1: Communicating with Patients About Complementary and Integrative Medicine

CHAPTER 1 Communicating with Patients About Complementary and Integrative Medicine


This book is designed to serve as a bridge between two great bodies of knowledge. On one side is traditional Western medicine, with its basis in biomedical science. On the other is complementary/alternative medicine (CAM), with its emphasis on the whole person, often in subtle but profound ways that we are now only beginning to understand. Like any bridge, the one between these two approaches requires a firm foundation on each side of the span. The two forms of medicine share certain fundamental strengths: an internally consistent theoretical basis, extensive empirical evidence, and observable results. Beyond those broad commonalities lie differences in the specifics of philosophy, conceptual framework, techniques, and, sometimes, even objectives. Together the two great bodies of medical knowledge provide a vast array of healing possibilities. Whereas 80% of the world’s population is confined to the limited range of health care options offered by local cultures, Americans have the unique and historical opportunity to integrate the best of the old and new healing practices of the Americas, Europe, Asia, Africa, the Middle East, and elsewhere.


In modern health care we have discovered that these different practices are not mutually exclusive and, indeed, they work well together. Eastern and Western systems, ancient techniques, and new therapies—all can be evaluated, selected, and combined in ways that greatly extend the spectrum of healing for an individual and for society.


As exciting as these choices are, knowing how or when to start making them is not simple. What criteria should be used to evaluate alternative/complementary therapies? When is it time to rely on traditional Western care? What about homeopathic remedies for insomnia or acupuncture treatments for chronic pain? Can St. John’s wort and Prozac be used at the same time? Should you undergo therapeutic touch before, during, or after surgery? How can you design a lifestyle or care plan that comfortably combines conventional and alternative/complementary treatments?


This book will guide you through the process of understanding alternative/complementary therapies and how they can be successfully integrated with traditional Western care. It will help you learn how to draw on a larger repertoire of healing therapies and systems to get the full benefit of all the resources available from the world health community. Many people in the world rely on ethnomedicine, in which a local healer who has an ongoing relationship with the patient uses traditional methods to address the whole individual, encouraging the patient to take an active role in the healing process. These indigenous approaches—some of which are highly sophisticated systems that have been used effectively for centuries or even millennia—have often been dismissed by the conventional Western medical community as primitive. Throughout the first half of the 20th century, cultural biases made it increasingly difficult for Americans to appreciate the richness of other health care traditions. We were appropriately impressed by advances in surgery, antibiotics, and other lifesaving technologies developed by the medical-scientific community. Western medicine seemed to be leaving everyone else behind. Then, in 1972, while in Peking covering President Richard Nixon’s visit, New York Times reporter James Reston underwent an emergency appendectomy. Reston’s Chinese physicians used acupuncture for anesthesia during surgery and afterward for pain control, with excellent results. This became front-page news, introducing millions of Americans to the potential benefits of this ancient practice and launching a scientific and social debate that has continued to grow for three decades.



WHAT IS COMPLEMENTARY/ALTERNATIVE MEDICINE?


Broadly speaking, CAM is any therapy that is outside the American medical mainstream but is practiced by a significant number of people with observable results. Mainstream American medicine, or conventional Western care, can be defined as the allopathic approach—that is, the one used by physicians who hold MD degrees. It is also known as biomedicine because of its firm foundations in the hard science of biology. The term alternative medicine became part of the English language in the 1960s, when acupuncture and other Asian therapies first became known to mainstream Americans, who viewed them as an alternative, rather than as an adjunct, to conventional treatment. Many people, especially physicians, took exception to the term because of its exclusive, “either/or” connotation. A more accurate term, complementary, was adopted by some to describe those alternative therapies that were being used in conjunction with traditional Western medicine. As a means of combining this more accurate term with the more widely recognized original, the phrase complementary and alternative medicine was coined, then shortened to the acronym CAM. More recently, the term integrative medicine was coined, implying an active, conscious effort by patient and physician to incorporate alternative and allopathic treatments in a cohesive approach. In this book, the terms alternative, complementary, and CAM are used interchangeably to describe the therapies and systems drawn from other traditions that are now being used in conjunction with mainstream Western medicine. The plural term alternative medicines is used to emphasize that CAM is not a monolithic field but one that comprises many distinct traditions and approaches. The following criteria were used to help determine which alternative medicines would be included in this book:


image The therapy is the product of an orderly, rational, conscious system of knowledge and thought about health and medicine.

image The approach has been sustained over many generations by many practitioners in many communities.

image Treatments have been widely observed to have definable results.

The goal of this book is to provide not the most comprehensive guide but the most useful one. The book does not include obscure therapies practiced by only a few individuals in isolated settings, therapies that have poorly defined theoretical underpinnings, or therapies that lack perceptible results. The complementary therapies described in this book were chosen on the basis of a significant body of rational, clinical, and scientific information and judgment; a history of results; and increasing integration into the American medical mainstream. This integration is largely a response to consumer demand, which has created a $50 billion alternative medicine industry, but it also reflects the recognition of new scientific findings that are expanding our view of health and healing.


Although each tradition carries it own rich history, benefits, and perspective, some characteristics are common to all of the therapies and systems presented in this book. They are oriented toward wellness and take into consideration the capacity for self-healing. Nutrition and natural products are also essential resources (Figure 1-1).


image

Figure 1-1 Self-healing and natural products are common themes through each chapter in this book.


(From Association of Women’s Health Obstetric and Neonatal Nurses, Breslin E, Lucas V, eds: Women’s health nursing: toward evidence-based practice, St Louis, 2003, WB Saunders.)

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Nov 4, 2016 | Posted by in OBSTETRICS | Comments Off on 1: Communicating with Patients About Complementary and Integrative Medicine

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