Humanized Medicine to Reduce Medications with Dr Maria

Dr Jedha, Host 00:55

Hello wonderful people, and welcome to Episode 27. Not so long ago, we covered some really important discussions around medications over a series of four podcasts in our Medication March series, and in the last episode of this series we covered deprescribing medications, and across the series we talked about how doctors primarily prescribe medications and how they often hesitate and they’re not supporting the deprescribing of medications. But that’s not the case for all doctors. That’s why I’m excited to bring on a very special guest today, a medical doctor with a passion for not only medicine but healing and wellness, and we’re going to talk about humanized medicine to reduce medications. So please welcome to Type 2 Diabetes Talk, Dr Maria Colón-González, or, as most people call her, Dr Maria. Welcome, Dr Maria.

Dr Maria, Guest 01:57

Thank you, Dr Jedha, thank you for having me here in the show and I love that you say and not all physicians are only about prescribing, but yes, medication deprescribing doesn’t happen a lot, unfortunately, in medicine.

Dr Jedha, Host 02:14

Exactly, and that’s what our conversation is all going to be about today. So Dr Maria has an impressive background. As I said, she is a qualified medical doctor, but we don’t get too many medical doctors with multiple qualifications in other areas of health and lifestyle, and Dr Maria is also qualified in lifestyle and integrative medicine, along with having education and an understanding of nutrition and culinary medicine and being a yoga instructor, acupuncturist and heart math practitioner. That’s a long list of qualifications, Dr Maria. Where did your passion for this comprehensive kind of healthcare come from?

Dr Maria, Guest 02:58

Growing up I was a sick child. I had asthma. I was hospitalized multiple times. I also had problems with my blood sugar level, but as a teenager I also started to have chronic back pain. So I was a child growing up with, like these, three conditions that are considered chronic.

03:20

As I grew up, I really had to learn how to take care of myself. What I discovered was that a lot of the things that would really keep me healthy unfortunately was not going to my doctor or to my pediatrician getting my medications refilled. A lot of what really helped me was changing my nutrition. With my back pain I had an MRI as a teenager. That doesn’t happen a lot.

03:52

I was not getting better with the traditional physical therapy. Eventually the doctor told my dad well, we need to consider surgery in her. My dad was like no, I really had to learn and read on my own and study on my own how I’m going to be healthy, versus living how I started life, which was from doctor to doctor in the hospital with my asthma exacerbations. Then, when I went into college, I was a group fitness instructor all the way until my second year of medical school, or maybe all the way until my fourth year of medical school. It’s probably like 10 years that I was already in the health and wellness industry by itself, before even medicine. In my own experience and working with people, what I have realized is that we cannot address only symptoms, we cannot address only numbers, the metrics, because that doesn’t necessarily mean that people are feeling good in their bodies.

Dr Jedha, Host 05:00

What an interesting journey, this has all happened too at a very young age and a very traumatic experience. Like you say multiple chronic illnesses, the asthma, the blood sugar issues and the back pain, someone even suggesting so early on in your life that you have to have back pain surgery as the only solution for your pain. That’s crazy, but this is similar to what we see in diabetes or lots of other health conditions. It’s just that the medical model it’s like push that medical model that there’s no other solution, and it’s not until people look outside that medical model themselves that they can begin to discover that there are. That’s obviously what Type 2 Diabetes Talk is all about too. Dr Maria, you frequently use a term that I really love, and that is humanized medicine. What I’ve seen from you is that humanized medicine is the basis, the core of your kind of practice. Can you please tell us what is humanized medicine, because I don’t think many people would have heard that term before.

