What Does Your Doctor/NP Believe In?

The other day I was speaking with an ER doctor about a client of mine who was having chest pains.  My client is a caregiver for her husband.  His illness occurred suddenly and my client spent the first three months trying to get what her husband needed.  She was over the top with stress.

I was getting the update on her condition and said she had been under much stress with her husband’s medical situation.  The ER doctor proceeded to tell me that she did not believe that stress had anything to with heart disease or acute problems.  I have to say, I was taken back.   I asked her what she meant.  She said the research doesn’t show a strong link between stress and heart problems so she didn’t believe in it.

I wasn’t going to argue with her on the phone as I was more concerned my client’s well being.  I hung up and thought is this for real?  Is this the way of evidence based medicine or is it this one person’s belief being imposed on a patient?

As it turns out, there are a variety of ideas and research on the relationship between stress and heart problems.  This month, there was a study released in The Journal of Cardiology, stating that veterans with PTSD are more likely to have heart disease progress faster than their peers without PTSD.

In the October 2007, Archives of Internal Medicine, a study of 9,000 civil servants in London for 12 years found that people who experienced negative close relationships – marked by conflict and fighting – had a 34% higher risk of coronary artery disease.  According to the authors,” the emotions that play out in a bad marriage can have a direct, cumulative wear and tear on the organs and tissues”.

Studies have shown that traumatic events like the death of a loved one causes the fright or flight response in the body and the release of adrenaline and cortisol.  This action impacts the heart directly.  It can cause increased blood pressure, irregular heart beat, increased cholesterol, and a decreased immune system.

Maybe some doctors don’t want to believe in stress as a part of the heart disease picture because it means you have to ask about a person’s life.  And with stress, there may not be an immediate solution.  However, the stress factor cannot be ignored as playing a role because if it is, you are only applying bandaids as a solution.

I guess my shock with the ER doctor was that she actually believed stress didn’t play a role in heart disease.  Besides the actual research proving her wrong, she dismissed it like it was  nonsense. It was a clear example of a doctor’s believe system trumping science.

We like to think science is objective.  It is the interpretation of the data that is subjective.  The problem is we as consumers never know when that subjectivity is being applied to us.  Where else does this subjectivity come in to play in healthcare?  For this reason, being an empowered patient is important for your own well being and safety.