CNN.com - Med Student: Integrative medicine is 'new way of healing'

[justskipee]

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Commentary: Integrative medicine is 'new way of healing'

-Justin Laube is a second-year medical student at the University of Minnesota in Minneapolis.

(CNN, Fri October 12, 2007) MINNEAPOLIS, Minnesota -- In a recent column, Emily Breidbart, a second-year medical student at New York University School of Medicine, expressed concerns about her medical education and the frustrating health-care system she will soon enter (Emily's article: http://www.cnn.com/2007/HEALTH/08/16/med.student.essay/index.html.

What deeply troubled me was her passive viewpoint and lack of resolve to practice the medicine she dreamed of when she entered medical school. She spoke of limited time with patients, fears about insurance, practicing defensive medicine, and the transformation of medical students who begin as idealists but eventually "start taking off [their] rose-colored glasses." Is this truly the "reality" of where medicine is headed?

This past year of medical school has been the most incredible and rewarding period of my life. I have emerged from my first year at the University of Minnesota excited by the infinite possibilities of my future, with a new appreciation for human life, and a strengthening of my idealism.

Like Emily, we are taught a medical interview format that includes 10-15 minutes for the medical history and additional time for the physical examination. This format has its strengths and weaknesses. For some acute clinical needs (e.g. cold, rash) it may be efficient and satisfying to the patient. But, what about a patient who presents with symptoms of a cold, but this is merely the tip of the iceberg? What if the patient is chronically stressed, overweight and dealing with anxiety about an uncertain future? The lines of acute or chronic care blur and the complexities of our lives are revealed, all aspects interacting and affecting one's health and wellness. This medical interview will be merely one of the tools in our physician handbag. Is this the only way to practice medicine? I strongly believe the answer is an emphatic "no."

Juxtaposed against this "limited- timeframe" medicine is a more humanistic medicine also emphasized in our training. The patient-physician interaction should be viewed as a relationship of equals, not a hierarchy. It is in this partnership that positive life change can be fostered. This is perhaps what Emily was referring to in her longing to "go back to simply learning the art of healing." But what is the art of healing? Are we as medical students and physicians truly healers?

For me, health is more than the absence of symptoms or disease -- it is the embodiment of wellness. It is this belief that led me to integrative medicine and a new way of viewing healing.

Integrative medicine combines the best of both conventional, allopathic care and complementary and alternative medicine, or CAM. Examples of CAM include traditional Chinese medicine (e.g. acupuncture, herbs), naturopathy, chiropractic, and mind/body medicine (yoga, meditation). Integrative medicine is based on the incredible power of our bodies to heal themselves. From this viewpoint, we as future physicians are facilitators of each patient's innate inner-healer. The beauty of integrative medicine is that it takes into account all dimensions of the individual: mind, body and spirit. Integrative medicine empowers patients with new choices and promotes preventative care.

Integrative medicine was also woven into my education as a first-year medical student -- which included an immersion experience in traditional Chinese medicine -- so that we would be exposed to other approaches to healing. This past summer, I participated in research on mindfulness-based stress reduction for family caregivers of dementia patients. I attended a weeklong seminar on integrative medicine in Portland, Maine, and I am also on the steering committee for the creation of a student-run integrative health clinic to bring CAM to the underserved.

All of these experiences, as well as connecting with the University's Center for Spirituality & Healing, local holistic practitioners and experiencing the power of complementary and alternative medicine have been integral to my excitement as a future physician. I urge fellow medical students to watch the PBS documentary titled The New Medicine (2006). The film examines the many medical schools, health-care clinics, research institutions and private practices integrating new and "alternative" approaches into their work.

I want to tell Emily and all the other medical students to never lose their idealism. The ideals at the core of one's reason to enter medicine should be continuously fostered throughout our training. I do not expect this path to be easy, but it is not impossible. We will have to deal with time limitations, insurance issues and family pressures; but that should never affect the way we care about our patients. Embody the belief that we are active players in our future and present-day life, and practice a kind of medicine that preserves and connects with your idealism and humanity. The only "reality" we face in the future is the one which we create.


http://www.cnn.com/2007/HEALTH/10/08/laube.essay/index.html


Forum thread on SDN about Emily's article (http://forums.studentdoctor.net/showthread.php?t=437711)

 

[78222]

This one doesn't make me puke as much as the last one, but I still taste a little vomit in my mouth. Whenver I hear the terms "holistic", "Integrative", or "CAM" I get the urge to stab myself in the eyes with a spork.

 

[smq123]

I attended a weeklong seminar on integrative medicine in Portland, Maine, and I am also on the steering committee for the creation of a student-run integrative health clinic to bring CAM to the underserved.

What, exactly, does "bringing CAM to the underserved" entail? Teaching yoga classes to inner-city youth? Or offering acupuncture to migrant farm workers?

Wouldn't bringing regular old western-based medicine to the underserved be the logical first step? Just curious.

 

[SomeDoc]

Honestly, I see nothing wrong with integrative medicine. Now that would obviously change if we started to see patients being harmed as a function of the implementation of such modalities in the treatment process despite the presence of scientific data recommending otherwise. If patients heal or recuperate faster, or are aided through the healing process more so than without, its a plus for both the patient and the physician.

