Self-Referral/Maximum Health: Solving the Healthcare Crisis

Preface

Coronavirus COVID-19: The Wakeup Call

The Coronavirus Pandemic was a major health threat that killed multitudes of people in the United States and across the world. The pandemic also created a unique first-time medical, social, political, and financial crisis. The Coronavirus Pandemic is a wakeup call to everyone who works in the medical system – or who receives services from it.

Critical medical journal articles across the world have made a compelling case that nearly all patients admitted for hospital care due to COVID-19 had underlying comorbidities. That means if the patient had one or more chronic condition, they were far more likely to become ill enough to require hospital care. The same was true for those who died from COVID-19. The most common chronic conditions found in these patients were hypertension, obesity, and diabetes. These are all quite common health problems that – in normal times - constantly populate doctors’ waiting rooms.

This underscores a fundamental problem in American medical care: we have a fixation on the Disease Approach that focuses on definable diseases found in the patient. This is not a bad thing by itself; it is generally helpful and often lifesaving. We find the disease, we treat it as effectively as possible, and get on with life. There is a downside to this bias; today’s medical care spends most of the energy, attention, and money on identifying and treating Disease. Where is promoting Health in all this?

This book - Self-Referral/Maximum Health - teaches the Health Approach today’s medical care critically needs. A vital part of this book is teaching the principle of Self-Referral as the basis of normal body operations. Through understanding how the body creates health through a vast web of interconnected feedback loops, we quickly see that Health is the natural state of the human body. Disease results from unnatural interruption of Self-Referral.

We must work to optimize Self-Referral to move toward Maximum Health. This brings the principle of consciousness back to the center of medical care. Everyone needs to understand this.

Three simple additions to today’s medical care will bring vast improvements. The first addition is simple and effective relief from the stress of modern life – never so obvious as in our present time – and will remove the chief cause of nearly all Disease. The second addition is evidence-based natural medicine that aggressively intervenes with patients to optimize their lifestyle - including diet, exercise, stress reduction, and better synchronization with the seasons and time rhythms of nature. The third edition is a simple system of manipulative therapy – hands on care for musculoskeletal pain – that will help enormously to reduce the Opioid Crisis. The goal of all this is restoring human consciousness through restoring Self-Referral.

What is consciousness?

How does this idea relate to medical care?

Medical care today treats the human body as a living biomechanical device. If this or that needs removed or repaired, it is time for surgery. If blood pressure or sugar is too high, it is time for prescription medications. Granted - we do give good advice on diet, exercise, quitting smoking and so forth – but it all stays at a level of working on the body more than working with the body. Until we acknowledge that the human body is a living, self-aware organism, we will continue working at the level of mechanics doing wrench work.

When we better understand the deep workings of the human body, we quickly see the body is not a biomechanical device that needs periodic tending. Rather, the body is a self-contained, self-aware living unit that has built-in command and control settings that create Health. The body has central monitoring of all body functions and can, when necessary, take actions to self-regulate.

When external conditions change, the body capably modifies its internal environment to adapt. When the body needs to run instead of walk, the body adapts to run. The common action needed for all this to happen is Self-Referral. The body refers to itself, by itself, and regulates itself - and adapts to create Health.

Maximum Health is the goal of all medical care, indeed of all life. This is the absolute best health the individual can maintain given present medical conditions and all measures taken to optimize lifestyle. The way we reach Maximum Health is to boost the body’s Self-Referral. How do we do this?

We do this by acknowledging that consciousness – Self-Referral – is the basis of creating Health. Treating Disease is critical and mandatory – but if we change the likelihood of future problems by creating Health – there will be a steady reduction in chronic conditions. And those with chronic conditions will have far better control of them.

This is how Self-Referral/Maximum Health provides the tools we need to rid ourselves of the chronic conditions that make us vulnerable to health challenges like COVID-19. The numbers established around the country and across the world clearly show that many people who contract COVID-19 have either no symptoms or minor symptoms. But those with chronic conditions – read poor Health Approach medical care – are those in the hospital, often in profoundly serious condition.

In the past, everyone assumed that good or bad health was beyond our control. Please take this book seriously; it turns out that this is no longer the case. We can treat existing Disease more effectively and have better outcomes. By creating Health more effectively, we will prevent chronic conditions from starting - and optimize the course of chronic conditions when they arise.

