Sustainable Medicine: Power to the Patients
In her book Sustainable Medicine, Dr. Sarah Myhill aims to empower people to heal themselves by addressing the underlying causes of their illness. She presents a logical progression from identifying symptoms to understanding the underlying mechanisms, to relevant interventions and tests and tools to tackle the root causes, and she empowers her patients to take responsibility for their health and well-being.
The following excerpt is from Sustainable Medicine. It has been adapted for the web.
I worked for twenty years within the Welsh National Health Service (NHS) in general practice and increasingly found myself restricted by what I was and was not allowed to do. Having spent six months as an associate specialist at the Royal Shrewsbury Hospital working with patients with chronic fatigue syndrome, I found these restrictions to be so great that I was simply unable to practice there.
All that I was allowed to do for patients was that which is “evidence-based,” and that evidence base certainly does not include one’s own years of experience.
Doctors should be patients’ advocates, fighting as hard as they possibly can for what they believe is the best treatment for each patient. Instead, many doctors have become what I call “defenders of the faith.” The problem is that the “faith” is laid down by Big Pharma, who manipulate drug trials in order to achieve favorable outcomes (and incomes!). As a result, medicine today no longer follows a logical and independent science base. The current system of post-graduate medical education is akin to mothers learning about nutrition from advertisements posted by the food industry.
I believe modern Western Medicine has lost touch with patients. What patients actually want is an answer to the question of why they have developed their particular problem, followed by which factors need to change to allow improvement. In my effort to answer these questions, my practice of medicine has evolved from what I learned through conventional training at the Middlesex Hospital in London to something very different. Now, I focus on looking for the causes of problems with respect to diet, micronutrient status, allergies, and lifestyle changes. This approach is highly successful at tackling the majority of medical problems.
I started applying these techniques during the 1980s in a village outside of Nottingham, where I was working in a mining community. Within a few years, I had interest from friends and relations of my NHS patients, and as a result, a small private practice evolved. A move to mid-Wales scuppered all this, and I spent a further ten years in general practice, working in a rural farming community. The same evolution occurred several years later, though, and friends and relatives of my NHS patients again wished to consult. After ten years, I had so much private work that I was able to give up all my NHS work. I am now in the position where my workload only allows me to offer full new patient appointments where there is a referral from NHS GP’s or consultants. However, I still can—and do—give advice to tens of sufferers on a regular basis. This is now mainly in the form of a comprehensive letter to the GP based on the information in a medical questionnaire and results of medical tests. Most of my patients are chronic fatigue syndrome sufferers, and for them, the Mitochondrial function profile, which I discuss in my book Diagnosis and Treatment of Chronic Fatigue Syndrome and Myalgic Encephalitis, is the best starting point when it comes to identifying underlying abnormalities and devising a patient-specific treatment plan.
The majority of GPs that I come in contact with are receptive to my ideas and suggestions, and support their patient in the difficult lifestyle changes I am often asking them to make. Some are not. The two things I dislike most about the medical profession are the power to access diagnostic tests and the power to prescribe. Patients who end up with the wrong practice are often completely disempowered through the process of diagnosis and prescription.
I do believe, however, that patients increasingly understand that they must take responsibility for their own health—they know they may not get their heart surgery if they keep smoking, and they may not get their hip surgery if they are overweight. I am greatly in favor of people taking responsibility for their own health. There is no doubt that those who are prepared to make lifestyle changes with respect to work, sleep, exercise, and diet, and those who avoid toxic stresses such as excessive alcohol, smoking, and junk food, can not only feel health improvements immediately, but protect themselves from the ravages of chronic disease and degeneration. Making these changes is extremely difficult, but there is an excellent scientific basis for doing so, which provides motivation and determination to continue.
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