An Effective Health Care System Requires New Beliefs

Once you understand the power that beliefs have to shape behavior and limit possibilities, you can begin to see why so many of society’s problems seem insoluble.  Societal beliefs prevent change in society just like individual beliefs prevent change in individuals.

For example, if you have the belief Relationships don‘t work, your options are limited.  You can avoid relationships altogether, not work very hard to make them work because you already know they won’t, not leave a bad relationship because you’ll never find a better one, and so on.  But a long-term loving and nurturing relationship is not a viable option with that belief.

Just like your range of possibilities is a function of your beliefs, so the range of possibilities for any social institution is a function of its beliefs.

Let’s take a look. Virtually everyone agrees that the existing health care system doesn’t work, even though there are a number of conflicting theories about why and what should be done. What’s wrong? Insurance premiums are rising faster than the ability of millions of people to pay. Tens of millions of people aren’t covered by any insurance at all. An increasing percentage of our national income is being spent on medical care. People with preexisting conditions can’t get insurance. People who can’t pay aren’t getting the medical treatment they need.  Corporations can’t afford the rising premium costs.  In other words, the health care system is broken!

Many solutions have been proposed but none seem to resolve all the problems, and some proposed solutions create new problems.  Why can’t we seem to find a way to create a health care system that works for all concerned?

If you imagine beliefs as a box that limits us—where we can only act consistently with what’s inside the box and what’s outside the box is virtually impossible because it is inconsistent with the beliefs—then there is no real solution to the health care crisis given the widely accepted beliefs about health care.

What are some of those beliefs?  For over a hundred years the health care system has been built on these and similar beliefs:

* Health care should focus on eliminating symptoms and disease.
* Body and mind are considered separate; psychosomatic illness is mental and may be referred to a psychiatrist. Mental phenomena are irrelevant in treating most physical illnesses.
* The body is a machine in good or bad repair. The primary intervention should be with drugs and surgery.
* The focus should be on treatment of symptoms.
* The patient is dependent. The professional is the authority.

In recent years some major medical institutions (such as the Cleveland Clinic and the Mayo Clinic) and millions of individuals have rejected at least some of these beliefs.  But these are exceptions, not the rule.  It is news that one-third of the U.S. population has tried some form of “alternative” treatment in the past year.

For the medical profession as a whole, for insurance companies, and for most people, these beliefs underlie their interactions with the health care system and their attempts to improve it.

Because the beliefs I listed above still rule the health care system, preventative medicine, the mind-body connection, and treating people instead of symptoms are “outside the box.”  Notice how these practices are described: they are “alternative medicine.”  In other words, they are an alternative to accepted practice.

When the beliefs that govern the health care system change, new possibilities will open up and a new health care system will evolve, eliminating the problems that cannot be solved in the current “box.”

How can we do that?  With a modified version of the Lefkoe Belief Process that can be used to create new possibilities for any social institution:

1.  Identify the beliefs that are responsible for the current behavior.

2.  Discover the source of those beliefs and realize that the beliefs made sense given the circumstances at the time.

3.  Recognize that the beliefs—the meaning given to the circumstances—are a valid way to understand and deal with those specific circumstances.   In other words, if the circumstances had been different, we would have formed different beliefs.  Our conclusions are “a truth” for a specific time, not “the truth” for all times.

4.  Take a look at today’s circumstances.  Notice that it’s very different. Create new beliefs as the best way to understand and deal with today’s circumstances.  Our answers are still not “the truth,” but “a truth”—only the best answers for today.

5. Because we now have a new set of beliefs, we also have many new possibilities that didn’t even exist before.  Given our new beliefs about the social institution, what should everyone connected with it do?

Let’s apply these five steps to the health care system.

Step 1: Identify the beliefs that underlie today’s health care system. (See chart below.)

Step 2: What is the source of those beliefs?

There is not enough space in this blog post to describe the source of all these beliefs, but here is a very brief summary.

Descartes, the seventeenth-century French philosopher, taught that everything in the material universe was a machine, including human beings. He claimed that the human body reflected the machinelike characteristics of the universe itself—machinelike bodies inhabiting a machinelike world. He argued, therefore, that disease was a disorder of the mechanism; the machine was broken. Descartes devised what became known as the scientific or reductionist method: To learn about the complex, study the simple. Learn about a germ and eventually you learn about the disease associated with it.

A medical theory that supported Descartes’ general scientific approach was the theory of specific etiology: an identifiable microorganism causes every disease or infection.

