The best of both worlds
BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7279.181 (Published 20 January 2001) Cite this as: BMJ 2001;322:181
All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
Many people would wholeheartedly support Prince Charles' personal
view of integrated medicine, as expressed in the BMJ. Why shouldn't we
strive for the best of both worlds, particularly if the path to this is
through an inclusive and synergistic partnership amongst orthodox and
complementary practitioners?
Unfortunately, the views of the Foundation for Integrated Medicine
(FIM), an organisation that Prince Charles highlights, may not be quite so
balanced and even-handed. One of FIM’s trustees is Professor Lesley Rees,
a co-author of the BMJ's current lead editorial on integrated medicine.
As already pointed out by several respondents on the BMJ web site, Rees
and Weil's view of integrated medicine is too one-sided for many people
within the complementary and alternative field. It comes across as
orthodox doctors selectively "cherry picking" from the complementary and
alternative therapies, in order to supplement conventional treatment plans
with biomedically-acceptable elements. This is not the same as Prince
Charles' image of the best of both worlds. Many complementary therapists
would not wish to operate under such orthodox medical constraints (which
is one of the lessons already learned over the past decade or so from the
medically dominated experimental models of complementary therapies in
primary care). Many patients would also continue to consult complementary
therapists outside of "integrated medicine", if they found that the work
of the "integrated" therapists was too constrained.
FIM has not always been associated with a biomedical bias. Those who
were initially involved with Prince Charles in setting up FIM (in the
early 1990s) shared his vision of an inclusive partnership amongst
orthodox and complementary practitioners. However, over time, the
organisation became more and more dominated by the perspective of orthodox
doctors. This was to an extent counter-balanced at a later stage, by the
increased involvement of complementary therapists in the organisation, but
there is still a widely held perception that FIM (to use Prince Charles'
own words) "is, like the celebrated Tower of Pisa, slightly off balance".
It appears to be tilted too far towards the orthodox medical perspective.
It is therefore vital for FIM to clarify where it stands as an
organisation, if it wants to win the confidence of complementary and
alternative practitioners. This is particularly important, given the
central co-ordinating role that both the House of Lords Select Committee
and the Department of Health appear to be suggesting for FIM. Does FIM
support Prince Charles' vision of a more equal and inclusive partnership
amongst orthodox and complementary practitioners, or does it prefer to
ally itself with Rees and Weil's more one-sided vision?
Competing interests: No competing interests
Indeed it is time that we all look at the way we practice and there
should be measure for the science and art in our patient management.
The science of healing and the art of caring are essential components
of health care delivery. In the advanced centers with hitech facilities
there is may be more stress on science and may be relatively less stress
on the art of caring due to cost constrains! But at the same time in the
under developed areas(technologically)there is more stress on the caring
and loving. It was not long back when there was no treatment for
tuberculosis there was more stress on the caring and caring for them in
special surroundings was considered essential. TB sanatoriums were
constructed and special attention was given to them with financial
commitments. But now those sanatoriums are closed in many places with
better scientific approaches as the results of treatments improved. There
is always a changing balance between the science and the art of caring in
a particular situation let it be a place, patient or disease. Knowledge is
essential and delivering that in the right way is also essential. There
should be a balance between science and art of caring and the progress of
humanity is possible only through such concepts. Many of us strongly
beleive that "Integrated Medicine" can also be perceived, practiced and
preached with scientific measures and means.
Pinjala R K
21 Jan 2001
Competing interests: No competing interests
What is alternative medicine?
I don't see how this article deals with the drawback of alternative medicine, which is that it is unscientific medicine. If some plant product or a procedure demonstrated clear evidence for its efficacy and safety, it would become part of standard medicine. Alternative medicine contains products and procedures that have not shown such convincing evidence. Allegedly, alternative medicine treats people more humanely than standard medicine. If so, the answer lies in making standard medicine more humane; not in accepting humane, unscientific medicine.
The popularity of alternative medicine testifies to the gullibility of people who don't understand the superiority of science over other ways of claiming knowledge.
Alternative medicine cloaks its unscientific basis in meaningless terms, such as holistic. If standard medical practitioners somehow treat a kidney without considering the interaction of all organs, and the interply of physical and mental factors, this would be unscientific and poor medical practice. The remedy would not be unproven treatments.
Competing interests: No competing interests