Post view

What impact is the Propaganda War against Integrative Medicine having on Health and Healthcare?

There is a war taking place. The target is Integrative Medicine, and the losers are the patients of the healthcare system as well as the healthcare system itself. The Winners are those that are making (bucketloads of) money off of the patients that find themselves residing in the confines of the current healthcare system.

Conventional Medicine is accepted by most as being quite good regarding “acute care” conditions, with significant improvements over the past few decades. We all should be very proud of the progress that has been made regarding lifesaving efforts as well as the ability to extend life. However, the same progress has not been made regarding “chronic disease” conditions. Currently, about 60% of the adult population has been diagnosed with at least one chronic disease (includes obesity, a risk factor for many conditions), many of which are considered somewhat preventable. This is where Integrative Medicine has had a lot of success and is showing the most promise for even more.

However, everywhere you engage, there are targeted attacks against Integrative Medicine, using words like pseudoscience, quackery, woo/woo woo, and others to try to discredit a form of medicine that makes perfect sense to both patients and to many healthcare professionals. It even makes sense to “science promoters”. Let‘s start with a couple definitions:

According to the Dictionary:

integrative medicine – noun: a form of medical therapy that combines practices and treatments from alternative medicine with conventional medicine.

More thoroughly, from Duke Integrative Medicine:

What is Integrative Medicine?

Integrative medicine is an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health. Employing a personalized strategy that considers the patient’s unique conditions, needs and circumstances, it uses the most appropriate interventions from an array of scientific disciplines to heal illness and disease and help people regain and maintain optimum health.

Definition

Integrative medicine is grounded in the definition of health. The World Health Organization (WHO) defines health as “a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.”

  

Integrative medicine seeks to restore and maintain health and wellness across a person’s lifespan by understanding the patient’s unique set of circumstances and addressing the full range of physical, emotional, mental, social, spiritual and environmental influences that affect health. Through personalizing care, integrative medicine goes beyond the treatment of symptoms to address all the causes of an illness. In doing so, the patient’s immediate health needs as well as the effects of the long-term and complex interplay between biological, behavioral, psychosocial and environmental influences are taken into account.

Integrative medicine is not the same as alternative medicine, which refers to an approach to healing that is utilized in place of conventional therapies, or complementary medicine, which refers to healing modalities that are used to complement allopathic approaches. If the defining principles are applied, care can be integrative regardless of which modalities are utilized.

 

The defining principles of integrative medicine are:

·         The patient and practitioner are partners in the healing process.

·         All factors that influence health, wellness and disease are taken into consideration, including body, mind, spirit and community.

·         Providers use all healing sciences to facilitate the body’s innate healing response.

·         Effective interventions that are natural and less invasive are used whenever possible.

·         Good medicine is based in good science. It is inquiry driven and open to new paradigms.

·         Alongside the concept of treatment, the broader concepts of health promotion and the prevention of illness are paramount.

·         The care is personalized to best address the individual’s unique conditions, needs and circumstances. Practitioners of integrative medicine exemplify its principles and commit themselves to self-exploration and self-development.

In addition to addressing and handling the immediate health problem(s) as well as the deeper causes of the disease or illness, integrative medicine strategies also focus on prevention and foster the development of healthy behaviors and skills for effective self-care that patients can use throughout their lives 

Setting the Stage

For most professionals practicing Conventional Medicine, they decided to enter this profession because they wanted to help people maintain or improve their health. For most professionals practicing Integrative Medicine, they decided to enter this profession because they wanted to help people maintain or improve their health. The good practitioners are arguably far more alike than they are different, though their specialties may vary. If this statement is a non-starter for you, I encourage you to STOP READING NOW!

The Problem

Patients (especially Chronic Disease and Cancer patients) are not really being fully served by Conventional Medicine and its practitioners. The current healthcare system is very much a treatment approach, often with a cocktail of prescription drugs and other interventions. While there is some concerted effort to diagnose causes and to focus on other ways to help a patient with their health situation, for chronic disease, the healthcare system has essentially become a “label and prescribe” approach. And it’s very good at it.

