Mouse in a room of tigers (or, a DC in a room of MDs)

I recently went to a Functional Medicine seminar.  As is true for all such seminars, it is cross-disciplinary, meaning that any licensed healthcare practitioner can attend.  However, most of my previous experience with Functional Medicine training involved classes in which DCs (Doctors of Chiropractic) dominated the landscape, so this particular class was an anomaly for me.

I emerged from that class having gone through a subtle yet significant transformation.

I also emerged with a new knowledge and respect for all other healthcare professions.  It’s not that I didn’t respect them before.  I knew that in terms of natural/holistic and allopathic/conventional disciplines, one leaves off where the other begins, and I readily work as a team with The Other Side for the patients’ benefit.

However, this class gave me a rare opportunity, one in which to talk shop with conventional practitioners before the class started and get a view of what it’s like on that Other Side.  Granted, what I experienced certainly isn’t true of all conventional doctors; by definition, these were the more open-minded, trail-blazing MDs who wanted to break out of the conventional mold and because that desire remains more the exception than the rule, it’s hardly a representation of the allopathic medical field as a whole.  But I did gain a few insights, ones I thought were important, because during our chiropractic training, the tendency is to vilify allopathic medicine and lump all of its practitioners together in a somewhat negative light.

In talking with one MD, s/he disclosed to me that this was their first Functional Medicine course and that s/he was seeking another path, something outside the confines of the current conventional model.  S/he said that (despite their infinite scope of practice) s/he felt limited.  The conventional insurance model did typically not allow for anything more than about 3 minutes spent with each patient (even though it’s meant to be 15), or more than the obvious cursory lab test markers to be ordered, or more than the commonly-accepted pharmaceutical prescriptions a la the conventional pharma-friendly Standard of Care.  S/he couldn’t answer all the patient’s questions during that short time, nor could s/he take any time to get to the bottom of the patient’s core problem.  S/he also couldn’t really recommend anything that didn’t have a long side-effects list attached to it.  This person wanted more.

Maybe it was that medical doctor, or a different medical doctor, or perhaps several, that upon finding out I was a DC, confided to me that I was lucky.  Yes, the “lowly DC” (not their words) who often ends up feeling like a second-class citizen in the grand scheme of the medical structure, was the one being envied by the kings at the top who had an endless sea of tools at their fingertips.

Why were they envious?  I think it comes down to several reasons.  First, many of us (DCs) are not as firmly locked into the health insurance model as most MDs.  They hate insurance as much as we do, but for most of them, it’d be a shot into their own foot if they didn’t succumb to it.  One expressed to me the difficulty of breaking free from the golden handcuffs (the insurance system) because his/her entire practice is built around that paradigm, and it permeates every aspect of said practice.  S/he suggested I was lucky in that I had never built such an insurance-dependent practice.

Another reason may have to do with previous training in holistic medicine.  Most MDs get an average of 12-16 hours of nutrition during their education, and I’ve heard (though not verified yet) that some get as few as 3.  I’ve also heard (another claim not yet researched on my part) that many of these nutrition courses aren’t required, but rather, elective.  Most of our schools only offer a class or two on nutrition as well, but nutritional concepts and clinical gems are often peppered across most of our other classes, and DCs are more likely than other types of doctors to have a better handle on the schedule of local nutritional seminars.

Most DCs are painfully aware that while we constantly must color inside the lines of our scope of practice, MDs seem to be able to do whatever they want.  This creates an undercurrent of animosity or resentment that ebbs and flows in varying degrees.  Interestingly enough, that endless scope comes with some fine print: you better adhere to the Standard of Care and be able to justify to the medical board (if need be) exactly what you did and why.  The Standard of Care (SoC) dictates the expected conventional course of action in screening, diagnosing, and treating a disease.  While on the surface the SoC appears to be a nice layer of protection for the public by setting minimum treatment standards, there are a few problems with it: 1) It is based on old information, anywhere from 17-50 years behind current knowledge gleaned from more recent research studies; 2) the lab testing is scant and incomplete; and 3) it is heavily biased, favoring pharmaceutical drugs and invasive procedures, while virtually ignoring potent, effective, and well-researched natural therapies.  Since DCs are steeped in the world of natural medicine during school and MDs are not, they realize that when it comes to practicing natural medicine, we have a slight leg up on them by default, just by comparing graduates of each discipline.

