Think Outside the Box

The beauty of integrative medicine is it is a paradigm of health optimization. It is a paradigm that can ultimately improve the quality of the life experience. If there are people out there who object to this, then I must ask what they have to lose by embracing change.
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The challenges of the 21st century loom large for mankind. We seem to be caught in a tug-of-war between technology and environmental concerns, world population and resources, quality of life and simply surviving. The world has become an extremely complex web of special interests (profiteering), and those both benefitting and victimized by it. These issues have long been addressed politically with those in the "power seat" running the show. The public (through lack of intimate knowledge of the mechanisms of many of these issues) falls victim financially, emotionally, psychically and physically to large corporations that prey on them in pursuit of profits.

If we take an honest look at health care in this country, in spite of the many wonders of modern medicine, we can see many flaws in the system. Technology, while amazing in its applications, has caused a fascinating focus on "diagnosis." From that, came a system of coding to describe the "diagnosis." Health insurance companies require these codes to evaluate "claims" submitted by doctors and hospitals. From that evolved the new "evidence-based" medicine protocols, designed to match the diagnosis codes. So, in essence, patients are "classified" according to a code and are permitted to receive treatment deemed appropriate through "evidence." The evidence model is based on the alleviation or reduction in the symptom complex. In my opinion, this represents just another example of immorality perpetrated on the public by wealthy health insurance companies whose real agenda is capturing the highest possible profits from the premiums they collect. Evidence-based medicine has now become a requirement because insurance companies will only pay for those services that quell symptoms quickly and cheaply. The "evidence" must support the use of a particular treatment or they will not pay. So what is my problem with this?

First and foremost, what exactly are symptoms? Are they accidental in nature? Do they occur spontaneously, with no rhyme or reason? Or, are they the end result of a particular metabolic or functional disturbance that the body is no longer capable of managing? In other words, consider that symptoms actually occur as the immune system calls upon mechanisms to protect cells that it is no longer capable of managing or healing. This means that when symptoms occur, there has already been a "silent" issue going on, taking the body away from optimal health and sending it in the direction of pathology (conditions and diseases). Therefore, if we place our entire focus on the symptoms, pick the right name to describe these symptoms (diagnosis) and apply a treatment to manage the symptoms (evidence-based medicine), what we are essentially doing in many cases is ignoring the underlying causes. This is a problem because there are millions of patients who now must be chronically managed. If we do not correct the underlying causes of the presenting symptoms, these very same mechanisms will eventually give rise to other conditions (known as co-morbidities) that will also require chronic symptom management. It's also important to note that patients with the exact same diagnosis do not necessarily have the same underlying mechanisms causing their condition. So what I am saying here is that the current medical paradigm, controlled and orchestrated by health insurance companies, is designed to allow people to get sicker and sicker over time because this symptom-care model represents the best profit model for them. It is not necessarily health care. Its design is not to optimize the health of the patient. Its design is to relieve symptoms as quickly and inexpensively as possible (i.e., lots of prescription medications).

As we all know, medicines can only be approved for public consumption after random placebo-controlled clinical trials and FDA approval. It seems, in my opinion, that the fact that any drug is "FDA approved" makes it "safe" in the minds of most doctors. In fact, many doctors belittle natural medicines because they are not "FDA approved." So what is the mechanism behind FDA approval of a drug? Simply that the drug is deemed "safe and efficacious" for the particular issue for which it is approved. However, what the clinical trials do not take into consideration are drug interactions, drug/herb interactions and the unique physiology of each and every person out there. So, unfortunately, the public becomes the guinea pig for many untoward reactions of the "safe and efficacious, FDA-approved" drug. And, if you do not already know this, over 100,000 Americans die each year from properly prescribed prescription medications. Also, once the drug is being prescribed in large numbers, new side effects not previously reported in the clinical trials become obvious. Does this give any doctor the right to rail against natural medicines that do not kill, often help and, in the worst-case scenario, may not help but do not harm when used appropriately? Additionally, the reason natural medicines are not "FDA approved" is simply that the FDA does not govern, nor approve, the medicinal use of natural substances.

Much of the resistance to the acceptance of integrative medicine by the "mainstream" cited is the "lack of evidence." Evidence now seems to only exist in the form of the placebo-controlled trials. The problem with this extreme limitation on scientific evidence is that it is not possible to look at integrative medicine protocols this way. The science is not single-agent as in drug therapy, it is protocol-based. So, if a particular patient is being treated with dietary changes, nutritional medicines, herbal medicines, exercise and stress-reduction therapy and they heal from a chronic condition, the question most commonly asked is, "Which one of these therapies was responsible for the cure?" You cannot create a placebo group when so much of integrative medicine requires active participation in diet and lifestyle changes. So what is commonly done is for "scientists" to isolate each piece of the protocol and try to test it against a placebo. This is doomed as a scientific method because it is the protocol (the combination of therapies) that is the driving force behind the cure. You cannot isolate each piece and announce that the protocol doesn't work or simply right it off as a "placebo" effect. Likewise, we know that apples are a healthy food. But if we tested apples alone to see if they can keep a person healthy, they would fail the trial since there are many other essential nutrients necessary to promote optimal health. Integrative medicine is not simply the integration of traditional and holistic medicine, it is also the integration of addressing the mechanisms of pathology along with the easing of symptoms.

In a country facing such a huge health-care crisis, the answer is not going to come in the form of a financial model. It is going to have to be addressed with a health-care model. Meaning, we need to improve the health of the public through education and through the understanding that treating the underlying mechanisms of pathology and supporting and optimizing the functions of the human body will ultimately create a healthier public. A public that is far less reliant on medical intervention. A public that understands the benefits of healthy, organic, whole foods that are chemical-free and not tampered with for flavor or preservation and demands it. A public that demands the cleaning up of the environment because they understand the negative health effects of pollution. A public that consumes less medication because they understand that in many cases, they are just making their condition more chronic by not addressing the causes. This is where we need to go.

The beauty of integrative medicine is it is a paradigm of health optimization. It is a paradigm that can ultimately improve the quality of the life experience. It is a paradigm that can help reduce pain and suffering. If there are people out there who object to this, then I must ask what they have to lose by embracing change. What is their agenda?

I invite all comments, but please, let's not turn this into a war of traditional vs. integrative medicine. Let's make it a potent conversation about how to improve the quality of life of as many people as we can. Thank you.

For more by Dr. Robert A. Kornfeld, click here.

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