When they were teenagers, my kids would tease me by telling me I wasn’t a “real doctor.” They usually waited to say this when they were bigger or faster than I was.
We are swamped with positive medical messages and role models like the docs on “Grey’s Anatomy,” “ER” or (for the older audience) “Marcus Welby, M.D.” The media cover new breakthrough drugs and surgeries or genetic control of diseases. Dramatic scenes of surgeries or rescues from tragedies like the Boston Marathon bombing are played over and over again. Certainly, these are the “real doctors.”
By contrast, doctors of chiropractic do not share this positive media portrayal. Because we do not attack diseases with drugs and surgery but instead use natural means to restore health, we sometimes are held up to ridicule, even scorn — just check out some of the online comments to my columns.
But there is another side to the equation that is not obvious or glorified in the media. The dramatic side of health care sometimes is called “heroic medicine.” However, much of health care is not “heroic” at all but is in fact pretty mundane. This is the type of care that addresses the day-to-day problems like stomach pain, back pain and headache. Even more important, it teaches the patient self-care and lifestyle changes they can make to stay well. This especially applies to wellness care, which tends to be pretty much the opposite of heroic care — it does not involve dangerous, expensive treatments like surgery or drugs with serious side effects. Instead, it helps the body heal itself.
I doubt there will ever be a TV health drama about chiropractors or naturopaths. There just isn’t a lot of drama to this type of care — though George Clooney is free to portray me if he wants.
Let’s look at back pain, one of the most common health problems. Surgery is the “heroic” version of medical care for back pain: The patient is unconscious, high-tech instruments are used and there is significant risk of infection. It is supposed to be reserved for the worst cases, after nothing else can help. But if there were a conservative, low-tech way to treat these cases without resorting to surgery, wouldn’t that be better?
One review of work-related back injuries showed that 9.2 percent of the patients ended up having surgery within three years of the injury. However, patients were much more likely to have surgery if they started care with a surgeon: 42.7 percent of injured workers who saw a surgeon first ended up having surgery whereas only 1.5 percent of those who started care with a chiropractor had surgery.
Which is the “real doctor,” the one who does the surgery or the one who prevents surgery in a significant number of cases?
It is the same with medications. Many patients are able to stop some of their meds when they begin care with a chiropractor, acupuncturist or naturopath because their health is restored. Is the “real doctor” the one who prescribes the drug or the one who helps the patient heal, making the drug unnecessary? Drugs can be lifesaving, but I see so many cases where they are prescribed without any attempt to correct the underlying problem.
To me, being a “real doctor” is not determined by whether you graduated from medical or chiropractic school or whether you prescribe drugs. It is about addressing your patient’s needs in the safest, most effective and cost-effective way possible. It is also important to understand the limitations of your treatment approaches. Not every low back case can be resolved through chiropractic. A few need surgery. But in the same vein, not every patient needs a drug for every complaint.
Most of these problems can be dealt with naturally, preferably by a “real doctor” who is trained in non-heroic, wellness-based, conservative care.
Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at firstname.lastname@example.org.