by Dr.Harald Wiesendanger– Klartext
What the mainstream media is hiding
Much of what is considered unscientific, bothersome, or detrimental to business in our ailing healthcare system actually deserves our sympathy. Individual cases and home remedies, medical intuition and compassion, the body’s self-healing power, and prevention all share the same flaw: they disrupt a system in which people become mere cases and health is reduced to an unprofitable nuisance.
An individual case is to statistics what a drowning victim is to the average water depth: a negligible deviation from the reassuring mean—one that’s best to just swim past. On average, after all, the water only reached the hips—the fact that it went over one’s head in one spot is statistically insignificant and, in hindsight, difficult to explain to the drowning victim. That’s how comforting aggregation is: it smooths every catastrophe into a footnote, as long as you mix it in with enough unharmed people. The individual patient disrupts this beautiful order because he has the audacity to experience his suffering in its entirety and not just proportionally—it is of little comfort to him that the side effect occurs in only three out of a hundred, if he is one of those three. For him, the probability is then not three percent, but one hundred.
To some doctors, a second opinion is like a second marriage: theoretically legitimate, yet personally hurtful—and with the unpleasant implication that someone thought the first one left room for improvement. Those who ask further questions are seen as distrustful—and distrust is considered a crime of lèse-majesté in the doctor’s office.
The body’s self-healing power has a reputation just as dismal as that of a do-it-yourselfer at a contractor’s shop: it does the work on its own, doesn’t ask for a cost estimate, and absolutely refuses to be billed. The real affront is that it has already performed its services while the bureaucracy is still reviewing whether the treatment is even eligible for approval—the fracture heals before the application is decided, the cold is gone before the prescription is filled. This makes it unfair competition within the system itself: where a proper procedure requires a diagnosis, medication, and a follow-up appointment, the body quietly goes about its business and heals on its own, without even acknowledging the value chain.
The placebo effect is like an extra in a play who outshines the lead actor night after night, delivering a resounding slap in the face to the spirit of materialism. Officially, it’s treated as a confounding factor—the “noise” that’s filtered out of every proper study; unofficially, it’s the secret director who helps every genuine active ingredient make its debut. Officially, it’s treated as a confounding factor, the “noise” that’s filtered out of every rigorous study; unofficially, it’s the secret director who helps every genuine active ingredient make its debut. It is treated like an unpaid intern who carries half the show yet isn’t listed in any program: free of charge, with few side effects—and, unfortunately, not patentable, which is why no one will ever write it a leading role. (1)
Medical intuition is viewed with suspicion because it is based on just thirty years of experience rather than a twelve-week study involving a few dozen medical students. An experienced doctor’s gut feeling is like a veteran detective at police headquarters: it has long since identified the culprit, while the software is still searching for an update and, following official guidelines, recommends suspecting every passerby at first. People don’t trust that feeling because it can’t be cited: it has no footnote, no case number, no p-value—yet all too often, it’s right.
The whole human being constantly crosses the boundaries of specialized departments without a valid referral. This is held against them: a back that weighs on the soul, a stomach that knows fear, a heart that not only pumps but also breaks—all of these are unreasonable demands for a system that is neatly organized by organ and has no department designated to handle the reality that “everything is connected.” The patient who gets by with a single ailment is the exception; the real human being drags his bundle of ailments from door to door and is politely turned away everywhere, because the crux of the matter always lies just beyond the boundary of each specialty. And so he wanders through the hospitals as an eternal border-crosser, professionally trimmed down to his specific segment by every specialist and, in the end, hastily patched back together in the coding process—namely, where five diagnoses finally become a billable whole. For the whole person certainly exists within the system, but only in one place: on the bill.
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Alternative practitioners are about as welcome in the medical establishment as vegetarians are at a butchers’ guild meeting. As long as they can’t be completely shut out, they’d better sit at a different table. Their mere presence is seen as a provocation: here’s someone treating patients without years of study, without the protective license to practice, without the faculty’s blessing—and yet patients still come, some even returning. A scandal that can only be explained by the fact that they don’t have the faintest clue about “evidence-based medicine.” Particularly annoying is the vast amount of time he takes: a whole hour for a consultation that any cost controller would recognize as a complete waste. He is therefore met with all the condescension of professional quality management.
Deviating from the guidelines is like parking illegally: Even if it makes sense in a specific case, you need a damn good reason—and you have to expect that afterward, someone with the rulebook under their arm will issue a ticket, regardless of whether anyone is still alive at the destination. Because a guideline is always right, even posthumously if necessary: If the patient dies according to the rules, it was fate; if he survives against the rules, it was luck—and both must be documented. The art of the perfectly socialized doctor therefore lies in, when in doubt, erring on the side of compliance rather than acting on one’s own authority to do what’s right. For the collective bears responsibility for a correctly followed wrong path, while the doctor alone bears responsibility for a solitary correct decision.
Home remedies are the natural enemy of the pharmaceutical industry: they can’t be patented, they’re unprofitable, and for generations they’ve been incredibly hard to eradicate. Its greatest offense: It’s already sitting in the kitchen cabinet before health insurance can approve anything, and it works with utter audacity without having gone through a clinical trial first. Where a proper medication painstakingly requires an active ingredient, a sales representative, and an indication, a home remedy needs only a grandmother as the study director and the kitchen as the regulatory agency. People bravely combat it with the verdict “not scientifically proven”—which is true insofar as no one will ever shell out money to test the onion sack on the ear in a Phase III trial. And if the day were to come when chamomile tea could be patented and reimbursed at eight times the standard rate, it would be the very same day that it would be considered an evidence-based first-line therapy overnight.