What we can accomplish together is to change the direction of time so we can avoid these problems in the future. Let us guide the destiny of medical care toward all harmony, happiness, and progress. Let us work together to learn and implement Self-Referral/Maximum Health.

Dr. Michael Borger

Nappanee, Indiana

August 31, 2024

The silly question is the first intimation

of some totally new development.

- Alfred North Whitehead

Introduction

Pursuit of a Theory

For too long we have tried to wrest health from our bodies as if struggling with an enemy. Let us rise to a more complete view in which everyone’s normal condition is health - and let us simply restore health when disease occurs.

The Silly Question

The silly question I want to ask – the same question I have been asking since college days in the 1970s - is this: the focus of medicine is always on disease, or what is wrong with people. I know we must identify and correct what is wrong when people need help. That is a central function of medical care. But beyond diagnosis and treatment, how do we move people away from disease – what is wrong - and move people toward health – what is right?

Whenever we look at diagnosis, this is the process of identifying what is wrong with anyone who goes to the doctor. Disease is simply a clear definition of what is wrong. Once we diagnose the disease, the next step is determining how to treat the disease, so it no longer troubles the patient. Whether we prescribe medicine, initiate surgery, or start any other treatment, the focus is the same: we must beat the disease – we must beat what is wrong.

How do we access what is right - our health? We can easily get a to-do list of known Risk Factors to avoid and thereby prevent disease. We are advised to get enough exercise, check periodically for cancer, follow a healthy diet, and to avoid stress. But this amounts to identifying measures to simply avoid what is wrong – disease. We’re back to that topic. Other than taking vitamins, exercise, and avoiding Risk Factors, we have no clear road map to health.

This undue focus on disease and its treatment has created today’s Healthcare Crisis. That is, because nearly everyone is so focused on combating disease like an enemy in war, few are looking toward peace: achieving health. A major reason for out-of-control healthcare costs is exactly this situation: we are so busy dedicating everything to combating disease that we completely fail to seek the goal of health – which, when achieved, will make disease obsolete.

Discovering the road map to true health as opposed to simply avoiding known risk factors is a journey worth taking. This journey will require a thorough examination of health and disease, and how we can better treat disease when it raises its ugly head. Equally important is the journey of discovery to find the path to create health and completely avoid disease.

Journey with Me

This is why I want to take you on a journey with me. This journey is one of inquiry and discovery, of questions asked and answers found. We will cover a lot of ground, you and I, but do not think that it will be a journey to make you weary. Rather, this will be a journey full of the joy of discovery, of puzzle pieces found and joined, of a big picture arrived at slowly, one step at a time. And anyone who loves a good mystery, and its solution, will find lots to ponder.

This is the journey of a freshman college student - who later became a medical student. The medical student went on to become a practicing physician. That idealistic young man wondered why people get sick, and how we can make them well again. This also is the story of a practicing physician who learned over forty years how to better promote health and prevent disease.

At last, that physician found practical answers – and he now wants to share those answers to improve healthcare for everyone.

This journey covers many times and places, many cultures and philosophies, and shows the unity among them all. Our journey will find us visiting with many interesting people, in many unexpected locations. We will prowl for wisdom in ancient China with the Taoist sage Lao-Tzu and the military genius Sun Tzu. Together we will examine the India of antiquity with Maharishi Patanjali and bring Vedic knowledge into modern times with Maharishi Mahesh Yogi. We will consider the teachings of the Bible’s King David and Jesus and see their application to modern healthcare.

Doctors from the past and present will share their vision of the body, health, and disease with us. We will hear from doctors ancient and modern. We will travel to nineteenth century Midwest America to follow Dr. Andrew Taylor Still as he creates a uniquely American brand of medicine. Moving back to the present, we will survey the latest developments in stress and body-mind research. And – above all – we will seek practical ways for people to improve their health. Together we will seek Self-Referral/Maximum Health.

Pursuit of a New Theory

Most people have an outside interest that they enjoy. Perhaps they play golf, watch television, or read books. My interest blossomed into a consuming passion: the pursuit of a new theory of health and disease to improve medical practice.