Pausing for a second, it’s important to understand that this is a generalization. Many doctors do NOT practice this way, but many are working within a healthcare system that has BECOME this way. The biggest issue is that the healthcare system has been focused far more on its business model (profitability), and its priority for focusing on health has become a second thought. Most doctors work within the parameters of this system. Under this system, doctors do not have as much time as they would like to help patients, and their recommendations of “eat healthy and exercise” are often hard to follow based on the patient’s situation (this is a very large topic in itself, and CANNOT be labeled as “victim blaming”, see more below).

Patients are looking for answers

When a patient is diagnosed with any kind of chronic disease, they are looking for answers. What caused this? Did I do something wrong? What can I do to get better? What is my long term prognosis? Patients are often filled with fear, and that makes them vulnerable. They are vulnerable to people “selling cures” and they are also vulnerable to their doctor’s recommendations that “all we know” is what we do in Conventional Medicine. But since they are not getting many answers within the Conventional Medicine system, they start looking elsewhere.

From a Canadian Association of Naturopathic Doctors letter to the National Post in 2019, regarding Integrative Medicine (Traditional and Complementary Medicine here):

It is not “controversial” to want to improve health outcomes for Canadians by increasing the focus on prevention through closer collaboration between conventional and complementary health care professionals. Indeed, the World Health Organization (WHO) has identified Traditional and Complementary Medicine (T&CM) – which includes naturopathic medicine – in a 2019 report as “an important and often underestimated health resource with many applications, especially in the prevention and management of lifestyle-related chronic diseases.”

In that report, the WHO Director General states that T&CM “would be an option offered by well-functioning, people-centered health systems that balances curative services with preventive care.” The WHO regards T&CM, including naturopathic medicine, as a credible and realistic approach to eliminating health care inequality and achieving sustainable health care for all as a human right.

Patients are finding answers

The chronic disease “epidemic” has been around for quite a while and people are actually finding answers in many ways. Some have had improved outcomes using strictly Conventional Medicine as recommended by their doctors. Many have had improved outcomes using primarily lifestyle modifications. Many have had improved outcomes using Integrative Medicine approaches.

Yet for virtually every diagnosis of chronic disease or form of cancer, there is no “one size fits all” solution. There are no crystal balls. There are no magic bullets. What works for some can have very negative effects on others. And vice versa.

The key point is that a large number of patients are reporting improved health outcomes and in some cases, remission of chronic disease. There is still very much to learn about these outcomes and the medical community has not been provided with a clear understanding as to the science behind these improved outcomes. More research is necessary.

The Propaganda

One can’t look at the concept of propaganda without recognizing that this is where the war (the war to reap the most financial rewards) is being fought. There is a LOT OF MONEY to be made from treating people with cancer and chronic disease. And this is where the nastiness begins.

Propagandists targeting “competitors to Conventional Medicine” often begin by describing the “four trillion dollar wellness industrial complex". They don’t provide comparison statistics for the sickness industrial complex? They highlight horror stories from patients being “tricked by charlatans” as somehow representative of Integrative Medicine and its practitioners. They don’t seem to highlight that there are many horror stories coming from Conventional Medicine as well.

On the other hand, propagandists targeting “Conventional Medicine” often begin by describing the “pill-for-every-ill” approach as being very bad, and move on to describe how their approach is so much better. They don’t seem to highlight that many prescription drugs have provided a lot of relief to patients when they needed it most.

As an aside, there is a whole lot of bunk that should be called out in the wellness industrial complex. And there’s a lot that should be called out in the sickness industrial complex as well. Saying “statins are bad or overprescribed” is not representative of the entire pharmaceutical industry. Targeting Gwyneth Paltrow and Goop to make this sound much bigger than it really is, while at the same time ignoring the benefits that patients are receiving from Integrative Medicine, is not helpful. Let's stop throwing out the baby with the bathwater.

The reality is that virtually all of this propaganda is intended to drive people to one extreme or the other. It’s FUD (Fear, Uncertainty and Doubt), used to create the illusion that they are focused on patient health and they are “the good guys”. And this is where the patients are losing as fallout from the war. The propagandists are NOT looking for solutions to improve health, they are looking to drive more people to their “solutions”.

But the real solutions are happening in the “middle ground” There are massive problems in healthcare, there are massive problems in population health, and there are some solid solutions and anecdotes coming from both Conventional Medicine and Integrative Medicine. This is where our efforts need to be ramped up.

