The role of clinical and complementary medicine in integrative health
If you follow my blogs regularly you’ll know that whilst I am a big advocate of an integrative approach to providing care to patients, that joined-up approach to health provision is not one that’s widely shared by the health ‘establishment’.
I’m not entirely sure why this should be the case. It’s not as though the concept is controversial, and in fact at the core of integrative health is the principle that the patient should be a stakeholder in their care plan – something you’d imagine should also be at the heart of any modern and forward thinking health service.
Yet from the moment a student enters medical school to the moment they retire the fundamental principles of truly patient-centric care are overlooked. To a greater or lesser extent medical teaching continues to reflect advances in clinical approaches, but fails to recognise how clinical medicine can be supported by complementary healthcare.
I think it’s time for a new approach.
It’s time for Public Health England and academia to work together to ensure that the next generation of medical professionals not only have an informed knowledge of how alternative health treatments can support their work (note the use of the lower case ‘a’ in alternative there), but are also able to give their patients the information they need to make informed choices about how their care is delivered.
To avoid confusion or misunderstanding, let me be clear on what I mean when I talk about integrative health.
Integrative health is a care approach that recognises an individual’s health is not concerned exclusively with the clinical treatment he or she might receive from their own doctor or a hospital.
The essence of integrative health lies in the acceptance and recognition of the fact that complementary services – acupuncture, non-clinical physiotherapy, herbal therapy, hypnotherapy, aromatherapy etc. – can augment and support clinical care that is delivered via surgical or pharmaceutical intervention.
It also absolutely reflects the fact that it is only when a patient has a say in their own care that treatment can have the greatest chance of being successful.
Let me unpack that a little bit more.
Imagine, for example, that a patient is suffering from depression. Let us assume that it’s a condition that began with mild symptoms but has, over time, worsened to the point where the patient is motivated to seek professional advice or treatment.
Under a conventional NHS approach to patient management, and assuming the individual’s symptoms don’t pose an immediate danger or risk to their future health, the patient might first see their GP.
If the condition is deemed to be manageable locally, the likelihood is the patient will be prescribed a pharmaceutical solution – perhaps in the shape of antidepressants. If it is deemed to be more serious and requiring more specialist care, then the GP may refer that patient to a specialist mental health service.
From there, the likelihood is either medication or counselling, or both.
It is unlikely, though not certain, that the patient will be asked for their opinion on or input into their ongoing care beyond describing the symptoms they’re experiencing, and their impact.
There is far less chance that their doctor or clinical specialist has offered this patient information about the non-clinical care options that exist and which may support whatever clinical treatments might be recommended.
In all likelihood, what we have instead is an individual who is sent down a path of pharmaceutical care because, as a non-medical person, they have simply accepted the treatment recommended to them and aren’t even aware there may be other treatment, support or care options available.
This, then is the world of the uninformed patient. With lack of information comes an inevitable lack of choice. And with lack of choice comes a lack of control over their own health outcomes.
Integrative health requires a collaborative approach to care. It is a three-pronged approach that means:
- The benefits and risks of clinical treatment options are clearly explained to, and understood by, the patient;
- A clear patient understanding of the potential and realistic benefits that may or may not be gained from complementary/alternative/non-clinical therapies and treatments that support clinical health pathways;
- Active involvement of the patient in determining the healthcare approach that is likely to achieve the best outcome for them
- The patient has the full collaborative support of their caregivers in delivering their treatment
Making integrative health a central plank in a modern health approach does not mean that complementary health treatments or therapies should be a part of every treatment plan.
But by embracing new ways of thinking, and recognising the overwhelming arguments and evidence that demonstrate the positive role non-clinical care can have in delivering successful health outcomes would mean an end to this era in which the patient is merely a passenger in their own recovery.
Moreover, and as I’ve said numerous times before, it would also serve to help take some of the pressure off our catastrophically under-resourced and understaffed NHS.