Why would a busy physician spend his spare time working on such a theory? Every health professional works to relieve the suffering of sick and injured people. This theory provides one more way to meet that lofty goal. But this theory is more than just empty ideas; we will discover together many ways to create health and prevent disease before it gets started. And this is not just useless theory; practical applications of this knowledge will greatly improve medical practice. These applications will reduce the need for medical care – and thereby radically reduce healthcare costs.

Did this theory emerge all at once? No, it did not happen that way at all. It came into being a little at a time, over many years. The theory is a product of reading countless articles and books, thousands of outdoors walks, long sessions of meditation, deep thought and prayer, and discussion with many people – including medical colleagues, scientists, and patients.

When I began college in 1970, the theory was only a vague idea. I saw a single explanation of both health and disease. As I collected articles from newspapers, magazines, and scientific journals, each was a piece to the puzzle and contained ideas. Soon these ideas were cross-connecting and creating bridges, one to another. This went on through college, medical school, hospital training, and over forty years of medical practice. I now store these articles and notes in multiple file cabinets, coordinated by a computer database. The ideas have solidified at this point and this book catalogues the result of all this study.

Go East, Young Man

During my quest for knowledge, I mainly read Western textbooks and medical journals. That was driven by the demands of college, medical school, and practicing medicine. My pursuit of comprehensive literacy¹ also included the literature of the East. I concentrated on works that obviously apply to medicine. My studies have included what we in the West call Yoga and related disciplines. My interest was to find what is useful to promote health. Finally, I have included many spiritual readings, from the Bible to the Vedas to the Tao te Ching to modern writers of many faiths.

As a physician trained in the Western scientific tradition, I had to stretch my conceptual ability to learn Eastern ideas. There really is a Western and Eastern way of looking at life, the universe, and how it all works. Applying a spiritual understanding to medicine - what is to many a strictly cold, logical, and scientific subject - is equally challenging. Many of you will find yourselves scratching your heads and wondering what I am talking about while you read this book. Please bear with me; it will all come together. Your efforts will be well rewarded.

My quest for comprehensive literacy taught me a lot about Eastern traditions, and – sometimes unexpectedly - I also learned more about Western traditions in the process. We know a subject much better when we compare and contrast differing viewpoints. That is why I learned a lot about Western thought by studying Eastern ideas. Eventually, my quest taught me the philosophical unity of Eastern and Western thought. Many people quote Rudyard Kipling, saying East is East and West is West, and never the twain shall meet.² I do not agree. There is more alike than different in Western science and ancient Eastern philosophy.

Unification of Western and Eastern thought will be helpful to both cultures. Western thought has solved many practical problems, but it often fails to provide inner peace for the individual. Eastern thought has solved the problem of inner peace for the individual, but often lacks practical success. It is as though each culture has gifts the other needs. If we can all simply listen and learn from each other, I believe medical care will improve enormously.

Finally, medicine is sorely in need of a renewed moral compass. Between the pressures of managed care, government regulation, and a medical system that relies more and more on technology, medicine has never had its compassion stretched so thin. Renewed attention to the spiritual basis of health and healing will vastly improve medical practice. All health professionals need to remember and practice what medicine is all about: love and compassion for others.

Focusing our attention on health and preventing disease through better lifestyle choices is central to this book’s purpose. It is wonderful to have the miracle medications, surgery, and other aspects of Modern Medicine - when they are truly needed. Finding better ways to promote health and prevent disease will pay enormous dividends – both reducing suffering and saving money. Surely it is far better to prevent health problems before they occur than to solely rely on medication and surgery for what could easily be prevented.

Forty-Two Years in Medicine

Forty plus years in medicine have taught me a lot³. I mainly practice Family Medicine, but I also care for Industrial Medicine and Emergency Room patients. My patients are people of all ages - from newborn to senior citizens. My experience also includes several years as City Medical Director of our local Emergency Medical Service⁴.

While my main practice is Family Medicine, I also have rendered care in patients' homes, inside rolling ambulances, at the Nursing Home, and in the Emergency Room and hospital. Because medicine is not always practiced in the daytime, I have seen patients at all hours of the day and night.

I carried out an ongoing education program for senior medical students to teach them practical skills as a part of their training. Many medical students gained instruction and experience as they rotated through my practice for clinical instruction. These young doctors in training taught me as much as I have taught them⁵. That is how, in the last forty plus years, I rendered medical care to thousands of people and taught medicine to scores of medical students in training.

