Time for a new model?

As doctors we mostly support patients to cope with illness: to manage or minimise symptoms and to improve quality of life. This is hugely important but what about going beyond coping to curing?

Cure is almost a dirty word in medicine. As doctors we learn that chronic illness is just that, chronic. It will most likely last forever. Chronic pain patients are told, for example, that the best they can hope for is to be able to manage their pain. To even introduce the idea of cure gives false hope and is cruel. As a GP I ran a Hepatitis C clinic for a year and had the privilege of actually curing patients. It felt like a novelty.

Of course, there are patients whose life circumstances mean that coping is the best they can hope for but for many others, by not even discussing the possibility of cure, aren’t we depriving them of the opportunity of health and happiness?

Recovery from chronic pain, for example, isn’t just possible, it is, with the right tools, probable. Dr Howard Schubiner (Director of the Mind-Body Medicine Centre in Michigan) and colleagues showed in the Bolder Back Pain Study 2021 (https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2784694) that 2/3 of patients with low back pain were pain free following an 8-week Mind Body intervention and this was sustained at one year follow up. Two thirds. That’s a lot of patients.

Dr Jeff Rediger’s wonderful book Cured, based on thousands of case studies of patient’s who recovered from terminal illness, looks at the mind body connection and the science of healing. He presents compelling evidence of patients who recovered, despite dire predictions from doctors. Now that I’ve seen it, I can’t unsee it. Huge numbers of patients are embarking on extraordinary healing journeys, often leading to recovery, and leaving us doctors for dust. The coping model is powerful, but it isn’t enough. Can we learn from our patients and open ourselves to the enormous potential of a new model- the curing model? How much more satisfying is this model for doctors? How liberating is it for patients? We can never promise a cure, of course not. But we can follow the science, which tells us that is it possible.