Rediscovering Medicine

Integrative Medicine is not "Medicine". And it's not "Complementary Medicine" either. It's something different, new and ancient, young and wise, scientific and story-driven all at once. It does not belong to medical practitioners, and it stands apart from my own medical profession.  

Integrative Medicine is not even truly integrated healthcare. Yet. There is no common undergraduate or postgraduate education that spans the history and philosophy of health, illness, suffering and disease, and without these common foundations there is tension between the professions, a battle for the mindshare and business of the public. 

Let's be clear, Medicine is not healthcare. I was trained in Medicine, and training for optimising health was very low on the agenda at Sydney University in 1974.  The taxpayers subsidised us to learn about disease, and to administer treatments to make the disease and suffering go away. We learned the practical magic of pharmacology, written in Latin, with mysterious symbols and scrawling on prescription pads, and passed our patients off to dispensaries and pharmacies with recipes that would reduce their distress. 

These medicines were powerful and when appropriately used in extreme circumstances, they appeared to be magic! We experienced it in our intern years, when one person after another was rescued from the abyss by potent drugs and surgical procedures. The harms done in hospitals were invisible to us, drunk as we were with the apparent powers bestowed upon us. The impact on us lasted a lifetime, and we were fooled into thinking that we had the power to control death and disease.

It was always an illusion, and my profession promulgated the delusion that we could do so much more – if we can control disease and death then surely we are the fountain of all health as well. 

Australia does not have a health care system. We have an efficient disease care system (Medicare), and professionals well trained in the identification of and management of disease (doctors). That profession is moving inexorably into statistical analyses, randomised controlled trials,  and so-called "evidence-based medicine" and runs the risk of alienating the public it is meant to serve. People are not numbers or subjects in a trial, and each individual brings their own story, their own background and their own beliefs into the complex equation that will see them either regain health or simply fail to die of the disease.

Do not get me wrong! Keeping death and suffering at bay is a noble task, but it is not the same as proactive health care and prevention. 

I remember the feeling, distinctly, when I began general practice in 1983 that the magic in the hospital did not really work when it was out in the wild.  The extreme cases were shuttled off to the hospitals for that magic to happen, and our medical practices filled slowly and frustratingly with people suffering chronic, debilitating illnesses and slow deaths. I felt so helpless time after time, with drug therapies that worked so well in the hospital setting simply making my patients sicker and more debilitated.

In short, the Medicine that worked so well in the hospital did more harm than good for most of my patients in general practice. There had to be a different way. 

So began my journey on the Central Coast of New South Wales in 1983. Little did I appreciate at the time that I was not alone, and that thousands of other doctors were making the transition to a more primitive, effective, and patient-centred approach to prevention and health. In those 32 years, we have transitioned from Complementary Medicine, through Functional Medicine and into the now "trendy" Integrative Medicine. 

But the deeper question remains - is this really "Medicine" or is it something different? I think it is something very, very different, and it is the sign of a medical profession growing up and moving towards what I believe to be the future of health care, and the rejoining of modern Medicine to its roots. 

The current apparent direction of Medicine is towards evidence-based diagnosis and treatment, rooted firmly in the statistical model of human beings as being aggregateable and treatable on the numbers. 

The new real direction of Medicine is far more complex, satisfying and complete. It pays attention to the story and the history, the aspirations and the knowledge of the people who are suffering. It seeks to identify the deep causes of loss of health and best ways to really prevent disease, and restore health. 

And critically, the new Medicine seeks to facilitate each person's efforts to understand their own individuality, the ways in which they became sick, and the best ways to rebuild their health and live a long and disease-free lives. 

The new Medicine is not the Medicine of my profession, it is the Medicine of the People. Our job as doctors is changing from authority figures dispensing Latin prescriptions to collaborators with Googlers who seek our care, to listen to the stories, and to advise them wisely from experience as well as statistics. Our reward is to experience the privilege of being allowed into the lives of people who transform themselves and their families towards health and to know we have played our part.  

Maybe this is Medicine!  The Medicine of our Hippocratic past, and the sustainable, joyful and deep Medicine of our future. 

For now, it's Integrative Medicine. A transition between two worlds.