Why Philosophy is Important in Medicine:
The three pillars, Part One
Hello and welcome to my blog!
Dr. Super’s House of Health has a mission to provide the people of the surrounding area a service that will help patients achieve and maintain their highest potential for health. In order to do this I had to make sure my business was built with a sound philosophy in mind; one that would serve as the basic structure for everything we do. But why is philosophy one of the pillars I decided to build my business on? How can you measure success using philosophy? Why does philosophy have a place in health care?
I decided to take some time to write a blog post about this because I take time to explain it during every new patient exam. In chiropractic school I was surprised to learn I had to take not one, not two, but FIVE philosophy courses (which ended up being the most important classes in my opinion)! Why was this pushed so hard in our curriculum? Well, chiropractic is built on three pillars; art, science and philosophy. Each one promotes and supports the other. I am the type of person that has to know WHY I am doing something the way you showed me, or WHY one way would be better than another. This drives me to learn about different techniques, to read evidence-based literature, and to question everything.
Understanding philosophy enhances a person's problem-solving capacities and contributes to their ability to organize ideas and issues, to deal with questions of value, and to extract what is essential from large quantities of information. After seeing over a hundred patients a week, there is a lot to process, remember, and treat. Sticking to my philosophy as a professional keeps everything in focus and in proper perspective. It also allows me to explain to my patient’s WHY we are doing what we are doing. That’s why my office is based on a salutogenic philosophy. But what is salutogenesis and why is it important?
Salutogenesis is a philosophy in medicine that focuses on the healing process instead of the disease process. It focuses on the solutions instead of the problems. This is different from a pathogenic approach which is commonly used in the medical field (pathogenesis being the opposite of salutogenesis; focusing on the disease process and symptoms instead of the healing process). The language required to treat patients changes with a salutogenic approach versus a pathogenic one. So when I treat my patients, I steer the conversation away from their symptoms and pain, and more towards their ability to heal, what improvements they are seeing so far, and what more they want from life now that they are no longer consumed by their pain.
It’s this change in language that really sets salutogenic practitioners apart. By focusing on the positives and providing solutions, I am able to give my patients hope in their healing process and I encourage them to focus on the changes they experience during treatment instead of the symptoms that hold them back from growth. When your mind focuses on the problem, the problem gets bigger. When your mind focuses on the solution, the solution comes into focus and you can finally overcome the problem.
Science has recently been discovering that a positive outlook in health makes significant changes to a person's ability to recover from or overcome a disease. A study at Johns Hopkins showed that people with a family history of heart disease but who had a positive outlook were 33% less likely to have a heart attack or other cardiovascular event than those with a negative outlook (“The Power of Positive Thinking”, 2022). This study hypothesized that positivity decreases inflammation in the body and therefore reduces the risk of a cardiovascular event. In fact, a special health report from the Harvard Medical School discussed how chronic inflammation in the body “plays a central role in some of the most challenging diseases of our time, including rheumatoid arthritis, cancer, heart disease, diabetes, asthma, and even Alzheimer’s” (Fighting Inflammation, 2022). By staying positive, we reduce the amount of cortisol in the body which reduces chronic inflammation and pain.
Pain is often something we are taught we can overcome with the mind. Imagine a pregnant patient preparing for birth, a long distance runner before they hit their second wind, or a rugby player who has to choose to get up every time they are knocked down. A systematic review performed in 2021 concluded that promoting and supporting psychological coping techniques, including optimism for cancer patients may decrease patients’ suffering, increase their quality of life at different cancer stages, and reduce opioid use'' (Antonio, 2021). When my Aunt was diagnosed with Cancer, I remember all her doctors saying the most important thing to do was to “stay positive” and “believe you can win”. She did and she overcame an aggressive stage four breast cancer, thyroid cancer (twice), and melanoma (twice). I firmly believe that it was her stubborn and inspiring positivity that allowed her to make it through such a difficult disease. To back up my belief, a prospective cohort study published in 2017 found that “a higher degree of optimism was associated with a lower mortality risk” (Kim, 2017). It’s a classic tale of “Is your cup half-empty, or half-full?”. How you answer that question can really change your attitude today, your outlook on tomorrow, and your health in the future.
As a chiropractor, I believe in the mind’s power and its ability to heal the body. My philosophy classes in school were based on these principles as well. Every clinical decision I make, every choice I present to my patient, the way I examine and talk to them, it's all dictated by this philosophy. It would be a disservice to them if I only focused on their issues, their pain, or their problems. I believe in giving the power to the patient. The power to heal, the power to grow, and the power to overcome. That’s why at Dr. Super’s House, I measure my success on how my patient is feeling, not how many patients I have seen, or how much money I made that month. Instead my success is measured in laughs, smiles, and joy. It’s measured on how positive the patient is when they leave, despite how negative they might have felt coming into my office. The joy and relief I can share with a patient when they realize they don’t have to live in pain, that their body doesn’t “hate them”, and they can overcome their family history is worth more to me than gold. So everyday I do my best to share this philosophy and spread this joy, one patient at a time.
Feel Well and Do Good,
ADIO
Dr. Super
The power of positive thinking. Johns Hopkins Medicine. (n.d.). Retrieved March 13, 2022, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-power-of-positive-thinking
Fighting inflammation. Harvard Health. (n.d.). Retrieved March 13, 2022, from https://www.health.harvard.edu/staying-healthy/understanding-inflammation#:~:text=Unchecked%2C%20the%20immune%20system%20prompts%20white%20blood%20cells,cancer%2C%20heart%20disease%2C%20diabetes%2C%20asthma%2C%20and%20even%20Alzheimer%E2%80%99s.
Antonio J. Forte, Gunel Guliyeva, Heidi McLeod, Abd Moain Abu Dabrh, Manisha Salinas, Francisco R. Avila, Adam Perlman, “The Impact of Optimism on Cancer-Related and Postsurgical Cancer Pain: A Systematic Review”, Journal of Pain and Symptom Management, Volume 63, Issue 2, 2022, Pages e203-e211, ISSN 0885-3924, https://doi.org/10.1016/j.jpainsymman.2021.09.008.
Kim ES, Hagan KA, Grodstein F, DeMeo DL, De Vivo I, Kubzansky LD. Optimism and Cause-Specific Mortality: A Prospective Cohort Study. Am J Epidemiol. 2017 Jan 1;185(1):21-29. doi: 10.1093/aje/kww182. Epub 2016 Dec 7. PMID: 27927621; PMCID: PMC5209589.