The statistics are alarming to say the least. “One in two Americans now has a chronic disease, and one in four has multiple chronic diseases…chronic disease accounts for 86 percent of healthcare expenditures…twenty-seven percent of children now suffer from chronic disease…seven of the top ten causes of death are chronic diseases.”
Most people who read this book will be generally aware of the health care crisis we face today. How can we not? The clinician that he is, however, Kresser gives it dimension and offers a blueprint for an alternate way. And it makes all the sense in the world.
Our current medical paradigm is disease-based and has a structural and financial bias toward symptom suppression, largely through the extensive use of pharmaceuticals, rather than the discovery and elimination of root cause. He calls his alternative model the ADAPT Framework, a combination of “…Functional Medicine, an ancestral perspective, and a collaborative practice model…”
Causal integration is a growing trend in all areas of science today. Richard Thaler was recently awarded the 2017 Nobel Prize in Economics “for his contributions to behavioural economics,” combining economic theory with psychological reality.
The explanation for the misalignment between the dominant contemporary healthcare paradigm and our current reality is both simple and logical. Through advances in science and technology, the evolution of Western medicine has outpaced the evolution of humankind. We have been hugely successful in repairing trauma and eradicating disease, but changes in our social and physical environment have presented new problems that the specialized symptom suppression model is simply not sensitive to.
While this book is about medicine specifically, I think Kessler has ironically thrown back the tarp on a much bigger problem that extends well beyond medicine. Rupert Sheldrake calls it “the science delusion.” It is the willingness of those with an agenda (In his case, Big Pharma.) to wrap opinion in a white coat and call it irrefutable.
Kresser notes, “In other words, most published research findings support the status quo; they’re not necessarily based on solid evidence.” He cites Marcia Angell, a former editor of the New England Journal of Medicine: “It is simply no longer possible to believe much of the clinical research that is published.” And John Ioannidis, a Stanford researcher, who published a paper entitled, “Why Most Published Research is False.” In it, Ioannidis concludes, “Claimed findings may be accurate measures of the prevailing bias.”
I will be interested to see if Kessler can break through the Internet gatekeepers and get the attention he deserves for this book. Unfortunately, the democratization of influence that the Internet promised has yet to be realized as alternative thought is squeezed into obscurity by the sheer volume of attention captured by celebrity and cute cat videos.
One concern I do have for the ADAPT Framework is that I don’t see how this medical revolution, as inevitable as it is, can take place given the dismal state of health care insurance in the US. His ideas, it seems to me, will take bold vision and an ironclad commitment. While I agree with Kresser on the long term cost benefits of his approach, I can’t imagine it will be an easy sell to private insurance companies and hospital administrators. The Cleveland Clinic is a crown jewel of American medicine, but it is hardly representative of the health care infrastructure that most of us rely on.
A national health care program, it seems to me, will have to be put in place before integrated and functional health care will get a fair hearing. Kresser notes that “Two-thirds of medical research is sponsored by pharmaceutical companies…” “Reimbursement-based medicine,” as he calls it, will not go down without a fight. And when there is so much money involved, we can expect it will be bloody.
My other concern is a general concern about dogma itself. The Greek philosopher, Pyrrho of Elis, the founder of the philosophical school of skepticism, noted that once ideas become dogma they tend to become vulnerable to the same lack of conceptual adaptability that made change so necessary to begin with. I am not suggesting that Kresser has done that, but I cringed ever so slightly when he talked about the importance of decorating the waiting room properly.
All told, this is a very good book and I hope all that have read will help to spread the word. Our health really does depend on it.