When Patients Go Alternative
The scenario is becoming more and more familiar. A patient is on the examining table, the physical exam completed, and with a furtive look in his eye, says: "By the way, Doc, I've been taking Siberian ginseng for the past couple of months, and I'm wondering if it might cause any problem with my blood pressure pills." This event is usually followed by a few seconds of uncomfortable silence.
Americans are increasingly using unconventional therapies for everything from the common cold to cancer. They are mixing botanicals with blood pressure meds and acupuncture with antidepressants. However, 70% of CAM users do not tell their physician. So why aren't they telling their conventional doctor? The fact is that the majority of patients withhold such information because they fear embarrassment or censure. More surprisingly, this reluctance to confess applies not only to alternative therapies, but also to over the counter products and drugs prescribed by other physicians.
So what should your physician do when you finally inform him or her that you have been taking a botanical medication they know nothing about? The first order of business is to not scare you back into silence with judgmental attitudes. If the product has scientific backing for efficacy and safety, they should support its use while keeping an eye out for potential adverse effects. If it does not, they should gently guide you into making an informed decision as to whether to discontinue the product and possibly search for another approach, alternative or conventional (or both). Of course this would require that your doctors educate themselves as to the supplement in question, something they are unlikely to do given the time constraints of daily life.
But there is a solution. The conventional MD may not know about unconventional therapies, but they should know where to ask. The obvious choices are the pharmacist and the naturopathic physician, which brings us back to the definition of integrative healthcare. Collaboration. Appreciation of another's knowledge. Putting the patient before ego. Practitioners recognizing that they are not the source of healing, but the means by which patients discover, or actually rediscover, their own innate capacity to regain health. Both becoming active partners in choosing therapies consistent with communal values and philosophical beliefs, acknowledging that the basis of any relationship, therapeutic or other, is open communication and trust - both the trust that you will reveal the truth, and the trust that your doctor will listen and advise without judgment.
Americans are increasingly using unconventional therapies for everything from the common cold to cancer. They are mixing botanicals with blood pressure meds and acupuncture with antidepressants. However, 70% of CAM users do not tell their physician. So why aren't they telling their conventional doctor? The fact is that the majority of patients withhold such information because they fear embarrassment or censure. More surprisingly, this reluctance to confess applies not only to alternative therapies, but also to over the counter products and drugs prescribed by other physicians.
So what should your physician do when you finally inform him or her that you have been taking a botanical medication they know nothing about? The first order of business is to not scare you back into silence with judgmental attitudes. If the product has scientific backing for efficacy and safety, they should support its use while keeping an eye out for potential adverse effects. If it does not, they should gently guide you into making an informed decision as to whether to discontinue the product and possibly search for another approach, alternative or conventional (or both). Of course this would require that your doctors educate themselves as to the supplement in question, something they are unlikely to do given the time constraints of daily life.
But there is a solution. The conventional MD may not know about unconventional therapies, but they should know where to ask. The obvious choices are the pharmacist and the naturopathic physician, which brings us back to the definition of integrative healthcare. Collaboration. Appreciation of another's knowledge. Putting the patient before ego. Practitioners recognizing that they are not the source of healing, but the means by which patients discover, or actually rediscover, their own innate capacity to regain health. Both becoming active partners in choosing therapies consistent with communal values and philosophical beliefs, acknowledging that the basis of any relationship, therapeutic or other, is open communication and trust - both the trust that you will reveal the truth, and the trust that your doctor will listen and advise without judgment.
References:
Related Topics: Technorati Tags: alternative medicine, complimentary medicine, integrative medicine, CAM, supplements, health-and-wellness- Eisenberg DM, Kessler RC,, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States: prevalence, costs, and patterns of use. N ENGl J Med. 1993;328:246-252.
- Complementary and Alternative Medicine (CAM) in the United States
Committee on the Use of Complementary and Alternative Medicine by the American Public
Board on Health Promotion and Disease Prevention
Institute of Medicine
The National Academies Press
Washington, DC
www.nap.edu
Executive Summary page 10, 2005
Labels: integrative medicine
4 Comments:
I have yet to see a conventional doctor put a patient before ego. I have seen them put pharmaceutical companies way ahead of the patient. Any rep that walks into the doctor's office is usually allowed to talk to the doctor as soon as possible. Patients? Well, they can wait as long as the doctor or office staff feel like helping them! What is wrong with this picture? Moreover, the prescribed drugs usually have side effects that need more meds to treat. It is a vicious cycle. No wonder many are turning to natural treatments.
I agree with anonymous #1. I don't think that the Dr. has a clue what the side effects are. He just pimps out these pills that the drug rep gave him some free goodies to pimp for him. You want to believe that he knows what he is doing, but its increasingly obvious that he doesn't. Look at Statin drugs for instance. Go to medications.com, look up the side effect. You will see where actual people have listed all of the problems they are having with these drugs. There are hundreds of listings, almost all are having problems with them. I also have problems with them. My sisters Dr. told he that, of coarse, her cholesterol was high. Take these pills. She had problems with them also. She asked him what she can do to raise her HDL count. Take these pills. (same pills) She took Lipitor before. Next thing you know shes diagnosed with "fibromyalgia". "We don't know what causes that". I, and she knows. Lipitor does. Well, not only Lipitor, but most drugs with Fluorine in them do. Well, what the Dr. should have told her to take was Niacin. That raises HDL.
(source? Mayo Clinic. Surely you've heard of them) Wht are Drs. so set on prescription drugs, when there are safer, over the counter suppliments that will do the same thing?
Oops. Should have proof read first before posting.
You both brought up issues that do indeed drive patients to natural medicine doctors. Nonetheless, we need both conventional and natural medicine, working collaboratively. This is why I really like the term "integrative" with the goal of getting the best from both. It is also why we need the doctors from both sides to talk with each other. Unfortunately, this integration seems to happen through the patient with most being afriad to tell their MD that they are seeing a CAM practitioner or using natural health products. The problem with this is the real risk of interacts between the natural health products and prescription drugs. In addition to the potential for interaction, there is the missed opportunity for better outcomes. A main problem with statin drugs is that they induce a coenzyme Q10 deficiency. In some patients, the deficiency is so severe that they develop symptoms such as described. These side effects can be prevented by CoQ10.
Bottom line: choose doctors (both conventional and natural) who choose to actively work together.
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