Letters

Integrated medicine

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7300.1484 (Published 16 June 2001) Cite this as: BMJ 2001;322:1484
  1. Andy Carr, professor of orthopaedic surgery
  1. Nuffield Orthopaedic Centre, Oxford OX3 7LD
  2. Centre for Integrative Sciences in Complementary and Alternative Therapies (CISCAT), London NW3 2QU
  3. Centre for Integrated Medicine, Institute of General Practice and Primary Care, Northern General Hospital, Sheffield S5 7AU
  4. University of Edinburgh, Edinburgh EH10 5HF
  5. Faculty of Health, St Martin's College, Lancaster LA1 3JD
  6. Private Veterinary Practice, Equine, PO Box 5231, Glendale, CA 91221, USA
  7. Bury Health Care NHS Trust, Bury General Hospital, Bury BL9 6PG
  8. Friarage Hospital, Northallerton, North Yorkshire DL6 1JG
  9. Crossmaglen, County Armagh BT35 9HD

    EDITOR—As an orthopaedic surgeon specialising entirely in elbow and shoulder disorders I could not let the editor's choice on restoring the soul of medicine slip by without comment.1 Unlike the orthopaedic surgeon you refer to, I do read the BMJ each week (although I confess that my wife, a paediatrician, pays the subscription). I also note that in the editorial from the previous week on shoulder pain at work the one year prevalence of shoulder pain in the general population was estimated to be 20-50%, but only 40-50% of those affected consult a primary care physician, let alone an orthopaedic surgeon.2

    Most musculoskeletal complaints are influenced, if not caused, by circumstances of daily life. This is not just physical activity but psychosocial factors, including job pressures and stress at home. The commonest elbow complaint is tennis elbow. It is a considerable problem to those who have it; symptoms are undoubtedly influenced by a range of factors, and it is eminently suited to an integrated management approach. Those affected should consider changing the pattern of their lives, reduce stress, and seek advice and help from complementary and conventional practitioners, and they may even benefit from seeing an orthopaedic surgeon. Orthopaedic surgeons should read the BMJ, but equally the BMJ should be aware that many orthopaedic surgeons do not think of patients just as malfunctioning elbows.

    References

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    Integrated medicine means doctors will be in charge

    1. David St George, director
    1. Nuffield Orthopaedic Centre, Oxford OX3 7LD
    2. Centre for Integrative Sciences in Complementary and Alternative Therapies (CISCAT), London NW3 2QU
    3. Centre for Integrated Medicine, Institute of General Practice and Primary Care, Northern General Hospital, Sheffield S5 7AU
    4. University of Edinburgh, Edinburgh EH10 5HF
    5. Faculty of Health, St Martin's College, Lancaster LA1 3JD
    6. Private Veterinary Practice, Equine, PO Box 5231, Glendale, CA 91221, USA
    7. Bury Health Care NHS Trust, Bury General Hospital, Bury BL9 6PG
    8. Friarage Hospital, Northallerton, North Yorkshire DL6 1JG
    9. Crossmaglen, County Armagh BT35 9HD

      EDITOR—Rees and Weil in their editorial on integrated medicine give a rather one sided view of the topic.1 They talk about selectively incorporating “elements” of complementary and alternative medicine into comprehensive treatment plans alongside orthodox methods of diagnosis and treatment. They also identify a need for doctors with the biomedical knowledge to be able to distinguish between the multiple options of complementary therapies. This comes across as orthodox biomedical cherry picking from …

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