The Lie Most Patients Believe

And the truth you need to know to better navigate your care

Before we get into “the lie” you should know my perspective…

Cause I’m a bit ‘weird’

And I view doctors and healthcare in ways that other people might think are ‘crazy’

Like, well, hummm - let me explain it this way…

Remember when you were little and something big and scary would happen, and just in that moment where you thought you might literally die, you hear the voice of Mom, Dad, your teacher or some other adult ready to swoop in and save Little You dramatically right in your moment of need?

Remember how confident you were in their ability to do so?

Remember how safe you felt?

Now, take a moment and try to remember the first time a pants-sh*tting moment occurred after you ‘grew up.’

Remember that moment you looked around for ‘the adult’ who would save you, before realizing moments later that - the adult was YOU?

SURPRISE!!!

Congratulations?!

Maybe you felt totally confident in your ability to manage the chaos.

OR maybe you felt absolutely unprepared for the immense responsibility that had just been placed on your shoulders.

Maybe as that realization hit you all at once like a 1000 poopy rainbows, you took a deep breath and thought:

“This is MY circus and these are MY animals”

And then proceeded to do the best you could for the people you were responsible for…

I bet you did.

Well-done.

And, actually that’s exactly how I feel about ‘the art of healing.’

So… welcome, my friend, to the Practice of Medicine.

Should I call you Doctor now?

The Lie

Back to the lie -

Look you grow up thinking that your parents know everything only to realize when YOU become a parent (or an aunt or an uncle), how clueless they must have been all those years - clearly just winging it.

But somehow it takes a bit more work to transfer that lesson to other areas of life and it’s easy to find yourself continuing to believe the lie that…

• Your financial advisor knows exactly what’s going to happen with the market

• Your lawyer knows everything about how that lawsuit is going to play out.

• Your therapist knows what changes to make in your marriage to avoid divorce.

And just like the caregiver that saved Little You when you fell off the monkey bars, these professionals actually do have essential knowledge and pattern recognition, that help them advise clients in specific areas, but to deify them is a catastrophic mistake.

I promised to tell you, ‘The Lie That Most Patients Believe’ and here it is.

“My doctor knows exactly what is going on in my body and how to fix it”

This potentially life-threatening assumption is… Simply. Not. True.

So what is real?

The only absolute truth is that science and medicine is an iterative process, and you don’t know, what you don’t know until you know it.

And guess what?

Neither does your doctor.

But that’s not a flaw in the system - it’s just how it works.

Clinicians know many, many things. We learn a ton in school and then we ‘practice’ for a lifetime, but the best practitioners of medicine are learning new things every single day - which implies at no point do we know everything.

But what does that mean for you, the patient?

First you must recognize that many, many things in medicine require a process.

No matter how brilliant or dedicated, your doctor will be wrong sometimes & ‘one and done’ is the exception, not the rule.

That blood pressure medicine you were started on at the ER?

There were over 200 options to choose from & that med will need to be adjusted, likely many times over.

• the dose

• the medication itself

• the timing of when and how you take it

And I know you’re thinking,

But why can’t my doctor just give me the meds that will freaking work and WHY do I have to COME BACK TO THIS HORRID PLACE?!

They want to, but they just don’t know without trying.

Changes will happen based on things like:

• Is the initial diagnosis accurate?

• How are your symptoms changing?

• How effective is this treatment for you?

• What are the side effects you might beexperiencing?

• Does this new thing play nicely in the sandbox with other meds?

• How might your body change with diet/exercise/lifestyle alterations?

And this isn’t just true for blood pressure or blood pressure meds, it’s true for so, so many things.

Which isn’t even considering that your response (or lack of response) to treatment may also uncover alternative reasons for your symptoms that may not have been reasonable to consider initially.

So what can I do?

Once you accept that no one really knows the perfect answer straight out of the box, you can begin interacting with the system in a way that will serve you - treating your doctor as a (hopefully brilliant) consultant and a human instead of a savior.

I’ll be the first to admit that there are tons of perverse incentives baked into the practice of medicine (I’m looking at you Big Pharma). And much of what happens in the course of our care IS part of a scheme to extract more money from you and the various parts of healthcare system BUT the concept of iteration, follow-up and repeat visits is not (inherently) a part of this evil.

Getting healthy requires trial and error -

Time, patience and honest communication between members of the medical team (including you) are necessary components.

But step one is simply accepting that your journey to ‘well’ will be an imprecise process, led by imperfect people.

And it’s worth it.

What’s next:

In the coming editions of RFH, I’ll be sharing actionable tips that I have personally found go a long way towards improving the quality of the communication between patient and clinician and streamline the process of improving your health.

I’m also considering a broad range of topics such as:

• How clinicians approach musculoskeletal pain (muscle/joint pain).

• How we think about urgent care and the ER.

• What the heck is primary care for anyway?

• The role of specialists.

• Post-viral syndrome.

• Pain management.

• What is a PBM?

So, so many directions to take long-form content.

Would love if you could hit reply and tell me what you are most interested in hearing about in future editions!

See yall next time!

P.S. Our first ‘Ask Me Anything' session for paid subscribers is tentatively set for October 3rd. More details coming soon.