22

From here:

Modern Western Medicine is all about chasing symptoms, rarely addressing causes...

and from here:

Western medicine misses the point and attacks symptoms, not root causes

Western medicine focuses on the symptoms. [...] Very rarely does Western medicine (allopathic medicine) actually seek or treat the root cause of disease.

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    Some does, some doesn't. Pain-killers for example address symptoms, whereas antibiotics attempt to address a certain class of root causes. – GordonM Dec 13 '17 at 13:05
  • Consider that the cornerstone of conventional homeopathic medicine (the antithesis of "allopathic" medicine) is to treat a disease by dosing the patient with drugs that would create the same symptoms if they weren't highly diluted. – Daniel R Hicks Dec 14 '17 at 01:06
  • I'm sorry, if you can't readily find the mountains, no, whole comet-sized bodies of evidence to support the claim that "conventional" medicine does indeed "address the causes" of disease that "conventional medicine" beats you in the face with every day... Nothing I can say can change your mind. – Ernie Dec 15 '17 at 17:35

3 Answers3

71

I assume by conventional medicine, you mean medicine.

Here are examples of medicine treating more than symptoms, but actually treating the underlying causes or preventing the disease/illness/addiction/etc. altogether:

  • Antibiotics kill the bacteria causing the infection; they don't just stop your cough.
  • In the case of recurrent infections (urinary tract infections, for example), medicine considers the underlying causes and recommends lifestyle and diet changes.
  • Orthopaedic surgery fixes the broken bone or soft tissue; it doesn't just take the pain away.
  • Sports medicine necessarily considers the sports-related causes of morbidity to help the athlete maintain fitness, return to activity, and avoid recurrent injury.
  • Preventive medicine includes public policy decisions to help lessen abuse of alcohol, drugs, or tobacco, to increase food safety, and to decrease malnutrition, among other things.
  • Vaccines are given to a healthy body with no symptoms making it immune or more resistant to specific diseases.
rjzii
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    A proponent of the theory, that conventional medicine doesn't address root causes or treat the whole person, might answer your first example with, "Yes but why do you get a bacterial infection in the first place?", and then suggest treatment to 'boost your immune system' etc. – ChrisW Aug 12 '13 at 08:18
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    @ChrisW True? A Western medicine doctor would also start wondering why a patient gets frequent bacterial infections and assess for lifestyle issues like malnutrition, poor sleep, etc. Would you like me to add something to my answer? –  Aug 12 '13 at 08:25
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    I think that adding that would make your answer stronger, iff you find a reference confirming that is normal behaviour of [allopathic](http://en.wikipedia.org/wiki/Allopathic_medicine) doctors. – ChrisW Aug 12 '13 at 08:42
  • (See also for example [ugoren's recent 'answer'](http://skeptics.stackexchange.com/a/17322/2703) which implies some need for an answer to such criticism) – ChrisW Aug 12 '13 at 08:47
  • These examples may be valid, but they are not address the claim that western medicine only "rarely" addresses underlying causes. – Flimzy Aug 12 '13 at 19:11
  • @Flimzy. Mostly due to the preventive medicine example, I believe this answer does refute the "rarely" aspect of the claim. Western medicine is working right now to address underlying causes. And now. And still now. –  Aug 12 '13 at 20:22
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    Furthermore, there is a financial incentive to not cure people. Sick people with managed symptoms make good customers. How would you handle this counter-argument? – Randy Aug 13 '13 at 12:29
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    @Randy IMO Sancho isn't required to (and cannot) handle that hypothetical counter-argument. But instead, you could pose that argument as separate/new question, if you can find anyone who makes that argument as a 'notable claim'; or you can try to make that counter-argument yourself, as a new answer to this question, and then see how your answer/argument is received. – ChrisW Aug 14 '13 at 12:22
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    I have a fairly good idea how that answer/argument would be "received" and respectfully decline that invitation in favor of more productive things... like thrusting my head repeatedly into walls of varying densities and the like. Thanks for the suggestion just the same! – Randy Aug 14 '13 at 22:17
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    @Randy Are doctors not in competition where you live? Does nobody (Say, an insurance company) have a financial incentive to find a better doctor who actually cures you faster? – shieldfoss Aug 15 '13 at 09:50
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    @medivh Its the holistic's view that drs aren't to blame, but the drug companies with revenue larger than GDP of many countries, http://en.wikipedia.org/wiki/Pharmaceutical_industry#Industry_revenues vs http://en.wikipedia.org/wiki/List_of_countries_by_GDP_(nominal) and the whole medical est that wishes you to be "good customers". The drs themselves are ethical, possibly brainwashed, but ethical. Now don't attack me... that's just the claim they have. If you refute that claim then you have alternative medicine over a barrel. Until then, you're just wearing out your keyboard. – Randy Aug 15 '13 at 10:56
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    @medivh And in refuting the claim you can't use anything published or peer-review because then they'll say the peers are the same brainwashed pawns of the drug cartels who make large donations to universities in exchange for "favors", so the only "evidence" you're left with is anecdotal. Its a fight you can't win from either side and wise to just not get tangled in it unless you just want to throw-down for a while. In the end you'll want to pursue wall-density testing exercises. – Randy Aug 15 '13 at 11:05
  • @Randy Traditional Chinese Medicine doctors e.g. the first source referenced in the OP don't SFAIK blame drug companies; it's just that they have their own theories about the cause of health in a body (Chi, meridians, interactions between the organs, etc). And the criticism that a regular doctor (e.g. paid by the State) will talk to you for minutes about your 'presenting symptom', whereas an alternative practitioner (e.g. who you pay for privately) will talk about your life for hours, is also a normal criticism. Just saying that you can't paint the view of "all holistics" with the same brush. – ChrisW Aug 15 '13 at 11:07
  • randy and chris, [chat] –  Aug 15 '13 at 15:31
  • This is the highest voted answer on Skeptics where the OP has decided to accept a different, lesser-voted answer (as of June 2014). – Oddthinking Jun 09 '14 at 01:33
39