And then the class began, and I learned even more.  I had always wanted to be a fly on the wall in an allopathic medical school and hear what they were taught in terms of managing their cases, their patients, their offices, breaking bad news, relating to people, carrying themselves, etc.  In observing many MDs over the years and how they all seemed to carry themselves according to a certain internal code, I knew there was something in their training that made it so.  I got a sneak peek at what is probably only one aspect: a concept known as Detached Concern.  Contrary to what critics of allopathic doctors might think, MDs don’t generally enter the medical field solely for its salary potential.  Deep down at their core, the majority of MDs, conventional and otherwise, genuinely want to help the sick and suffering.  They want to make an emotional connection with their patients; they want to give the caring support that a patient desperately needs.  They want to heal their patients’ diseases.  But they must balance these lofty goals with the fact that they must spread this out among all of their patients, and they must always appear professional and in control (of themselves).  Understandably, this creates some inner tension, a dilemma the schools attempt to solve by teaching a semi-happy medium: Detached Concern, more recently known as Clinical Empathy.

Despite the assumption that MDs have all the answers, the conventional doctors teaching our classes admitted that they did not.  Truthfully, they experience the same internal mental freak-out moments that we do when there is a patient in front of them whose symptoms they don’t understand.  One of our instructors said that, since the advent of Google, people will come in with diseases the MDs haven’t even heard of.  Just like with chiropractic, it’s not uncommon for an MD to excuse him or herself from the room to sprint down to their medical library to quickly look something up.  And like us (DCs), they spend every second on the way praying that the answer will be found quickly.

I learned that in school, they are taught from a pathological (i.e. disease) point of view.  Aside from basic sciences like Physiology, their curriculum does not spend much time talking about health, healthy function, or how to promote wellness.  About the closest allopathic education gets to wellness is the concept of prevention, which, in a pharma-driven atmosphere, tends to take on a skewed definition.  For example, breast cancer’s favorite “prevention” tool, the mammogram, actually causes more breast cancer than it prevents, due to the high amount of radiation used.  The conventional doctors in my class were looking for a better way; they sought to finally learn about the body and its disorders from the perspective of true health.

I also learned about the bias against women in the medical profession.  Although it has improved greatly over the past few decades, it persists even today.  I’d been dimly aware of this, given various examples such as the tough time women endure when attempting to be sterilized, whereas for a man he can walk in and have his procedure done, no questions asked; or the fact that the aforementioned mammogram is still performed by squeezing the breast tissue with a painful vise-like apparatus (men would never stand for that if it was done to their scrotum for purposes of detecting testicular cancer).  However, what amazed me is that many allopathic schools perceive female body functions like menstruation, pregnancy/childbirth, and menopause as pathology.  Yes ladies, despite the fact that these are features common among all females if they live long enough (except the pregnancy/childbirth), these normal female health aspects are filed under Pathology, sending a subtle but strong message that there is something wrong with you just because your body is female.  I had not known that before, and it certainly wouldn’t have crossed my mind that such reactionary ideas would persist into the 21st century.

I’ve tried to make it obvious that none of this is meant to be an “us-versus-them” division.  I’m not trying to artificially pump up or promote one discipline over the other.  Rather, I found these MDs humble and friendly.  When telling them I was a “chiropractor”, they did not shun me, sneer at me, turn away, or say anything condescending.  Instead, it was a true meeting of the minds, a unity for the good of the patient.  In fact, I felt more at home in this room than I do at a typical chiropractic seminar.  (This should tell us something!)  This course was a breath of fresh air, and a very welcome one at that.

One thought on “Mouse in a room of tigers (or, a DC in a room of MDs)”

  1. Thank you for the detailed notes. Very insightful. Which “Functional Medicine seminar” did you attend? Was it through the Institute for Functional Medicine, by chance? I have found that audience to be a good place to find a “meeting of the minds” that you write about.

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