All this experience has taught me a lot about people, health, and disease. As a husband and father, I know the experience of having loved ones sick or injured. As a caring human being, I have never chosen to grow calluses over my feelings. Being a physician has not made me immune to the suffering of others; it has made me more sensitive to them.

The wear and tear of life causes many physical and mental health problems. Today's fast moving, high-tech lifestyle piles on stress - more than any other time in history. My experience has taught me that stress is a major cause of disease. Doctors need better ways to help patients combat stress. The result will be vastly improved medical care.

Many people working in healthcare today are stressed-out. The result is they often reach and pass the burnout stage. Why does this happen? They are under pressure from government regulations, managed care, and keeping up with the Electronic Health Record in our over-regulated, hyper-technological age of medical practice.

Doctors, patients, and all health professionals desperately need to get back in touch with positive spiritual ideas, values, and practices. These are the great positive principles that have taught and inspired human beings throughout time. Healthcare personnel and patients alike will benefit from a dip in those healing spiritual waters.

Toward a New Synthesis

I have not been alone in contemplating these matters. My wife, Bonnie, is a wonderful best friend, loving wife, and excellent intellectual sparring partner. Much of this book came into being during discussions with her.

As ideas came, we winnowed them to separate the wheat from the chaff. Our most important exchange was when she told me, Boil your ideas down. What do you have to say? Without hesitation, I knew; I was creating a new synthesis of ideas to improve our knowledge of health and disease. My goal was to improve the practice of medicine – and all of this in a spiritual context.

The dictionary defines synthesis as the combination of parts or elements into a whole.⁶ This definition exactly captures what this book is to accomplish. Many parts of seemingly disparate knowledge must be brought together to make a new, more complete knowledge – a new whole instead of parts scattered all over the place, unconnected and without purpose.

My perspective is unique. I am a practicing physician, a scholar of the Western medical literature, and a student of Eastern knowledge. As a practicing Christian, I also am a person of faith. I believe the information that I have collected suggests a new vision of the human body, health, and disease. This unique collection of knowledge must be brought together for the good of everyone.

I have another unique perspective. I am an Osteopathic physician. Dr. Andrew Taylor Still founded Osteopathic Medicine in 1892 at Kirksville, Missouri⁷. Dr. Still founded a distinctly American reformation of medicine.⁸ Today, Osteopathic physicians earn the degree DO, or Doctor of Osteopathy. DO is one of the two academic degrees one can earn in the United States to be licensed for the unlimited practice of medicine. The other degree, of course, is the more familiar MD, or Medical Doctor.

Osteopathic physicians like me practice the full range of medicine like our MD colleagues – but we also have a strong commitment to practicing Wholistic Medicine. Today, the term Wholistic (sometimes spelled as Holistic) is a popular term for widely integrated medical practice, frequently centering around a more natural approach. This is why the DO is committed to a Wholistic approach to medical care. The DO works to treat the whole person instead of just the obvious disease or symptoms. The DO also has the most effective and comprehensive system of hands-on therapy to treat medical problems of the musculoskeletal system.⁹

Modern Medicine has much to offer, but improvements are possible. Osteopathic medicine combines Modern Medicine with a wholistic approach and a sophisticated system of manipulative therapy. Both schools of medicine have much to offer, but neither has all the answers.

Eastern knowledge has seldom come to the public's attention except as a curiosity. And spiritual aspects of medicine are largely ignored except as speculation. This book is an effort to integrate these fields – and to unify them within a spiritual framework. A major goal of this book is to harness this new synthesis of knowledge to improve medical care.

Ideas Can Bring Change

Ideas are often the forerunners of change. This is true in politics, education, and the social sciences. It also is true in the so-called hard sciences of physics, chemistry, and medicine. This book shares ideas that are eminently useful, if not revolutionary.