In their book The Healer Within, Steven Locke and Norman Colligan describe the medical advances that flowed from these two theories:

“In 1906 researchers used Koch’s discovery of the tuberculin bacillus to develop a vaccine for the disease. In 1911 researchers developed a special arsenic compound, Salvarsan, which effectively treated many forms of syphilis. In the 1920s insulin was isolated, and insulin injections were extending the lifetimes of diabetic patients. In the 1930s, sulfa drugs appeared, and with them cures for bacterial pneumonia, meningitis, gonorrhea, and urinary tract infections. By the 1940s, the sulfa drugs were largely replaced by even more potent drugs, the antibiotics, made possible by the discovery of penicillin. It seemed that there was no disease that medical science could not handle.”

The biomedical approach resulted in physicians focusing more on diseases than on the patients who had the diseases. This trend was exacerbated by advances in medical technology, an early example of which was the stethoscope in 1819. Locke and Colligan write that diagnostic technologies “further reinforced the image of the patient as an object of study. By the turn of the century, doctors had tests for tuberculosis, diphtheria, typhoid, cholera, and syphilis. Soon after came the X-ray, the electrocardiogram, the electroencephalogram, and blood tests. The patient became less and less a fellow human being with an illness and more and more an amalgam of medical data.”

Step 3: The beliefs made sense given the circumstances at the time.

So where did physicians (and their patients) get the belief that the source of most illness and disease was an invading microorganism or a malfunction of the body/machine and that the influence of the mind was irrelevant? From their experience over several decades. As Locke and Colligan put it, “For most of the history of modern medicine this biomedical approach has dominated the philosophy of science for the best of all reasons: it worked.”
So where did physicians (and their patients) get the idea that a doctor’s job was to diagnose an illness and treat it, as opposed to dealing with a whole person who had a body and a mind? Again, from their experience in dealing with the world. Their conclusion was not illogical or invalid. It made sense. Their interpretation fit most of the available evidence.

The problem was that the medical establishment as a whole (with some exceptions) and most patients considered this conclusion an absolute fact—“the truth” rather than “a truth”—the only accurate description of illness and how the body worked, then and forever. Once the belief was formed, they became blinded to new evidence that was incompatible with their beliefs.

Step 4: Take a look at today’s circumstances.

It is clear that we now live in a world that is very different from the one we inhabited a century ago, a world in which there is irrefutable scientific evidence of a mind-body connection, evidence that existed only anecdotally during the years that the paradigm for modern medicine was being created.

The current paradigm is at variance with the new medical reality, as Dr. Larry Dossey (Beyond Illness) points out:

“What is the success of modern medicine? What can it do? These are the questions in need of answers in the debate . . . . The fact is that for the majority of patients who see physicians, the likeliest diagnosis is some type of psychosomatic or stress disorder. And regrettably, it is in this area—the area from which most patients suffer—that modern medicine is not at its best . . . . Actual studies show that three-fourths of all illnesses brought to physicians are self-limiting (that is, will go away without medical treatment). And of the remaining one-fourth, in only about half of the cases is medicine dramatically helpful.”

None of this is meant to denigrate physicians or modern medicine. The only point I’m making here is that what we observe when we look at what is known about health and illness today is vastly different from what we observed a century or so ago when the current medical model was being formed.

Today’s strategies are a function of an institution’s group of beliefs, which in turn were designed to be an appropriate response to a specific environment that existed when it was created. If today’s environment is significantly different, can you see that neither the current strategies nor the current beliefs can work for today? That neither are “the truth”?

Step 5: It’s fitting to ask: If we originally formed a set of beliefs and a course of action that was based on a careful analysis of the environment as it existed then, why don’t we do the same today?

Notice in the above chart that for the most part the existing beliefs generate questions and strategies about illness, especially how professionals can make people better after they get sick, usually using such “mechanical” aids as drugs or surgery. Can you see that the beliefs constituting one possible new set of beliefs lead to questions and strategies about a state of wellness, emphasizing prevention, involving the patient as well as the professional, and using the patient’s internal resources as a significant aid?

Each new belief opens up new possibilities for strategies and solutions. Experts in each field can provide better solutions than I can, and many already have. What’s been missing is the acceptance of a paradigm that allows solutions outside the existing one. Once people realize that the existing beliefs are “a truth,” not “the truth,” and view the alternative beliefs presented here as another “a truth,” one that is more appropriate for today, new health care and wellness strategies will be devised and implemented widely, not just in isolated situations.

Perpetuating outdated beliefs makes it impossible to resolve the problems of society. As Seaborn Blair once said, “Everybody wants to change the world, but nobody wants to change his mind.” Why don’t we want to change our minds? Because we are convinced that our beliefs are “the truth.”

Our only hope for resolving the myriad problems that confront us today and really improving the state of the world is to change our minds. If we are to create a society that really works for everyone, we must get unstuck from our existing beliefs and open our minds to alternative ones.

The Lefkoe Belief Process is one effective way to do that.

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Copyright © 2009 Morty Lefkoe