Alternative Medicine, Medical Education and Health Policy: An Update

For the past few months, I’ve been on the guest blogger rotation for Kevin MD, and I must say it’s been an interesting experience that has really enabled me to see how the rhetorical techniques that I am learning in my writing persuasion class play out on the internet. Among these lessons is the Millian principle that one learns the most not by rehashing agreed-upon principles but by engaging in furious debate about them with someone who vehemently disagrees with you.

That has been my experience with my latest cross-post on alternative medicine. Honestly, the post in its original form was a bit of a thought-dump that predictably generated few hits but got me writing on this blog again. Now that it’s been under the crucible of Kevin MD commenters however, I can more clearly say what I meant to say.

1) It’s not that allopathic medical schools need teach alternative medicine, but that aspects of health, e.g. nutrition — which alternative medicine practitioners do focus on — that we should be including in our education.

I’m not talking about the statistical argument that since 40% of our patients using alternative therapies, we all must learn the basic principles of acupuncture and chiropractic. This statistic has been gracefully debunked in a recent article on Science-based Medicine, and I can honestly say I’m still on the fence about that issue.

Instead, I’m talking about two things that are much more basic: the musculoskeletal system and nutrition. Lower back pain is one of the biggest reasons that people go to see their doctor. The high prevalence of obesity and other diet-related illness (i.e. hypertension, heart disease, etc.) are also huge costs on our system. So there is honestly no excuse for why so many allopathic medical students are graduating feeling unprepared to deal with musculoskeletal diseases or why so few medical schools offer anything more than a cursory nutrition education. Since musculoskeletal issues and nutrition are such core features of their healing philosophy, osteopathic and natural medicine schools will feature these areas more prominently, but allopathic medical schools have no excuse for trailing behind on these issues. We need to step it up. If that means mobilizing more research funding at our institutions to focus on these issues so we are able to explore them with a greater basis on scientific evidence, so be it. But I honestly doubt that a lack of science is necessarily the barrier here.

2) Alternative medicine has very real detractors that it has every reason to be defensive against — but that is all the more reason they should get more involved in more mainstream debates.

As I was thinking about the musculoskeletal and nutrition education concerns that I detailed above, I also realized that these issues are not just issues that affect alternative medicine but health care in general. We consistently need more leadership from the health care sector regarding better food in schools and more cost-effective ways (read: less CTs) to deal with chronic issues like lower back pain. We also could use more health practitioners standing up for the fact that spending more time counseling patients is actually better for their disease management. From what I learned at this conference, these are issues that alternative medicine practitioners hold very near and dear to their hearts. Yet, they rarely speak out about the importance of these issues generally, instead choosing to advocate for their particular form of medicine against all its detractors.

Therefore, instead of Western medicine practitioners constantly antagonizing medicine for lacking an evidence-base (rather than paying any attention to the issues that have been more accepted by modern science and medicine) and alternative medicine practitioners secluding themselves from policy debates by taking out-of-pocket payments only, I strongly feel that there are many areas where alternative medicine and Western medicine practitioners could see eye to eye and should work together to advocate for better health care.