Dear Don,

I was really glad when President Obama chose you to lead the Department of Health ad Human Services. First of all you’re a pediatrician; that means you chose to forego the higher income specialties to provide primary care to children. Then your work with the Institute for Healthcare Improvement was also a step in the right direction; except you didn’t step far enough.

You wanted to establish a way to pay doctors, not just for services, but for good services. You wanted better results from the system. You wanted to instill some accountability. Your arguments and wishes were given a big boost when the Affordability Care Act included the establishment of Accountability Care Associations–groups of health care providers who would provide this better care, and get paid more for it.

The way you intend to insure the better results is to make sure that best practices are followed. That sounds good too.

But it begins to sound familiar. A few years ago we had an educational crisis that we resolved by making schools and teachers accountable. That sounded good too. We started doing a whole lot more testing to make sure that the students were learning what we thought they should know. Now students are taught to the test, other programs are sacrificed, and principals and teachers are caught cheating to make their scores better. Indeed the whole program was built on one of President Bush’s favorite Houston schools, that was later found to have been cheating. And now it appears you are heading down the same road in healthcare, and if you think that educators are the only ones cheating and gaming their system talk to some of the experts in your own fraud department.

It is a general conclusion that No Child left Behind is a miserable failure. Please don’t take us there in the health care professions. We have had our fill of gaming the endless regulations the government has put on the profession in the attempt to control costs. More regulation, more testing, more ‘best practices’ and evidence based medicine is not going to get us there; it’s going to spur the gaming, just as it did in education.

What will get us there is finding a way to empower the American people with the information they need to make wise health care decisions and the financial ability to execute them. In nature we see very soon that the health of an ecosystem is reflected best by its diversity. The diversity and the health of our health care system would be effectively destroyed by regulated best practices and evidence based medicine. I don’t think that is what you want.

The need to take the bigger step to realizing what we are dealing with in these decisions is outlined more fully in The Boids and the Bees: Guiding Adaptation to Improve our Health, Healthcare, Schools, and Society, published by the Institute for the Study of Coherence and Emergence and available at their web site, www.emergence.com

Lon Jones DO

Our current brand of medicine is based on the world view that we had back a bit over a century ago. We had just given up bloodletting because we found out it killed people and had to come up with an alternative to the humoral system. The humoral system defined disease in terms of an imbalance of the four humors; symptoms that indicated either too much or too little of the particular humor were treated with drugs or other treatments designed to balance them, or at least to make the symptoms go away. So the essence of the humoral system was doing something to make symptoms go away. In the time of the humoral system the symptoms were often misinterpreted; the symptoms of too much blood, for example, were the redness, pain, fever, and swelling we know today as the inflammatory response. Of course no one then knew about the inflammatory response so they thought that it was the loss of blood itself that killed people. But the people doing the bloodletting were more experienced than that. They knew that people could bleed to death and they were very careful not to go that far. If they went just part of the way the symptoms of too much blood went away and they didn’t die, at least right away. The research that killed bloodletting was done on people with pneumonia in the 1850s and they died only when their disease killed them. We think they died because bloodletting hobbled the inflammatory response. If you hobble the defense of your favorite football team they are going to lose and, unfortunately it’s the same with us.

But most doctors still don’t see things this way, possibly because they don’t yet see the proper role of these defenses. What replaced the humoral system in the early years of the last Century was what is called scientific medicine. Doctors looked at how the body works to get a scientific basis for the symptoms they were treating but that didn’t appear to change things very much. Beginning in the 1930’s, not long after we finally stopped bleeding people, researchers started looking at the role of histamine, the trigger for the runny nose. They developed antihistamines in the 1940s. They were the miracle drugs of the period. In the mid 1960s they were seen as safe enough that they were made available over the counter, without a prescription. These pills are sold at the counter for cold and flu symptoms and there is a vast variety of them. It wasn’t until 40 years later that some doctors got suspicious that these drugs were related to some deaths. When this was confirmed in 2007 these drugs were rapidly and voluntarily taken off the market for children.

Cold and flu symptoms are mostly a runny nose, rhinorrhea in medical language, and a fever with all the aches and pains that often accompany it. But these symptoms are defenses, just like the inflammatory response. Your nose doesn’t run when nothing is bothering it, and when something is bothering it the first response is to try to wash it out. The people who developed antihistamines were focusing only on the symptoms; together with those who use them they are still practicing humoral medicine. The symptom in this case, the runny nose, was actually made into a disease that could be easily treated with the wonder drugs of the 1940s.

I contacted the FDA in 2007 and suggested that what they were seeing, rather than the results of overdosing, was the effect of blocking a defense; I suggested that the increased mortality of children exposed to these drugs was the same thing the French researchers saw in people exposed to bloodletting in the 1850s. “That’s an interesting way to look at it,” was their only response.

Medical researchers like Christer Svensson have looked carefully at what histamine does in the nose and concluded that it’s function is defensive; it is trying to wash out something that is bothering us and it gives us an edge in our ongoing game with the infectious agents in our environments. Defenses such as these need to be honored and supported, and certainly not just turned off as bothersome symptoms, which is what too many continue to do today.

In our book, The Boids and the Bees, we discuss the defenses protecting our most threatened areas—the openings to our bodies—and how to honor and support them.  We think this is a much healthier way of coping with some of our more uncomfortable symptoms.

Our fundamental mistake is thinking that our system can be analyzed where we take it apart, look at the parts that make up the system, find the faulty one(s), fix them, and put the system back together, working like new. This has been the way we have dealt with problems ever since we joined together in groups larger than tribes.

Today, for example, we are analyzing our educational system and many are blaming the teachers and their unions. But if that would resolve the problem Texas would have a better system because in 1982, following the advice of H. Ross Perot, all of the teachers in the state had their teaching certificates canceled. In order to be reinstated they had to pass a literacy test. This was followed by competency tests covering the areas taught. It didn’t help Texas and it won’t help the whole country.

It’s not that easy. Analysis works well when one is dealing with a mechanical process. We make machines and they are simple. We can take them apart, find out what is not working, fix it and the device works better. But human beings are not machines, and treating them as such is the fundamental error of western medicine.

Sure we can point to the progress we have made by using this model, but that is the nature of progress. In the natural world we explain what is happening using our best model. Then anomalies start coming up that don’t fit, so someone comes up with a new model that is better and explains more. That is where we are now. We need a new model.

At Common Sense Medicine ® we think this new model is recognizing that human beings, indeed all living organisms, are better seen as the adaptive organisms they in fact are. We are established to help fund research that sees human beings in this way. It is funded by royalties from the sales of our book, The Boids and the Bees: Guiding Adaptation to Improve our Health, Healthcare, Schools, and Society, where applications of this new way of thinking are described in many of our problematic systems. If you would like to help fund this endeavor we encourage you to purchase the book. If you have read the book and want to support this further please send a check to the address below. If you wish to follow up on what research we are funding please include your E-mail address.

On the article page you will find a variety of articles and comments on different aspects of this view. They are added to from time to time.

Disclaimer: All material provided in this web site is provided for educational purposes in the hope of improving our general and societal health. Access of this web site does not create a doctor-patient relationship nor should the information contained on this web site be considered specific medical advice with respect to a specific patient and/or a specific condition. Copy any articles in question and consult with your own physician regarding the applicability of any opinions or recommendations with respect to your symptoms or medical condition.

Dr. Jones and Jerry Bozeman specifically disclaim any liability, loss or risk, personal or otherwise, that is or may be incurred as a consequence, directly or indirectly, of use or application of any of the information provided.

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last updated 8 December, 2010

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