Dr Maria, Guest 06:04

So humanized medicine. Where did this concept came from? Well, I think about both for the patients as well as for the physician. We are so focused on the science, the metrics, the numbers, the achieving, the results, because, at least in the US healthcare system, if you are getting paid by the insurance, that’s how you’re going to get paid, but you might be categorized as a better doctor than the other based on all those numbers and metrics. But again, the reality is that that one doesn’t mean that there is a therapeutic relationship with your physician or that you have trust. That doesn’t mean that maybe your blood pressure numbers and your A1C and your cholesterol, all of that is improving, but maybe you’re still not feeling good in your body. It may be you don’t have a diagnosis of like depression or anxiety that requires treatment, but still your emotional well-being, you’re still living in sympathetic rather than in parasympathetic. And most of all, then I think that this is very true for the Western culture is this we’re very focused on the doing, the task, the actions, the achieving, but then there’s no connection with being who you are.

07:36

So I used to be in academic medicine and I remember I was in this meeting with two other chairs of the department. This was like my first job out of residency and we were putting together a module and some stuff for the medical students and I was, like you know, I think that one of the things that they should be asking their standardized patients is like, what are your goals and life and what are your dreams? What do you want to achieve? And the chair of the department was like why do they need to ask them that they don’t need to do that, like you know, like there is no purpose, because medicine should be an art. It should be, you know, more of a healing. We make it more of a science and we’re trying to fix the machine and the symptoms and the numbers.

08:22

So for me, humanized medicine is I want my patients, yes, to not have the symptoms and, yes, I want to see their numbers improve and their outcomes improve. But I want them to be able to do that because I want them to enjoy life, I want them to be able to be present in life, I want them to be able to experience life in a calm state and I don’t want to rush in an appointment without being able to connect with my patients and their story of who they are, because a lot of the time you know what’s going on in our lives, all of our lives, is really affecting our health. Then sometimes we just focus on, like the microcosm and we forget about seeing like, that big picture.

Dr Jedha, Host 09:18

Yeah, it’s such an important thing. I really love it because it really seems the way that all doctors should be providing care, because, say, when we look at the medical care guidelines in diabetes, for example, some of the core values there that they always talk about person-centered care but we’re just not seeing that actually translated into the medical environment, into proper care for many people. I hear these stories all the time that they just get talked at and they’re not listened to or they feel misunderstood and unsupported. And something that you really touched on there was that therapeutic relationship and also that rush that most medical environments are in, like the very short appointments and they’re focusing on those numbers and not those therapeutic relationships and building that trust with people, whereas your humanized approach is developing that therapeutic relationship, building that trust with people, putting the person first, seeing them more than just I’m here to fix your numbers and, yeah, you’re more than your disease and looking at, yes, the physical needs, but the emotional needs, the spiritual needs and the person’s goals.

Dr Maria, Guest 10:33

Yes, absolutely, absolutely. And not only the person’s health goals, but how are those attached to overall their goals in life, where they’re going in their life?

Dr Jedha, Host 10:45

Yeah. So getting down to another thing, like a lot of people with prediabetes or type 2 diabetes don’t know that they do not need to be on medications for life because, again, they’re taken down this systematic route, down the medication pathway as a dominant form of treatment, and I talked about this across our Medication March series, episodes 15 to 18. But we’re here with Dr Maria, so let’s get this straight from a practicing doctor. As a medical doctor, once you start taking medication, do you have to keep taking the medication forever? And I’m not just maybe referring to the glucose or meds, because people are often on multiple medications for cholesterol and blood pressure as well, for example.

Dr Maria, Guest 11:31

Yes. So you know, my simple answer is no. I have had patients that ask me that and I tell them no, you don’t have to take them for life. I think that, that you know there’s like these two tensions that happen. So one is yes, patients do not need to take, you know, medications for a lot of the chronic medical conditions that we see nowadays for life. And in order for them to achieve that, the type of care that they would see from the traditional health care system, right as it is, it’s not for that, not to support a patient whose goal that might be. I think that there’s that tension between some patients wanting that but then a system that does not support that. I think that also, then there is the role that a physician maybe wants to play in order to sustain that, but really then the physician again in the system is not supported to do that. When what you have is 10 minutes or less with a patient, you cannot support that. 