 

[8744]

What, exactly, does "bringing CAM to the underserved" entail? Teaching yoga classes to inner-city youth? Or offering acupuncture to migrant farm workers?

Wouldn't bringing regular old western-based medicine to the underserved be the logical first step? Just curious.

A-friggin' men. Everybody's looking for an angle to advance their own interests and helping the Underserved (PBUTHN) provides cover for a lot of highly mercenary people.

 

[8744]

Honestly, I see nothing wrong with integrative medicine. Now that would obviously change if we started to see patients being harmed as a function of the implementation of such modalities in the treatment process despite the presence of scientific data recommending otherwise. If patients heal or recuperate faster, or are aided through the healing process more so than without, its a plus for both the patient and the physician.

No. You miss the point. The miniscule benefit gained is not worth the money spent. That's the whole problem. Not that CAM is 99.999 percent ridiculous, just that it costs money and this money is being thrown away.

 

[SomeDoc]

No. You miss the point. The miniscule benefit gained is not worth the money spent. That's the whole problem. Not that CAM is 99.999 percent ridiculous, just that it costs money and this money is being thrown away.

The issue of cost is most certainly important.

It would make sense from a practical perspective that CAM should not be used in the presence of data which suggests from a cost/benefit perspective that it has little value in the domain of efficiency, and vice versa. If some therapies are being used for a measurable minuscule gain in patient outcome, considering cost/benefit analyses, then it would make sense to not implement them.

That being said, I am not sure which CAM therapy implementations lead to high cost/benefit ratios. But why a medical group would implement therapies with a high cost/benefit ratio if data suggests to do so otherwise makes no sense, unless they are running a clinical trial using grant funds to begin with, so that they can begin to collect data to be analyzed, or unless they grow money on trees.

 

[Slide]

I'm always filled with a sense of humorous irony whenever I read these articles by "idealistic" med students. They propose and attempt solutions to social problems with fancy, fluff-filled unorthodox treatments, when what is really needed is a practical solution that directly attacks the problem.

 

[Doctor Bagel]

I'm always filled with a sense of humorous irony whenever I read these articles by "idealistic" med students. They propose and attempt solutions to social problems with fancy, fluff-filled unorthodox treatments, when what is really needed is a practical solution that directly attacks the problem.

But the odds of any practical solution coming to pass seem so dismal that maybe we retreat into our dreams of bringing acupuncture to the masses. 🙂

 

[MSKalltheway]

The settings I've seen CAM used in have been mostly on patients who have chronic illness/pain and have tried other treatments first that have been proven to work via EBM, but dont work so well for them. I don't see why we shouldn't suggest CAM to patients if NSAIDs/injections/surgeries haven't worked, but some acupuncture may. I'm not crazy about CAM but if nothing else is really working, its worth exploring, IMHO. Even if it is only placebo effect and/or expensive, a good portion of these patients have nowhere else to turn.

 

[Hayden2102]

It really, really riles me when "placebo" and "expensive" go in the same sentence. There's a shonk somewhere getting richer while a little old lady thinks she's feeling better while her life savings/pension are dwindling...

 

[MSKalltheway]

Of course every new medication that comes out "proven" to be more effective is completely affordable to patients as well 🙄

I'm not for making patients spend money or go into debt over treatments. Part of the reason I said suggesting CAM is fine IF other treatment regimens aren't effective is because of the expense. If something is proven to work through EBM, you should go with that first. Suggesting CAM as a last resort isn't a necessarily a bad thing. It may carry an expense with it, but the patient will tell you whether or not they have the ability to pay. Patients dont get treatment for procedures they NEED to have done, so why would they pay for something that is elective if its unaffordable? We saw someone earlier in the week who wouldnt go to the ER to get treated for a heart attack because he couldnt afford the $1,000 just to be seen. He didn't even want to mess with the cost of tests, treatment, a hospital bed, etc.

Again, I'm not putting stock into this stuff saying its going to treat cancer or anything, or that it even will work well for everyone. But some people do find it effective, and again, I see nothing wrong with trying it after any and all other common treatments no longer work. Many patients are going to try this stuff anyway, so I feel its better to be educated on it so at least they can be informed about the risks, benefits, and possible complications so they can decide for themselves from there.

 

[The Angriest Bird]

It just entertains me when the media can beautifully rename things. "Integrative Medicine?" Sorry, to me, this whole idea sounds more like "Contaminated Science."

I'm not denying that herbs or spirtual healing have zero therapeutic effect whatsoever. They do. But just be honest with yourself. Western medicine, i.e. medicine backed up by the scientific method is way way better.

The reason our patients turn their heads to "alternative medicine" is that they simply don't get answers from us. And guess what, that's because we are being honest. We don't tell the patients that we have answers when we don't!

Let the body heals itself? Sometimes. My experience tells me, whenever you leave a problem to the body, it simply makes it worse.

 

[MadameLULU]

Closing since this is a duplicate thread. If you'd like to contribute to the conversation, please see this thread.