R. Buckminster Fuller was a one-of-a-kind human being who, following the Great Depression, went to the library and taught himself everything he could, in every field of study he could find. Fuller is known as the inventor of the geodesic dome and originator of many other brilliant ideas and inventions. He made a career of theorizing, inventing, writing books, and lecturing in a sincere effort to help all of humanity improve itself. He taught that, by knowing as much as we can about as many subjects as we can, we can better understand and improve our world - and thereby improve the lives of all human beings.¹⁰

One of his central themes was this: we all need to know as much as possible about many subjects – and then integrate that knowledge to better understand our world. Fuller called the complete knowledge that he advocated comprehensive literacy. It is my hope that we all will emulate R. Buckminster Fuller's concept of comprehensive literacy.¹¹ By applying these ideas to defining health and disease, we can better understand both. We will gain a more complete vision of man's health-promoting Self-Referral – the way to Maximum Health. Combining these ideas teaches us the reality of Self-Referral/Maximum Health.

This book is a useful synthesis; it integrates approaches to health that were formerly thought separate and unrelated. Physicians and scientists of the world will examine these ideas and, based on their merit, will test and explore them further. The resulting knowledge will enter the mainstream of Western medical thought. This will bring a refreshing unification of many ideas, producing a clear improvement in medical care. The most important result will be a better chance for suffering people to regain their health.

For too long we have tried to wrest health from our bodies as if struggling with an enemy. Let us rise to a more complete view in which man's normal condition is health - and look to restoring health when disease occurs.

Thanks to jet planes and the electronic media, the world is fast becoming a small place where everyone knows each other. Let the West learn from the East, and the East from the West. Let all people of faith talk with and respect each other. Let us together seek Self-Referral/Maximum Health.

Chapter 1

Bringing Ideals Back to Medicine

Returning lost ideals to any field can refocus thinking and resources. Medical care can expand beyond just treating disease and work toward creating health and harmony through the Self-Referral Paradigm.

The Silly Question Revisited

One of the most familiar quotations from the history of science refers to a pretty basic idea. That idea is: when someone has a brand-new theory, they nearly always question what went before. This is true whether we are referring to physics, biology, chemistry, astronomy, or any other field.

Whenever someone proposes a new theory, they always have some kind of question they are working to answer. The question inspires the new theory. This is often a source of disruption to those experts of the field in question. Those who defend the old guard nearly always dismiss such questions as without merit or just plain silly. However, the question may turn out to be the start of something new and worthwhile. Alfred North Whitehead states this quite clearly:

The silly question is the first intimation

of some totally new development.

After over forty years in medicine, I have concluded we need to refocus our attention in healthcare. Yes, we need to continue combating disease as it appears, but we also need to focus on health. This is a different point of view for many people – both in the medical field and outside of it. It is very clear to me that we desperately need to promote health – and thereby prevent disease.

When we consider pursuing the path to health - while combating disease as we encounter it - we need to examine the sweep of history that brought medical care to where we are now. How was medical care conducted in the past? Is today’s medical practice the way it always was, or has it changed?

Bringing Ideals Back to Medicine

This book is about bringing ideals back to medicine. Ideals? you may think. What ideals? Whose ideals? Aren't doctors, nurses and others working with ideals already? What are these ideals, anyway? Now that’s a silly question. Don’t we already know what the ideals of medicine are?

Ideals are our highest possible aspirations. Some ideals include ethical behavior, universal love, and respect for all, and working for world peace. The world's great religions teach these ideals. Because such ideals usually spring from our faith, they are among the strongest beliefs we have. They are the real inner force driving our lives.

Our personal list of ideals inspires us all. Perhaps one of the best statements about ideals came from a quote by Carl Schurz on a greeting card I received:

Ideals are like stars: you will not succeed in touching them with your hands, but like the seafaring man on the desert of waters, you choose them as your guides, and following them, you reach your destination12.

Medicine is based on the well-known ideal of the Golden Rule. Do unto others as you would have done unto you,¹³ we have heard

taught by Jesus. Treat other people the way you want to be treated.¹⁴ What demonstrates this ideal better than helping sick or injured people regain their health?

While helping sick people is noble, many today say that ideals are too abstract, too impractical to apply to the field of medicine. Others say that business and political concerns have driven ideals from medicine like deer before a forest fire. How can we bring ideals back to the practice of medicine?

We often learn ideals by hearing about people who are good examples. These people dedicate their lives to their profession. The quality of their work leaves an impression on our culture that inspires those who follow when they are gone. No one in the history of medicine has surpassed the excellent primary care offered by the General Practitioner doctors.

