A plea for integrative medicine

I recently read several scathing blog posts lambasting the University of Toronto for allowing integrative medicine into the hallowed halls of its schools of pharmacy and medicine. Judging by the tone of these blogs, you would think the end of world is coming. But to patients who use the medical system every day, it is, in fact, good news.

The Consortium of Academic Health Centers for Integrative Medicine (and Wikipedia) describes "integrative medicine" as

the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing.

Sounds eminently desirable. But to some purists defending the status quo it represents nothing less than a tainting of conventional medicine because it allows "quackery" such as acupuncture, TCM, Reiki or biofeedback through the door. This exclusionary stance is as arrogant as arrogant can be in that it assumes conventional medicine to be the one and only option. If medicine can't help you, the reasoning goes, nothing will.

I will present a case here that shows how much integrative medicine is needed right now to help people who have come to the end of their tether with conventional medicine.

I will call the patient Robert. Two years ago Robert had a bypass. This is the kind of intervention modern medicine excels at, and everyone was glad to see Robert get his pink complexion back after years of looking ashen.The good news, however, didn't last. Robert developed debilitating heart arrythmia. His heart would start racing, and keep racing, for no apparent reason. Robert is not alone in this; many people with bypasses share his problem. He has made numerous trips to the ER and has had further tests and further surgery. He is on medication. All to limited effect. He is getting increasingly frustrated with the medical profession and with what he calls the arrogance of doctors. To me it also sounds like the medical profession is getting increasingly frustrated with him. They've done everything they could and it wasn't enough. Now there is little more they can offer and he serves only as a reminder of their limits.

This is where integrative medicine comes in, or rather could come in, if it were allowed to. Instead of waiting for 45 minutes for a doctor who then sees him for seven minutes, spending 5 of those 7 minutes on the phone, Robert could be sent to someone who would listen to his problem and offer him some comfort. He could be sent for counselling, for meditation training, for Reiki, for biofeedback, for massage or acupuncture, some or all of which would help him at the very least to feel better, or even to take control of his problem. But to the doctors who are treating Robert, these options are not even on the radar.

Stress and a feeling of lack of control are large components in heart disease, so Robert is not being helped and is perhaps even being harmed by the status quo. In effect, his doctors are harming him by keeping him waiting and treating him with what he sees as disrespect. He would very much benefit from a type of medicine that treats the whole person and focuses on the relationship between doctor and patient.

I wonder how many of us know a Robert, or are Roberts ourselves. Kudos to the University of Toronto and to all the other forward-looking and courageous medical schools, hospitals, and treatments centers that recognize the importance of integrative medicine.