One hundred years ago, medical care was unrecognizably different than it is today. There was no reliable way to determine the value of any available medical treatment. Standards for surgical procedures or for prescription of remedies had no scientific basis. Medical practice was literally an art, handed down from one practitioner to another. Some treatments were based on long traditions or bodies of experience, but others had less noble origins.
That all changed when Abraham Flexner chaired a committee that called for establishing scientific study as the basis for treating illness, eventually creating the multi-billion dollar industry that provides the majority of the health care we use today.
All of that money and the resources that have flowed into investigations of surgical and medicinal treatments have produced a curious mixture of results. On the one hand, medicine offers miraculous treatments that have prolonged life and cured or improved many conditions. Nobody wants to go back to the days before that was possible.
But, on the other hand, Americans consume half of the narcotics prescriptions produced in the world, and undergo nearly half of the invasive heart procedures done in the world, with only 5 percent of the world’s population and at the highest per-capita cost.
Despite those numbers, we don’t live any longer, have less pain or live healthier lives. At least half of the medical treatments performed in this country fall into the categories described as “alternative,” “holistic” or “integrative,” as opposed to the traditional mainstream treatments that the Flexner report advocated a century ago.
So, what is wrong with this picture? Could it be that despite our success in producing medical practices that are wonderful and ingenious, we are missing the whole picture? What might we be missing or able to improve on?
Traditional medical practice in this country consists essentially of two approaches to treatment: surgical or medicinal. Recently, chiropractic therapy, naturopathic approaches, and acupuncture have become increasingly accepted, but still have the stigmas of being outside the mainstream and are thought to have less of a scientific basis. And there are many practitioners of other approaches that are considered to have little scientific basis. Massage therapy, Reiki, meditation practices, sound therapy, yoga, Ayurvedic practices, Feldenkrais and others are in this last category.
In all of these cases, treatments are offered that are alternatives to traditionally prescribed therapy. But the term “alternative” really does not do justice to what these practices offer. The word “alternative” carries the meaning that it is a case of either/or, when what is really meant is that traditional therapies may not offer everything that is needed or desired.
“Complementary” may be a more accurate descriptor. To “complement” means to provide a more complete approach to treatment, an approach that can be added to existing treatment options to address possibilities to provide a richer, more satisfying outcome.
We see this approach already in the world of traditional medicine: medications are often used together with surgical or manipulative techniques to provide a fuller approach. Why not add other approaches as well? Why not add complementary medical treatments and further extend the range of possibilities?
One obstacle to the consideration of complementary medical treatments is that people are
unfamiliar with the scientific information available about the effectiveness of complementary medicine. When Flexner’s report came out in 1919, it set the expectation that treatment should be based on science, not stories, beliefs and opinions. More information is needed on effectiveness before such treatments can be unconditionally recommended.
Another issue is the reproducibility and consistency of medical practices. Practitioners of traditional medical therapies undergo training, examination, licensing and regulatory oversight designed to create a reproducible process. Reassurance is needed that complementary practices have a similar quality-control approach. How can one find the information needed to make a good decision about choosing a complementary treatment?
My interest in these issues prompted me to write this article, which I hope will be the first of a series designed to help you explore the possibilities of seeking complementary treatments for your medical care needs. I will explore further the evidence underlying treatments, and the application of standards of care.
If you are interested in seeing additional pieces exploring the potential of complementary medical treatments, contact the editor at news@stowereporter.com.
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