Your Health - The Buck Stops Here

Copyright Glow Images: Model used for illustrative purposes.

Former President Truman had a plaque on his desk with these words "The Buck Stops Here" and on the reverse side it said "I'm from Missouri." Truman said "The greatest part of the President's job is to make decisions -- big ones and small ones... No one else can do the deciding for him. That's his job."

To this day, residents of the Show-Me state are often described as staunch individualists, people who like to take charge of their own affairs with minimal government interference. Yet, in many cases, this confident decision making ability doesn't necessarily translate to taking responsibility for one's health.

"Depending on others to occasionally help us is not unwise. But why does depending on others to manage our health seem to be the norm?" asks John Clague ["Taking Responsibility For Our Health -- Will It Make Us Healthier?"]

Clague might have found a clue to how it all began when he looked into the first American Medical Association code of ethics 1847. It advises physicians: "The obedience of a patient to the prescriptions of his physician should be prompt and implicit. He should never permit his own crude opinions as to their fitness, to influence his attention to them." Phew, if that's not passing the buck then I don't know what is.

Still, the medical profession is witnessing a sea change, as individuals are increasingly more involved with their health care decisions. This trend was confirmed for me when I recently had the privilege of meeting Dr. Lance Luria, who oversees an Integrative Medicine program at Mercy Care Management in Springfield, MO. Integrative Medicine begins with a model of health and wellness instead of a model of disease. After twenty five years in mainstream medical practice, Luria did a fellowship through the University of Arizona under Dr. Andrew Weil, often seen as the poster child of Integrative Medicine, and then brought what he learned back to Springfield. Luria is passionate about this new direction for the medical profession, a shift from drugs and surgery as a first resort, to a more holistic (but by no means mystical) approach.

As Dr. Luria describes it, his Integrative Medicine approach is akin to being a conductor with an orchestra. The team of specialists - representing a wide array of health modalities -- are the orchestra, he's the conductor, and, you guessed it, the patient is the audience. His talented team's job is to play the right tune for the audience, with the theme being to have a better life.

And, what kind of audience finds its way to Dr. Luria and what will they learn by working with him? Luria says that many of his patients have been through difficult personal circumstances and have not learned behaviors that promote self-care. In a chapter he wrote titled "Integrative Pain Management: It's Just Good Medicine" [Pain Tamers by Helen Dearman] he said, "The single most important challenge I have is changing negative mindsets." From the start, Luria counsels patients that by their own efforts, as well as working with his team, they can dramatically improve their situation. Part of the healing process means patients begin developing a sense of empowerment and become responsible for their health/their own healing. Maintaining healthful lifestyles is also part of the healing process and acts as a counter balance to whatever disease or condition they may have.

The healing process can be a struggle for adults, especially if it is the first time in their lives to think deeply about what may be the cause of ill health. Mainstream medicine goes after the smoke, says Luria, he and his team go after the fire. He chuckles in delight when he tells me that he loves to hear his patients tell him what they need to do, "rather than my telling them what they need to do." Luria continues, "No doctor could ever heal somebody. Healing is an internal process as we all have a huge ability to self-regulate and internally problem solve."

Integrative Medicine is now an established part of healthcare in the United States. [Bravewell Collaborative, Feb 2012] There are over 50 academic institutions that support Integrative Medicine, from Johns Hopkins to the Mayo Clinic, to Harvard. In 2014, there will be Board Certification in Integrative Medicine, and Integrative Medicine modalities are already being taught in family practice residencies.

Although the latest surge toward whole person therapy is often seen as something "new," it really is not. Taking into account a person's emotional and spiritual state, including their spiritual beliefs and practices as part of a holistic approach, has been around off and on - and in a variety of traditions - for a long time. The Bible states, for example, "Heal me Oh Lord and I shall be healed." In Anatomy of an Illness, Norman Cousins wrote, "The vaunted 'miracle cures' that abound in the literature of all the great religions...all say something about the ability of the patient, properly motivated and stimulated, to participate actively in the extraordinary reversals of disease and disability." [quote in Mind Over Medicine -- Rankin page 59]

This reminds me of what Mary Baker Eddy, a 19th century theologian and health researcher, said about physicians. After being ill most of her life she ultimately achieved health by better understanding the connection between thinking, the body and healing through prayer such as practiced by Jesus. "Physicians...should be models of virtue. They should be wise spiritual guides to health and hope," she said. To encourage the sick to take responsibility for their thinking, Eddy also counseled, "The physical affirmation of disease should always be met with the mental negation. Whatever benefit is produced on the body, must be expressed mentally, and thought should be held fast to this ideal."

Learning to think differently about our health, taking responsibility for it, and embracing whole person care -- are three keys to increased well-being. Certainly these are things to which Missourians can bring their "the buck stops here" attitude.