Forty years ago, the last of the fabled General Practitioner physicians were widespread. The GPs were trained in an era where all doctors learned a broad range of family medicine. Doctors who wanted to specialize had to master that formidable body of knowledge first – only then could they go on and train to become specialists. The GP focus was on families – children and adults alike.

That system of medical education and practice produced physicians who had an incredibly broad and deep skill set. They could handle anything from delivering babies to suture repairs; management of complex internal medicine problems to childhood diseases; and they practiced medicine day, night, and weekends. They often juggled an enormous office practice with concurrent care of many hospital patients.

The GPs also had a marvelous way with people. Those doctors had a magnificent personal touch. They seldom rushed anyone, and they never gave their patients less than complete respect. Those doctors made the effort to know their patients as complete human beings. Then - and only then - did they prescribe remedies. The GPs were not cold, emotionless technicians; they were members of the family.

Where Did the General Practitioners Go?

Today, the doctor who treats your soul as well as your body seems outdated, something forever gone - like poodle skirts, soda fountain Coca-Cola, or the Chevrolets with big fins on the back. Nevertheless, the GPs today – even as a memory - tell us a lot about what people want in a physician.

Do they want knowledge and technical prowess? Certainly, but there is no substitute for your family doctor who knows you and treats you like a member of their family – like the GPs truly did. Time has passed, and now the GPs have either retired or passed on. But the memory of their contribution remains, and the high standard of the care they offered is legendary.

Many miss the old Chevys and the rest, but the doctor is different. Cars and soft drinks come and go, but nearly everyone needs a doctor’s care. When the doctor meets our needs, it is a wonderful healing experience, and we are deeply satisfied. Today, many people are far from satisfied; rather, they come away from medical care unhappy or even angry. What is different about today’s doctors? Why are so many patients dissatisfied?

One important difference between today’s doctors and those of forty years ago is specialization. Forty years ago, most doctors were broadly trained family doctors - the old GPs. They used their skills to care for everyone – any age, male or female, no matter what your health status.

The medical profession has changed since then. More doctors have specialized. Today many people complain that they cannot find a well-rounded family doctor. Instead, doctors refer patients back and forth from one specialist to another like ping-pong balls. Even with all the specialists, patients often fail to find the relief they seek.

Another difference is economics. The ongoing controversy about how to pay for medical care is one of the top hot-button issues of our time. We know that everyone needs medical care - for day-to-day problems, chronic conditions, and the major emergencies requiring hospitalization or surgery. The question of how to pay for medical care remains a Gordian knot that defies solution.

Because of economic pressures, many today see the doctor's role as anything but healing. People want the caring, healing physician like the old GPs, but feel that Ebenezer Scrooge is treating them. There is a perceived gap between what the public wants and what they see in today’s doctor. Whether this is truth or propaganda, the impact on today’s patient often causes disappointment and anger.

This is disconcerting - to say the least - to doctors. In previous eras the public regarded doctors as the cream of society's crop, leaders in morality, and champions of the public trust. How do we repair the damage that has occurred to the doctor-patient relationship?

Patients are equally nonplussed by changes in the healthcare system itself. Rather than getting great respect with comprehensive medical care at a leisurely pace, they are hurried through a system that often fails to respect the individual. I want to examine these issues - what is wrong? How did this situation develop? What can we do to improve things? How can we restore ideals - and dignity - to medical practice?

The Ideal of Caring

Why do people want doctors like the venerable GPs? The answer is simple: The General Practitioners of the world became personally involved with patients as people. I don’t mean tending to diseases that happen to have patients attached; I mean caring for people.

Patients are not health statistics or dollars earned. Most especially, they are not an interesting case. Their needs go way past the prescription pad and the surgery table. Their needs are physical - but they also are complete human beings with emotional, psychological, social, economic, and spiritual needs. Doctors should be people-oriented servants of mercy whose mission is to relieve suffering of all kinds.

Some say doctors like this are extinct. Are there doctors like this in the world? You bet there are. Two uncles of mine¹⁵ were real-life General Practitioners. Dr. Donald R. Hinton and Dr. Robert L. Hinton knew patients by their first names. When patients had personal problems, they dealt with them directly.

They were greeted by patients as members of the family at the hardware store, in church, or at the grocery. These were doctors to look up to, and in my practice, I try every day to follow their excellent examples.

