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Saturday, June 25, 2011

Alternative medicine

I really enjoyed this article from The Atlantic, about alternative medicine.  I found myself thinking about it a lot, and telling several people about it, after I read it.

It was mostly about the mainstream medical community's wider acceptance of alternative practices, partly because it's incredibly lucrative, and because the NIH has grants to support it.

But the article also addresses the troubling issue of the placebo effect, suggesting that many mainstream medical practices also benefit from the placebo effect, and that more medical and mental health practitioners are seeing the placebo effect as a positive outcome rather than a confounding alternative interpretation.

The article also discusses the failures of the mainstream medical model and the gap that these failures have created.  There are two simultaneous problems - current practices were developed based on the infectious disease model, which is now outdated, and the problems presented by today's patient are predominantly chronic ailments like pain and gastric trouble, which drugs and surgery are not as effective at relieving.

It was terribly interesting and thought-provoking.  Here's a couple of key paragraphs:

The medical community knows perfectly well what sort of patient-care model would work better against complex diseases than the infectious-disease-inspired approach we’ve inherited. That would be one that doesn’t wait for diseases to take firm hold and then vainly try to manage them with drugs, but that rather focuses on lowering the risk that these diseases will take hold in the first place. “We need to prevent and slow the onset of these diseases,” says Blackburn. “And we know there are ways to do that.” Aside from getting people to stop smoking, the three most effective ways, according to almost any doctor you’d care to speak with, are the promotion of a healthy diet, encouragement of more exercise, and measures to reduce stress.



Medicine has long known what gets patients to make the lifestyle changes that appear to be so crucial for lowering the risk of serious disease: lavishing attention on them. That means longer, more frequent visits; more focus on what’s going on in their lives; more effort spent easing anxieties, instilling healthy attitudes, and getting patients to take responsibility for their well-being; and concerted attempts to provide hope. Studies have shown that when a doctor speaks to a patient about quitting smoking or losing weight, the patient is more likely to do it. A 2008 study on physician-patient relationships found that physicians deemed “exemplars” based on their reputation and awards received were likely to create an emotional bond with patients; to convey to patients that their commitment to caring for them will endure over time; and to imbue patients with “trust, hope, and a sense of being known.” Hippocrates put it this way: “It is more important to know what sort of person has a disease than to know what sort of disease a person has.”

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