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Mindful of integrative medicine
Chiropractic care is fundamentally holistic, seeking to affect whole mind and body wellness by restoring the nervous system to full, optimal function. This interview with Dr. Jeffrey Schaefer, Medical Lead of the Integrative Medicine Program for the Calgary Health Region, outlines the new acceptance of mind and body therapies worldwide and here in Calgary.
Dr. Jeffrey Schaefer is helping take medicine back to the future. Way, way back. Schaefer, the Medical Lead of the Integrative Medicine Program for the Calgary Health Region, is a proponent of a mind and body approach to patient care.
"Two thousand years ago in Hippocrates' time, the prevailing theory was the mind and the body were one and the same," says Schaefer.
"Two centuries ago, advances in anatomy, physiology and pathology taught us a lot about the human body and disease but, as they learned about abnormal hearts and infected tissue, the connections between mind and body were lost. Disease became strictly bio-medical and nothing to do with how stressed you are, where your headspace is, or your spirituality, any of that stuff. It's only now in the last five or 10 years that we are rediscovering that there are real connections between the mind and the body again. It's rediscovering the past."
But it's not throwing away the lessons learned from the present. The whole idea of integrative medicine is to combine conventional medicine with the best of what alternative medical traditions have to offer. Traditional Chinese medicine, East Indian medicine, botanical medicine, manual medicine (chiropractic, massage therapy, etc.), meditation, imagery and spiritual care are all examples of medical practices with long traditions.
For years, alternative medicine was considered outside the norm. "What makes it different this time is we actually have rules around evidence," he says. "We accept now it's no longer good enough to say just because people are using a particular medical practice, it must be good or, because it wasn't taught in medical school, it must be bad. The rules of evidence can be applied to any intervention and, with time, notions of what is conventional, complementary or alternative will be replaced with measures around benefit, risk and cost. Having this evidence has now leveled the playing field. It means we can look just as critically at mind/body and herbals. We no longer are limiting our scope to, say, surgery or antibiotics."
But the most important thing about integrative medicine is the way it empowers people to manage their own symptoms and condition. "Illness isn't always the physical," says Schaefer. "Illness is about how people perceive the illness. It's not whether you're rich, if you have $100 or $1 million, it's how you feel about it." Schaefer says stress hormones connect the brain and body. He cites a study where both stressed and non-stressed people were given punch biopsies (the removal of a small piece of skin) in their arms. With all other factors the same, the stressed people took nine extra days to heal.
Studies show at least half of the population in North America uses some sort of alternative medicine and those people tend to be on the higher end of the education and economic scale. Of those people, 57 per cent have never told their doctor about their alternative medicine use. Schaefer says people like to feel they have some control of their care and are given choices. "If doctors are criticized, it's usually around the issue of communication and not giving much in the way of choice," he says. "You come in with a sore throat and the doctor doesn't say anything but writes out a prescription and you're expected to take it. That model of being prescriptive and not talking about it, folks aren't taking that anymore. They're not accepting that anymore. They probably shouldn't have accepted it in the beginning." What people want, Schaefer says, is someone who can listen to them and involve them in what kind of care they receive.
Schaefer says over the last 40 years, there has been an increase in medically unexplained symptoms with which people come to see their doctors. Headaches, body aches, insomnia, chronic fatigue or lack of concentration, tingling sensations and dizziness account for one third of visits to doctors. "In the old biomedical model, if somebody's tingly or not feeling a certain part of the body, you just follow the nervous system and figure somebody's got multiple sclerosis, a stroke or nerve entrapments or what have you," he says. "Those are the list of the possible diseases, so it's got to be one of those. But we do all that looking and we don't find anything. The story is it's probably related to chronic stressors; it's our high-paced life. Regular medicine just hasn't been able to deal with that. It has always done a poor job of that. We do a poor job by telling patients, 'You know it's just stress, it's all in your head, have a nice day,' and pat them on the back. The patient walks away thinking the doctor doesn't even believe they're feeling anything."
Schaefer says doctors end up putting patients on too much medication, too easily reaching for painkillers and anti-depressants. "There has to be a better way of dealing with it," he says.
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