Is the personal touch important? Medical experts know the personal touch can be the difference between life and death. Some newborn babies suffer from failure to thrive: They fail to grow and develop normally, becoming weak and sickly in spite of good nutrition and care. Some of these babies die. What causes this deadly problem? American orphanage research shows that failure to thrive results from a lack of physical cuddling and love. These babies actually die from a lack of personal love and affection.¹⁶

Should all doctors hug their patients? Within reason, it never hurts - and it often helps. More important is a loving, caring attitude from the doctor to the patient. People know when their doctor cares about them - through a sympathetic hand on the shoulder and an open and caring attitude. It may be difficult to measure or prove, but we all know that patients need love and concern from their doctors to recover their health. That is why one of the most important ideals of medicine is caring.

Business versus Healing

The business side of medical care is in severe disarray. Everyone needs medical care, but a solution for how to pay for it eludes us. Patients are caught between the need for medical care and punishing medical costs. As the baby boomer segment of the population ages, the number of older people who need medical care has grown. The strain of finding ways to pay for medical care is causing a financial crisis and forces more and more emphasis on cutting medical costs.

There is nothing wrong with keeping the cost of medicine as low as possible. Cutting costs today, however, often seems more important than helping people recover their health. Insurance companies and government refuse to pay for services without rigid compliance to mountains of regulations and paperwork. The resulting conflict makes life miserable for doctors and patients alike.

Today's economic pressures threaten to make the caring doctor-patient relationship extinct. This is a tragedy because effective medical practice relies more on compassion, understanding - and, yes, love - than business concerns. When we only watch the bottom-line costs of medical care, we easily assume there is little to it other than the doctor poking around and writing prescriptions. Yes - patients need the technical knowledge and skills of the physician, but that is not all they need.

Medical care is no longer a private matter between caring people. What was once a sacred trust between doctor and patient has deteriorated into just another tough business deal. Today's medical mess results directly from doctors and patients alike turning their backs on the ideals of medicine.

Doctors are supposed to place the needs of the patient above all else. Patients are supposed to respect the doctors and take medical advice to heart. True healing requires a doctor-patient relationship based on mutual love, care, and concern. This healing relationship has more in common with family than with hard-nosed business practices. Today’s healthcare system delivers just the opposite.

What can we do about this? As in all other fields, practical applications come from theories. Medicine got into the present mess by holding to the wrong theory. We need a new theory – one that will return medicine to its ideals. But whether we like it or not, we are where we are. What drives the non-caring, bottom-line approach to medicine? How can we change it?

The Scientific Tower of Babel

Bringing ideals back to medicine is important, but why do we need a new theory to change things for the better? How did we get to this point in the first place? There are thousands of doctors, nurses, and medical scientists active in the world today; why do I see a need to offer a new theory of medicine?

Several reasons come to mind. One is poor communication among physicians and research personnel. Many brilliant people simply do not know what other brilliant people are studying. The same is true for their findings. How can this happen in our age of instant communication?

Many professionals specialize in areas that hold the most interest for them. A doctor may specialize in Neurology or Internal Medicine. It is the same with researchers. One scientist may specialize in studying the lung; another may focus on the kidneys. Specialization has advanced scientific knowledge, but it also causes communication problems.

Thousands of scientists publish hundreds of articles every month. Many professionals lack the time to follow the literature outside their field. The most educated person can accidentally suffer tunnel vision. This is the case in today's world. We have a scientific Tower of Babel: many people, trying to improve medical practice, completely fail to communicate with each other. Confusion resulting from this communication snarl is preventing progress.

Let us imagine that researchers discover pieces of a large jigsaw puzzle with each article they publish. If we widely separate the pieces of the final picture, they make little sense. When we place together two pieces from different fields, they may fit together in unexpected ways, teaching us more about the big picture. They may suggest unexpected or even surprising conclusions. This is why thinking across specialty lines often yields unique perspectives. Architect-Inventor-Polymath R. Buckminster Fuller described the solution to this problem:

The only way we can get somewhere is by a completely different way of seeing our world: an informational approach. You pay no attention to sovereign boundaries – you transcend them. You have to get away from any ideas of specialization and develop your comprehensive literacy. It takes a long time to know anything that way, but once you do, you know it so clearly and cleanly that anybody who’ll sit down and work it out can’t go wrong.¹⁷

I have pursued Fuller's comprehensive literacy since 1970. This book is a diligent effort to share the knowledge gained in the process. The result is a theory based on an eclectic collection of information. I also believe that it communicates clearly and cleanly what I have learned – and how all this can greatly improve medical care.

