Peter Zafirides
Physician
Hi Everyone! I recently posted the following response to a question asked of me at the TMSHelp forum. I thought I would share my answer to the question with you:
Q: (Stryder) "Curious about your opinion on something, why the medical complex is not doing oodles of clinical trials and studies on TMS ? Is it because there is no 'product' to back the study ? Do you think it really does come down to making more dollars with physical treatments ?"
A: (Dr. Z) This is a very complex question to answer fully, but I will do my best.
First off, we must realize the realities of western medicine today. In my opinion, we have veered terribly off track with such attention to symptom-based treatment. The proliferation of specialized medicine - while critical in health care - has tended to lose sight of the person as a human being. We see that changing because the marketplace of patients is demanding it. Holistic and integrated medical centers are growing everywhere - and for good reason. People are people, not symptoms.
For example, when I see a person for depression, I may write them for an antidepressant. But I take the time to educate them on how they should understand the medication's role in their health. The meds play the part of reducing the "noise", if you will, that is cause by the depression or anxiety. How a person progresses in their life after that has happened is all their responsibility. THEY are making themselves better, not the pill. The medication may get some of the "noise" out of the way, but it should ALWAYS be seen as a very small part - and NEVER the whole - of the treatment.
I tell people they WILL be better. I tell them they should EXPECT to get better. I tell them it is part MY FAULT if they do not feel better and that I will will work with them to get them to health. I don't say this to give a person false hope or to patronize them. I TRULY BELIEVE THIS. People are simply that powerful. They really are, they just don't believe it or they doubt themselves. Part - perhaps the most important part - of what all of should do as physicians is to empower our patients and have them truly understand the capacity they have to improve their health on their own. No one should ever feel that the only reason they feel better is because of a medication - or because of a doctor. It just simply isn' the case at all.
People get healthy - and stay healthy - because they believe in themselves and are active participants in their lives. We seem to have forgotten that as physicians today. We have relegated people to their symptoms - the depressed patient, the back pain patient, the hypothyroid patient - rather than understanding them as a whole human being. It is a sad irony today. We have the best technologies, the brightest minds in medicine, the brightest minds in research - and we still have unbelievably high levels of illness (cardiovascular disease, cancer, diabetes, depression, chronic pain etc) in this country.
Something is wrong.
There are very real financial influences in the medical industrial complex as it exists today. Don't get me wrong, I am a believer in the free market. That said, we must understand that money will also drive the advances that come in medicine today. It is simply a fact. I am not sure how you create an incentive to take risk of researching medical advances - and shouldering the risk of failure - without an incentive to be rewarded for your work. I think we can all agree upon this basic premise. But with TMS - and its treatments - vast amounts of money CAN BE SAVED. I think this will be the main platform for advocacy within the PPDA and TMS movement going forward. Those that control the purse-strings will listen when you can convincingly show them it is in their best interest, financially, to listen.
But how do you get them to listen? PROOF.
One of the most important aspects of any treatment gaining acceptance is evidence of efficacy. All of us here DEEPLY believe in both TMS and its treatment. But that is simply NOT enough for mainstream acceptance as a valid treatment. I think that is a reasonable standard though. Just because WE believe TMS exists and its treatment works does not necessarily mean TMS actually exists and its treatment work for everyone. This is not a criticism of TMS, we just need to be aware of our bias. We must continue to produce research and evidence for the treatment of TMS for it to gain traction in the medical community at large. Advocacy can only take you so far. I am not saying this to be defeatist. On the contrary actually. To those who believe in TMS, we can offer individuals great hope and profound relief. I am simply talking about why we don't see this talked about in medical schools, residencies (except at OSU where I finally have secured a lecture course on emotions/pain/TMS) and in the doctor's office.
We need evidence. With evidence, we gain traction and acceptance. This is why I advocate and support Dr. Howard Schubiner as much as I do. He has clinical proof of improvement - via his research - in the pain of Fibromyalgia by using the treament methods outlined in his book "Unlearn Your Pain". In my opinion, Dr. Schubiner is the embodiment of the next generation of TMS progress, with the additional clinical PROOF of treatment via his published research in peer-reviewed, medical journals. He also has been give a multi-million dollar grant to research his treatment method further. Clearly, the people with the purse-strings are listening. They see the potential - even if it is simply in terms of in cost savings - within health care.
So these are some of the challenges. Patients and doctors need proof to have their minds - and actions - change. Even with proof, a change in treatment doesn't always follow. Habits and preconceived understanding is hard to extinguish. The Truth is not always enough.
So we pick our battles. We advocate as best we can and treat those who dare to take a look at their pain a little differently. Every day we progress that much further. We put our thoughts out there. We set "brush fires" of TMS in the collective mind our culture and society. We do the all we can - the best that we can - with honor, respect and dignity.
One day, one of those brush fires will catch hold of the collective consciousness as it relates to TMS.
Of that, I really have no doubt....
-Peter
