Sun
19
Apr
Alternative vs. traditional medicine: similarities, differences and how to bridge the gap
by Jacki Hart, M.D.
Alternative and traditional medicine have a great deal to learn from each other and we all have a lot to learn in terms of bringing the two closer together. This is the first in an ongoing series of articles designed to ask questions, raise awareness, and initiate discussion on topics related to the overlap as well as the disparity between complementary and conventional medical disciplines.
I am Board Certified in Internal Medicine and as such will express my opinions and my perspective on a bimonthly basis regarding the importance, necessity and practicalities for bridging the gap.
To begin, lets look at how alternative medicine and traditional medicine are defined, what constitutes some of the differences between the two approaches to medical care, and how these systems can work together.
Alternative and traditional medicine have a great deal to learn from each other and we all have a lot to learn in terms of bringing the two closer together. This is the first in an ongoing series of articles designed to ask questions, raise awareness, and initiate discussion on topics related to the overlap as well as the disparity between complementary and conventional medical disciplines.
I am Board Certified in Internal Medicine and as such will express my opinions and my perspective on a bimonthly basis regarding the importance, necessity and practicalities for bridging the gap.
To begin, lets look at how alternative medicine and traditional medicine are defined, what constitutes some of the differences between the two approaches to medical care, and how these systems can work together.
Defining the differences
Alternative medicine is referred to in many different ways -- alternative
medicine, complementary medicine, complementary alternative medicine (CAM),
non-traditional medicine, non-conventional medicine, unorthodox medicine, and, I
am sure, a whole host of others. My preference is either alternative or
complementary medicine. CAM is the term used by the National Institute of Health
(NIH) and other mainstream medical establishments. The use of an acronym is a
common practice in conventional medicine and, in my opinion, highlights one of
the differences between the two disciplines- an attempt to objectify vs. an
attempt to personalize medical practices and treatments.
Traditional medicine is also referred to in many different ways - allopathic,
traditional, conventional, orthodox and Western medicine, to name a few. The
term "traditional", although used quite commonly, seems somewhat inaccurate,
given that many alternative medical disciplines have been around for thousands
of years, while many conventional practices have been around much less than a
century. Most of these terms, actually, are only relevant in the context of
Western culture.
A commonly used definition of alternative medicine is " practices that are not
in conformity with the beliefs or standards of the dominant group of medical
practitioners in a society." As one might imagine, therefore, in another society
our so-called traditional approach would be considered alternative and a
particular alternative approach would be considered traditional.
The role of the AMA - how does it affect alternati
In 1847 a body known as the American Medical Association (AMA) was
established to try to regulate medical care. The initial goals of the
organization included licensing physicians and setting standards for the
delivery of medical education. Now, this governing body controls state medical
boards, and determines whether doctors can receive or maintain hospital
privileges, and whether they can keep their medical license. A medical license
can be revoked for a reason secondary to incompetence, which is essentially
defined as deviating from what is known as the "standard of care".
As long as Western medical practices are considered "standard of care," it makes it very difficult for alternative medical practices to become recognized, accepted and respected; in fact, the implication is that, because they deviate from the "standard of care," the practices and practitioners are incompetent.
As long as Western medical practices are considered "standard of care," it makes it very difficult for alternative medical practices to become recognized, accepted and respected; in fact, the implication is that, because they deviate from the "standard of care," the practices and practitioners are incompetent.
Studies show use of alternative therapies is on th
Even though the medical establishment has been reluctant to recognize
alternative therapies, patients have been flocking to alternative practitioners
in droves. Surveys conducted by David Eisenberg, MD and his colleagues reveal
that the use of CAM increased from 33.8% to 42.1% in the United States between
the years 1990 and 1997. The total number of visits to CAM practitioners between
those two years increased from 427 million to 629 million, far exceeding the
total number of visits to primary care physicians. And if money is a good
yardstick of success, alternative health is thriving: people in the US spent an
estimated $12.2 billion of their own money for alternative medicine
practitioners in 1997 and $27.0 billion for alternative therapies.
However, the caution, or sometimes outright disagreement, that many physicians harbor towards alternative health practitioners has not been lost on patients. The same studies which found a rise in CAM use also noted that less than 40% of these individuals have shared this information with their own medical doctors. This is a good example of the importance of bridging, at the very least, the communication gap in order to assure safety for individuals who combine the two types of medical approaches for themselves.
However, the caution, or sometimes outright disagreement, that many physicians harbor towards alternative health practitioners has not been lost on patients. The same studies which found a rise in CAM use also noted that less than 40% of these individuals have shared this information with their own medical doctors. This is a good example of the importance of bridging, at the very least, the communication gap in order to assure safety for individuals who combine the two types of medical approaches for themselves.
