Ethical Promotion Of Complementary Medicine: A Guide For Doctors
Complementary medicine includes a range of popular practices, from herbal supplements to massage, chiropractic treatment, and meditation – and these products and practices are growing in popularity. In fact, according to a 2012 survey, 17.7% of Americans have used natural supplements (besides vitamins and minerals), while 8.4% have consulted chiropractors and osteopaths in the past year. Despite their widespread adoption, however, many mainstream practices have failed to consider how these complementary practices fit into their approach to care.
All medical professionals today should develop a deeper understanding of complementary medicine so that they can provide informed guidance regarding the safety and suitability of these different treatments. This overview of complementary medicine practices can help you get started.
Complementary Versus Alternative
The first thing you need to understand in order to guide your patients toward appropriate complementary treatments is how those practices are different from those of alternative medicine. Historically, the two have been grouped together; the NIH even housed the National Center for Complementary and Alternative Medicine until the name was changed in 2014 to the National Center for Complementary and Integrative Health (NCCIH). Removing “Alternative Medicine” from the name was a key step towards recognizing that alternative medicine is fundamentally unproven. As the old joke goes, “what do you call evidence-based alternative medicine? Medicine!”
Alternative medicine practices like homeopathy are intended to replace medicine and are fundamentally non-scientific and useless and patients should be discouraged from pursuing these treatments. Complementary and integrative medicine, on the other hand, consists of those treatments that are used alongside traditional practices. They can still be contraindicated – for example, you can’t take St. John’s Wort with antidepressant medications – but most have scientific backing, and the NCCIH is working to fund further research.
A Selection Of Supplements
A small group of complementary and integrative treatments make up the majority of the market, and supplements lead the way. Most physicians see this in practice when asking patients what types of medications they take – you’ve likely heard lists peppered with products like fish oil, probiotics, and glucosamine and chondroitin. Each of these supplements has some research-based backing, and you may have even recommended them yourself. Things get trickier, though, when you get into the world of herbs.
Patients should take greater precautions when taking herbal supplements as many are contraindicated with prescription medication, and it’s okay to ask patients to stop taking any particular supplement until you have time to research and approve it. Additionally, you should be sure to ask patients specifically about their use of any and all supplements, as many think that they don’t need to mention natural products.
Another popular complementary medical practice is chiropractic care, which focuses on spinal manipulation and can help treat musculoskeletal and nervous system disorders – and from a medical perspective there’s plenty of evidence that chiropractic treatment can help. In particular, chiropractic adjustments can be a good treatment for back and neck pain, as well as headaches. In many cases, these conditions are caused by compression in a specific area or excessive muscle tension.
When patients bring up chiropractic care, your role is to eliminate any possible risk factors. For example, patients with certain spinal injuries shouldn’t receive chiropractic treatment. It’s typically a good plan to refer to patients’ CT or MRI scans to check for more serious problems before they pursue chiropractic care.
Many doctors view acupuncture, a form of traditional Chinese medicine, with skepticism, but research has shown that this gentle treatment can be beneficial for back and neck pain, nausea, insomnia, and possibly even infertility – and most of all, it’s generally safe when performed by a trained practitioner. Acupuncture is performed by inserting very fine, sterile needles into the skin along energy lines, sometimes known as meridians, based on known correspondences. For patients who are hesitant about taking medication, acupuncture can be a good treatment option, and it can also supplement medication regimens ranging from antidepressants to painkillers.
Mindfulness And Meditation
Finally, mindfulness and meditation are central parts of the complementary medicine framework, and almost everyone can benefit from these sorts of mental health treatments.
For example, supplementary services like art therapy and horticulture therapy can help people recovering from addiction to develop new hobbies and interests and process their feelings, while mindfulness and guided meditation can help people struggling with anxiety, insomnia, or those dealing with trauma.
Complementary and integrative medicine practices don’t just work well with traditional healthcare practices, but they also work well together. That’s why, when working with patients who are interested in these types of treatments, it’s important to find the right combination of practices to best benefit your patients. By opening the conversation and learning what patients are interested in, you’re creating vital room in your practice for holistic patient care.