12:48

Then you have the factor of, I’m going to say noise. The reason that I’m going to choose noise is because there’s the media. In the media, all of these commercials that you might see related to certain drugs or certain pharma, the media that might promote a certain lifestyle that really does not support health. Then you have the noise and the confusion, because then you have certain influencers that might be telling patients to do certain things. They’re not necessarily qualified professionals.

13:25

I’m talking about influencers that are there in social media that have no training and education at all. That might be confusing patients, because then somebody tells them one thing and then the other tells them the other. Then, finally, the noise that the family members and what they have seen in their families of, well, everybody in my family has trigger problems and everybody takes their medication. I guess that is just a family thing. I have to live with it and accept it. I think that those are all tensions that then come into play that for somebody to get that really, really, really wants that to be their goal, then they have to be so supported and have a lot of accountability and direction in order to achieve that.

Dr Jedha, Host 14:13

Yeah, really great points. Just to emphasize for our listeners that Dr Maria did say that no, you do not have to be on your medications for life, but, like we talk about a lot on Type 2 Diabetes Talk, in order to do that, you do have to be proactive and take control of your own health, as we spoke about a lot in the Medication March series. Be the boss of your own medicines and have conversations with your doctor. I’m so glad that Dr Maria brought up some of the things we talk about a lot.

14:47

I love what she called it noise. I call it the misinformation, the Wild West Web. I call it because it’s just crazy out there and, like you’ve pointed out again, so much of the information that people receive isn’t from qualified professionals who have experience. The media as well, the news headlines I talk about that a lot. There’s so many barriers, which is why it’s really important to find trusted and reliable sources, such as we provide here on Type 2 Diabetes Talk, and it’s great to have Dr Maria in here having a chat about exactly the same things I do as supporting the same perspectives. So why do you consider it important, from your perspective, to reduce or minimize meds?

Dr Maria, Guest 15:32

A couple of reasons. One is my experience has been especially for patients that continue in that cycle. By the time they’re like mid-50s, 60s, then they have a medication list of 9 to 13 medications, polypharmacy, and that creates an entire new level and layer of like I’m going to call it masks to be able to then, you know, treat that patient. Polypharmacy is never good for anybody. Two, if you think about it, yeah, there might be moments that you might need to take medications, and it’s not that medications are bad, but there might be some side effects that they might need to be willing to tolerate. There is an expense to it. And then the other thing is sometimes medications can keep people attached to behaviors that are, at the end, not really beneficial for you.

16:45

It then makes you more aware of how the culture is influencing your health, and it’s not only the culture of pharma, but also the culture of the hyperpalable foods. It’s the culture of the go, go, go, do, do. Do you know? Busy, busy, busy is good, is productive, and it’s not. Until you start to take a step back and you’re like well, who is driving the car here? Who is the pilot? Is it me? And I think that then that empowers people to independently if you’re able to come off all of your medication or not. I think that then that empowers people to say, oh wait a second, I’m not going to let this happen. What? That these foods were created by people also, and that used to be in the tobacco industry, and that they purposefully sell it to my kids, uh-uh. So I think that then you start to become aware and you can retake control.

Dr Jedha, Host 17:51

Yeah, exactly, but that’s just coming back to the whole system thing and it’s a Western dominated cultural system. We’ve got big food and big pharma basically ruling the whole world. Sometimes I think I mean they’re trying to keep us sick, because big food we eat a lot of that food we get sick. And then big pharma are great, they can sell us the pharmaceutical drugs or whatever. I’m not going to go down that rabbit hole because it’s just too big at the moment. But something else you brought up that I often speak about and I’d like our listeners to think about is don’t rely solely on meds. And because you do see people thinking, okay, well, the medication is reducing my A1C, so I can keep drinking my Coca-Cola. They’re attached to those behaviors, as you said, and those behaviors aren’t good for you. But those medications are really masking the symptoms. They’re not necessarily healing you, right?

Dr Maria, Guest 18:49

Yeah, they’re not empowering people to retake control of their health.

