Modern life is exhilarating, but living in a fast-paced rhythm also brings worries, stress, tension, anxiety, and even mental exhaustion. People’s desires and expectations for health are becoming more prevalent. Dr. Yang Jingduan, a well-known Chinese psychiatrist in Philadelphia, launched a series of lectures titled, “The Three Tiers of Doctors Forum” to share his insight into spiritual health and physical health. The following is a transcript of his talk.

Last time at the Three Tiers of Doctors forum I talked about lower-tier doctors treating diseases. Today, let’s talk about the pros and cons of treating diseases by these doctors. In this context, when these doctors are involved, they are treating the later stages of the disease—the most discernible state—and in some cases, the disease has reached its most urgent condition.

According to traditional Chinese medicine, if the condition is urgent, the doctor will treat just the surface or the symptoms. And if the condition is not yet at the final stage, the doctor will spend his or her efforts in treating the hidden symptoms and finding their root cause.

With the symptoms of the disease fully exposed—whether it is fever, pain, dizziness, diarrhea, bleeding, loss of consciousness, or convulsions—all will inevitably bring patients suffering and sometimes threaten lives. It is at this stage that the doctor’s priority is to relieve symptoms and pain and save lives in a timely manner. Lower-tier doctors are thus of utmost importance as they need to manage all the resulting emergencies or the advanced stage of the disease.

Today’s large hospitals, with advanced equipment, precise treatment methods, and a wide variety of medicines are mostly for the purpose of relieving or trying to cure diseases—and they all belong to lower-tier medical treatment. This kind of treatment has a huge impact on human survival. But at the same time, it has limitations, because it only treats diseases that already exhibit symptoms.

For example—for tumors—surgery is often the first treatment to be considered. If surgical resection is not possible or complete removal is beyond reach, radiotherapy will be used to try to shrink or eradicate it. When all the above fails, chemotherapy is applied to kill the tumor cells.

Surgery, radiotherapy, and chemotherapy are basically the three main methods of modern medicine to treat tumors. These methods may be effective, but they may lead to the spread of tumors or lead to a decline in immune function—allowing tumors to return. Because of this, patients may simply die of complications resulting from such treatments. All in all, this kind of treatment is to treat the symptoms of cancer, without going into the cause of it, and how the recovery can be conducted, and how to ensure that cancer will not recur, all of which are within the scope of the middle-tier doctors.

National medical policies put all the energy and financial resources on the treatment of the symptoms of diseases (the lower tier), neglecting to emphasize prevention and treating the root cause of diseases, resulting in a situation where there are more and more patients needing care and more and more diseases to be treated.

Two approaches are much talked about in the treatment of diseases—one is drug therapy, and the other is surgical physical intervention therapy. Drug therapy itself brings many side effects, such as uncontrollable and unpredictable adverse reactions. We clinicians often see that patients start with one drug, and gradually take two, or three—using one drug to counteract the side effects of another.

It is very common for many patients in the United States to take more than a dozen or more medicines after they reach a certain age. As a result, the expenditure on medical care is very significant, with more and more people needing to be employed in the medical system—but the general health status of the average American is getting worse.

The United States should be the most advanced country in medical technology in the world, and it should be at the forefront in terms of the “lower tier” medical treatment. However, the health status of Americans only ranks in the tenths, or sometimes in the thirtieth in the world. An important reason for this is the emphasis on lower medicine for the treatment of illnesses, not enough emphasis on middle medicine for the treatment of people, or upper medicine for the treatment of the country.

To cite two simple figures, about 2 million to 3 million people in the United States go to the emergency ward due to adverse drug reactions every year, and 100,000 of them die from such adverse reactions every year, which has become the fourth leading cause of death in the United States.

The adverse drug reaction here does not mean taking the wrong medicine, nor taking a large amount of it, or being prescribed the wrong medicine, but simply the patient, unfortunately, had an idiosyncratic reaction. So, from this, we can see the risk of drug treatment. In terms of surgical physical intervention therapy, according to statistics, there are 40 operations per week performed in the wrong place of the body which does not include medical accidents caused by various reasons in hospitals—all together they lead to 90,000 to 100,000 deaths every year.

So, some of the consequences of the lower-tier medicine that treat the disease are also very serious. In the future, this forum will introduce various new methods and developments in the treatment of diseases. At the same time, we will also introduce the importance of the other two tiers of medicine, the middle-tier medicine that treats people, and the upper-tier medicine that treats the country.

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