Getting to Why
Logic in Medical Decision-Making
Author:
Dr. Lauren Deville
C.A. Gray (Dr Lauren’s pen name)
Practitioners treating chronic disease share a problem that cuts across every discipline: they have more diagnostic tools than ever, but no shared logic for sequencing intervention. A naturopathic physician, a functional medicine MD, and an integrative NP looking at the same patient will often reach for different treatments first — not because they disagree on the underlying science, but because none of their training gave them a decision hierarchy for when to intervene, only lists of what to consider.
Getting to Why: Logic in Medical Decision-Making first challenges the reader to reconsider common medical assumptions that rest upon fallacious reasoning. From there, it gives practitioners of all specialties a decision framework for chronic disease that doesn't depend on already knowing the diagnosis. It assumes the reader already has a working knowledge of physiology and pathophysiology, and provides a heuristic for finding root cause and building a personalized treatment plan from there — rather than defaulting to standard-of-care algorithms.
Getting to Why is a clinical reasoning text built around the therapeutic order — an eight-level framework that sequences care from root-cause identification and removal through palliation. The therapeutic order reframes the clinical question from “what should I do for this diagnosis" to "what does this patient's physiology need first, and why" — treating the body as a self-regulating system to be supported in sequence, not a set of symptoms to be matched against a list of interventions.
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Getting to Why
"In her new book, Getting to Why, Dr. Deville provides a common sense approach to evaluating patients and getting to the root of any medical problem, extending well beyond making a diagnosis based on symptoms alone. The book describes a rigorous and logical questioning process to delve deeper into the background and history of each patient to identify causal factors contributing to their symptoms. The process requires recognizing common logical fallacies often leading to a misdiagnosis and inappropriate/ineffective treatment that ultimately harms the patient. Profit-driven conventional medicine falls short of training practitioners on asking these critical 'Why?' questions nor does it allow ample time for physician's to evaluate their patient with the intent to heal. This book is strongly recommended for seasoned healthcare practitioners, providers and even medical trainees in search of answers to our failing medical system."
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Dr Russell Witte, Ph.D., Professor, Radiology and Imaging Sciences, Optical Sciences, Biomedical Engineering, Surgery and Neurosurgery at the University of Arizona
"Physicians quite understandably approach the analysis of their patients through the lens of their individual training, experience, interests, and areas of expertise. Dr. Lauren Deville challenges us to look beyond these individual perspectives by presenting what might be called a unified field theory of medicine—one in which practitioners can systematically broaden their focus in the search for the underlying cause of a patient's illness. After carefully laying out many of the problems and limitations inherent in the conventional Western medical approach, Dr. Deville makes a compelling case for returning to a more vitalistic, life-promoting approach to disease—one that seeks to identify the first principle, or root cause, underlying the patient's condition. Once that underlying cause has been identified, she provides a practical, stepwise pathway for moving forward: beginning with positive changes to the patient's environment, progressing to supportive therapies, and employing natural therapeutics whenever appropriate. What I find particularly valuable is her effort to give practitioners not simply another collection of treatments, but a framework for thinking—one that encourages us to ask, "Why?" before simply asking, "What should we treat?" I look forward to seeing Dr. Deville's vision continue to develop and, ultimately, to seeing these principles receive broader consideration throughout the medical community in the years to come."
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Dr David Teitelbaum, D.O., D.V.M., Osteopathic Physician, Veterinarian and Author of Optimal Brain Wellness
"The depth of research in this book is truly extraordinary! Dr. Deville has a gift for translating scientific literature into a clinically relevant resource that is both comprehensive and applicable. Even as a practitioner deeply rooted in vitalistic naturopathic medicine, I was humbled by how much I learned and I'm proud to call her a colleague. This is an outstanding resource for practitioners committed to understanding the 'why' behind symptoms and advancing patient care."
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Dr Shawna Eischens, NMD, Hope and Healing Naturopathic Owner and Founder
"All medical schools and libraries should carry this in their libraries and bookstores as required reading. Naturopathic medical schools, take note!"
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Dr Christie Fleetwood, ND, RPH, FNMI