What is cookbook medicine? It’s when the doctor’s judgment doesn’t reign supreme. It’s when his skill as a physician doesn’t really matter and neither does the patients need or response to treatment.
Cookbook medicine is often called “standards of practice” where the most frequently successful treatments are given to all collectively, and you as a physician are discouraged from doing what is right for the patient, but must merely follow the recipe, or you will not get the same $$ per member per month based on your HMO and PPO scores in treating disease, and your fraternity of physicians will frown at you (peer pressure) or worse you will lose your license to practice. You are told, you must do what is most often right for the collective (In the opinion of the elite) and not what is right for the individual patient.
1) The patient demonstrates symptoms of x disease
2) Do all the tests in the cookbook to verify or rule out x disease
3) X disease is indeed verified based on the criteria in the cookbook
4) Order the cookbook treatments for x disease, regardless of patient response to or desire for them. If the patient dies, it was the disease, not the treatment.
In many cases the individual needs or desires of the patient are not even recognized as legitimate. The control freakish nature of some physicians (not all) is allowed to flourish because they hold power over you and your life and in some severe cases is a power trip for them, and they feed off that control they have over you. But only if you let them that is, and think their answer is the only answer. I prefer never to give anyone that power, because it is in your power to relinquish or keep it. Just like your other freedoms you can give up your freedom of choice of treatment for the “security” of their “expertise” of only one treatment. Modern medicine is simply one opinion of many that I may or may not follow and I fully take responsibility for my choice, because it is made thoughtfully and with research and with much debate and review of all choices, not just the one the box of medicine is giving me.
A recent case comes to mind of a child who was treated in Michigan for cancer. The child became tumor free after the initial bouts of incredibly difficult therapy. The doctor wanted to follow the cookbook and give several more rounds. The child was barely able to handle the past treatments and the parents didn’t believe he could handle more, so in an effort to preserve his life they protested, with solid and good reasoning, but still the doctor pursued at great length until child protective services was called in. The parents are arguing 1) the drugs can cause major side effects (heart failure, irreversible heart damage, infertility, nerve damage etc.) 2) the drugs are not even approved to be used in children [side effects with greater frequency and higher risk seen than in adults] 3) they were not proven to be effective on the child’s form of cancer. and 4) The child is without tumors or objective evidence of cancer so why continue to make him suffer the treatments, especially when prolonged treatment causes later cancers to develop, and he is already so frail from the previous treatments. So why take the risk? This is being fought on the grounds of parental rights by the HSLDA. We use reason to decide it makes no sense to continue. The doctor pursues and says you must because that is how we treat the disease; judgment and reason play no part in it. Even without FDA approval for these indications or use in children, even with the extreme warnings and side effects. It does not matter to the cookbook.
You see, when the time comes after Obamacare has been in place and no physician can make enough money to warrant the hassle for his efforts and hours put in, there won’t be any really good ones left on the government dole, so the cookbook style medicine will work with lesser skilled medical service providers; little judgment necessary only cursory medical knowledge to categorize and recognize general types of disease and order tests. Anyone can do it right? If the “judgment” of the physician is to always follow the recipe is that really judgment? Now I know I’m using an absolute here, but it is relevant in this case, because that is exactly what the doctor said, and I have found in practice to be true in many (not all) cases. [said for the benefit of prudentis, yes I do listen! :-)]
“The doctor told me during the deposition that she thinks that she should make the call—for every child in this situation. And she would give the same answer every time, rather than making an individual judgment.”
(BREAKING: Farris defends major parental rights case (medical decisions) in Michigan Michael Farris, HSLDA Chairman)
So you tell me, what is better, individual judgment and skill or collectivist judgment and application over the whole no matter the result or situation? I have seen many not respond well to the cookbook treatments and others that respond the way they are expected to (which is still only suppression and not true healing). The human body is highly individualistic even in its metabolism. I remember reading a piece of quotation by “Allen Roses, worldwide vice-president of genetics at GlaxoSmithKline (GSK), [who] said “The vast majority of drugs – more than 90 per cent – only work in 30 or 50 per cent of the people,”. This is why they want to explore genetic manipulation so much to “fine tune” the effect. At least they are admitting it right? No we are being softened up for the next stage in scientific experimentation, genetically tuned drugs.
Even lab standards and indications for drug treatment (blood pressure measurements, temperature and other vital statistics) are individualistic. You are not supposed to treat just the numbers; you are supposed to treat the patient. The indicated measures may be too low or too high and still be normal for the patient and not causing any problems for them, or they are ‘normal’ and the physician will refuse to do anything because there are no ‘indicators’ to do so. “Its all in your head”. The real skill of a physician is here, individualizing care to the unique needs of the patient, whom they have gotten to know well. And where you find a physician such as this, you have indeed found a treasure.
I reject collectivist ideas and the obfuscation of the individual (lost and blurred into the collective). I prefer the old days, where the doctor got to use his or her brain, make real physical assessments (not cursory ones; relying only on lab values and gizmos), make decisions on what drugs did or didn’t work, used the sales pitches of the drug men and practice standards of professional groups as general indicators, but not absolutes, and basically went by how his patients responded as opposed to what he is told to do, including using (gasp) nutrition therapies and approaches. We can still use the cook book as guidelines for newbies, but you really shouldn’t hold the hammer down on them if at best, you have 50% response.