Tactics

So what does the “war” look like? Let’s look at some of the tactics that are used by Propagandists to attempt to discredit Integrative Medicine

1.       Appeal to Science and the Scientific Method, and “Evidence based” treatments

Science helps to provide answers on a lot of diagnoses and treatments regarding health, and “Science Based Medicine (SBM)” and “Evidence Based Medicine (EBM)” are seen as the pillars of Conventional Medicine. In a perfect world, science would be able to provide all of the answers regarding every possible health condition, every possible cause, and every possible treatment. But it can’t. Science is ever-evolving, and what is at one time seen to be indisputably true according to science, is found to be untrue at a future time. Everything we “know” according to science is always on a continuum based on “what we know so far”. Everything we “know” about Integrative Medicine is also on that continuum. It is NOT that “everything about Integrative Medicine is NOT evidence-based or science-based, it’s that some of the components are on a different point of the continuum. This is EXACTLY the same for Conventional Medicine. Regarding chronic disease causes and treatments, we are at a point relatively early in the continuum. 

However, Propagandists and critics of Integrative Medicine use FUD to create the illusion that virtually all of Integrative Medicine is neither science-based nor evidence-based.

Ignore the Propaganda!                                                                                                                           

2.       “Anecdote”

Whenever propagandists are informed of a case where a patient’s health improved using Integrative Medicine, the first response is often “that’s anecdotal” followed by “the plural of anecdote is not data.” The implication they are trying to make is that the science doesn’t support this “story” because the same positive results have not been covered in a scientific study.

One could easily be lead to believe that anecdotes are not part of “science”. Yet they very much are. Anecdotes, especially as there are increased occurrences of similar anecdotes, provide a signal to the scientific process that something needs to be studied. They form the early stages of the continuum. As part of EBM, as doctors are informed that there seems a growing number of anecdotal incidents supporting improved patient health, it becomes a “potential” part of their toolkit, even prior to the science being robust and fully conclusive.

Ignore the propaganda!

3.       Using broadbrush impact of stories to paint entire field of Integrative Medicine

A favorite tactic of Propagandists is to share sad, sometimes horrific, stories and attribute them to Integrative Medicine in its entirety. The link to Integrative Medicine is often tenuous at best, though someone in the story is a “practitioner of some form of Integrative Medicine”. In one very sad example, Ezekiel Stephan (National Post coverage from September 2019) was a 19-month-old toddler that died of meningitis and his parents were charged and later acquitted of failing to provide the necessities of life. The subheading of this article reads: “The Stephan case raises significant questions about the ability of the legal and medical system to cope with a rise in the use of alternative therapies”. The article goes on to interview a professor who says “We really should stop tolerating the spread of pseudoscience.” When people read these terrible stories, anger naturally ensues and the link to Integrative Medicine (or more specifically in this case homeopathy, or naturopathy) is established and the word “pseudoscience” implanted in the reader’s mind. If different parents had made similar choices and the same outcome occurred, that alone would be the story. It would be equally horrific and the parents would be equally seen as “horrible” by those hearing the story. NOTHING about this story should be raising the questions about the ability of the legal and medical system to cope with a rise in the use of alternative therapies. And NOTHING in this story has anything to do with the spread of pseudoscience. This is propaganda, pulling on the heartstrings of the reader.

Ignore the Propaganda!

4.       Integrative Medicine includes Naturopathy, Naturopaths use Homeopathy, Homeopathy is Bullshit, therefore Integrative Medicine is Bullshit

This is a favorite tactic of Propagandists. It is another tactic to take a single component of Integrative Medicine (in this case homeopathy) and use it to paint Naturopaths as “quacks” and Integrative Medicine as a whole as “quackery”. Acupuncture and chiropractic are often used in the same manner. There’s only one problem. What do we tell the patients whose health has improved and they are no longer on Rx meds for the rest of their lives?

