Trust Issues
A Discussion of "Beyond the Prescription" by Dr. Lucy McBride
“People may not remember the details of what you said but they’ll remember how they felt when you said it.”
Advice from my medical school mentor, Karen J. Nichols, DO
I’d like to start by thanking everyone who reached out or commented well-wishes to my eldest fur-child as we’ve battled through his recent health problems. He’s making slow and steady progress. There’s still a lot of pain management and bed rest ahead but I’m cautiously optimistic about his ability to make a full recovery.
Thank you for your kindness during this challenging time.
This week marked a few milestones in my world. July 1 was Canada Day; my second celebration of being in this beautiful, diverse and civic-minded nation. I appreciate that the Province of British Columbia extended an invitation for me to resettle here and contribute my skills to the people of this amazing country.
July 1 also marks the beginning of residency training for newly minted physicians in the United States. It’s a time when new graduates hit the ground at safety net, academic and corporate hospitals across the country. If you’ve ever watched an episode of The Pitt, ER, Gray’s Anatomy or This Is Going to Hurt, you have an idea of what that experience looks like. If you encounter any of these new doctors, please be kind. There’s a good chance they’ll study your case with far greater attention to detail than many of their more seasoned colleagues. They’re learning and not deserving of dismissal. If you have a medical trainee in your life, check in on them. The next 3-7 years will put them at extraordinary risk of anxiety, depression, burnout, substance abuse and suicide.
July 2 marked the first anniversary of my practice here in British Columbia. It’s been a humbling year packed with professional development. I’ve expanded my clinical knowledge, given several public and ticketed talks on topics related to women’s health and am learning to navigate a whole new healthcare system. It’s been a lot to take in but I’m finding my way. The learning curve this year hasn’t been as intense as residency but there are certainly parallels. I’m grateful to have the teaching of Canadian icons in women’s hormone and sexual health to guide me.
The deeper I dive into the complexities of women’s health and the meaning of wellness more broadly, the clearer it becomes that women’s bodies are completely misunderstood and decontextualized in conventional western medicine. And in medical education. This is a distressing situation because the gaps are being filled by unqualified influencers who have no accountability for giving and charging for dangerous advice online. I have so much to say about this but my thoughts need a little more time to marinate.
In the meantime…
For those who missed it, I recently did a LIVE with Dr. Lucy McBride to discuss her new book, “Beyond the Prescription: A Doctor’s Guide to Taking Control of Your Health.”
In the course of that dialogue, we discussed some of the systemic constraints that undermine the doctor-patient relationship. We also touched on how the wellness industry grew up from between the cracks in the healthcare system and how the tech industry is trying to make doctors dispensable. The through-line is that patients are mostly left to their own devices to sort out what makes the most sense for their bodies- taking into consideration personal values, legal frameworks, demographic access and payment structures.
The time at home with my boys this summer will hopefully provide space for me to begin to write my thesis on the shortcomings of institutional medicine, the unregulated ubiquity of online medical advice and some suggestions I have for restructuring medical education. It may be messy. And you may take issue with some of my opinions. But whether you like it or not, having a body means you’re a stakeholder in the transformation of healthcare through technology. So I hope you’ll stay with me as I try to make sense of it.
In the meantime, you can go buy Dr. McBride’s book here:
Doc Hull, I enjoyed my time in Vancouver, BC, and joined everyone here celebrating Canada this past Wednesday. There is not the polarization here- people are even friendly. Hope your puppy gets better soon:)! Love to you and yours:):)! David Gay
Looking forward to the analysis that you reference towards the end of your post. It's very interesting seeing patients need to navigate an increasingly complex health system on their own. That's interesting that you refer to technology as trying to displace /disrupt physicians. I hadn't thought of it from that lens, more from the optimistic side, but I acknowledge both sides.
Best wishes for your pup as well.