‘Terminal’? We’ve only just begun

Rosy Daniel stands up for integrative medicine and calls on the academy to join her

四月 25, 2010

So, the University of Buckingham Medical School and the Integrated Health Trust (IHT) have decided against a second cohort of integrative medicine (IM) students in 2010 (Times Higher Education, “It’s terminal for integrated medicine diploma”, 15 April).

But the situation is far from “terminal” for IM in the UK, despite our critics’ claims.

As well as offering the UK’s first diploma in the study of IM, the IHT will open its full programme of postgraduate educational activities in September 2010 – offering IM induction courses for doctors and other healthcare professionals, as well as a series of masterclasses from national and international leaders at the cutting edge of IM research. The programme will be launched on 15 May by the IHT’s US advisory board member, Andrew Weil.

When it comes to IM, the UK lags 15 years behind the US and Australia, where IM Fellowships have been provided for hundreds of doctors by Weil and his colleague, Avni Sali.

Thinking about IM in the UK is still clouded by complementary and alternative medicine (CAM) detractors owing to an important misunderstanding: IM is not CAM.

IM is an overarching model of whole-person care that focuses primarily upon health rather than illness, and on each individual achieving optimum health and wellbeing whether they are ill or seeking to prevent illness. It uses the crisis of illness as a springboard for positive personal change and the development of the “fully engaged” scenario envisaged by Sir Derek Wanless.

However, people do not become fully engaged or change their health-defining behaviour on the basis of information alone. IM doctors study the interaction of emotional, social and physical needs and evaluate interventions designed to bring about measurable improvements in health and wellbeing, using the full spectrum of healthcare interventions from orthodox medicine, nutrition, psycho-spiritual support, self-help and, if helpful, complementary therapy.

“Engaged” people develop a proactive relationship to their health and wellbeing, with improved health outcomes and advancement of the primary prevention of illness.

The University of Buckingham Medical School does not wish to continue with the diploma after September 2011 for intellectual, financial and reputational reasons, which is understandable for a new university. But what about IM’s potential importance in addressing the crisis caused by lifestyle-related illness?

Health expenditure rose by 82 per cent over the past 10 years, yet obesity, diabetes and allergies, plus cardiac, respiratory and depressive illness rates continue to rise alarmingly. To make things worse, all this comes at a time when health cuts are inevitable.

Karol Sikora, dean of the University of Buckingham Medical School, who championed the creation of the IM diploma, has said: “There is an urgent need for IM training, teaching and research. The combination of ageing populations, technological progress and an informed, demanding clientele will result in increasing financial strain in all healthcare environments.

“Predominantly tax-based systems, such as Britain’s NHS, are particularly vulnerable to meltdown unless new approaches can be found to return people to health with simpler and cheaper holistic strategies.”

Admirably proving Sikora’s point is a key IM study from 2007, which looked at the relationship between healthy diet and exercise in improving survival rates among women with breast cancer.

The study by researchers at the University of California, San Diego, “Greater Survival After Breast Cancer in Physically Active Women With High Vegetable-Fruit Intake Regardless of Obesity”, found a doubling of survival at 14 years in women who took this proactive approach.

Sikora says that the impressive survival graph in this study is better than for conventional treatments for breast cancer, and the costs were negligible by comparison. Yet have we seen a wide-scale roll-out of this finding into oncological practice? Certainly not. If any drug had been shown to have this level of benefit, every breast cancer patient would be administered it. How can such valuable findings be assessed and disseminated unless there is a serious body of IM academics evaluating IM research?

This study illustrates why the campaign by David Colquhoun, professor of pharmacology at University College London, who is neither a clinician nor a representative of a patient group, to discredit and disrupt IM advances is so misguided. Attempts to stymie the study of IM disadvantage the public and are non-democratic, antisocial and prejudiced. Patients served by doctors who do not know about IM evidence are being deprived of choice. They are left stuck with a medical model that the majority of people are seriously disenchanted with and which the government cannot afford.

The question is: who will stand up and support the formalisation of IM education for doctors and nurses in the UK? The IHT’s IM diploma will continue with or without renewed university validation, but this falls short of our ambitions. We are working to see IM based firmly within the academic community and developed to MSc, MA and PhD levels.

The IHT is now looking for a strong collaborating university partner that will not be intimidated by the likes of Colquhoun and invites dialogue with those who would like to work with us to study developments in this area of medicine.



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