| The Cutting Edge of Medicine by Arthur Rapkin Let's face the facts. The focus of traditional medicine is to treat disease with drugs and surgeries. This paradigm was developed primarily in conjunction with the pharmaceutical industry, which happens to be in staunch support of medical schools, wherein doctors are educated in techniques to fix, repair and replace. While some doctors may start out with a good intent to make a difference, high educational costs coupled with increasing administrative costs have too frequently dictated bottom-line considerations. These health care providers are now experiencing rough waters in the health care industry, AND FOR GOOD REASON. What are the values that drive our health-care culture? It seems that power, righteousness, authority and financial wealth are most valuable to many doctors, whose attitudes toward patients are unrelentingly authoritative even dictatorial. They are focused on convincing, compelling and controlling their patients. Try to openly disagree with your doctor and see where it gets you. It may get you thrown out of his or her office. It happened to me when I openly disagreed with the pediatrician about what was right for my child. I know it could happen to you. What isn't being said is that conventional medicine is the big shark circling in on the kill. There is talk here about wellness. There is talk about mind and body medicine, but really, at the end of the day, that's not what they get paid for or what they've been trained for. These views will undoubtedly be perceived as negative due to the fact that the American Medical Association and its constituency is so powerful in this country. As well, an unprecedented perception of fear is sweeping through the minds and hearts of the alternative medical practitioners in this country, whose hopes and dreams are hinged on the recognition of their training and expertise in the alternative medical field. Their optimism about being accepted by the so-called traditional medical community is being dashed by the sentiments that I express. My peers have so long yearned for the acceptance that they perceive is on the horizon with respect to traditional medical practitioners. Their hopes of being accepted by insurance companies and HMO's are also motivated by their desire for financial success in their own right. As an acupuncturist, herbologist and doctor of Oriental Medicine, I have practiced for 17 years, both independently and in conjunction with medical doctors, doctors or osteopathy, psychiatrists and psychotherapists. I understand what it's like to truly desire to be accepted as a peer by medical doctors and third-party insurers. However, is financial reward the only incentive in the health care practice? Is the bottom line the only value that should be driving an entire health care movement; namely, to care for a customer or a consumer? What about the patient? If values like power, authority and righteousness are driving health care, the collective, best thinking of both sides of the fence is not being made the priority. There are some well-known medical schools that are implementing programs in certain methods of alternative medicine, holistic heath care or mind-body medicine. Some of these doctors may be better prepared for these studies in a general practice, but what about the existing practitioners throughout the country who have completed their medical training? These practitioners know little to nothing about alternative medicine and, yet, are they scurrying to implement them in their practices? A medical doctor who is also a qualified and trained acupuncturist with four years of training is not the same as a medical doctor who has merely attended an abbreviated seminar that offered a reductionist, cookbook-like approach to acupuncture. Nine times out of 10 you will encounter medical doctors who attended such a seminar during their training. Let me give you an example of a case study. Consider the medical doctor who had abbreviated training in acupuncture. The doctor is shown some major acupuncture points, what they're generally used for and to which conditions acupuncture responds. Having been taught how to insert the acupuncture needles well enough, the doctor begins to implement this procedure into his/her practice. A woman who had been in a car accident the previous day comes into this doctor's office. She complains that her neck and shoulders are stiff and very sore. The doctor is enthusiastic in trying acupuncture on this patient. So, he inserts the needle at the point that his abbreviated training stated was the appropriate point to treat a stiff neck and the woman is sent home. Within 24 hours, the woman, who failed to tell the doctor that she was pregnant, has a miscarriage. One of two scenarios could then play out: • The woman does not connect the acupuncture treatment for her stiff neck to the miscarriage (which is unfortunately likely). • The woman, for whatever reason, does make a connection and files a lawsuit against the doctor. Let's add to this the fact that the insurance company would more than likely have paid for the procedure to be done by her doctor, whereas if she would have visited a qualified and licensed acupuncturist, the insurance company may not have paid for this procedure. On the witness stand, the doctor is cross-examined and asked how many hours of acupuncture training he has undertaken. Whatever the answer may be, it certainly isn't equal to a four-year program in an accredited school of acupuncture and oriental medicine. Unfortunately, this abbreviated program did not teach its students about contraindications of acupuncture points during pregnancy (i.e., the point traditionally known to have good results in relieving neck strain/sprain is also known to cause contractions in the uterus). As you can see, such a lack of training is not only damaging to a doctor's practice and career, but the effect that it could have on the patient's life is potentially devastating. When the various disciplines of alternative medicine are utilized as mere additions to a medical doctor's established area of expertise, the results are not optimal for the patient's well-being or pocketbook. It is time for doctors to stop demanding, "Show me the money!" The focus of health care communities should be turned toward establishing an open and honest dialogue between the practitioners of traditional medicine AND of alternative medicine that will place equal importance on their roles in promoting a patient's overall health and well-being. We need more than a new system of health care in this country. We need new thinking. We need to reflect on the assumptions and conclusions that helped to create this monster. For example, why do we continue to treat medical doctors as if they are authoritarians? Why are other practitioners deemed less knowledgeable than them? They are only human beings with schooling in specific expertise. Acupuncturists have schooling in specific expertise. Massage therapists have schooling in specific expertise. Nutritionists have schooling in specific expertise. If we want to create change in our health care system, we need to create change within our culture. Let's challenge the medical community at every opportunity. Challenge our doctors' conclusions and ask that they share their strong-seeded beliefs. Are they retained by us as consultants and coaches? Are we not hiring them for their expertise or are they the generals, doling out orders for us, the good soldiers, to follow? Let's turn common sense into our most common practice. Arthur Rapkin, O.M.D., is the Director of the Kindo Center for Health located in Shorewood, Wisc. Dr. Rapkin is on the Wisconsin Acupuncture Advisory Board and a member of the Wisconsin Acupuncture Association. He is also a consultant and professional speaker. Copyright © 2003 Arthur Rapkin, O.M.D. |
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