Medicine began as a sacred art thousands of years ago based on the profound power of the therapeutic relationship. We go see the doctor, healer, or shaman and through our relationship with him or her, along with the therapy they provide, we heal. The art of medicine is ancient, yet with our current medical system, we are losing this connection to the service of medicine and the ceremonial aspect of healing and health.
Unfortunately, this loss is fueled by the sad truth that this is a chaotic time in the field of conventional medicine. Health care is a for-profit industry and big business. Health care costs are rising, and more and more of Americans are uninsured. Insurance companies are dictating what health care practitioners can do in multiple ways – they refuse medical care, tests and medicines, as well as refusing to cover previous medical conditions and proven complimentary medicine therapies. Add to this the pharmaceutical companies that advertise to the public which pills will improve problems, even if they only show a small benefit. As well, as a society we love technology and we are buckling under the weight and price of this technology. We live in a for-profit medical system and the therapeutic relationship between patient and practitioner is taking a back seat to the bottom line dollar. Patients, doctors, and nurses are all ringing their hands with the break down of the medical system. In my work at the Arizona Center for Integrative Medicine, I see high work burnout rates with the MD’s and nurse practitioners that arrive at our door for training; in fact I am seeing burnout in the medical students and residents before they go off to practice. I see patient burnout as well; patients are frustrated, tired, and cynical. The structure of our medical system is undergoing a breakdown. I have become worried, very worried, about the future of medicine. I’ll bet you are too.
There is some good news in this chaos of change within medicine. We are experiencing an emergence of older and ancient modalities of healing being practiced in our culture; we have labeled these modalities Complementary and Alternative Medicine (CAM). I believe many of these ancient and new therapies are effective; I also believe we are also seeking CAM because of the power of the patient-healer relationship is still intact in many of these other modalities. There are changes in conventional medicine too, if you look closely. Medicine is beginning to re-discover and teach in the importance of the art of medicine, the doctor-patient relationship and the use of other therapies and paradigms of healing in order to provide the most comprehensive care for our patients. This shift in medical care is happening, albeit too slow for much of the public. There are medical schools now that offer courses in the art of healing, humanism, effective listening and even botanical medicine and integrative medicine. We are, as a culture, coming to realize that while conventional medicine is excellent for some illness, other illness are better treated with some of the CAM modalities or a combination of conventional medicine and these other modalities. We are integrating disparate paradigms of healing into one large model that incorporates all the forms of healing. This will take time, and yet, it is still exciting.
So what can we do? How can we all navigate these swirling choppy waters and make the most of what we have now? I believe this is not the time to throw in the towel on conventional medicine; there are many things provided by conventional medical care that are necessary and very healing. Yet, there are things you can do to take more responsibility for your health and be your own guide in your health and care of your health. This begins with creating your own structure of health to replace or augment our older ways of seeing and experiencing medicine.
First and foremost, taking good care of yourself is the best step. Most of conventional medicine is based on illness once it happens, so taking good care of yourself to prevent illnesses in crucial. Heart disease, diabetes depression, and multiple other illnesses have a lifestyle component. See your own health in a holistic fashion and begin to take care of all aspects of your health -nutrition, exercise, relaxation or stress management, spirituality, community, sleep hygiene, and whatever else is pertinent to your life. This is simple but not always as easy as it seems. Tackle each aspect of your health one step at a time. You can’t develop good habits in each area all at once. When we try to change too many things at once, we often fail and ignore all of it. Tackle one aspect of your health every 3 to 6 months. For example, start with nutrition by eating an anti-inflammatory diet with whole grains, fruits and vegetables and a minimum of animal protein. After you have mastered this aspect of your health, move on to exercise. Once you have exercise in place, add the next aspect of change to take better care of yourself. While this order is a suggestion, you must start with the healthy behaviors that are easiest first. This will help you to build confidence in caring for your health so you can continue on. The multiple components of health are like pieces of a puzzle that begin to fall in place – with a bit of effort and a lot of work to form good habits. Follow your own wisdom; for me, I had to put spiritual health, stress management and exercise in place before I could actually tackle the nutrition. However you do it, do it one step at a time so you do not become bogged down in “too many things to do” and quit.
