Patient Doctor Divide On CAM

As noted in the blog post Complementary Medicine In Cancer Treatment, the number of patients using complementary and alternative medicine is too large to ignore, or avoid, by anyone involved. It is in everybody’s interest to have open, objective discussions on more holistic treatment. When 38 to 60 percent of patients take complementary medicine without informing their doctors, it is a significant issue for both. Why is there this divide?

According to the paper we have been working with in these posts, here are some reasons:

* the topic never comes up in discussion with the health care team
* patients believe that they will be met with indifference or a dismissive reaction
* doctors do not know how to respond
* conventional medical providers don’t know anything about CAM

Talking to the doctors in our network of family and friends who are willing to express themselves anonymously, we find the following:

* many doctors do not think there is any legitimacy to CAM and it also raises serious issues of medical legal liabilities for them
* they are afraid of what their peers and other patients (who are not open to CAM) may think and are therefore reluctant to step out of the normal bounds
* they do not know anything about CAM and given how busy and hard-pressed they are, there is no time to learn enough to give adequate advice to patients

These are all valid and understandable reasons on both sides. However, the numbers suggest that unless this divide is bridged, there are risks to patients. Here are some:

* patients rely on hearsay, the Internet, dubious and misleading advertisements for information–some of it is just plain wrong and dangerous
* patients use CAM treatments that are at best useless and at worst, harmful to them
* these treatments may interfere with, or impede, their ongoing conventional treatment–as their doctors do not know what the patients are doing, they have no way of knowing why the treatment may not be working or perhaps the cause of some adverse reaction

So bridging this divide is critical. I know of several people who persistently talk to their doctors about the yoga and meditation they are doing and supplying them with information regardless of whether the doctor reads it or not. They are proactive patients who do not expect the doctor to raise the topic. Over time, some doctors start becoming more open as they see that something is working well for these patients. At least for some the holistic approach that combines the best of conventional medicine and CAM is producing better outcomes, a better quality of life, better overall function, less anxiety/fear/loss of control.

The next post will discuss what evidence-based CAM is recommended in the paper. I am still waiting to get a response from the lead author for the request of an updated list of resource websites as some in the paper do not seem to exist now.

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