Monday, September 7, 2009

UND and Integrative Medicine

An article appeared in the Labor Day paper about integrative medicine, Dr. Paul Abramson from San Francisco that is misleading in several ways. I work at the Center for Family Medicine and it a fine institution and part of the University of North Dakota Medical School. Our function is to train family physicians to practice in the state. There is a shortage of primary care doctors in this state and we are trying to fill it. Our job is provide education that is evidence based, that is to say science based, not based on systems of medicine that have no basis in science.
I agree that a lot of people use alternative medicine, but that doesn’t mean that it should be promoted. As physicians we should understand what our patients are using and why. Then our job is to try and steer them to use effective methods of treatment. To do otherwise is to break our contract with society, and that contract is to provide effective diagnosis and therapies based on scientific evidence. The alternative medicine establishment has for years saying that conventional, traditional medicine can be and is dangerous. Yes, it can be, but so can alternative medicine. The danger in alternative medicine is providing therapies to people with real disease that will suffer and die if they are not afforded effective treatments by wasting time on wishful thinking. And some have been shown to be dangerous in and of themselves as therapies. NIH has a branch that was started by Iowa Senator Harkin, an advocate of alternative medicine that showed this last spring that all but one treatment was no better than placebo. Senator Harkin sells bee pollen to his congressional colleagues for various complaints; therefore he has a vested interest in these types of therapies. It has been shown scientifically that acupressure, acupuncture, homeopathy, many dietary and herbal treatments are no better than placebo. There is good science on placebos effects. A lot of what we do as doctors is to treat a lot of aliments that will get better no matter what we do, but our job is to identify the ones that really do need diagnosis and treatment.
The place of integrative medicine might be to guide that patient to effective treatments and if the patient is using alternatives and it is causing no harm then encourage healthy living. Healthy living is doing things that promote a healthy body and mind; integrative medicines own definition and it is a good one.

Skeptical DoDo

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