Chapter 9: Complementary Medicine - The Future of Medicine
I was walking down the halls of the University of Maryland Medical Center one day on my way to a meeting when I passed one of our senior managers. I said the ritual, "how are you doing?" and he gave me the wrong answer. I was late for a meeting and really only expected to hear the usual, "Everything is fine." But not today. "Terrible, just terrible." The look in his eyes told me I had to stop and inquire further. He had been having migraine headaches for a number of years, had seen multiple physicians and was taking a variety of different medications. But recently the migraines had become both more frequent and more severe and nothing seemed to help. He had gone to a good neurologist who had nothing more to recommend, so I offered a suggestion. "Why don't you try complementary medicine? Let me send you to Dr. Brian Berman." Dr. Berman, a physician trained in family medicine, became dissatisfied some twenty years ago with his inability to alleviate a variety of chronic pain problems troubling his patients. He began to learn acupuncture and found it helped. He moved to London where he continued his training in acupuncture but also in other traditional medicine techniques. In the early 1990s he returned to Baltimore with a matching grant of $1 million from the Maurice Laing Foundation to establish a medical school-based program in complementary medicine which would do research, both basic and clinical, into various complementary medicine approaches. I had been involved in helping him set up the program and had heard some positive patient comments before this day's encounter in the hallway. So I called Dr. Berman and got our manager in for a visit.
A few weeks later he stopped by my office to say that his life was fundamentally changed. "It's like a new lease on life. I am actually living again! Dr. Berman used acupuncture which had a fairly immediate effect and then he also taught me relaxation techniques which I have been using regularly and it helps a lot." Comments like these are not uncommon from individuals with various types of chronic pain problems once they are treated with complementary medicine. Many complementary medicine techniques exist and many individuals seek out complementary medicine practitioners. Individuals spend vast sums of money yet they rarely tell their physician of their complementary medicine usage. Until recently these techniques were not accepted since they lacked a scientific basis, but in the last decade high-quality research is beginning to evaluate them.
So how does complementary medicine, with techniques many millennia old, fit into a book on the future of medicine? Their use is indeed developing into a major trend in this country and many others. People are voting with their feet and their pocketbooks. They visit complementary medicine practitioners in ever- increasing numbers and they pay for most of it with cash since it is usually not reimbursed by health insurance. It is a significant mega trend in medical care. Increasingly, we are learning how these treatments work - or if they work at all. Research dollars are available to learn what works and what does not and, even more important, why something works when it does.
Scientific Studies of Complementary Medicine
The National Institutes of Health created an Office of Alternative Medicine, in part due to congressional pressure, to study alternative and complementary medicine in a scientific manner. The Office offered grants to institutions to from centers and study diseases such as cancer and musculoskeletal pain to see how complementary medicine might be of benefit. Later the Office was upgraded to become the National Center for Complementary and Alternative Medicine (NCCAM) initially under the leadership of a highly respected infectious disease investigator, Stephen E. Strauss, M.D. The Center is heavily engaged in multiple studies to assess the scientific validity of complementary medicine practices. Some studies have shown positive results (acupuncture for osteoarthritis pain) and some have been negative (St. Johns Wort for depression.) The point here is to learn what does and what does not work in a manner that is scientific and unbiased.
Some of the complementary medicine practices that we might consider are acupuncture, herbal medicine, support groups and a variety of mind-body approaches such as meditation, the relaxation response, creative visualization and prayer, along with touch therapies such as massage.
The Mega Trends Related to Complementary Medicine
Society is less and less satisfied with the brief encounters and lack of personal attention that we receive all too often in today's health care environment. Many feel that simpler care is better care. As a result, patients are voting with their feet and their pocketbooks and using complementary medical practitioners and approaches more and more often. Concurrently, physicians, nurses and other health care providers are learning more about these ancient practices and are putting them to work - or at least referring their patients to trusted practitioners in the community. And at the same time there are now sound scientific studies ongoing to test and understand which techniques work, for what and how. Over the next five to fifteen years, I believe we will see a flowering of complementary medicine practices, procedures and practioneers and a true integration of Western scientific medicine with complementary medicine. With it will be a much more holistic approach to care where the patient - and not the disease - is the focus of attention.
Last Modified: June 11, 2010