Secondly, find an advocate in the medical system. Our current medical care is fractured. What I usually see is that people have multiple doctors – someone may have an internist, an ob/gyn, a dermatologist and a psychiatrist. This means that he or she, as the patient, are stuck tracking all of the details of their care to put the whole picture together for themselves. It is akin to having a one mechanic for your engine, another for your carburetor, another for all the fans and belts and a fourth for the tires. If we try to manage our health on our own, we are reliant on both information and misinformation that is so readily available in our society. It is crucial to find a good advocate within the system that can translate the jargon, communicate with and refer you to other doctors when you need it, and stop you from worrying when you do not need to. I often see people who are healthy that have not developed a relationship with a primary care practitioner. So when they become ill, they are forced to go to the emergency room or urgent care, settling for quick medical solution instead of a long-term plan with a trusted practitioner who knows their history over time. This is a mistake. Take the time to find a primary care practitioner. Primary care practitioners (PCP) are trained to manage all aspects of your health care and refer out only when a problem is beyond their scope; these PCP’s include family doctors, general internists, integrative medicine doctors, primary care nurse practitioners and naturopaths (in the states where they are licensed to prescribe medications.) Find a PCP who will help with prevention and also fit you in as a patient on the days you aren’t feeling well. They should act as the central aspect of your health care, with specialists and CAM practitioners acting like spokes on the wheel. Your PCP does not need to know the specific details about CAM, yet find someone who is open to the fact you may be seeking alternative medicine remedies as well. Most PCP’s are open to it even though they may not be trained in these modalities. Integrative medical doctors and naturopaths also can manage your whole health picture with the added benefit of being able to prescribe, teach, or refer you to non-traditional therapies such as acupuncture, massage and mind-body medicine. Remember that you are developing a relationship with this practitioner and that they are under time constraints due to the breakdown of the system. One thing you can do to facilitate the relationship is to come with only one or two problems or complaints at a time. If your list is long, you may want to book another appointment to allow your PCP to have adequate time to spend with you for each issue you need to discuss.
Thirdly, begin to use the other modalities. This is a whole picture of healing that honors not only our current wisdom, but the wisdom and experience of the ages. There are many things to treat some illnesses (once anything serious is ruled out,) besides medications, with similar or better results. Begin to visit practitioners of CAM to see what else works for what ails you. For example, try traditional Chinese medicine for menopause, mind-body medicine for fatigue and stress, massage for chronic low back pain, and a nutritionist and trainer for a good plan for heart disease.
Now, once you have jumped into the dense thick jungle of information about CAM, it is important you do not believe everything you hear or read. Again, as with Internet medicine, there is as much information as misinformation. Use reliable sources and web sites to research your choices. A wonderful free website is from the National Center for Complimentary and Alternative Medicine (NCCAM) which is a branch of the National Institutes of Health, at http//nccam.nih.gov. You may look up specific modalities, or specific illnesses. The patient information is excellent. My favorite website is Natural Medicines Database at naturaldatabase.com. This is an independent source, not biased by conventional medicine or any branch of complementary medicine. They have wonderful information with data, research, traditional uses, and information. There is a fee yearly, and you may try it for a month for $9.99. I also like Natural Standard at naturalstandard.com. There is a fee yearly, and they include current accurate information about multiple CAM modalities.
Another important area you must be aware of is botanical supplements. While some of these are wonderful, they are largely unregulated as to contents of a specific product. The Food branch of the Food and Drug Administration (FDA) regulates botanicals supplements. This means that the manufacture must make the products in compliance with food regulations, but not quality regulations as we expect with medications, both over the counter and prescription. What this means for you is that many of the supplements and botanicals that are sold today do not actually have the amount of product they claim. Check out the products you choose carefully. For education on this, you may go to http//nccam.nih.gov. As well, you can look for supplements with a “USP” on the label, certified by the United States Pharmacopeia, www.USPverified.org. This can help you find good quality inexpensive botanicals and supplements. If you have a specific product you want to investigate, try looking up the products on the Consumer Labs website at www.consumerlab.com. Consumer Labs independently tests products and publishes if the product meets the standard it claims. Spend your money wisely by doing your homework with what you choose to use.
Finally, and most importantly, carry with you consciously the sacred aspect of going to see a physician/nurse or healer. Try treating your visits to see doctors and healers as healing ceremony. It does not matter if your practitioner knows you are doing this, it only requires one person in an interaction to make the moment sacred and meaningful. Take a few breaths as you walk in and honor yourself for having come to see this healer or practitioner. Internally honor the sacred job they are doing. If you approach them with this in mind, you may find you have a different experience. I am not talking about blind belief here, you should still sort through the information the practitioner presents and choose what to do. Yet, my experience is that knowing that this is a healing ceremony often takes the anxiety out of the interaction and allows for clearer decisions from a more centered place. There is a spiritual wisdom that declares “The face you present is the face you receive.” Put the sacred back into your approach to your health care and your approach to you own body, the place you live. This will help you place your health and health care in the place it belongs, within you.
For more information on Dr. Chiasson, visit her resource page in the Library.
