Intended for healthcare professionals

Rapid response to:

Editorials

Integrated medicine

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7279.119 (Published 20 January 2001) Cite this as: BMJ 2001;322:119

Rapid Response:

A new integrated medicine, not integrating alternatives to medicine.

A new integrated medicine, not integrating alternatives to medicine.

Medicine is an art and a science of caring for individuals and for
humanity. As such it should integrate everything that touches the health
and well being of people.

The dialogue on integrated medicine relates not medicine's
limitations but our limitations in integrating these diverse aspects of
care adequately. One response to such a difficulty is to find a better way
of integration rather than to embrace non-medical practices.

There are better ways of integration within mainstream science, such
as chaos and complexity theory, from which is derivable a postnormal or
chaos based medicine, as evidence based medicine used in context (1,2,3).
Such new ideas, embraced widely across many disciplines, allow us to
practice good medicine, responding to patients needs, using a medicine
that works.

After all, according to Angell and Kassirer, editors of the New
England Journal of Medicine, there are only two kinds of medicine,
"medicine that works and medicine that may or may not work" (4).

This new post-normal or chaos based medicine provides better
explanations of how and why things happen and how patients' beliefs and
practices, however unscientific, integrate with everything else to
influence health. It could be the centre of a new integrated mainstream
scientific medicine.

Disenchantment with the current practice of medicine or the
limitations of evidence based medicine should not propel us to practice
alternatives to medicine, such as an integrated medicine which includes
complementary or "alternative medicine." It should instead impel us to a
scientific integrated medicine - a better medicine that works, learning
about everything that impacts people's health, responding better to their
needs, and offering better explanations of the nature of health and
disease (5).

References:

1) Rambihar VS. Science, evidence and the use of the word scientific.
Lancet 2000; 355:1730.

2) Rambihar VS. A new chaos based medicine beyond 2000: the response
to evidence. Toronto: Vashna Publications, 1999.

3) Kernick DP. After postmodernism. Lancet 2000; 355: 149.

4) Angell M, Kassirer J. Alternative Medicine - the risks of untested
and unregulated remedies (Editorial). NEJM 1998; 339: 839-41.

5. Rambihar VS. If evidence is the heart of medicine, then chaos
restores its soul. BMJ Rapid Response Feb 19, 2001.

VS Rambihar

Competing interests: No competing interests

28 February 2001
Vivian S Rambihar
cardiologist
The Scarborough Hospital, Toronto, Canada.