Breaking down the barriers to integrative health
Last month I wrote an article that made the case for a greater emphasis to be placed on healthcare strategy in the UK.
If you missed that piece, you can read it to find out what I mean by integrative health and why I think it’s important that everyone’s health should be protected and managed through an integrative approach.
The simplified version of my original article was that very often the care delivered via the public health system in the UK is primarily driven – at least initially – by prioritising symptom management above diagnosis.
I believe a better way to manage public health is to work in better partnership with providers of complementary medicine and therapy – acupuncturists, physiotherapists, homeopaths, aromatherapists, etc. – to support the clinical work of doctors in conventional and alternative medicine.
This collaborative and integrative approach – which blends the benefits that therapists like me can offer with pharmacological solutions and a sharper focus on patient lifestyle – is much more likely, in my view, to deliver better and more lasting outcomes for people.
But that does require the NHS, via government guidance and policy, to play its part in breaking down the barriers that currently exist to those partnerships being properly established.
But before we get into that, it’s important to make two things clear:
First, I’m not criticising GPs and other health service workers. By and large they do a fabulous job in the face of difficult circumstances and a lack of resources.
Second, when I talk about not prioritising diagnosis, I’m really talking about those health conditions where a diagnosis isn’t necessarily obvious – as an example, and one I used in my original article, a recurring headache could have multiple causes, from allergies to weight issues to deteriorating eyesight.
Given no reason to suspect a serious condition, the current NHS consultation model would likely prescribe painkillers and suggest you return for another appointment if the problem doesn’t clear up.
Why is that? There are many potential reasons, but one common one is that generally speaking GPs are under resource and funding pressure and so the cheapest way to approach the problem (both in terms of time and money) is symptom suppression, which may allow time for the root cause of the problem to resolve itself.
And if it doesn’t? Well, that’s the point at which you’ve been encouraged to return for another consultation, where further investigation – possibly via referral to a specialist – will be pursued.
(Ironically, it is also at the point of a second appointment when engaging the support of complementary therapists and practitioners may well begin to factor in a GP’s treatment strategy.)
Quite why the NHS is unwilling to engage with other non-clinical healthcare providers on a more organic level isn’t totally clear, other than the obvious argument that gets rolled out in the ‘complementary vs. clinical’ debate – namely, that science does not support the outcomes.
In fact, the truth is that science does, in some cases, support the outcomes (which is why GPs will refer quite readily to, say, a physio), and where it doesn’t, it is because the medical sector either cannot or will not invest in the clinical trials necessary to provide base data.
And as I pointed out in my article from last year on why acupuncture’s critics are missing the point, it’s also ironic that clinical trials only positively prove the effectiveness of 11% of the treatments and drugs that go through clinical trials (81% are considered to be somewhere between ‘likely to be beneficial’ and ‘unknown effectiveness’).
The greatest barrier to integrative health is the unwillingness of the ‘establishment’ to engage with those working in the field of complementary health – most of whom, like me, find their work focusing on both physical and/or emotional health and lifestyle.
Having said that, I was really encouraged last week to see that NICE, the National Institute for Health and Care Excellence that advises and governs health strategy for the NHS, has suggested that painkillers should not be prescribed for primary chronic pain and has specifically recommended acupuncture as an effective treatment for patients with this type of pain.
By taking the first steps to collaborative working, as NICE have done in this specific area, I believe the NHS will see a tangible benefit in better diagnosis, improved recovery rates, outcomes that ‘stick’ and a better awareness of self-care.
And the net reward of that? Less pressure on GP surgeries and GP’s resources, more time to treat patients with chronic clinical conditions that require greater support and a network of trusted and qualified health partners who collectively have decades of experience that can inform primary healthcare providers.
It’s hard to see what the downside of that might possibly be.