Why is alternative medicine so popular—
Reflection on the above statistics raises the question: why is alternative
medicine so popular?What is the appeal?Although the approach and focus of
different types of alternative therapies may differ, they all seem to share the
following characteristics:
- Empowerment of the individual to participate in and take responsibility for his or her own health
- Recognition and emphasis on lifestyle issues such as proper nutrition exercise, adequate rest, and emotional and spiritual balance.
- Treating the individual as a whole person, as opposed to a series of parts
- An emphasis on preventing disease and maintaining health
Challenging some common criticisms - from both sid
A common criticism of traditional medicine by alternative practitioners seems
to be that medical doctors treat symptoms, such as pain or fever, without
searching for the root cause and that they tend to give medications to try to
mask these symptoms. This is not entirely true. Although it is true that we
often give medications or use approaches to control symptoms, we do also search
for causes of symptoms such as infection or inflammation in order to be able to
treat them allopathically.
Looking in the other direction, one frequent criticism of alternative medical practices made by conventional practitioners is the occasional sensationalism in reporting the merits of a particular approach. For example, there are books about certain dietary approaches that claim to cure a whole host of ailments; the same types of claims are sometimes made about particular supplements. Logic makes it unlikely that one approach could be the answer for so many health problems. When one is trained to "think objectively," as medical training is supposed to teach, it makes it very difficult to accept this cure-all type of thought process. Medical doctors are trained to be skeptics.
Another example of recounting information which some traditional practitioners may think of as sensationalist, is the method of case reporting - in other words, telling a story, or what we refer to as an anecdote, of someone who did quite well with a particular approach. Any medical doctor can also tell you individual stories about someone who did either quite well or quite poorly with one or another method of treatment. The objective approach, the so-called evidence-based approach of Western medicine, however, is intended to look at how likely a particular treatment is to help a person with a certain problem. Evidence-based medicine is the application of a scientific process to distinguish outcomes due to chance from outcomes which are reproducible and, therefore, presumably more reliable.
Looking in the other direction, one frequent criticism of alternative medical practices made by conventional practitioners is the occasional sensationalism in reporting the merits of a particular approach. For example, there are books about certain dietary approaches that claim to cure a whole host of ailments; the same types of claims are sometimes made about particular supplements. Logic makes it unlikely that one approach could be the answer for so many health problems. When one is trained to "think objectively," as medical training is supposed to teach, it makes it very difficult to accept this cure-all type of thought process. Medical doctors are trained to be skeptics.
Another example of recounting information which some traditional practitioners may think of as sensationalist, is the method of case reporting - in other words, telling a story, or what we refer to as an anecdote, of someone who did quite well with a particular approach. Any medical doctor can also tell you individual stories about someone who did either quite well or quite poorly with one or another method of treatment. The objective approach, the so-called evidence-based approach of Western medicine, however, is intended to look at how likely a particular treatment is to help a person with a certain problem. Evidence-based medicine is the application of a scientific process to distinguish outcomes due to chance from outcomes which are reproducible and, therefore, presumably more reliable.
Bridging the gap
In order to help bridge the gap and bring the two disciplines together, I
wanted to offer some insight into how your doctor may be thinking and why you
may be met with resistance when you try to discuss your desires for and
experience with alternative medicine.
There is a very important role for the objectivity that a Western medical doctor learns. This objectivity should, in many ways, provide you with a certain degree of comfort and confidence. There is also an extremely important role for the personal and holistic approach of alternative medicine practices and practitioners. This warmth and individuality should provide a different type of comfort and confidence.
Ideally, there is a way to bring aspects of the two together and have the best of both worlds. One word of advice I can give to the alternative medicine consumer is to try to not be intimidated or scared about discussing your practices with your medical doctor. We all have a great deal to learn in terms of integrating these important areas of health care and communication is one of the best places to begin.
There is a very important role for the objectivity that a Western medical doctor learns. This objectivity should, in many ways, provide you with a certain degree of comfort and confidence. There is also an extremely important role for the personal and holistic approach of alternative medicine practices and practitioners. This warmth and individuality should provide a different type of comfort and confidence.
Ideally, there is a way to bring aspects of the two together and have the best of both worlds. One word of advice I can give to the alternative medicine consumer is to try to not be intimidated or scared about discussing your practices with your medical doctor. We all have a great deal to learn in terms of integrating these important areas of health care and communication is one of the best places to begin.