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Tag: Problem-based Medicine

The Purpose-Driven Doctor

By ROB LAMBERTS, MD

My older brother is also a doctor, but not a PCP like me. He’s a specialist: a limnologist.  If you have problems with blue-green algae in your lake, he’s the man to see.  Limnology is the study of lakes, and fittingly, Bill works in the “Land of a Thousand Lakes” as a professor in fresh-water ecology.

I’m not sure he’s thinking of switching over to direct-care limnology.  I’ve been afraid to bring it up.

We do have a lot in common in our professions, as we both see a mindless assault on the things we are trying to save (patients for me, lakes for Bill).  My frustration with our health care system is matched by his anger toward those who deny global warming and the harm humans are causing on our world.

Just as he can get my blood pressure up by asking if his child will get autism from the immunizations, I simply have to suggest this week’s cold weather as proof against global warming to raise his systolic pressure.

So it was notable when I heard a rant against an unexpected target: “You know the Gaia hypothesis?” he asked.  “They think the world is a ‘living organism’ that works toward a ‘balance’ to maintain life.  They believe that humans act against nature, and so are responsible for everything that’s wrong with ‘mother earth.'”

“It’s total bullshit,” he went on to explain, not waiting to hear if I knew what he was talking about.  “Do you know that when trees appeared on the earth, they caused a mass extinction (called the Permian Extinction)!  Trees! There’s no mystical ‘balance of nature;’ it’s always in a constant state of flux, of imbalance.”

Let me make this clear: Bill is not saying that it’s OK that we are harming the earth, nor is he trying to absolve us of our responsibility for what we are doing.  His beef was with the notion that there is some kind of ‘balance’ of nature, when the evidence clearly points to the contrary.  The result of this belief is that that there is somehow an imputed moral goodness from this ‘balance’ (resulting in the idea of ‘mother earth’), and a subsequent implied immorality to any assault on our mother’s sacred ‘balance’.

This has come to mind as I have had significant changes to my thinking about giving good care my patients, especially as it applies to the area of “wellness”.  Since leaving my old practice, which was immersed in a world of ICD (problem) codes and CPT (procedure) codes, I have shifted my thinking away from a medical world where every problem demands a solution.   I have moved my thinking away from reacting to every thing that is going on at the moment, and toward the bigger picture.  I am focusing less on problems and more on risk.  I am focusing less on solutions, and more on responsibility.

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