|LETTER TO THE EDITOR
|Year : 2015 | Volume
| Issue : 1 | Page : 107-108
Who is holding us back from providing integrative and holistic health care?
Venkatesh Soma1, Chandrasekaran Venkatesh2
1 Assistant Professor, Department of Pediatrics, Mahatma Gandhi Medical College and Research Institute, Pillaiyarkuppam, Puducherry, India
2 Assistant Professor, Department of Pediatrics, JIPMER, Puducherry, India
|Date of Web Publication||31-Jul-2015|
Assistant Professor, Department of Pediatrics, JIPMER, Puducherry - 605 006
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Soma V, Venkatesh C. Who is holding us back from providing integrative and holistic health care?. Educ Health 2015;28:107-8
During one of our not-so-busy childhood asthma clinics, a resident presented the clinical case summary of a young boy with mild persistent asthma. The child was brought in by his father, and was lost to follow-up for the past six months only to end up with an acute severe exacerbation occurring one week earlier. Since then, they have come back twice. I asked the boy`s father the reason for the loss to follow-up. To this, the boy's father replied "I had been giving Siddha medicine (an alternative Indian system of medicine) to my child all these days". I was not able to hold back my surprise (or rather displeasure) and asked him the reason for revisiting us now, if he was already taking Siddha medicines. The boy`s father replied "when my son was on those medicines he was totally asymptomatic until last week when he had an attack. So I thought I might ask you if I can continue to take those medicines along with what you are about to prescribe". Hastily I retorted, "I am an allopathic doctor and I cannot comment on whether you can take both forms of treatment as I am unaware about Siddha medicines and I fear it might result in adverse drug reaction of some kind. You should probably continue to follow one system of medicine in which you have placed your complete faith". The boy`s father was perplexed and did not know how to react, but agreed to think about it and get back to me. In the meantime I had put the boy back on controller and reliever medications, and saw him off.
I almost forgot that incident and was about to retire to my bed that night, when, out of habit, I picked up my mobile phone to look at the messages, which I missed the entire day in Whatsapp and Facebook, when a particular message caught my attention. "Drugs from Indian spices to fight hypertension", a pediatric cardiologist had shared this message on his wall. Curious to know what was cooking, I clicked the link to find out that a mixture of Indian spices (cardamom, ginger, cumin seeds, long pepper, dill, licorice and white lotus petal) brought down blood pressure in an experimental study on rats. When many allopathic drugs are available to treat hypertension, what was the need for this animal experiment I thought? The spices, the authors claim, do not produce any side effects.  And then, I began to wonder, if Indian spices are really good enough to cure hypertension, why are we not ready to acknowledge the fact and start using them? Why do we become jittery when individuals discuss alternative medicines? Are we becoming biased? Are we developing visual field constriction? Or is it just that we are naïve about alternative medicine practices?
It is probably a combination of the above, with an added element of the great Indian quack practices by self-styled alternative medicine physicians who claim that healing powers have been bestowed upon them by none other than God himself. The allopathic medical system came into existence in the early 18 th century and rose to prominence, spreading throughout the world in a short span of time. The popularity was in part due to the increasing antibiotic and vaccine discovery that was able to bring about a sea of change in the perceived health and wellness of individuals as a whole. As more and more people became enchanted with the allopathic system of medicine, many natural cultural practices and 'grandma' recipes began to fade out of memory.
Suddenly now, a realization has started sinking in: More and more people are turning away from allopathy either because of perceived inefficiency or side effects of allopathic medicine and switching over to Complementary-alternative Medicine (CAM). The shift to CAM is not unique to India but occurs throughout the world. In the past decade or so, one in three Americans has visited a CAM specialist for their ailments at some time or another. From 20% to 70% of people in Western Europe and Australia have been regularly using CAM.  In our practice too, we are likely to see several such patients.
Well, then, how do we handle them? What do we tell them when they want to try a combination of allopathic and alternative medicine? Maybe it might work better for a small group of patients. But is there any way we can be sure about it? Where do we draw the line? Are we going to say a big no-no to our patients and discourage them from taking other medicines in the blind belief that they are no better, or rather worse? These thoughts should perhaps make us really wonder about how to provide holistic and integrated health care to our population. How do we integrate ourselves with CAM practitioners?
Should we not start educating ourselves about the best practices in the alternative systems of medicine? Maybe we should stop being skeptical and try to find out ways of integrating with CAM services and seek new information without any kind of bias. We should evaluate such new information and build up evidence, which we can later use to support or refute their claims. An integrated approach could also be a solution for failing medical care systems around the world.  Health service managers are beginning to understand that CAM can enhance their service capacity and can fill crucial gaps, especially in chronic ailments. 
To achieve this integration, a new stream of doctors will likely be needed, who can study the best of both worlds and can apply a combination of treatment principles for a holistic and integrated care. The day may not be very far when a basic allopathic undergraduate medical course might have subjects from Siddha, Ayurveda, Homeopathy, Unani and other such CAM specialties included in its curriculum. To achieve that, conventional medical schools have to sit together with CAM academic institutions to have systems in place so that a combined medical curriculum can be evolved. So, now who is really going to hold us back? It is none other than we ourselves.
| References|| |
Frenkel MA, Borkan JM. An approach for integrating complementary-alternative medicine into primary care. Fam Pract 2003;20:324-32.
Maizes V, Rakel D, Niemiec C. Integrative medicine and patient-centered care. Explore (NY) 2009;5:277-89.
Singer J, Adams J. Integrating complementary and alternative medicine into mainstream healthcare services: The perspectives of health service managers. BMC Complement Altern Med 2014;14:167.