Another vital issue in improving healthcare is poor communication between medical researchers and the public. Scientists speak in precise, technical jargon. This language is often incomprehensible to the average person. The result is ongoing frustration or even anger between scientists and the lay public. Columnist Samuel Broder wrote:

Some researchers stop trying to make their scientific goals understandable to the public. This leads to frustration on all sides . . . We must find a way to speak a common language . . . [improving] communication.¹⁸

Many well-known scientific geniuses of history knew the necessity of communicating well.¹⁹ Physicist Erwin Schrödinger offered: If you cannot – in the long run – tell everyone what you have been doing, your doing has been worthless.²⁰ Physicist Albert Einstein stated, Most of the fundamental ideas of science are essentially simple, and may . . . be expressed in a language comprehensible to everyone.²¹

Doctor, We Are Not Communicating Well!

A major complaint from many is poor communication with their doctor. Some say their doctor does not take enough time with them. Others say their doctor does not seem interested in communicating with them. The result is a growing gap between doctor and patient. Most people find medical care difficult to understand. Poor communication with the doctor only amplifies fear and puts a damper on working together.

Adding to this confusion is the ubiquitous Internet. Many computer-literate people try to learn medicine online, going from one website to another. Others use the Internet to second-guess their doctor’s choices on medications, surgery, or other aspects of medical care. If their doctor will not explain their health problems and treatment alternatives, who can blame people for going anywhere they can for information?

We also should remember that communication is a two-way street. Many patients refuse to communicate with their doctor. Some patients are intimidated by the doctor, or just plain nervous; they freeze up when their opportunity with the doctor comes. Others are sure they already know everything about their health status and merely need to confirm their thoughts with a quick prescription. Neither extreme is helpful.

A good doctor-patient relationship requires both parties to be willing partners. Both doctor and patient need to appreciate the need they have for each other. They must desire a positive relationship and then work together for better communication. Returning to the ideas of R. Buckminster Fuller, we see the need in medical care to communicate both clearly and cleanly.

The Need for Harmony

Considering the many sources eroding the quality of medical care, we see a common problem. I submit the problem is a lack of harmony.²² Looking at business pressures, poor doctor-patient relations, overspecialization, and scientific confusion, we see little harmony. These disparate problems cause nothing but disharmony in the present healthcare system.

Harmony is something that today's medicine - and today's world - needs very badly. Critics of the medical system complain about the skyrocketing cost of medical care – and justifiably so. These concerns are driving cost reduction measures like second opinions, prior approval for hospital admissions – and healthcare reform at the national level. All these measures are, at their base, attempts at restoring harmony to the healthcare system.

Everyone seems fixated on the problem of who is going to pay for medical care. By contrast, there is little attention on how we are practicing medicine. This is a fundamental mistake, and I believe this error is causing everyone to miss the real problem. In fact, I suggest that the high cost of medicine is not even the root cause of medicine’s problems. Rather, it is the result of faulty assumptions about health and disease. The fundamental lack of harmony is not caused by economics; the lack of harmony causes the economic problems.

This is a novel idea. Is it possible that we are fixated on the wrong problem? Could it be that economic issues are not the problem at all? Could changing our perceptions improve medicine?

Perception and Paradigms

Perception is the meaning we attach to what we see, hear, touch, taste, or smell. If we smell smoke, we assume something is hot or burning nearby. We know that someone is at the door when we hear the doorbell. When driving, our time to cross the intersection comes when the stoplight turns green. If we get cold, we know to put on a jacket. This is how perception via the five senses informs us of the world.

We rely on the senses to inform us about our surroundings, but we use our intellect to attach meaning to the information. When we have the same experience, over time, we come to assume that certain facts are true. In medicine, we assume a fever indicates an infection. Pale, cold, and clammy skin may indicate blood loss or shock. A certain rash indicates chicken pox, and a red and coated throat suggests tonsillitis.

There are many