Over the last century, there has been a quiet medical revolution. Go back to the early 1900s and the doctor was the main source of treatment. They needed to earn enough to live on, so you were always required to pay your way. But, there may be some truth in Sue Lowden's story about chickens. As you may remember, she was one of the Republican Senate candidates standing in Nevada. She hit the headlines for reminding people that, in the rural areas, people would offer the doctor a chicken or to paint his house. Whether barter was generally accepted does not matter. Everyone relied on their local doctor and the growing hospitals for whatever medical care was available.

Look around now. Hospitals have grown into major institutions and, with all the problems over paying for treatment, the pharmaceutical industry has stepped into the limelight. Now all doctors need do is decide which pill to give you. If you don't have the money to pay a doctor, there's always the internet where you can buy all the major drugs without ever having to see a doctor. The focus is now on the pill. Watch TV or open most newspapers and magazines and you will see ads telling you which drugs to rely on for every illness. Indeed, some suggest the pharmaceutical industry make up illnesses and then invent cures for them.

So, what's the problem? Well, there's no doubt some drugs are very effective but the problems come through the way they are used. Let's take pain relief as an example. There are some remarkable drugs across the range of treatment, from minor injuries to the most severe problems causing agonizing pain. For whatever you need, you pay the asking price and the pain is reduced or goes away completely. This sounds like a good deal but it overlooks one problem. Painkillers have a good name. It describes accurately what they do. But it also shows their limitation. They may kill the pain but they do nothing to treat or cure the cause of the pain. Let's say someone shoots you, leaving the bullet inside your body. You could take painkillers but the long-term solution is having a surgeon open you up and remove the bullet before you get an infection and risk death.

The best treatment always sees the whole problem and gives appropriate treatment. If you have an injury, you may need surgery to repair the damage. Illnesses may require antibiotics or antivirals. Just taking a painkiller like Ultram is never the right answer on its own. This is a wonderful drug but, unless you want to become dependent on it for months or years to come, you should have all the treatment necessary to remove the cause of the pain. Keeping this real, if the doctor cures the underlying cause, the pain usually goes away. Ask yourself which is better. That you should keep taking Ultram, or that you should be free of pain and no longer have to take a painkiller? Perhaps your grandparents always had spare chickens and could always barter with their doctor. But the best value for their chickens was treatment for the whole body and no longer term payment for drugs.