Intended for healthcare professionals

Rapid response to:

Editorials

Let the patient revolution begin

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f2614 (Published 14 May 2013) Cite this as: BMJ 2013;346:f2614

Rapid Response:

Re: Let the patient revolution begin

I believe that asking patients as partners to choose wisely among various medical options, etc, will be in vain if we do not tackle the human weakness of fear of death, normal human cognitive bias, biased information already implanted in their brain which will bias their decision. Nowadays patients often choose to use material means to sooth their mental worry, as our system only focuses on material means.

I think that we should tell patients that the current limitation of bio-medical system biases doctors/patients into believing that negative emotions don't matter too much. It is this normal human fear of death that our bio-medical system can only solve with physical means to support their normal psychology. Feeling stress when having physical problems or during work is normal, it promotes productivity. Our system returns patients to normal physical health to contribute to GDP, and allows normal stress to develop into common diseases. A busier disease care business also contributes to higher GDP.

Only those patients having leader mindset will benefit from bio-psychosocial medical model, while those who remain followers will eternally follow what catches their eyes through advertisements.

I suggest creating a movement telling patients that follower mindset patients cannot get the best result within the framed current system dominated by fearful/worry/subconscious worry patients who receive material provided by our medical system to soothe their mind with proven damage. It is unavoidable for follower mindset people as they sacrifice their body for the public health that our government wants (public economic health, employment, etc, and material medicine progress). Those who want better personal medical results have to open their mind to active learning to lessen human weakness, cognitive bias, cleanse their brain of biased information each time they visit doctors, or even before they have disease. However, doctors did not learn sufficient cognitive psychology for self appraisal.

Doctors publicly speak about a slow approach to health but have to resort to a quick approach due to time restraints and lack of patience/motivation and mind skills during consultation. Resources are given for high tech toys rather than taking time to talk about health. Doctors are trained in disease searching rather than health searching. The segregation of health business (religion, social worker, psychologist...) and disease care business (doctors are misquoted as health care professionals) into distinct non-overlapping businesses ensure that doctors exhaust disease means and then send the patient to psychiatrists or alternative therapists to be treated.

Ultimately all doctors or eastern doctors are restoring patients' confidence in their daily life through rituals or materials. We are all psychotherapists, but we are trained to use material means to support their psychology.

In the end, all doctors should be trained as psychotherapists and material medicine therapists before licensing, otherwise we will keep on using material means until one day we wake up to find that we were only creating disease in pursuit of health, as our "customers" want a disease explanation to explain their dis-ease. Also "customers" can only pay out of their pocket for "personal health", as public money from public system can only afford to buy disease treatment (public health) for them.

People can never rely on public for best private personal health. The system is always for the majority.

Competing interests: No competing interests

08 July 2013
Kam Fai Cheung
western doctor MBBS
Hong Kong integrated mind and body medicine centre
8A Lin Fook House, 3 Jardine's Crescent, Causeway Bay, Hong Kong