My 48 year old friend told me he might need a hip replacement soon. I asked him if he planned to explore holistic treatment strategies before his surgery date, as I know it is an extensive surgery that requires a lot of strength and conditioning post-op.
His response was expected and basically boiled down to “not really.” And in truth, he’s no different than most patients, those who think it’s easier to take a prescription drug or go under the knife to “fix” a problem.
Are we taking the easy way out?
Patients aren’t the only ones hesitant to incorporate holistic medicine practices into their Western medicine regimen: many doctors are just as hesitant.
We are generally not educated in holistic or alternative approaches./complementary medicine. In medical school, I never learned about nutrition, lifestyle changes to prevent chronic disease, supplements for joint health, the importance of spending time outdoors , acupuncture, or any other over-the-counter remedy to prevent and treat disease. But these types of lifestyle modifications and complementary therapies can be incredibly effective.
Our inexperience is a detriment
Our medical training does not include training to comfortably discuss nutrition, diet and weight loss with our patients. Although 80% of chronic diseases can be prevented or reversed through lifestyle modification,() 75% of U.S. medical school curricula do not include the minimum 25 hours of nutrition education recommended by the National Academy of Sciences.()
Instead, we prescribe polypharmacy to our patients, because that’s what we studied in medical school, even though we know that the likelihood of adverse effects increases with each additional medication.
Yet our quality metrics tell us we should prescribe beta blockers, PPIs, and statins, even though our patient is already taking 12 other medications.
We have failed because of the failing, high-paying healthcare system that only allows us 15-minute patient visits. This does not give us enough time to have effective conversations about lifestyle modifications and integrating holistic medicine into a comprehensive treatment approach. Even if we could have these conversations, we are not reimbursed for these lifestyle prevention services.
We are manipulated by a healthcare system to choose the quickest treatments: the prescription pad or, in my friend’s case, the scalpel.
Talking to your patients about CAM
“Western medicine is not bad and should not be cast aside, but when we incorporate alternative medicine approaches, we can improve the care of our patients.”
— Kristen Fuller, MD
Studies show that 30% of patients in the United States use complementary and alternative medicine (CAM).()— another way of referring to holistic medicine. This number is even higher among oncology patients.()
Patients who use CAM have expressed concern about discussing them with their doctors, citing their fear of disapproval. They also expressed a desire for their PCPs to consider traditional Chinese medicine approaches and refer them to traditional Chinese medicine practitioners. However, research has shown that PCPs rarely initiate the conversations they want.
We should feel comfortable talking about these things with our patients. We may ask them if they are currently taking vitamins, supplements, herbal treatments, or over-the-counter medications, or if they are exploring naturopathic therapies, acupuncture, therapeutic massage, or chiropractic treatments.
We can ask them why they use CAM – remember to be sensitive to cultural practices.
“Recognize your patients’ choices and efforts in self-care and complementary and complementary medicine. The fact that they use preventive medicine means they care about their health and well-being.”
— Kristen Fuller, MD
What is integrative medicine?
Andrew Weil, MD, was the visionary physician and author who helped make integrative medicine a specialty.() The ideas he promoted about treating and caring for the “whole person” integrated scientifically validated therapies from conventional medicine with selected practices from areas we would consider CAM.
Integrative medicine is powerful and can do wonders for chronic disorders.
This holistic approach begins by listening carefully to your patient and integrating many different disciplines, including the best Western scientific medicine, combined with nutritional medicine, stress management, exercise physiology and massage therapy/chiropractic.
When these services are combined and coordinated by the PCP, it can have tremendous positive effects on a patient’s well-being and life.
Joint pain, for example, can potentially be relieved by strengthening the soft tissues around the joint while performing non-weight-bearing exercises. High blood pressure, high cholesterol, acid reflux and prediabetes can be relieved by a drastic change in diet and initiation of exercise. Headaches can be improved with acupuncture, Botox and a change in diet.
An unhealthy lifestyle can significantly lead to poor health – and our answers are often prescription drugs to treat the symptoms rather than the root. When we doctors work with the patient to resolve these lifestyle issues, the return to good health can be just as dramatic. This is the power of holistic medicine.
Each week in our “Real Talk” series, mental health advocate Kristen Fuller, MD, shares straight talk about situations that affect the mental and emotional health of today’s healthcare providers. Each column offers key information to help you navigate these difficult experiences. We invite you to submit a topic you would like to see covered.
