Humility and the Labyrinth
“I’m getting a lot of conflicting information.”
This quote is taken directly from approximately all of my patients. Embarking on the fertility journey is like grad school: one very long research project. Each doctor gives a different recommendation, preferring one protocol or another. As a layperson, you’re expected to understand the complexity and nuance of research, to be versed in statistics on population health and how that works. It can be understandably paralyzing. This is especially true with some proponents of “Evidence-Based Medicine (EBM)”, painting any and all alternatives with a coating of snake oil.
Each doctor has their own clinical expertise, their own experience, and thus their own unique treatment methods that go beyond a simple difference in clinical style. There are many ways up the mountain (that’s a jewel of wisdom from an ancient text). Often when protocols are modified, it’s because new research has spurred a change. However, it’s not always research; sometimes the doctors review their own stats or do case studies, review files, consult with trusted colleagues, or make wise observations and try new things. Sometimes, thankfully, they even use their intuition. We all do this: make observations, deduce, draw conclusions, and conduct ourselves accordingly using all the evidence of our senses. It’s an innately scientific process. This is not only the case with modern medicine. In my Traditional Chinese Medicine practice, I also change protocols based not only on jewels of wisdom written in ancient texts, but on research, both clinical and observational trials, and also my own knowledge established over many years of practice.
The concept of evidence-based medicine (EBM) is not a new one. The idea has been around for over a century. The notion that clinical protocols should be based on facts seems obvious, and of course everyone can agree on that. A strictly EBM approach has an obvious advantage: it meets the need of a large entity, such as a health authority, to implement standardized protocols across all platforms in the hopes of benefiting the largest number of people with the least amount of confusion, time, and cost. However, the “facts” are not as clear-cut as we might hope. Protocols for “best practice” are established on population-based research. Opponents suggest that perhaps these protocols do not represent the needs of individual patients, expounding instead a patient-centred approach. After all, the vast majority of research is done on white adult males, so understandably critics of EBM question the broad applicability of population-based protocols. Many doctors and researchers in the field propose the idea of Cultural Competence in Medicine (CCM), which aims to incorporate individual circumstances and preferences into clinical decisions. Ultimately, the goal is to integrate these two concepts.
Fundamentally, despite all the nuance, my primary goal as a medical practitioner is to heal, and that is a massive responsibility. When someone comes to me for help, puts their trust in me, believes what I tell then, follows my advice, regards me as an authority, I take that very seriously and I’m not alone on that front. We are a well-intentioned bunch. In all my years of practicing Traditional Chinese Medicine, I have never met a single practitioner who doesn’t ask themselves regularly if they are giving the best care possible. In fact, far from gold-digging, many of my colleagues share that it took them their first full year of practice to feel comfortable accepting payment from their patients.
And as we learn, we are constantly confronted with new information. As a result, we change our protocols. When I suggest that a patient try the laser, for example, or when I change a point-prescription, or add electro-stimulation, or update my recommendations for diet or frequency of treatment, I am often asked: “why didn’t you suggest this before?” The answer is simple. I didn’t know. New information arrives, and I integrate into my practice. The protocols change, so the treatment you receive will look different than when you visited the clinic two years ago.
Our medicine is a labyrinth. I’m sure any medical doctor or allied professional would say the same thing; when you know enough, reach a critical mass or base of knowledge, you suddenly realize how very little you actually know. This kind of humility is required for the clever and true application of medicine. I know less every day, but this fact does not discourage me. It’s exciting to know that each new patient, each new study, brings new knowledge, protocols, practice, and healing.
To book a session for your own individualized, evidence-based care, please call Acubalance Wellness Centre today.