May 14, 2003

The modern healthcare system assumption: the mind is unimportant in healing

I completely agree with Abram Jacobon's letter. As a recent "convert" from contractor to University of California status, I discovered that my primary-care physician was not "in-network." Plus, irony of ironies, my dentist who was a Delta Dental member when I was first hired as a contractor has since fled the "provider" [exactly what they're providing is moot]. As is probably obvious, I'm less than thrilled by my new "benefits."

The fundamental problem here is that the western medical model -- always light on psychosomatic medicine -- has become even more detached from that healing modality since the age of HMOs dawned on us like a nuclear holocaust. A rather thick volume entitled "Psychoneuroimmunology" should be required reading for both physicians-in-training and for health-care administrators. It describes in great detail how one can successfully apply Pavlovian conditioning to an animal's immune response, both potentiating and depressing it with neutral substances such as saccharin, when appropriately paired with behavioral stimuli.

"Rats," you say [or "salivating dogs"]. Indeed, but there is virtually no difference between a rodent's and a human's immune system. As to behavioral conditionability, that's a matter of opinion. But in my humble opinion, the trusting interaction that develops over time between a physician -- or dentist -- and his/her patient is a valuable component in healing, at minimum, capable of altering stress-hormone patterns to either potentiate or depress immune competence. To suggest that discarding that interaction is trivial is to proffer a disservice, not a benefit.

--Vin LoPresti