Yet Debunkers and Propagandists use these as their starting point for debunking ALL of Integrative Medicine. They thoroughly discredit practitioners, and, intentionally or not, treat patients like they must be stupid. When called out they point to science, or SBM, or EBM, or some other deflection to show how smart they are and how stupid others are. And the patient whose health improved? Afraid to talk about it because people will think they're stupid. Sadly, for health and Healthcare to improve, we need these stories to be heard, not discredited. And science is not the problem, rather it's the people doing and interpreting the science, including what is simply not yet understood. This gets magnified by Debunkers and Propagandists, with blogs, news interviews, Netflix programs, etc. Are all Integrative Medicine practitioners perfect? No. Are there charlatans and profit seekers? Absolutely. Do we need to debunk these? Definitely. But let’s keep the focus on the problems that are real.

More importantly, we need people to find their voices and share their stories. Maybe we should spend less time telling people that these approaches “don’t work” and spend more time figuring out why they do.

Whenever a conversation about Integrative Medicine is taking place and someone interjects with a comment about “homeopathy is bullshit”, the appropriate response might be “SQUIRREL”.

Ignore the Propaganda!

5.       Adds nothing to Conventional Medicine

Propagandists claim “the false dichotomy at the heart of CAM or “Integrative Medicine” is that Conventional Medicine is nothing but pharmaceutical medications and surgical procedures, while CAM encompasses lifestyle and dietary interventions.” Conventional Medicine includes diet, exercise, etc.”

From the CNDA article:

Acknowledging that naturopathic medicine emphasizes a healthy lifestyle as a core preventative principle in no way negates the role of diet and exercise in conventional medical practice. Further, we would never purport that NDs are the owners of preventative health or that NDs “invented” the concepts of good diet and exercise...

First off, Integrative Medicine practitioners do not believe that Conventional Medicine is nothing but pharmaceutical interventions and surgical procedures. That’s FUD. That’s propaganda. That’s what they want their readers to believe about Integrative Medicine and its practitioners, it just so happens that it’s simply not true.

Conventional Medicine doctors COULD do a lot of the same things as Integrative Medicine practitioners do, if they had the time to do so. Many do, but for the most part Conventional Medicine practitioners do not have enough time to spend with patients to consider all aspects of health as covered in the definition of Integrative Medicine provided above. This is as much about the limitations of the healthcare system as it is about the style of the practices. But for the most part, they don’t. And for chronic disease patients who have exhausted the options available from the healthcare system, they are left still looking for answers. And in many cases, finding them.

Ignore the propaganda!

6.       Quantity of life vs Quality of life

Propagandists love to point to outcomes showing that people are living longer as proof that Conventional Medicine is working. And in many, many cases it is. Period. Full stop. But, in many cases, while people are living longer, they are also dying longer. Quantity of life is not the only measure of a person’s life, quality of life is arguably even more important. The same propagandists don’t seem to place the same emphasis on quality of life as they do on quality of life. If a person is living longer due to Rx interventions, that is seen as a success. And in many ways, it is. But patients make health and treatment choices based on both of these factors. If the treatment that they are going to be receiving will make them live longer but they are concerned about side effects and quality of life, they will seek to understand complementary as well as alternative methods to improve their quality of life.

Most Integrative Medicine practitioners embrace this decision. Most encourage the treatments that will increase their life (as offered by Conventional Medicine), and then go further to attempt to help the patient improve their quality of life. Pause for a second and let that sink in. Integrative Medicine and its practitioners are NOT the enemy of the patient. They work WITH the patient. They help the patient.

Ignore the propaganda!

7.       Vaccination

Propagandists love to try to suggest Integrative Medicine practitioners are against vaccines. From the CAND letter: 

Finally, we contest claims made in the National Post article that anti-vaccine rhetoric “isn’t uncommon among naturopaths.” This is patently false. The CAND and its members support public health policy. The importance of childhood immunization is taught within the curriculum of accredited naturopathic medical programs and students must meet clinical competencies for immunization education in order to graduate. Where immunization is within the regulated scope of practice for NDs, as in British Columbia, NDs certified to provide immunizations must follow the same BC Centre for Disease Control course and guidelines as other immunizers in the province.

Ignore the propaganda!

8.       Placebo Effect / Placebo Theatre

Propagandists claim that the components of Integrative Medicine that are not also part of Conventional Medicine are nothing more than “placebo theatre”, somehow trying to get readers to believe that “therefore it’s bunk.” While they acknowledge that the “placebo effect” (as well as the “nocebo effect”) have scientific relevance, they go on to say that it would be “unethical to knowingly deceive a patient by prescribing a placebo.” It is important to understand the distinction between “prescribing a placebo” and “invoking the placebo effect”, which has much more to do with the entire engagement between practitioner and patient.

