It is time we integrated complementary, evidence-based medicine into the allopathic, or conventional, medical curriculum through research and nutrition, to bring about a gentle, humanistic approach to healthcare.
The idea of incorporating and teaching complementary and alternative medicine (CAM) in the conventional medical school curriculum has been a raging debate for too long. The argument is not so much as to whether or not conventional medical institutions are receptive enough to integrate evidence-based CAM knowledge in their own academic or clinical setting, or whether CAM should be a part at all. What is imperative is a balanced view, because the community at large expects medical professionals to be able to provide information and guidance about the quality and therapeutic use not just of conventional medicine, but also complementary, integrative or functional medicine, which most patients use some time or other.
CAM is a term used for different complementary and alternative medical practices and medicines. There is more than definitive therapeutic and scientific evidence for a number of them, albeit skeptics often “sweep them off the ground” as being just placebo. The fact is that, any which way you look at it, a host of CAM modalities are derived from ancient sciences. Ayurveda, the Indian system of medicine, for instance, has a long history of successful traditional use.
Many skeptics likewise consider homeopathy, a growing CAM approach, as pseudoscientific “mumbo-jumbo.” They argue that it shouldn’t be taught at the university level, or in CAM protocols in conventional medical schools. There’s adequate evidence for homeopathy as a clinically effective mode of treatment for several conditions, right from allergies and skin diseases to functional disorders, such as irritable bowel syndrome (IBS), to name a few. What’s more, studies have demonstrated that homeopathy, when used as an adjuvant with conventional medicine, is more effective than treatment outcomes with the latter alone. This relates to conditions such as diabetes, hypertension, and arthritis, aside from hormone replacement therapy (HRT), among others. The question is: why shouldn’t conventional medical students and practitioners learn about such evidence and apply the Ayurvedic, or homeopathic, option to augment treatment choices and improve patient outcomes?
Well, skeptics again may have their own purpose for stalling the idea; they may also ask for more evidence and expanded evidence. Yet, there could be a way out of the impasse – because it certainly won’t take long to establish review boards to identify what CAM information resources are of high-quality, evidence based, unbiased, well structured, or flawed. There are certain high-quality CAM resources already accessible; they are also a part of educational curricula and research at universities. They could be scaled up and meta-analyzed.
Many factors also highlight the rationale for greater attention to CAM in undergraduate medical education (UME). They are, in précis:
- The widespread use of CAM by patients and their projected increase over the next decade.
- A majority of CAM users continue to use conventional medicine, creating potential safety risks due to medicinal interaction effects.
- Only a minority of patients reportedly disclose CAM use to their conventional physicians.
- Patients report wanting to receive information about CAM from their physicians.
- The growing evidence base for certain CAM therapies.
The best place for medical and health professionals to accrue knowledge is at the university during their academic studies. The best advantage universities possess is the close relationship that exists between research and teaching. Besides, students are better engaged and inspired by research-led teaching, especially research provided for queries while teaching. It is, therefore, not surprising that a handful of universities in the West research CAM to generate evidence-base and/or disprove its efficacy.
So, why the dichotomy to block CAM in conventional schools, as some skeptics would want? The CAM riposte is obvious: why support research, when one excludes teaching of CAM in conventional medical schools or universities? All one needs is intent, or the will to translate CAM research results into better CAM practices for everyone’s benefit. The best mode is to start teaching new conventional medical practitioners the uses, or the downside, of CAM in a given situation or condition.
The point today, or in the future, is not so much whether conventional medical students who learn about CAM approaches ever incorporate CAM in their practice. The big point is that they certainly stand to gain from viewing medicine in a more holistic manner, not with dark glasses. As a Texas medical student said in a newspaper interview, “It’s ironic … as medical students, we approach our education as scientists who make decisions on evidence and fact. But, learning about CAM has really led me back to the humanistic part of medicine…”
Photo is from Microsoft Office Clipart Collection
This is a shorter version of the article that was first published in ©Townsend Letter, December 2014.
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