Of Ducks and Pigs

One of the rising trends in medicine is the concept of integrative medicine. The idea behind this is the combination of Western, Eastern Traditional Medicine and other Traditional Medicine practices into a single cohesive practice. Actual medicine is combined with yoga, acupuncture, chiropractic, homeopathy and a variety of other practices in order to treat the patient. It’s champions include Deepak Chopra and Prince Charles, and it claims to provide succor to mind, body and spirit…

It sounds wonderful, but it is pretty sinister. It’s proponents make the claim that they are providing medical care from every single source in a complimentary fashion.The idea being that there is a wide range of effective treatment options from every source and therefore patients should (theoretically) recieve the best possible care. Many of it’s champions try and delineate medical conditions into ones treatable by alternative medicine and ones that aren’t. So they won’t interfere with real diseases while providing support for chronic conditions. The also make the claim that with an integrative model of medicine you will have more choice and greater compassion.

The core of the claim lies in the workload of the average doctor. I as a student have had days in India where I have had to go through 70 patients. A queue of patients almost constantly coming through the door to be seen and “processed”. There is no time for understanding, hand holding, empathy and sympathy because it doesn’t help these patients. You can treat 5 patients or 70. The so called art of medicine is a lot more rougher this way. It is here the quacks rule. They do not have 70 patients to see. They have just one. They can afford the time to listen and indeed take down a variety of things that they are interested in. The modern doctor is portrayed as inhuman, technical, heartless and soulless.

Modern medicine is not perfect. But the truth remains. That we in the west have the best medical care available not only in the world but also throughout history. And it can only get better via the scientific basis of our medical science. Alternative medicine functions by making faulty claims about the weaknesses of medicine and that it can cover up these defects by the usage of it’s treatments. Now these quacks normally wouldn’t be able to match their treatments to medicine because they are clearly bogus treatments or scientifically proven to not work. So how does one gain legitimacy?

By quacks piggybacking onto medicine and utilising the lack of understanding of the layperson to further the belief that alternative medicine works. It’s the difference between wrapping your broken leg in plaster of paris or some sort of pristene clay handled by virgins. The plaster of paris may function perfectly fine but it isn’t as romantic as clay handled by individuals who have not had sexual intercourse, so people will assume that this magic and above all hypothetical clay is superior to plaster. The clay handling virgins will make a profit while the patient will get treated and everyone goes home happy. At it’s core integrative medicine is merely an attempt to legitimise quackery by stealing the benefits of actual medicine and applying it to quackery.

Except that the patient will have payed for something that doesn’t do anything better or faster than the medical alternative. In doing so the patient will believe it was virgin plaster and indeed spread the word mocking real orthopaedic plaster users as soulless barbarians who would encase their own limbs in concrete rather than the gentle caress of clay mud. And thus a quack piggybacks onto medicine to gain legitimacy.

One doesn’t need to disconnect the compassion in medicine from science. Cold hard fact can sit side by side with compassion. One doesn’t need to trade science for woo in order be compassionate. Integrating unproven and disproven treatments will not improve science and it certainly won’t improve bedside manner. All it will do is provide inferior care for patients. A good doctor is one with science, knowledge, skill and bedside manner. The very idea that a doctor cannot be compassionate but a chiro or a homeopath can is an insult to every doctor who does the best to meet the needs of his patients. The bedside manner of a quack no matter how good does not give validity to his quackery.

As doctors and medical students (and indeed as nurses and the various healthcare staff) we need to emphasise the art of medicine even within the limited time frame that we do have to see a patient. Otherwise the word “Doctor” will cease to have any meaning.

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