It's worth looking at the context of the quotes, to understand why they say that, and what they recommend instead.

The first citation is from an article which recommends acupuncture (and more generally "Doctors of Oriental Medicine and Acupuncture Physicians"). There seems to be some legitimate doubt about Acupuncture ... therefore (because it doesn't suggest an effective alternative) I would discount its (somewhat vague) criticism of western medicine (I would argue that anyone can be a critic, but the criticism is meaningless or not constructive unless there's a better alternative).

The second citation has exactly one concrete example of its thesis: which is, treating atherosclerosis using "heroic/interventionist" pharmaceuticals, instead of by "addressing the source of the problem: the patient's lifestyle". I'm not sure what source you consider a credible reference on the subject of Western medicine; there are many of them. I will choose the Mayo Clinic as an exemplar: the opening sentences/paragraph in the "Treatment and drugs" section of its atherosclerosis article says,

Lifestyle changes, such as eating a healthy diet and exercising, are often the best treatment for atherosclerosis. But sometimes, medication or surgical procedures may be recommended as well.

Its next section recommends Lifestyle and home remedies.

The claim is somewhat true, if [only if] you define "Western medicine" as "prescribing medications". In practice, Western doctors (perhaps especially "Family doctors" aka "General Practitioners") routinely do more than prescribe medications: for example they also talk with patients, ask them questions, and give lifestyle advice.

In summary, Western doctors /also/ prescribe medications: they don't /only/ prescribe medications.


The term "medicine", used in the OP, has two meanings:

med·i·cine
/ˈmedisən/
Noun
1. The science or practice of the diagnosis, treatment, and prevention of disease (in technical use often taken to exclude surgery).
2. A drug or other preparation used for the treatment or prevention of disease.

The claim is:

  • Untrue per the first meaning of the term (and IMO the first meaning is implied when it is spelled with a capital-M: "Western Medicine").
  • Truer per the second meaning of the term.

Wikipedia's General Practitioner article starts with:

A general practitioner (GP) is a medical practitioner who treats acute and chronic illnesses and provides preventive care and health education to patients. "The good GP will treat patients both as people and as a population".[1]

As a difference to medical or surgical specialized doctors they intend to practice a holistic approach that takes into consideration the biological, psychological and social environment in which patients live. Their duties are not confined to specific organs of the body, and they have particular skills in treating people with multiple health issues. They are trained to treat patients of any age and sex to levels of complexity that are defined by each country.

IMO this shows that the theory is false, at least according to the opinion of "Western Medicine" itself!

There is of course some difference between theory and practice. For example, the British What is a good GP? (from 1987) opens with,

Treating patients as people
It has been said that "though sometimes 'what is the illness' is the question dominating the doctor's task, 'who is ill' is what is usually crucial to patient care."' What this implies for good practice falls under the following four headings.
Assessing patients' problems realistically
Making a precise diagnosis is not always necessary or always sufficient. It is all too easy to focus on a disease process in one part of the body and to neglect the "owner" of the body and his or her physical, psychological, and social circumstances in their entirety. Unless these aspects are considered, not only may many factors that affect the aetiology and natural history of the disease and the choice and effectiveness of treatment go unnoticed, but so may the patient's real reasons for consulting the GP.

IMO this shows that Western Medicine isn't supposed to only treat symptoms, and that if (but only if) best practices like these are followed then it won't.

However it is (sometimes, or, often) less true in practice, for example because of time+money constraints (see for example rob's answer).

I expect that it is also less true of various Western medical specialists, for example, a surgeon, to whom a GP will refer you iff s/he thinks that's appropriate for you.

