THE MOST COMMON MISTAKES MADE BY PATIENTS
THE MOST COMMON MISTAKES MADE BY PATIENTS.
"Of course it comes from deep in the rain forests of the Amazon jungle - nobody's going to buy it if it comes from eastern Poland!"
When I refer to patients common mistakes, I include myself and all clinicians - the Human Condition is not unilateral by any means; we all do things from time to time which are not in our best interests. When I went to research this article, there wasn't a lot of research - in fact there was none worth quoting. What I decided to do instead was look back through my diary at a typical month's case load, and also draw on everyday experiences together with conversations we commonly have with colleagues.
It is all rather long winded, so I'm going to abbreviate it as much as possible... Here, possibly in descending order of importance, are the most common mistakes patients make. If you use these five points as a check list, you'll have pretty much covered your bases...
1. Not trying to prevent disease. (Prevention is better than cure.)
This is right at the top of the list by far. Out of all of last month's cases in clinic, one was due to ageing, one was a genetic disease, a number were bi-annual check-ups, a number were anti-ageing medicines, one was a completely unknown cause of some sort, one I gave the benefit of doubt to the patient, and all the rest were most likely due to a combination of failure to get check-ups, ignoring symptoms for too long, cessation of preventative medicine, nutrition and lifestyle problems, self treatment, and so forth - all of which constituted the largest percentage group. You can never be sure you can prematurely prevent something, but there is now more medicines and evidence than ever to help you try to do so.
2. Following fads.
Oh, the effects of successful advertising! Any marketing guru will tell you that you need a good gimmick regularly, which is why you can't again buy the perfectly good toothbrush you were so happy with three months ago! The health food industry is very good indeed at promoting health gimmicks - here are the ones I've seen come and go over the last thirty years, which they'd have you believe life is impossible without: vitamin E (in the 70's, you couldn't have sex without it!), Vitamin b complex, and various vitamins through the 80's, especially C, comfrey, St. John's wort (it became so popular in the late 80's that it was doubtful many of the capsules had any herb in them at all - it was impossible for the suppliers to have produced anywhere near the amount sold), fish liver oils, barley greens, wheat grass juice, St. Mary's thistle, jojoba oil, ginseng (again, very poor quality), aloe vera, gotu kola, co-enzyme Q10, guarana (just caffeine in another form - no herbalist ever prescribed it!), ginkgo biloba, then fish oils made a comeback, horney goat weed, goju berries, vitamin D, and now it's krill oil (due for a good run, methinks). There is much wrong with a lot of the marketing hype surrounding each of these. In the case of krill oil for example, it is not all that bio-available, and as an anti-inflammatory and so forth is inferior to all the anti-inflammatory herbs. There may also be evidence of organochlorine and peroxide contaminants - it's not known for sure yet how widespread this but some evidence is pointing to it.
I made the mistake of switching on morning television one day a few weeks ago, and therein being flogged was a new anti-wrinkle cream made from a herbal medicine obtained from deep in the rain forests of the Amazon jungle - of course it came from deep in the rain forests of the Amazon jungle; nobody's going to buy it if it comes from eastern Poland! For similar reasons, we've seen an explosion in the uptake of Chinese herbs, but ask yourself why herbal medicines of one continent should be any better than herbal medicines of another continent? The answer is they aren't! But for some reason, the public think that if something comes from the mystical East it must be superior to something from the non-mystical West. The fact is the medicines from any one continent are just as good as those of any other continent. Oh yes yes, alright - with the possible exception of Antarctica.
3. Placing too much credibility in tests.
A friend of mine had a patient with a lump in his gluteal muscles. The usual investigations showed it to be a myosarcoma (muscle tumour) and recommended immediate amputation of the leg and hind quarters. Within several days of scheduled surgery, the mass ruptured - it was nothing more than an abscess. Of all the investigations which are a complete waste of time, pregnancy ultrasound is easily at the top of the list - a complete waste of time. All the studies have shown it to be so - it does absolutely nothing at all to improve pregnancy outcomes. Radiology is not definitive - any osteopath has numerous cases attesting to this. One of my patients was telling me that a young woman in her church was urged to have a therapeutic abortion on the strength of ultrasonic investigations, couldn't do it, and went on to have a healthy baby.
Getting a pap smear does not necessarily mean you have a healthy cervix, getting a negative mammogram does not necessarily mean you have healthy breasts (I think half of all women with breast cancer have had a negative mammogram in the previous year), getting an MBA (multiple biochemical analysis) blood test returned within normal parameters does not necessarily mean you're healthy.
It is of course important to pay some attention to tests, with the caveat that 'fools rush in'.
4. Internet medicines and the 'Overseas Syndrome'.
Of all the medicines peddled on the internet, very very few are manufactured by practitioners - I've seen none. Nearly all of them are marketed by business men and women with no qualifications at all, and since the manufacturing is outsourced, quality control is left to a sub-contractor only, which means there may be little at all. There is very seldom any batch numbering which means batches are not being monitored for quality control and contaminants cannot be traced. They are very expensive for what they are, and they are often marketed by multi-level methods with huge commissions built into the purchase price.
The reason practitioners use 'Practitioner Only Medicines' and supplements is that all our medicines and supplements are 'Scheduled' by the TGA, and they are therefore much more potent than retail medicines which are unscheduled. No practitioner uses retail medicines. They don't work nearly as well.
For some reason, Australians have it in their minds that if something is made overseas it is superior to what we have here. Australian herbal medicines are the equal of the best in the world, easily, and Australian trained naturopaths and herbalists are easily up with the best of Europe, and better than the English and much better than the Americans, in my opinion. There is simply no need to look overseas. We have the best of everything right under our noses.
5. By-passing the consultation.
A close friend of mine who is a senior barrister once said to me "The facts never emerge until the consultation." One of the tenants in my clinic building, an accountant, once said to me "How come people don't consult anymore? Every client I have with a problem has caused it by not consulting." A friend of mine who was a very successful financial consultant said "People are going to financial seminars instead of consulting us and causing themselves all sorts of problems."
Some patients seem to think that if they see their practitioner it is going to be a half hour consultation, but that just isn't the case. Many consultations are fifteen to twenty minutes for advice, brief visits for infections or a listen to a chest to exclude an infection, and so forth.
For Heaven's sake - DON'T DO IT YOURSELF. IT'S FALSE ECONOMY. Even when I get sick or need a check-up, I go to a colleague.
I wanted to talk this week about the stupidity of footballers, or more specifically, getting the best performance without the need for drugs, but space and time are against me so we'll save that for next week.
I know you are all breathless with anticipation!
Have a great week, and remember to use these five points as a light to your pathway to good health - they will stand you in very good stead.