Yo' mama...

My mother is an integrative, complementary and alternative medicine (ICAM) practioner. To be more precise, she is a retired registered nurse, a herbalist, and an iridologist. Or, as some of my doctor colleagues would put it, she is a quack, a snake-oil saleswoman, and my favourite: a fear-mongering fraudster.

I'm not writing this post to defend my mother or other ICAM practitioners. Rather, I wanted to write about how I've noticed that the doctors I've met who are the most perjorative about alternative medicine also happen to be the ones who know the least about ICAM. Be it chiropractic or crystal therapy, massage or healing touch, homeopathy or naturopathy, it's all garbage so why waste time learning about it?

In 1999, the Fraser Institute published a report which found that 50% of respondents had used at least one alternative therapy in the previous 12 months. It's not hard to understand why patients who are met with opposition from doctors on the subject of alternative medicine may then go on to withhold information from their doctors. My father was recently diagnosed with high cholesterol, and when he asked his doctor about garlic and herbal remedies, the doctor merely rolled his eyes. My dad would never dream of arguing with a doctor, so he dutifully renews his prescription for a statin every 3 months but disposes of the pills. For whatever reason, his cholesterol has since normalized, and his doctor is delighted with yet another triumph of modern medicine.

Don't get me wrong... I'm appalled by my dad's behaviour, and I sincerely believe that patients who aren't honest with their doctors are only hurting themselves. But, contrast the above doctor's response with what I usually say to patients who inquire about "natural" remedies for high cholesterol: "I haven't seen a lot of strong research to support the efficacy of alternative remedies, and I do have some questions about their safety and cost. Did you have any specific concerns about cholesterol medications?" Sometimes, the patient wants a 3-month trial of alternative therapy. Depending on the situation, I don't usually take issue with this. I guess I can't be sure, but I think this approach promotes better compliance and doctor-patient communication.

As Graham at Over My Med Body recently pointed out, an increasing number of medical schools are including information about ICAM in their curriculums. This has prompted much shaking of heads, wringing of hands and dire stroking of beards. I certainly don't think that medical schools should be promoting the use of unsafe or unproven modalities. But, I think that patients would definitely benefit if there were more doctors who had a basic understanding of the more commonly used alternative therapies. I suppose in some ways I'm almost advocating a form of harm reduction when it comes to alternative medicine.

At the very least, I think including ICAM in the medical school curriculum could promote respect and cooperation between doctors and alternative practitioners. I mean, I may not agree with everything my mother does, but I can still have friendly discussions with her about medicine.

I think both of us, and the people we take care of, are better off for it.