18:54

And then I think that whenever, as a person, you stay in a way like in this victim position, then you’re not empowered, you do not take again the wheel drive right, you don’t take control and you don’t start doing the driving.

19:13

I think that that actually is not beneficial for anybody at any point. And one of the things when I was in training, a lot of what I was taught was like how I’m in a position of more power than my patients because I have more knowledge, and how, oh people, you have to talk to them at a third grade level because of health literacy, like all of these things. And as I have practiced, I think that some of those things we might take it way too forward and, in a way, what we’re doing is that we’re creating people that are depending again on the system. The system is the navigator, the case manager, right, all of these things. And I can understand that, yes, patients might not have, you know, my medical degree, and that, yes, I have to water it down with some, but I think that when we do it to the core of it, what we’re actually doing is more harm than good.

Dr Jedha, Host 20:21

I completely agree with you on that one and I find that people really want to be treated intelligently. And sometimes this whole concept of health literacy. People can understand If they’re given the respect and explained the concepts in a way they understand it. It doesn’t mean you need a medical degree. People aren’t stupid, they are capable. So I agree, watering it down just isn’t helpful. All the generic information even, when people go and search for information on type 2 diabetes, it’s all just still so generic. They’re not getting that proper help, that proper support, that information, and they are intelligent enough to understand it.

Dr Maria, Guest 21:01

Yes, absolutely, and not only that. Right, then they can start making choices, then they can start to say yes versus not, rather than it always being imposed, well, this is the option that you have. Guess what? Your A1C is not getting better. Well, let’s put you on the insulin. Well, it’s not getting better. There’s no other choice when maybe they don’t want that, maybe they don’t want to be on injectables, and then they stay in this like, well, do I want to end up like I don’t know my dad that died with hemodialysis? And then, because of that fear, because they do not know any better, not because they’re not intelligent enough, it’s because sometimes, again, in a system, we do not want people to become intelligent enough.

Dr Jedha, Host 21:50

No, that’s exactly right and just being talked down to and that kind of brings in that other thing that happens a lot the stigma and the judgment that comes from many medical professionals, many health professionals, where it’s like I’m better than you or I’m judging you because you’re this way. It’s certainly not that therapeutic relationship and that trust that you really need to find support in your healing journey.

Dr Maria, Guest 22:15

Absolutely, absolutely, and I don’t think that there’s any doctor out there that has it all together when it comes to health and to their own health. For multiple reasons, I think that comes into play.

Dr Jedha, Host 22:28

Well, they’re humans as well. Right, they’re humans as well. So under a lot of pressures as well.

Dr Maria, Guest 22:34

Yes, but definitely I think that when, as a patient, you can have not only more information but be in power. So I think that there’s this component of empowerment that again, when I was in training, I remember right, and in a lot of the EMRs, we have to give the patient education handout, patient education handout, the patient education handout, but that does not equal empowerment. So I think that there’s still areas where there can be improvement in the way that we take care of our patients. I think that, at least for me, I think that it is much harder for that to happen in a system that there is other big players in power. That will trunk, the reality is, that will trunk the human being.

Dr Jedha, Host 23:30

Very true, and we’re certainly not like that here. We’re all about empowering people with the knowledge and skills they need to make informed choices, and it’s important to recognize that there is a lot tied up in it, and I think that’s why sometimes we can feel so challenged, and it can be a struggle, and it can take us one step forward, two steps back. One step forward, two steps back. It is a process, it is a journey, isn’t it? Yes, there are just so many things that can be obstacles, but you’ve always just got to keep trying to be proactive and stay positive.

Dr Maria, Guest 24:07

Oh, yes, absolutely the positive mindset, not only about our health, but about a lot of it in our perspective, and life can make us or break us. Absolutely, I love that, yes.

