Manifesto for a New Medicine

Manifesto for a New Medicine.

By Doug Brozell M.D

Recognizing that medicine is in a state of crisis, that illness, instead of being controlled and no longer a dominant force in society, is burgeoning both here in America and globally. Recognizing that the financial cost and the cost to society because of lost potential, lost quality of contribution is too dear, I propose a new manifesto for medicine. Recognition of the truth of which will help to transform not only medicine, but society, economics, and the evolution of mankind.

1) Medicine is integrated into society not set apart

Medicine has become a separate entity rather than becoming holistically intertwined into the fabric of everyday life, in the family, home, school, factory, field, and church. Health is a natural outgrowth of healthy society, educational system, agriculture, institutions and government. It is not separate. Therefore part of the role of medicine is to address ills that result from a sick society. It can’t look the other way when food industry, entertainment industry, pharmaceutical industry, and governmental institutions foster decisions that undermine health. It also can not be placed to be in a weaker position by becoming financially dependent on those same institutions if its freedom of expression is compromised. It also must exercise care to not be a source of societal ills itself by becoming overwhelming costly, exclusive of disadvantaged groups, practicing ineptly or incompetently or not internally regulating itself, being wasteful of financial and other resources, or allowing others to accumulate wealth as a result of its actions.

2) Medicine embraces change and is inclusive of divergent perspectives

Healing as an art has a tradition that has anteceded the development of the scientific method. The practices that date back to indigenous cultures and civilizations in the past have also dealt with illness and injury. Their practices may be difficult to contextualize in the scientific method and are informed by beliefs, intuition, spirit and deep commitments to compassion. They are capable of permitting major shifts in a person’s state of health in a less toxic, often less costly way that provides more meaning and empowerment to the person who is ill. They often embody an individual’s belief in a transcendent reality that forms a matrix of beliefs that is often called spiritual. This alliance needs to be maintained in any system of health. It does not need to be reduced to scientific terms to be included in any person’s plan of treatment. It should be respected.

Medicine is served by being inclusive as its depth of knowledge and experience can be broadened as has been the case by including acupuncture and exploring plants for new medicines.

3) Medicine offers empowered choice

Empowered choice occurs when education precedes decision making to the extent that absence of true life threatening emergency has occurred. It means that the facts of the condition and its treatment are fully shared with the patient.

That the choice of not treating and other forms of treatment which are not currently based in medicine are always included and that services are provided to allow the choice of no treatment to be respected and the patient continues to receive care services and supervision to remain as comfortable as possible.

4) Medicine embodies spiritual principles

Spiritual principles are inherently embodied in medical practice. The greatest of these are compassion, kindness, forgiveness and benevolence. Medicine should strive to ensure that everyone that contacts or connects with the patient do so with these principles in mind. It is recognized that patient may be ill because of lifestyle choices that were suboptimal or continue to be suboptimal. This occurrence should not lead to judgment, threat of termination of services, substandard or any pejorative treatment. It should recognize that serious illness is often both an emotional and spiritual crisis, if not indeed having an emotional and spiritual root, and provide care or referral for those issues.

5) Medicine treats without discrimination

Care should be provided equitably. Neither cultural, racial and ethnic, religious or spiritual, sexual orientation or lifestyle choices nor socioeconomic status should inform the need or type of care provided. Each should receive care and education to the level of their ability to understand with appropriate translators and patient advocates as needed.

6) Medicine is part of the global community

As such, it should consider its use and disposal of all its resources, financial, energy, and material to be included as part of its global footprint and should strive to use resources that are sustainable or renewable. It should exercise care in avoiding toxic substances and minimizing the pharmaceutical imprint on the population which has be degraded in the environment.

7) Medicine recognizes that the primary mode of healing is in relationship

The treatment of a condition by the appropriate remedy is not always enough. Illness sometimes even those that may appear as minor may be accompanied by personal meaning, significance and a need for education and understanding that can not be assumed to be negligible. Also the purveyance for minor care contextualizes the future power of care for a more serious illness, by diminishing fear and creating a sense of sanctuary and safety. Therefore it appears necessary that the ingredients for provision of care include the capacity to establish a relationship that allows care to be expedient but also allows that caring relationship to thrive. This can occur only by meaningful, patient, unrushed care. It is assumed that elements of the patient’s history be explored as a database of beliefs towards medicine, meaningful sources of support or fulfillment to contextualize the illness that is being presented. That effort be made in any system of care to ensure that relationship’s survival if the patient chooses. That quality of care also includes evaluation of quality of the doctor-patient relationship. It is also recognized that technology and information should be at the service of this relationship and never a detractor or substitute. One of the primary roles of providers is education and education becomes more powerful when it is part of the provider’s interaction.