Affection is a drug without approval, a patent, or pharmaceutical representatives—and it’s dosed just as carelessly. Its package insert could be just one line long: “Side effect: The patient feels better, without it being clear what was billed for.” That’s exactly what makes it suspicious: A remedy that works but leaves no bill defies all business logic. There is no code in the catalog for the active ingredient “five minutes of genuine interest.” Furthermore, “attention” is the only medication whose effect increases with the amount administered; yet it is consistently underdosed.
The business-damaging assumption that the body might be able to resolve a problem without paid medical supervision tempts people to adopt a “wait-and-see” approach. In the medical industry, this approach has the same reputation as a waiter advising guests that they’d be better off eating at home. “Watchful waiting” may sound like a strategy, but it essentially boils down to the outrageous suspicion that nature knows what it’s doing—a scandalous idea in a system that pays for intervention but nothing for watching. Health without treatment is and always will be the natural enemy of any performance-based compensation.
A patient’s experience is treated like a witness statement without a stamp: personally experienced, and therefore scientifically suspect. What the patient feels in their own body counts for less than what the scale shows—the witness is biased, the measuring device is not. Yet human medicine deals with subjects, of all things. How could it not care about the subjective?
A detailed conversation is considered a luxury: medically beneficial, but economically hard to swallow—and, with billing by the minute, about as likely to happen as a coffee break during piecework. Those who listen aren’t producing anything that can be coded. They’re just wasting time—and in return, they sometimes arrive at a diagnosis that others would need three referrals to reach.
.Asking about a patient’s personal circumstances can sometimes feel like a private digression from the actual topic at hand in a doctor’s office: the patient’s lab results. Whether someone lives alone, works night shifts, is being bullied, or hasn’t been able to laugh since his wife’s death—it may be interesting, but it’s not relevant to billing. The idea that life, of all things, might have anything to do with the illness seems like a romantic notion.
Looking for causes is like exposing the foundation: time-consuming, messy—and dangerous for anyone who makes a living by regularly covering things up. The symptom, on the other hand, is the ideal customer: it reliably returns as soon as the last layer of cover-up peels away.
Deprescribing is the art of weaning a patient off medications that he or she has come to rely on to cope with the side effects of other medications. Stopping treatment takes time and courage; prescribing it takes nothing more than a pen.
In some treatment plans, quality of life is like the view from a hotel room: nice, if it’s good—but all that was booked was the bed. The patient no longer sleeps, no longer loves, and can barely make it up the stairs? It doesn’t matter—the main thing is that his blood test results are now in exemplary shape.
Prevention is highly regarded in the medical field—but only as long as there’s money to be made from it. That’s why profitable prevention is celebrated with such fervor—vaccinations, preventive colonoscopies, annual screenings, anything that can be quantified—while the free alternative is met with a telling silence: The fact that someone eats sensibly, exercises, gets enough sleep, and avoids cigarettes may be commendable, but there’s no way to bill for it, and where there’s nothing to bill for, a medically suspicious silence reigns. Most unsettling of all, however, is perfect prevention, for it destroys its own evidence: Those who prevent a disease can never prove that they have prevented it—after all, you don’t thank a doctor for the heart attack you didn’t have. Thus, prevention remains the only craft whose highest achievement lies in making itself obsolete. This is why it becomes the nightmare of health economics: a disease that never develops in the first place represents lost revenue from a business perspective.
The patient who thinks for himself is practically overstepping his bounds: after all, his body is merely the site of treatment, not his responsibility. He is supposed to be the object, not have a say—the case belongs to the file, not to the person carrying it around. Anyone who asks too many questions is quickly considered to be in the wrong mindset—not regarding his medication, but regarding the system.
In the healthcare market, a patient who has recovered has the same appeal as a subscriber who cancels on time: proper, ungrateful, without a guilty conscience—and, from a sales perspective, a total loss. The chronically ill patient, on the other hand, is the actual business model: the loyal regular customer with a standing order who reliably returns at the start of each quarter, often with a lifetime contract. The ideal scenario, therefore, is not the one who never returns, but the one who keeps coming back: not healthy, not dead, but reliably in need of treatment—a walking subscription that kindly leaves its cancellation to the event of death.
All these troublemakers share the same fundamental flaw: they serve the patient, not the system. A healthcare system that views them as saboteurs may simply have forgotten whose health it is actually supposed to manage. That is why they are so likable: they tenaciously remind us of the one purpose that the system has most thoroughly rationalized away—that, in the end, someone is supposed to get well.
(1) For more on the placebo effect, see Harald Wiesendanger, *Spiritual Healing for a New Era—From “Miracle Healing” to Holistic Medicine* (Kösel, Munich, 1999; 2nd ed., 2005), pp. 203–214; ibid.: *AUSWEGE – Helping the Sick in a Different Way*, Schönbrunn 2015, pp. 52–59: “Do You Have to Believe in It? The Unspeakable Placebo Argument.”