One of the main differences between Western and Eastern medicine is the holistic approach of the latter. While in the Western world, we often regard the patient as a mere object of a disease, in the East, doctors tend to take into account the patient’s body, spirit, and mind.
Luckily, things are slowly changing, and in recent years, Western medicine has started to adopt a more holistic focus, prioritizing a patient-centered approach rather than an illness-centered one.
One of the ways to keep pushing for this change is by improving the relationship between doctor and patient. But how can we do this?
Understanding The ‘Why’
Dr. Neinstein, the founder of Neinstein Plastic Surgery, expresses concern over the emphasis many doctors place on the method of treatment rather than the underlying cause, particularly in relation to certain diseases. He highlights this issue in the context of eating disorders. Dr. Neinstein points out that while therapy is commonly integrated into the treatment for some types of eating disorders, surprisingly, it’s frequently overlooked in others. This discrepancy underscores the need for a more comprehensive and cohesive approach to healthcare.
The UK’s biggest health website, nhs.uk, with over 50 million visits per month, only mentions therapy when discussing certain diseases connected to our diet. While on the page dedicated to anorexia, the website states that the aim of treatments is to “to help you understand the causes of your eating problems”, mentioning treatments such as focal psychodynamic therapy, family therapy, and cognitive behavioral therapy, its obesity page is mainly focused on diet and exercise, completely ignoring the psychological side of this disease.
The importance of focusing on the patient rather than the illness was already stressed in 1964 by psychoanalyst Micheal Balint. Mr. Balint emphasized the need to center modern medicine on the patient’s complaints “Not only in terms of illnesses but also as expressions of the patient’s unique individuality, his conflicts, and problems”(Kaba, 2007).
Dr. Neinstein does this by understanding the patients’ ‘why.’ According to him, this is a fundamental step to avoid focusing merely on the illness itself but rather on the patient, providing better treatment. “Each patient has a life story, and when they come to see me, they are typically at a point in the story arc where they have something to overcome. In fairy tales, it’s slaying a dragon to proceed, but in our office, it’s the post-baby changes or changes from weight loss that they are battling with and want to become the victorious hero,” said Dr. Neinstein. “By understanding their ‘why’ not just the ‘how,’ we can truly create a surgical plan that allows them to control the next chapter of the story.”
A Collaborative Journey
Dr. Neinstein also stresses the importance of taking a collaborative approach rather than establishing a power dynamic in which the doctor has full power when it comes to decision-making processes. Several academic papers have proven how patient participation is positively correlated to improved health outcomes (Longtin, 2010; Arnetz, 2014). In order to achieve this, researchers suggest that doctors “May need to learn to be humble, relinquish (their) role as experts (Marincowitz, 2014).”
“It’s important to understand someone before asking them to understand you,” said Dr. Neinstein. This surgeon firmly believes that the body is a vehicle for the mind, playing an active role in shaping our thoughts and experiences. As such, he thinks that plastic surgery has the role of bringing harmony between the body and the mind, a journey that “Can only be done collaboratively as it requires deep probing questions to elicit true fears, feelings, and desires.”
Prioritizing the Sense of Community
Improving the patient-doctor relationship is only one of the many ways to shift towards a more patient-centered, holistic approach. Dr. Neinstein believes that a good relationship between surgeon and patient is often not enough to create that sense of community needed by the patient to approach each operation with ease. This is why he often builds connections between current and past patients who went through the same type of surgery.
This is fundamental as it not only allows patients to talk to someone who had to face similar struggles and fears, but it also helps them create honest conversations around difficult subjects, supporting them in their decision-making processes without the judgment they may otherwise face in other settings.
“One of the unique aspects of our practice is our lifelong connection to our patients; this helps us truly create a community,” said Dr. Neinstein. “Surgery with our practice helped like-minded, driven, family-oriented people find each other and became a platform for social engagement.”
