by Joshua Saul, AOMA student
“If I have seen farther than others, it is because I was standing on the shoulders of giants.”
-Sir Isaac Newton
The path by which we travel is neither always clear nor firm and certain. The ancient masters of medicine upon whose shoulders we stand today could never have imagined the complexity that faces us as healers of the modern world. Thousands of years have passed and we find ourselves at the junction of traditional and contemporary, energetics or science and technology, and the decision of what to take with us. Rather than steer our respective ships towards the bow of the other, it is important that we find mutual passage to a place that allows for the best of care to all mankind. While some claim that the modern health care system is broken, out of touch with the individual, others may claim that Oriental medicine is antiquated, anecdotal and unscientific. It is my opinion that each has much to learn from the other and the use of herbs and botanicals can serve to bridge the gap in forming truly integrative medicine.
The healthcare delivery system in America has experienced remarkable changes in a relatively short period of time with the development of new technologies, drugs, medical devices, tests and procedures1. In the process of advancement, modality specialization and the pursuit of perfect care, the role of the patient as the ultimate center of focus has been lost. The growing public sentiment of mainstream healthcare often includes a perception that the patient is rarely enrolled in the decision making process of their own treatment while profit is placed before need in an effort to balance the rising costs of insurance-driven managed care3. More importantly, dissatisfaction of care surrounds the prevalent philosophy that “one size fits all”. As drug therapies have become the standard of care for many conditions, patients are increasingly concerned about the harsh side-effects of synthetic pharmaceuticals engineered for a theoretical standard patient.
It is here that acupuncture and Oriental medicine practitioners have the greatest advantage in bringing herbal medicine and botanicals to the developing field of integrative medicine. For the acupuncturist, each person is seen as a unique individual, a whole entity created from the sum of his parts, influenced by lifestyle, emotion, diet, and environment. Chinese herbal therapy draws upon a pharmacopeia of several hundred herbs allowing for the practitioner to engineer a custom-made therapy to suit the distinct needs of each patient. Both herbal therapies and pharmaceuticals can be used to focus on the root cause of disease or its symptoms but only an herbal formula can be tailored to address each unique presentation in a clinical setting. It is important that herbal medicine be marketed to the patient population with continual emphasis on the merits of its ability to be individually modified for each patient and continually altered as the condition in question changes. As a practicing intern, I use this approach with my own patients. Compliance improves as my patients feel empowered by individualized aspects in their plan of care, outcomes are enhanced, and health is restored more effectively.
As with any major change there are obstacles to overcome. The most important fundamental challenge that must be addressed is the pursuit of corporate profit in the healthcare industry. Like many others, the pharmaceutical industry must walk a fine line between providing a valuable resource to the public and answering to shareholders. Rather than threaten the bottom line as a competitor in this industry, herbal medicine must work in conjunction with pharmaceutical therapies. In particular, conditions requiring a life-long regimen of drug therapy can benefit from the action of herbs in managing long-term side effects. This is applicable for both chronic conditions such as reduction of inflammation in multiple sclerosis7 and acute situations such as alleviating nausea during cancer chemotherapy6. As herbal medicine proves its efficacy as a low-cost, natural option in the treatment of disease there will also be opportunities to promote its use in the prevention of disease itself. The inclusion of herbal medicine in the practice of integrative medicine allows for primary care providers to consult and work directly with herbalists in the name of providing truly patient-centered care that offers the best aspects of both worlds.
As we look into the future of integrative medicine it is hard to see where we will go. What we have before us is endless possibility to create a new way of caring for the ill, an opportunity to choose the very best knowledge from East and West, join together different philosophies and write a new definition for the concept of integrative medicine. It is now our responsibility, like our fathers before, to stand upon the shoulders of giants and dare to look forward in the direction of a blindingly bright future.
CDC. Healthcare in America: Trends in Utilization. Centers for Disease Control. Washington, D.C, 2004.
Olsen and Whalen MD. ” Public perceptions of the pharmaceutical industry and drug safety: implications for the pharmacovigilance professional and the culture of safety.” Drug Safety (2009): 805-10.
Jha, et al. “Patients’ perception of hospital care in the United States.” The New England Journal Of Medicine (2008): 1921-31.
YM, Cai, et al. “Research on frequency of application with modern Chinese herbal medicine.” Chinese Journal Of Integrative Medicine (2011): 64-70.
CZ, Wang, et al. ” Effects of ganoderma lucidum extract on chemotherapy-induced nausea and vomiting in a rat model.” The American Journal Of Chinese Medicine (2005): 807-15.
M, Namaka, et al. ” Examining the evidence: complementary adjunctive therapies for multiple sclerosis.” Neurological Research (2008): 710-19.
Hao, Xu and Yin HJ. ” Reflections on the research status of Kampo medicine: a most rewarding visit to Japan.” Chinese Journal Of Integrative Medicine (2010): 357-60.
C, Hudon, et al. ” Measuring patients’ perceptions of patient-centered care: a systematic review of tools for family medicine.” Annals Of Family Medicine (2011): 155-164.