Sunday, November 14, 2010

When Mainstream Medicine Was CAM

When Mainstream Medicine was CAM

by Earon S. Davis, JD, MPH, NCTMB
Adjunct Professor, School of Health Sciences

There was a time, not so long ago, when American Medicine was a blend of folk medicines, home remedies and observational science supported by the scientific theories of the day.  One of the prominent treatments of the 1800's was to drain blood from a patient.  From these beginnings, tracing back to western medicine traditions thousand of years old, science has continued to evolve.  Whereas most of what was accepted as the science of the day was eventually proved wrong, the process continued and improvements were gradually made.  This process continues today; most of what we know as "science" today will be seen as primitive and woefully inadequate in 50 years.

It is natural for the child to criticize the parent, often ridiculing their elders' connections with the technologies and disproven scientific "truths" of their day.  Adolescents in the 1930's were just as bemused by their parents' use of a horse and buggy as today's adolescents are bemused by their parents writing a letter and "mailing" it.  This transition takes place within every generation, as "advances" are tested and those that hold up move into the future with pride, only to be replaced themselves by the next generation or the one after that.  Of course, many of these "advances" are later disfavored because of unintended consequences (e.g., they cause too many illnesses, disabilities or deaths).  
Thus, the supposed duality of Mainstream Medicine vs. Alternative Medicine is culturally determined, as one generation's experiment is judged by the next.  It is not absolute, but rather a reflection of where one is at a given point in time. From a systems perspective, there is no "mainstream" or "alternative" medicine - just medical ideas, diagnoses and treatments that are held in favor or not.  In fact, the most advanced theories and technologies from our most gifted scientists remain unproven, "alternative" and non-mainstream for years - waiting to be accepted by the powers that decide whether a procedure will be taught in medical schools and/or be reimbursed by insurance companies.  The same negotiating process goes on within our medical community deciding whether to accept a new infertility treatment - regardless of whether it is a high-tech, ultra-scientific breakthrough or an ancient remedy from Chinese Medicine or Shamanic Herbalism.  Until it is accepted, everything is CAM.  Once accepted, it simply becomes a medical option.

In an important way, it seems that the battle against "Alternative Medicine" has always combined scientific enlightenment with cult-ish ignorance and self-interest.  Human nature applies to all of us.  This is nowhere more apparent than the astounding refusal of mainstream medicine to put acupuncture to the test on their chronic pain patients for the past 100 years.  How many patients have become addicted to painkillers and cost how much pain and grief to their families?  How many billions of lost productivity have been caused by the ignorant proliferation of dangerous narcotics when safer alternatives were available - but would have risked acknowledging that the mainstream scientific establishment simply did not know everything.

The mind-body effect (also known in the pejorative as "pacebo effect") was scientifically proven by the 1940's.  The powerful healing effects of meditation and prayer have likewise been proven for decades.  What, aside from arrogance, could support the stigmatization of these important medicines by the medical community?  To be sure, they would have been referred to as "experimental," but rejected as "voodoo" and "quackery?"

With the growing popularity of Complementary Medicine and Integrative Medicine models, new generations of physicians are open to the challenge of using ALL appropriate, safe and efficacious medicines.  This only enhances their ability to help their patients.  They are not fighting the old battles of their predecessors - obsessed with eliminating superstition and adhering only to an ill-defined, but rigid concept of grandfathered-in "science."  They understand that the purging of ancient practices sometimes threw the baby out with the bathwater, sometimes perhaps motivated more by unconscious cultural factors such as racism, jingoism and bigotry than by science.  And these physicians are also working to unshackle science from the vested interests that have dominated it for generations.  
Yes, the culture of medicine is changing.  In addition to being open to the latest patented medicines from big pharma, the new culture is taking a look at the riches that may be sitting in plain view, unpatentable and lower-cost, - no longer rejected as "alternative" and completely "off-limits," but seen instead as medicines that may just work.  There's an old saying that "There's no saint like a reformed sinner."  In the history of medicine, each generation has been proven, over time, to have been primitive and to see how their bad science had failed to help their patients - yet how the future may be better.  This is one of the "dark sides" to being a physician, one of the most challenging and worthwhile of all human endeavors. 
So, physicians are pushed along by science, forced to give up their old patterns and practices as scientific method is applied to test them.  Some cling to the old, just as others push for improvements.  Some of the visionaries of medicine may be too quick to put forth their improvements, perhaps because of the profit motive, perhaps because they are eager to ease suffering.  Sometimes, the cures are worse than the illnesses they are treating.  Sometimes the drugs that are pushed through the approval process prove to be terrible mistakes.  And sometimes the old practices, the low-tech cures that have been around for centuries are proven to have been rejected too quickly.

Professor Davis teaches Complementary and Alternative Medicine for Kaplan University's School of Health Sciences, in the B.S. Degree program in Health and Wellness.  He is a former lawyer with a Master's of Public Health and is a CAM practitioner, performing Integrative Bodywork at NorthShore University HealthSystems, a major hospital network in the northern suburbs of Chicago.


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