I recently read Slow Medicine: The Way to Healing by Victoria Sweet, MD.
The book’s introduction captured my attention immediately. In it, Dr. Sweet describes the downward spiral her elderly father suffered when he was admitted to a hospital.
At 90-something he was in pretty good health; in an ironic turn, the hospital almost killed him with unnecessary diagnostic tests and prescription drugs.
Even though she was a medical doctor and tried to intervene on his behalf, she felt ignored and put down.
In a brilliant yet desperate attempt to save her father’s life, she had him put on hospice. Dr. Sweet felt it was the only way to pry her father away from a healthcare team that seemed determined to treat him at all cost.
With hospice, her father was able to go home to his wife and family, and was taken off the heavy cocktail of prescription drugs. He immediately improved.
As she says in her book:
What Father had gotten was not Medicine but Healthcare—Medicine without a soul.
Fast Medicine vs. Slow Medicine
The Slow Medicine movement began about the same time as the Slow Food movement, which was started to promote fresh, locally grown foods and push back against corporate agriculture and its nutritionally-depleted, highly-processed Fast Food.
Fast Medicine is also about big corporations: Big Government, Big Pharma, Big Data and huge healthcare conglomerates.
Unlike Fast Food, however, Fast Medicine is costly.
Fast Medicine emphasizes the use of technology—sophisticated diagnostic equipment, high-tech medical devices, and high-cost prescription drugs. Algorithms, mandates and regulations drive patient care.
Fast Medicine is profitable.
Slow Medicine, on the other hand, takes its time. It gets to know patients as individuals rather than population subsets. It focuses on having conversations, providing counseling and developing trusting relationships. (None of which make any money in Fast Medicine, so are frowned upon.)
Throughout the book, Dr. Sweet details her medical education and the memorable patients or cases that helped her grow as a physician. She appreciates the science of medicine, but very early in her career realized the style or “art” of medicine is equally important to the caring and healing process.
Western medicine, Fast Medicine…d[oes] a wonderful job with acute diseases—infections, trauma, catastrophic illness—but not an especially good job with diseases that come on slowly—cancer, diabetes, autoimmune disease.
So many of the health problems in this country are diseases of lifestyle: diabetes, heart disease, cancer, dementia and substance abuse. These are long-term illnesses and treating them with Fast Medicine is not only expensive, but it doesn’t get to the root problems, which might be emotional, social or economic.
I learned a Slow Medicine lesson: how individual medicine was. It wasn’t true that one size fits all, that everyone or no one should have that treatment or this pill. Rather, the right answer had to do with style, with who you were, who the patient was.
Patients vs. healthcare consumers
One particular passage in her book described very well, I think, how our healthcare has been hijacked by bureaucrats.
It was the first time I had ever heard the phrase “health-care provider.”
“What?” I asked.
“Hunh?” He stopped walking, too. He turned and we faced each other.
“What’s a health-care provider?” I asked him. “What does that mean?” He was thin and tall and I couldn’t see his eyes against the light.
“It’s the doctors,” he answered. “And the nurses and the hospitals and the clinics—it’s whoever provides health care—health-care providers.”
I was shocked. “And the patients? The people who are sick, who we take care of? What are they?”
“They’re the health-care consumers.”
“”That’s ridiculous,” I said. “Patients are consumers? Like in a restaurant? They consume healthcare?”
“They’re health-care consumers,” he insisted. “They choose to spend their money on healthcare; they buy it in the marketplace; they consume healthcare.”
My patients went through my mind. The heart attacks, the strokes, the cancers, the mental illness. My patients didn’t choose to spend money on healthcare. They didn’t have any money to spend and then they got sick. Then they came to the clinic or hospital and depended on me and mine to get them better.
“If anyone is a consumer,” I told him, “it’s us, the doctors. We’re the ones who consume resources—tissue paper and test tubes, silver and palladium, effort and energy.”
The Head of District Twenty-two stared at me for a second and then resumed walking. “Health-care providers,” he repeated. “Doctors are health-care providers and patients are health-care consumers. It’s the economic model.”
Dr. Sweet wrote a previous book about the Slow Medicine movement, God’s Hotel: A Doctor, a Hospital and a Pilgramage to the Heart of Medicine.
Both are beautifully written memoirs of a life in medicine. They entertain, but also serve as a warning to Americans that we are losing (or have already lost) the wholesome art of Slow Medicine, and have been given a greasy bag of Fast Medicine instead.