Dr Jedha, Host 24:23

You have such a positive approach, Dr Maria. I really love it. Just the whole thing about building therapeutic relationships. That’s a beautiful thing that we should see more often the trust and taking a whole person, a holistic approach. I wish the whole medical model was like that, because we’d see a very different world if it was. But I know that not everybody has access to this, and so for those out there who don’t have access to a doctor who practices, you know, humanized medicine in such a way, what are your recommendations to them?

Dr Maria, Guest 24:58

Oh, such a good question, one. I love the word that you use to be proactive. To be proactive, to be in power of taking control of their health. I think the other thing that I would say is, if you have access to health care that is outside the traditional system whether that is that you pay for it out of pocket, or perhaps you have or know of a physician that is trained in other modalities if you have some sort of access of outside of traditional health care, I would say, really consider it. I think the other thing is, yes, it’s good to read, yes, it’s good to know, but not everything that you hear in social media or Google or the news, you can take it and implement it for you. I would advise that to be very careful. The other thing that I would recommend and I talk a lot about this is journal, journal, journal, journal, journal and journal. You might be thinking like, what, like why, how is that related?

26:24

I think that journalling is a really good exercise to become aware, to have introspection, to develop that being, to sit down and to say what is it that I want in life?

26:37

Are all of these decisions that I’m making, are those taking me where I want to be in life, to develop that relationship with yourself, with your soul, with your spirit. Because I think that again, we forget so much, even on the wellness industry. We might focus on again, the diet and the exercise and you seem certain, whether it is products or whatever it is, and then we forget how is the relationship with yourself? The other thing is one of the things that I notice also with my patients, is you go to the doctor and you’re having the vague symptoms like headache or abdominal pain, some of these vague symptoms that you cannot tell me more. I think that journaling also, you can use that as that tool of tell me more. Oh, this is the type of abdominal pain that I get, and maybe I get it when I eat certain things. So I think everybody should have a journal and a pen that they love and, even if it says five to ten minutes, just sit down with your pen and your paper and just write.

Dr Jedha, Host 27:52

Yeah, journaling is such a powerful tool and obviously, being in nutrition, sometimes we get people to journal for recognizing patterns and habits in their eating plan and, obviously, recognizing patterns and habits in their blood sugar monitoring numbers. When we do that it brings awareness because if we don’t put it down on paper we wouldn’t see those patterns. And it’s the same when you journal for other reasons. Like Dr Maria said, it’s so great for identifying symptoms if something’s going on in your life that you’re not feeling well about, because we know in randomized control trials or qualitative studies that when people are asked a question directly the recall is not great. But if you’ve journaled those symptoms over time and you can recognize and bring awareness of when those are happening, that can provide your doctor or your health practitioner with information that can help support you better as well.

Dr Maria, Guest 28:46

Yes to be proactive, to be in power of taking control of their health.

Dr Jedha, Host 28:53

Well, thank you so much for joining us today on Type 2 Diabetes Talk. We have covered a lot of ground, but before we go, can you tell our listeners where they can find out more about you and your services?

Dr Maria, Guest 29:04

Yeah, so I specifically see patients in the state of Texas. I do that virtually. The name of my practice is SaludRevisited. Salud, like health in Spanish S-A-L-U-D, revisited R-E-V-I-S-I-T-E-D dot com (SaludRevisited.com), and you can get to know more about the services that I offer to patients and how I could help you best.

Dr Jedha, Host 29:36

Well, thank you so much for joining us. It’s really been a wonderful pleasure.

Dr Maria, Guest 29:41

Thank you. Thank you, Dr Jedha, for the opportunity. My pleasure.

Dr Jedha, Host 29:43

Just to reiterate, Dr Maria is a medical doctor and of course she provides that wonderful humanized medicine and care, and we’ll leave the website links on our website as well, so you can head down to Type2DiabetesTalk.com to find links to her website if you want to connect with Dr Maria. 

When it comes to food products, the FDA sometimes approves health claims based on research, but how robust is the relationship between the original research and subsequent foods that use the health claim on their food labels? Tune in next week as we explore an example. 

Until then, take care, Dr Jedha, over and out.