ChrisW
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  • "Western doctors routinely do more than prescribe medications..." is a statement that really depends upon where you live and how much time MDs actually spend with their patients. – rjzii Aug 12 '13 at 11:07
  • @rob -- I agree with you. My personal experience is limited: to a Canadian teaching hospital, a small-town French doctor, and (I hope) reputable but perhaps idealistic internet literature e.g. from the Mayo clinic. I hope I addressed the two specific sources in the OP, but perhaps those two were too easy to answer (strawman examples). Anecdotally I've read that an attraction/benefit of alternative practitioners is that they have/give more time for their patients. – ChrisW Aug 12 '13 at 11:21
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    I've seen some studies that note the same thing with regards to alternative medicine and tired to address that point in my answer. Patient perception is largely driven by how little time is spent with a doctor which is partly driven by the mechanism of delivery. – rjzii Aug 12 '13 at 12:13
3

This question can be looked at from two directions: what is supposed to be done and what is actually done.

With regards to general practice, medicine strives to actually identify the cause of the problem, i.e the etiology, and not the symptoms whenever possible. The "gold standard" practice is evidence-based which requires that there is strong scientific evidence for a given cause and course of treatment. An example of this would be a test for streptococcal pharyngitis when a patient presents with a sore throat and a prescription for antibiotics if the test comes back positive.

Another more detailed example of the link between "etiology" and "evidence-based medicine" can be found in Uncommon causes of cough: ACCP evidence-based clinical practice guidelines:

RESULTS:
A substantial number of uncommon or rare pulmonary and nonpulmonary disorders were identified. The uncommon occurrence of these diseases made it difficult to develop a meaningful evidence-based guideline to the diagnosis and therapy of many of the uncommon causes of cough. As cough was the major or presenting symptom, it was usually initially attributed to common respiratory diseases (eg, asthma or bronchitis). As a result, a substantial time lag existed from the onset of cough to the diagnosis of the etiologic entity. Diagnostic tests limited to the respiratory system did not always provide clues to the diagnosis of uncommon causes of cough.

And:

CONCLUSIONS:
Cough is the major or presenting symptom in many uncommon pulmonary and nonpulmonary disorders. A strong index of suspicion is essential to consider and diagnose the uncommon causes of cough. The diagnosis and management of cough in patients with uncommon causes of cough is dependent on the underlying etiology.

Note that the first quote shows that, in practice, some practitioners did initially fail to diagnose the underlying cause. The second quote shows that diagnosing (and then treating) the underlying cause is a 'best practice': the ambition or goal, even though practitioners sometimes fail to.

Notwithstanding, there are situations where symptomatic treatment may be appropriate due to a variety of reasons which means that there are cases where only the symptoms may be treated while the underlying root cause is not. For example, the cause of major depression is not known so treatment is necessary focused on the symptoms rather than the root cause. Likewise, hospice care decisions might focus solely on the symptoms of an illness as opposed to the actual treatment of it.

From the perspective of what is actually done, this claim may come about due to the fact that the opinions that many people hold with regards to medical practice are closely tied to how it is delivered to the patients, e.g. managed care in the United States, National Health Service in the United Kingdom, and so forth. In these systems, one of the most common complaints about the practice of medicine is that doctors don't spend much time with their patients and nor do interns. Indeed, studies have shown that the time spent with the patient is tied to prescription rates and malpractice rates as well as patient satisfaction with their care.

Patient satisfaction is important since patient perceptions can drive the placebo effect as well as recovery time for treatments. Given that whether or not a doctor stands or sits during a conversation can affect patient satisfaction so it can be argued that less time being spent with the patient could cause the perception that doctors are merely treating the symptoms as well. In fact, the time patients spend during homeopathic consultations drives part of the patients attitudes towards its efficacy:

It has been suggested that homeopathy appeals to patients who like the feeling that attention is being paid to more aspects of themselves than just the symptoms (English, 1986). In a survey of 161 CAM practitioners cared out by White et al. (1997) it was found that the mean time spent with patients for a first consultation was 75 minutes (Acupuncture), 90 minutes (Homeopathy) and 40 minutes (Chiropractic). Subsequent consultations were between a third and a half less. There is substantial interpractice variation in consultation length of allopathic GPs in the Uk, from a mean of 5.7 minutes to one of 8.5 minutes (Carr-hill et al., 1998).

So to summarize, in general medical practices strive to treat the etiology of a problem as opposed to the symptoms where possible when practical. In terms of actual practice, there is some very mild support for the claim since patients might perceive that practitioners are engaged in the treatment of the symptoms alone.

ChrisW
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rjzii
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  • While this is true, I think it misunderstands a part of the claim against "Western Medicine", which could be rephrased: part of what you treat as primary "causes" are actually "symptoms" which have another cause. Common "underlying causes" are assumed to be stress and various forms of nutrition defects. The claim is reducing stress or fixing the nutrition defects can have more positive benefits for the patient health than treating individual outbreaks of various illnesses. There seems to be a serious medical research in this area: http://en.wikipedia.org/wiki/Psychoneuroimmunology – Suma Aug 12 '13 at 12:35
  • @Suma I suspect the question is actually a lot deeper than the person who asked it might have originally intended. :) Your point about psychoneuroimmunology is very true though. In many ways the lifestyle of a patient likely has more to do with why they are getting sick in the first place than the fact that they might have a given illness. – rjzii Aug 12 '13 at 12:40