one single authority. Doctors have expertise in the medicine in which they were trained. I’m the expert when it comes to what goes on inside my skin because I live in here and have learned from the experience. When we pool our expertise, we have the greatest possibility of success.
As shown in the diagram, I imagine this scenario as a triangle with all points working toward the centre. Triangulation is a principle used by engineers. We’ve all seen them out with their tripods measuring from various points. They do this to get a fix on a location that would otherwise be difficult to pinpoint.
In a less physical context, triangulation has been adopted in research as this professor briefly explains to his students.. The Qualitative Research Guidelines Project describes it this way:
Triangulation involves using multiple data sources in an investigation to produce understanding. …Qualitative researchers generally use this technique to ensure that an account is rich, robust, comprehensive and well-developed.
When I have a health issue to resolve, I’m an experiment of only one. But it makes sense to me that the same research principles would apply. And I like the sound of a process that ensures a report that is “rich, robust, comprehensive and well-developed.” Seems to me this is the most likely means of getting to the best decisions at any given time.
Change is occurring. Integrative and functional practitioners are getting easier to find, and there are organizations training and supporting them.
The mission of the Institute for Functional Medicine is to ensure the widespread adoption of Functional Medicine as the standard of care. It offers conferences, training, and certification for practitioners, and a search engine to help consumers find a practitioner.
The Evolution of Medicine is an online resource for health professionals who work from the perspective of root cause resolution. This includes Medical Doctors, Naturopathic Doctors, Registered Nurses, Chiropractors, Osteopathic Doctors, Nutritionists, Nurse Practitioners, Registered Dietitians, Health Coaches, Pharmacists and Physical Therapists who use a functional or integrative approach. This site helps them develop their practices to deliver their care to as many people as possible.
With initiatives such as these, I’m optimistic that critical mass isn’t far away.
I’ve talked a fair bit about functional medicine throughout this series. Next week you’ll hear a practitioner’s experience in his own words.
Very well expressed and a good model for self-assertion without incurring defensiveness in the doctor or other expert/professional!