Tarring complementary medicine is anti-choice
THIS year kicked off with the unedifying spectacle of a group calling themselves the Friends of Science in Medicine demanding the wholesale banning of universities from teaching “complementary medicine”.
I had to pinch myself to make sure I had not nodded off and woken up in a parallel universe where patients just did as their doctor told them, asked no questions and made no choices for themselves.
I actually have to wonder whether the 400 or so luminaries on the list knew how their names and reputations were going to be used by the organisers and whether they signed on to this agenda.
Regardless of some of the “big names” attached to its agenda, this group really needs to take a long hard look at itself.
They are putting those of us trying to navigate the real world of clinical medicine in an invidious position.
Talk about a risky double standard!
Foremost is the reality that no one paradigm of healthcare has a monopoly on evidence. If you argue that only “our” brand of healthcare is science-based, then number one: it is just plain incorrect. And number two: how do we as doctors defend ‘medical’ scandals like the withdrawal of Vioxx or Reductil because of the number of deaths attributed to these heavily marketed “evidence-based” drugs?
A joint investigation by the British Medical Journal and BBC labelled the use of metal-on-metal hip joints “a very large uncontrolled experiment exposing millions of patients to unknown risk” due to the release of chromium and cobalt from the prostheses. Try having that conversation with a patient wanting to know how best to manage their advanced osteoarthritis.
And let’s not even start with the French breast implants and their dodgy silicone!
Those of us in general practice know that high level evidence is not available for much of the work we do, and we rely, not unreasonably, on our traditions, experience and clinical judgment.
I work with and actively refer to a range of ‘complementary medicine’ practitioners, all of whom have been university trained. They include, but are not limited to, osteopaths, chiropractors, acupuncturists, naturopaths, exercise physiologists, herbal medicine practitioners and others. Some, like massage therapists, are not university trained, but I expect a minimum level of education and training.
Many of these disciplines rely, as we often do, on clinical judgment and traditional experience, but with a substantial and growing evidence base.
There may well be a point to be made to reassess the curriculums being offered in healthcare courses generally.
I, for one, would like to see our medical schools adopt an integrative medicine model of teaching like many major medical schools in the US.
This is a far better reflection of what our doctors are likely to encounter and would prepare them far better for clinical practice of the future.
And while we’re at it, how about the NHMRC kick in some real funding to accelerate the gathering of more Australian clinical integrative medicine research?
Most GPs these days refer actively to a range of allied and complementary practitioners and we need to know that these practitioners are highly trained in an academic environment and engaged in active research within the university sector.
GPs who have taken the trouble to seek further education in areas of medicine outside of our fundamental training, and who believe this is in the best interest of quality care for our patients, are despairing at the retrograde demands of the so-called Friends of Science in Medicine.
To throw all of “complementary medicine” into one big grab bag, call it all “quackery” and call for teaching of “it” to be removed from universities is extreme, ill-informed, divisive, unwarranted and certainly not in the best interest of the Australian health consumer.
Maybe we should start up a new group – the Friends of Choice in Healthcare?