Talk:Complementary and alternative medicine

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A proposal for a fresh start: integrative medicine

Pat, to some extent, I've tried a new start in integrative medicine. I will, to some extent, defend the problem that people are seeing different practitioners, who could work together, but there is no coordinated care. A conventional physician must know any herbals or dietary supplements the patient is taking, or, variously, a drug could be prescribed and cause a deadly intercation, or laboratory results are completely skewed. If a patient chooses to use an herbal preparation, and the medical prescriber knows it, different choices can be made.

"Complementary" is not, to reasonable practitioners, a bad word. "Alternative" is a problem, when it is seen as a substitute. integrative medicine is a paradigm of cooperation. For example, I've been involved with several multiphysician groups that either have in-house acupuncture, manipulative therapies, or routinely cross-refer. I lost a close relative because an "alternative" practitioner decided that his particular discipline would cure everything, and missed basic signs of major internal bleeding. Pain management clinics are very frequently multidisciplinary, which, perhaps, is another way of saying complementary. Physicians often don't know how to teach visualization, meditation, and other techniques that they agree are worth trying in chronic, or even acute pain. I'm as bioscience oriented as anyone you will find, but if I get a headache, I use some learned visualization techniques first -- and take conventional medications if they don't work in 15-20 minutes. I might decide to take acetaminophen and then use relaxation and visualization.

As a term of art, multidisciplinary tends to involve multiple defined medical specialties and subspecialties, where complementary simply refers to things not in a core medical curriculum. Some of those things, under that definition, are as straightforward as art therapy, therapeutic massage, and manipulation. There are some exciting synergies: certain manipulative therapies can only be done with a patient under anesthesia. That may look like a patient going into an operating room with the anesthesia equipment, then a chiropractor, working with the anesthesiologist, does the manipulation. A friend of mine is a dual-boarded (family and emergency medicine), but also is osteopathically trained and can do the manipulations himself.

Actually, I rather like the couple of paragraphs above, and may take them to integrative medicine. I would like to invite everyone to work in that framework, because the whole idea of integrative medicine is about collaboration. Howard C. Berkowitz 23:51, 26 December 2008 (UTC)

Howard, would you please move this debate to MY talk page and give people some space here to try this? I'd very much appreciate it. You and I can talk offline about some of these issues.Pat Palmer