Tag Archives: osteopathic medicine

Is Alternative Medicine, Medicine or not?

This question comes up often in medical practice today. Medicine as I was taught to practice was based on treatments tested by the scientific method. The Scientific Method consists of a set of ways to test a therapy and determine its effectiveness. It uses statistical methods to measure and determine the outcomes. This method continues to be refined and improved.

Scientific Medicine fails to address the real questions of healthcare.

What do we want health career to do? This gets to some fundamental questions of life and how we live it. Much of scientific Medicine uses death as the measured outcome. Since all of us will die alternatives to immortality suffice. How long did one group live v. the other often becomes the outcome measured.

As my practice drifted away from straight Internal Medicine into Geriatrics, the question of death became less important. We talked of Quality of Life and not Quantity. Quality of life is harder to measure and thus is often ignored in Mainstream Medical research.

In the social sciences Quality is the only outcome they can measure. Thus methods have been developed to do that. I am sure you have taken surveys that asked questions like how much you liked or disliked a statement or situation. Yet mainstream medicine refuses to incorporate such questions into their studies.

You never see patient’s asked to compete Quality of Life questionnaires at various points in in study. We do count the number of patients who don’t complete the study or therapy. This “Intention to Treat” requirement increases the rigor of the study, but fails to answer the quality of life issue.

Yet many therapies are intolerable.

One of my aunts died of breast Cancer. For a long time she was a “Breast cancer Survivor”. She developed the cancer in the 1950’s. In those days the therapy was really toxic. She recovered and lived for decades. But the therapy had other tolls.

Her young daughter was traumatized by the experience. When she herself was diagnosed with Breast Cancer, she sought alternative therapy. The Cancer did not respond to those therapies. Was it effective?

If longevity is what we seek, then No. if avoidance of the suffering she saw her mother goes thru, probably. Death from Cancer is not pleasant, either. My cousin left a ten your old child behind along with her] husband.

When considering a therapy what should we ask?”

Doctors are required to list the accepted therapies along with their risks and benefits. Most lack training in the “alternative” medicines. They offer only alternatives among mainstream therapies.

How can you choose?

First, what do you really want? Few of us pause to consider this. Our busy lives prevent the time to reflect upon this. Yet what has more importance?

Second, for whom do we decide? In the case of my Aunt and her daughter it went well beyond the “patient” herself.

Third, who would we include in the process? My parents included the whole family in the process. This made it easier for me and my siblings to be with them in their final days. We have been able to share our grief and continue our lives.

Fourth, with whom should we share our decisions? Those who will be affected by the decision need to know. That list includes family, friends and health care providers. Health care providers get involved when you die. Their default mode of care is to “preserve life at all costs”. Thus their actions can be traumatic if not dramatic. Ways to prevent unwanted interventions exist.

Thus Alternative Medicines are not part of the Science of Medicine. They are part of the Art of Medicine. That is what mainstream medicine lacks by staying scientific.

What are your thoughts about “Alternative Medicine”?

As All Ways, Seek Joy,

Coach Dr. Dave

Host of the upcoming webinar on “the life Transition of a disability”

Osteopaths, are they .O.D.’d MD’S?

Osteopaths (OD or DO0seem to be physicians with an excess of training. Who needs to be able to manipulate the spine if you are suffering from asthma?  How could the muscles and spine be connected to the lungs?

I have always been aware of Osteopathic medicine, but never understood why the fuss. Ever since medical school I came across Osteopaths who were treated just like MD’s.  Yet In some states the two groups did not talk to each other and even had competing hospitals across the street from each other.

Why is Osteopathic medicine different from Medicine?

In the 1800’s Health care was not as organized or regulated. A young person would seek out an older and respected physician and learn from that practitioner. Where were schools as well, in fact at the University of Maryland we attended lectures in a building that had been used since colonial times.

Anyway, in 1874, Andrew Taylor MD started treating patient with spinal and muscular manipulation.  In those days surgeons and medical doctors often trained and worked separately. The various medical sciences were in their infancy. If you were ill there were very few truly effective therapies, at least not by today’s standards. The principles of medical science were beginning to be set down. (Actually they are still evolving.)  Much of the science consisted of trial, error and observation and conjecture.  There are some well-known experiments that would be respected today, but most would not be accepted for publication.

The students of Dr. Taylor went two ways. Dr. Taylor insisted that his students also be MD’s, but others just taught the muscular skeletal approach. Their practice became much like Chiropractors. In most parts of the world and Osteopath practices just like a Chiropractor. In most parts of the US they are treated just like MD’s.

Osteopaths are not MD’s

Osteopaths differ from in MD’s not just in name. The thinking of Osteopathy is that they approach their patients with four principles in mind. First, the mind, body and spirit are one. Second, the body has self-regulatory mechanisms that seek to return the body to best function. Third, structure and function are related, a tight muscle indicates a dysfunction. And fourth, no one of the first three principles operates alone.

This sort of approach was not taught in my medical school. We attended many courses that thought the medical science. The idea of a mind – body connection was not talked about. Spiritual aspects of health were not mentioned. The idea of prayer healing was weird.

I remember a colleague mentioning a patient of his who had had cancer. He had little to offer her. She had taken herself to a prayer healer. When she returned the cancer was gone. We did not understand it, but if it worked for her, Great! However, it would have been malpractice to refer other patients her prayer healer.

In recent years studies on prayer and other forms of spiritual therapy often appear in the medical literature. Duke University has a Center dedicated to this. Other centers also exist.

As I retrained in Public Health, I became aware that for many the spirit was the source of illness not the other way around. I was apt to encounter people who believed as such. In fact Native Americans have always believed in such. The old westerns seemed to emphasize the herbs and potions as much as any ritual. The native American Beliefs were not mentioned in those westerns.

So to whom do you turn for healing?

That depends upon what ails you. Unfortunately, your symptoms don’t always tell the whole picture. We easily recognize common illnesses because they are common. Many times they will bet better on their own. Physicians have to restrain themselves when faced with a cold. Antibiotics can actually make matters worse. They kill the common bacteria and leave the body open to uncommon bacteria. If a virus caused your cold, the antibiotic had no role in your recovery, even if you feel they did.

Other illnesses like stomach upsets can have many causes. They usually get better on their own with only Tender Loving Care and Time. So enjoy your chicken soup.

Inflammatory conditions are not well understood. The interplay and mind, body and other factors remain elusive. Understanding the body as an integrated whole is essential.

If the tried and true does not work for you, then try what has worked for others. It will take time and much work to generate the evidence we have for the tried and true to become mainstream. New ways to study them will need to be designed.

Taking charge of your health and deciding to get better, may just do that. So, decide to be healthy.

PS. Joy can help a lot.

As Always, Seek joy,

Coach Dr. Dave