If one of the key differences of Integrative Medicine practitioners is that their style of practice invokes the “placebo effect”, that’s a good thing. Conventional Medicine practitioners (and even more importantly the healthcare system) could learn a lot from this. Embracing it could have a significant positive impact on health outcomes. If a patient’s health improves and there are virtually no side effects, how can this be seen as something to debunk? Is it unethical to invoke the placebo effect, or unethical not to?

Ignore the propaganda!

9.       Root Cause

Simply mentioning that Integrative Medicine practitioners focus on “root cause” is sure to infuriate propagandists. But the truth is that we have fairly good ideas about causes of many chronic disease diagnoses (diet, stress, environmental factors, etc.), we just don’t know exactly what caused the condition for each particular patient. As Integrative Medicine practitioners work with the patient to understand the “whole patient”, there is a much better opportunity to figure out potential causes and deal with them, beyond treatment for the particular condition. It is common sense and far less expensive to try to figure out and fix a cause than it is to just continue to treat the symptoms.

Ignore the propaganda!

10.   “Victim blaming”

As Integrative Medicine practitioners work with a patient to try to determine potential root cause(s) of a particular medical condition, they are often helping a patient dig deeply into their “life story”. Propagandists like to label this “victim blaming” as they are encouraging a patient to figure out “what they did wrong.” When one looks beyond symptoms and digs deeply into the potential cause of a problem, they often find more effective solutions. In business this is “smart”, in Integrative Medicine it is “victim blaming.”

Ignore the propaganda!

11.   Natural fallacy

This fallacy arises when we infer something is good because it is natural, or something is bad because it is unnatural. When propagandists see this item included in the defining principles of Integrative Medicine, they call it the “appeal to nature fallacy”

·         Effective interventions that are natural and less invasive are used whenever possible.

The “whenever possible” phrase seems to be missed in the discussion. Many of today’s pharmaceuticals are based on something that occurs in nature. However, something in nature is not patentable whereas a pharmaceutical “equivalent” is. Hmmm?

Ignore the propaganda!

12.   Use of Metaphors

An article highlighting the tactics of propagandists to attempt to discredit Integrative Medicine wouldn’t be complete without a bit of humor. Let’s look at some of the metaphors that propagandists often use:

  • "When you combine apple pie with cow pie, neither is improved." ~ Mark Crislip à I think the only question here is which is the cow pie and which is the apple pie. Of course, neither are actually cow pie, this is just a tactic to get the reader to believe that one is.
  • Problems in medicine do not mean that homeopathic sugar pills work; there are problems with aircraft design, that doesn’t mean magic carpets really fly” ~ Ben Goldacre à Interestingly propagandists love to only use the second part of the quote and apply it to much of Integrative Medicine. For relevance to this discussion, it might be more appropriate to suggest “when there are problems with aircraft design, we connect with others that are trying to solve the same problems to see if we can solve them more quickly
  • You know what they call alternative medicine that works? Medicine.” ~ Tim Minchin à Different Medicine practitioners may practice in different ways. They are all practicing Medicine.

In Closing

In closing, let’s go back to the original question. What impact is the Propaganda War against Integrative Medicine having on Health and Healthcare?

The toll is high. We should be thankful for the progress that Conventional Medicine has made and be respectful of pharmaceutical interventions that are helping patients to manage and/or alleviate symptoms, but clearly, we are not going to medicate ourselves out of the chronic disease epidemic. Nor are we going to solve the issues by being inundated with propagandist rhetoric. Many of the answers to health and healthcare issues are already available to us, and already being practiced by IM practitioners.

It’s time to start identifying causes and finding answers. It just might be time for a peaceful solution. And this time, let's make it about the patients.

Ignore the propaganda!

So what do WE do?

That’s a topic for another post.

 

 

KenJaques 06.12.2019 0 1726
Comments
Order by: 
Per page:
 
  • There are no comments yet
Post info
KenJaques
Check out the Education and Videos posts
Rate
2 votes
Actions
Recommend
Categories
Community (2 posts)
Health (2 posts)
Physical Health (6 posts)