Always on? Switch off

The fourth industrial revolution has exciting implications for the future of work. Artificial intelligence, and machines that can learn to do many of our jobs better than we can, will inevitably take over many of our tasks. Our happiest expectation is that big data will handle the most repetitive, data-crunching parts of our work – yes, even for professionals such as doctors and lawyers – freeing humans up to focus on the parts of the job that no machine can ever hope to do.

For instance, AI can already produce a diagnosis from an X-ray faster than a trained radiologist. Better technology means drugs can be developed far quicker, and your own health can be monitored more closely with exceptional accuracy. One day, robots could be performing highly complex operations better than surgeons.

The more technology improves, the more likely doctors are to move away from reactive disease management to proactive prevention and health promotion. Such a shift could disrupt the entire healthcare sector and leave many medical professionals out of a job. Those who stay in healthcare will be the professionals who are good at human connection and who have the ability to look at the whole person rather than a constellation of symptoms. This could well be the X factor that will future-proof the next generation of doctors.

In The Professional, a podcast series by Profmed Medical Scheme, Talk Radio 702’s Bongani Bingwa interviews guest professionals about the future world of work. One doctor who is embracing a new way of treating patients is integrative medical practitioner (and GP) Dr Ela Manga.

Dr Manga is interested in the phenomenon of burnout. She reckons one of the pitfalls of 4IR is precisely the always-on culture that the knowledge revolution demands.

We perceive everything as high demand. We are unconsciously reacting in that way so stress hormones are pumping through our system constantly. The body doesn’t have a chance to drop down into the relaxation mode, where healing can happen.

Dr Ela Manga

As a GP in a successful private practice in the mid-2000s, on paper Dr Manga had it all. But despite commercial and professional “success”, she felt something was missing. Her day-to-day job consisted of dispensing advice and prescriptions, but was she really helping the patient in front of her?

Her patients were often presenting with hard-to-pin-down problems: insomnia, irritable bowels, heartburn, constipation, bloating, fatigue, irritability, a collection of little niggles that added up to a significant loss in quality of life. Dr Manga wondered if she was really treating the causes behind these symptoms.

Dr Manga started thinking about burnout – a term coined in the 1970s by a social worker who described feelings of de-personalisation, cynicism, emotional exhaustion and a lack of personal connection and accomplishment at work. At first, dismissed as pop psychology, the term gained traction and the WHO finally recognised burnout as an occupational syndrome in May this year.

And it’s not only patients who suffer. In South Africa, researchers Zeijlemaker and Moosa report in the September 2019 issue of the South African Medical Journal that a whopping 84% of registrars (junior doctors) polled tested positive for burnout using the Maslach Burnout Index. Something is wrong in our healthcare system.

It was probably no accident that Dr Manga started looking for alternatives to the Western medical model of treating patients. After all, she had nurtured a childhood dream of becoming an Indian classical dancer. That was vetoed by her parents, as was her second choice – journalism.

Dr Manga may have qualified as a doctor, but her interest in the learnings from her grandfather’s country of origin remained, as did her interest in telling people’s stories: “You know I was always interested in stories. And looking at where my life is now, I’m back to listening to stories again.”

These days, Dr Manga is what’s called an integrative medical practitioner – someone who is a legitimate, qualified doctor, but is also interested in treatments that don’t always fit the mould of modern Western medicine.

Together with a social worker, Dr Manga opened a holistic wellness centre, and joined a growing community of medical professionals who are trying to help people in new and different ways. They’re drawing on knowledge that is thousands of years old – and combining it with modern medical know-how and the latest advances in science to try to help people deal with the root causes of their illnesses, instead of just treating the symptoms.

These days she spends much more time than usual in a standard GP’s practice listening to the life story of the person in front of her, trying to find patterns out of early life experiences or predispositions. Then, together with her patient, they craft a way forward. Often, the solutions lie in things like mindfulness, energy management and breathwork.

French GP Dr David O’Hare developed a breathwork method called cardiac coherence or the 3-6-5 breathing method, because you do it three times a day, six breaths per minute, for five minutes. This is supposed to “trick” your body out of its stressed fight-or-flight mode and into the rest-and-digest mode.

In medical terms, that’s the parasympathetic response, when the body is able to replenish its energy stores,” explains Dr Manga. “This is when inflammation is brought down. This is when cells regenerate. And if we’re not giving our bodies the opportunity to drop into that space, eventually it will have a devastating impact on our entire mind-body system.

Dr Ela Manga

Dr Manga believes that it’s only a matter of time before the power of breathwork, mindfulness, and energy management are accepted by the mainstream medical community. In the meantime, it’s changed her patients’ lives – and revolutionised the way she conducts her business.


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