Making Health Care Better

3TreasuresHealing header Making Health Care Better This article is by David Leonhart and was published in the New York Times Magazine November 3, 2009 issue

This article contains alot of great information about the current state of the health care system and ideas that could make hospitals and doctors perform with fewer mistakes.

During one of our first conversations, Brent James told me a story that you wouldn’t necessarily expect to hear from a doctor. For most of human history, James explained, doctors have done more harm than good. Their treatments consisted of inducing vomiting or diarrhea and, most common of all, bleeding their patients. James, who is the chief quality officer at Intermountain Healthcare, a network of hospitals and clinics in Utah and Idaho that President Obama and others have described as a model for health reform, then rattled off a list of history books that told the fuller story. Sure enough, these books recount that from the time of Hippocrates into the 19th century, medicine made scant progress. “The amount of death and disease would be less,” Jacob Bigelow, a prominent doctor, said in 1835, “if all disease were left to itself.”

Yet patients continued to go to doctors, and many continued to put great in faith in medicine. They did so in part because they had no good alternative and in part because, as James put it, they wanted a spiritual counselor with whom they could talk about their health. But there was something else, too. There was a strong intuitive logic behind those old treatments; they seemed to be ridding the body of its ills. They made a lot more sense on their face than the abstract theories about germs and viruses that began to appear in the late 19th century.

So the victory of those theories would require a struggle. The doctors and scientists who tried to overturn centuries of intuitive wisdom were often met with scorn. Hippocrates himself wrote that a physician’s judgment mattered more than any external measurement, and the practice of medicine was long organized accordingly.

In the end, of course, the theories about germs and viruses won out. They had the advantage of being correct, and doctors — haltingly and skeptically, but eventually — embraced them. “Medicine adopted the scientific method,” James said as we were sitting in his Salt Lake City office, which looks out onto the Utah State Capitol Building and the Wasatch Mountains. “It transformed medicine, and it’s easy to make the case.” Diphtheria, mumps, measles and polio were conquered, and pneumonia and heart attacks became far less deadly. In 1910, life expectancy at birthin the United States was less than 50 years, and it had not risen much for centuries, James noted. Life expectancy today is 78 years.

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