Thursday, August 27, 2009

Integrative Medicine a Reasonable Speaker

I was a little apprehensive about the speaker that I went and heard. The doc is a family medicine doc from UCSF. He did the fellowship at U. of A. For starters I would like to say there was a lot that I heard tonight that I thought was good. He did mention accupuncture and chiropractic, but did not dwell on them. One of his statements I agree with whole heartedly; "you must have open minded skepticism." The very essence of skepticism itself. He talked about the need for outcomes research. He also mentioned something I found fascinating, he talked about the sliding scale of evidence; "The greater the potential a treatment has to cause harm, the stricter the standards of evidence it should be held to in terms of efficacy." This includes the treatments risks, risk of foregoing other treatment and costs. I agree with this premise whole heartedly. I got the feeling he was talking about using the patients own desire to control their own health, via their own biases in promoting their own health and treatment. That is very good because we know that placebo effect, ones beliefs, is very strong and does affect how ones responds to treatment. So "integrating" this approach into the care of the patient has sound basis. Even in the face of some treatments are know to be no better than placebo, they may get the person to do a better job of complying with good treatments. Of course this as he said assuming that they will not forego proven treatments for bogus ones in the environment of serious disease. As I have said for years 80% of illnesses will get better on their own. Our job is to identify the ones that will not and treat those. He talked about letting patients use alternatives if he knows that they will cause no harm. And I see no arguement with that because 1. as he pointed out a lot of people use alternatives anyway, and 2. they may trick themselves into getting better. It is all psychological. The danger is that people may then attribute their getting better to the shame or placebo, not the real treatment. All in all I thought this was a very good talk and the speaker said many things that I agree with and could incorporate into my own.

Skeptical DoDo

1 comment:

Anonymous said...

Thanks,Dr.Stripe, for the contructive critisism. Appreciate it. Paul, myself and many others in Integrative Medicine resonate the same principles and philosophy Paul discussed during that lecture. The new book, "Why our health matters", which will be published in September articulates well our philosophy.