If you had asked me at the beginning of my career about alternative medical techniques, like Chinese, naturopathic or Ayurvedic medicine, I would have told you it was fringe stuff. I would have stated it didn’t belong in the tool chest of conventional medicine. But the maturation process is interesting, and I’ve changed a lot from the way I handled things as a young doctor.
I now believe some aspects of complimentary alternative medicine (CAM) can be an effective adjunct to the Western approach. In fact, this year I participated in the development of an integrative medical department at the clinic where I’m medical director. (“Integrative medicine” describes the combination of mainstream techniques with complimentary alternative medicine.)
What triggered my evolution? Part of it is easy experience. I’ve witnessed first-hand patients who exhausted Western medical options, then benefited from acupuncture, meditation or by ingesting traditional naturopathic herbs. I also believe patients deserve choice. Conventional medicine doesn’t have the answer for all maladies.
According to a 2010 University of Calgary study, the proportion of Canadians who use alternative medicine is about 12%. Women, high-income and high-education groups are more likely to use it than others, as are people with pain disorders such as migraines, arthritis, gastrointestinal symptoms and back problems. Studies on Canadian cancer, gastrointestinal and orthopedic patients show that they pursue alternative remedies because they seek fewer treatment side effects. They’re looking for symptom relief from chronic conditions. They want to feel in control of their health, and they seek a boost to their immune systems. And in my own practice, the proportion of people interested in alternative medicine seems to be growing.
My thinking started to change early in my career, after I became the chief occupational physician at Husky Injection Molding. The company’s founder, Robert Schad, is a huge proponent of naturopathic medicine. I worked at a multi-disciplinary Wellness Centre alongside naturopaths, chiropractors and massage therapists. It was there that I came across the shared-care concept between conventional medicine and CAM, which dictates that practitioners such as naturopaths and conventional medical physicians can work together to the benefit of the patient.
Then maybe four years ago, our clinic offered a mind-body medicine course for physicians based on the work of Jon Kabat-Zinn, the University of Massachusetts medical school professor whose work melds yoga and other Asian influences with Western medical science. At about the same time I organized a family trip to Korea. While on the trip we happened upon a Buddhist temple, where we witnessed monks meditating, and I had an epiphany: The therapeutic effects of meditation seemed so clear.
Since then, I’ve met hard-nosed physicians from respected U.S. hospitals who take seriously the effects of alternative medicine. For example, world-renowned cancer centre Memorial Sloan Kettering has Dr. Barrie Cassileth running its integrative medical department, and Johns Hopkins has Dr. Linda Lee.
I now believe that conventional Western medicine and alternative techniques can co-exist, and even benefit each other. Alternative medicine can help with symptoms and patient resiliency. But my support is qualified. In August, Dr. Cassileth wrote a review in the journal Oncology titled “Cancer Quackery.” It listed a series of supposed cures, everything from prayer to the ingestion of shark cartilage, that people attempt to fight cancer in lieu of conventional medicine. “Unproven approaches are hazardous to patients,” Cassileth wrote. “People too often select to shun conventional treatment entirely and replace it with an alternative treatment that does nothing to diminish their disease.”
I concur with Cassileth. What’s important to avoid is the pursuit of alternative techniques to the exclusion of conventional therapies. Apple founder Steve Jobs is an important cautionary tale. He attempted natural remedies to cure his cancer before pursuing more conventional options — and the delay in treatment may have affected the course of his disease.
Early in my career I was doing my patients a disservice by dismissing alternative medical techniques out of hand. Studies reveal that patients will pursue these therapies regardless of what their physician thinks. Ideally, every therapy the patient pursues would be conducted with the doctor’s knowledge. Conventional clinics and hospitals that open integrative departments are assisting patients by continuing to supervise care under an evidence-based umbrella.
The goal is to help control symptoms and develop physical and emotional strength. Treat the whole person, not just the disease. First, do no harm.
—Dr. James Aw is the medical director of the Medcan Clinic, a leading private health clinic in Toronto. For more information, visit medcan.com.
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