8) Medicine does not seek its own survival

Medicine should survive only if it provides care that is valued by patients. The moment that ceases to be the case, it no longer has value. Business models may be valuable to enhance service and to reduce waste, but should not exist as they exist in other arenas. Provision of care that is competitive unduly increases cost and provides expenditures of resources for business overhead and advertising and promotion which detract from the mission. Care should be offered in health promotion in such a way to render patients less needful of services. Areas of emotional and physical wellness through diet and exercise, both traditional and non-traditional, should be promoted. Partnerships should exist across different care platforms that are based on co-operation not competition.

9) Practicing medicine should be a life enhancing experience

Practitioners should have schedules and benefits and case loads that allow a high quality of both professional and private lives without compromising the quality of either. The pursuit of recreational, meaningful avocational, spiritual, exercise related pursuits is needed to sustain the vitality and longevity of its practitioners. Support should exist to assist physicians so that they can excel at what they are most needed to do, not be reduced to secretarial or clerical duties.

10) Medical Practitioners are stewards of the life force in others

As such there is the need to recognize with humility the limitations of our knowledge and ability and recognize that forces greater than us are allies in our work. That health and the ability to heal is the inherent ability of every living organism. That illness serves purposes beyond our understanding. That death is never defeat. That our chief role as stewards and servants is to evolve our understandings of the mysteries that play out at our feet and find the obstacles that our patients present to their own healing be it physical, mental, emotional, or spiritual. That our role should not reduce the concept of people to mere representations of the scientific principles that we understand. That courage, hope, optimism, compassion, and love are as important tools as scalpels. That words, attitudes, and beliefs are just as capable as causing harm as healing. That we enlist the Source however we recognize our nourishment and seek to emulate it in our work. And seek to recognize the Source in those we serve and seek to draw out a more clear expression.

11) That the Healing Professions being Human Institutions and comprised of humans may also be in need of healing

There are those among us who are called to be healers. The motivations may on the surface not always appear altruistic or may be out of psychological roots. However to embark on a rigorous course of hard work and deprivation bespeaks of a powerful force and a powerful sense of purpose. When mistakes occur or methods used and attitudes adopted are suboptimal, healing should be extended to those that are willing to preserve the power of their legacy. As humans all of us are wounded and all of us make mistakes, punitive actions rarely serve the purpose of correction, but engender fear and contempt, and can have a threatening effect on the profession itself. No one should become excessively wealthy because of human error and no one should become impoverished because of a mistake. Mistakes often serve a grander purpose of moving towards perfection. Because of the fact that forces other than we can understand choreograph these mistakes and because they are not strictly speaking random, society should proscribe guidelines for compensation, adjudicated fairly and consistently regardless of the ability to hire attorneys. That having third parties involved in getting wealthy as a byproduct of mistakes strips society and the individuals of resources that are better spent towards improving systems, rehabilitating or retraining providers of care, and providing care and compensation after injury.

12) That Medicine’s Role is to aid in the evolution of mankind

We no longer need the past except to distill the humanistic, scientific and spiritual principles that have brought us to this point in history. That the frontiers of medicine are to equitably distribute resources, knowledge and technologies, thus contributing to provide a climate of hope and healing that has never been seen on this planet. To evolve technologies in such as fashion that they are sustainable, done ethically and carefully to preserve what is best in this human existence and not create slaves to technology and create a new world of the haves and have-nots. To conduct research mindful of its consequences without endangering the ingenious potential that already is capable of excellence. To value life and thus extend life not out of fear of death. To seek wisdom at every juncture and to involve society in potentially species changing endeavors. To realize that the evolution of mankind is being guided and shaped by benevolent forces and to use the spirit of benevolence to shape our leap into the future.

13) To recognize that the New Medicine is in the province of all of us

The physicians of the future may well be the leaders, however they arise, who have the effect of changing mass culture, and re-instilling timeless values and healthier patterns into the minds and hearts of man. He may be the politician who steers money spent to harm, dominate and intimidate through non-peaceful, military means into humanitarian causes such as economic development, education, and disaster relief. He may be the man who organizes to prohibit the tyranny of workers by corporations. She may be the woman who teaches to quell the seeds of hate that inequity foster. Each of us plays a role in what we do, and in how we craft a vision for the future. Each of us plays a role in developing a sense of unity with all who dwell on this planet. Each of us has a major personal role in how we seek treatment and how we inform the systems that exist that they need to change. And ultimately each of us has a role to play in our own personal healing which furthers the cause and template by which others are healed.

I thank the gift of inspiration which has allowed me to author these principles. I welcome input from the inspiration of others to perfect this document and enjoin you to sign this to accumulate signatures to indicate that these principles should effect medical, societal, and political change.

Email Dr. Brozell at: mailto:dbrozell@comcast.net