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Posted by Michael Finkelstein | May 21st, 2014

Doctors Have a Moral Responsibility to Discuss Alternatives to Conventional Medicine

This article was first published in The Huffington Post on May 21, 2014.

A growing number of scientific studies underscore the need for more training in and, by extension, dialogue about alternatives to conventional medicine, for a few reasons:

First, education and information about such alternatives will empower doctors to guide their patients through the maze of therapies available — distinguishing between therapies that are helpful and harmful, as well as ensuring that there is no contraindication between conventional and alternative therapies that a patient is using. Second, this knowledge will provide doctors with the skills to help patients optimize treatment of the symptoms associated with chronic illness. As underscored by Andrew Weil, M.D. — director of the Arizona Center for Integrative Medicine at the University of Arizona — in my recent interview with him, “In many cases of common disease conditions, the alternatives [to conventional medicine] are safer, cheaper, and more effective.”

Third, by themselves practicing the lifestyle modifications associated with these alternatives, doctors will become more healthy themselves, and by extension, will serve as better role models for their patients. As is well-documented in scientific literature, the practice of medicine puts extreme stress on the body, soul, heart, and mind of its practitioners — leading to psychological problems, burnout, strain on inter-personal relationships, job dissatisfaction, and more. These consequences ironically leave doctors vulnerable to the stress-induced illnesses of their patients and increase the risk of doctors providing sub-optimal care to their patients.

Still, despite the proven need for increased training in and dialogue about integrative medicine, the field of conventional medicine has been slow to respond. “What’s interesting is that we are actually doing more and more studies on lifestyle medicine now, at academic institutions across America, and yet some in the medical hierarchy are becoming even more violent in their attacks on those who publicly discuss these viewpoints,” said Kulreet Chaudhary, M.D. — director of neurology at Wellspring Health in Scripps Memorial Hospital — in my recent interview with her. “It is totally illogical and a highly emotional response that has nothing to do with scientific advancement.”

Even Francis Collins, the director of the National Institutes of Health, “has been supportive to the fact that we are dealing with an outmoded model of medical care and it needs to expand,” noted Ken Pelletier, Ph.D., M.D.(hc) — clinical professor of medicine in the Department of Family and Community Medicine and in the Department of Psychiatry at the University of California School of Medicine, San Francisco (UCSF) — in my recent interview with him.

As the institution of medicine nonetheless continues to drag its feet, the public continues to demand alternative options. In response, Mehmet Oz, M.D. has served as a model for physicians by stepping forward to boldly explore alternatives on the Dr. Oz Show. In doing so, he not only has educated the public directly, but he also has encouraged physicians to more openly embrace dialogue with their patients — good news for the approximately 175,000,000 Americans with chronic illness.

“Dr. Oz has done and continues to do good work in empowering many people to take greater charge of their own health,” said Weil in our interview. As Weil additionally noted in a study published in the American Journal of Medicine, “Patients want physicians who have time to sit down with them and help them understand the nature of their problems and who will not just promote drugs and surgery as the only way of doing things.”

In essence, the public is tired of the “old guard” of medicine limiting access to care that might truly make a difference in their lives. Attempting to bar this information, said Chaudhary, is ethically questionable: “There is a point where we are violating our moral responsibility to patients by not at least publicly discussing the roles of lifestyle medicine in curing diseases that are fundamentally reversible, as shown through existing research.”

Similarly, I would argue, some doctors behave questionably, if not unethically, when they use their power to attack Oz’s attempts to bring alternative options to light, rather than leverage the opportunity to strengthen our body of knowledge about alternatives, through healthy dialogue and research. Regarding the accusations that Oz promotes quackery, Pelletier offered this perspective during our interview: “I think some of the things [Oz] recommends are questionable, but that may be 5 percent of the time. If you are looking across this vast array of personal healthcare, you’re going to be wrong sometimes; that is inevitable. In that sense, it’s understandable that [Oz] steps on those land mines every now and then. I don’t always agree with him, but I do agree with the necessity of having an open forum of expressing ideas that simply don’t show up anywhere in the common daily dialogue. He does a great job.”

Chaudhary echoes my sentiments, when she sums up the issue this way: “It’s fine to have differing opinions. But to create a hostile environment, where we publicly attack a physician who is willing to discuss alternatives, raises a concern over the motivations that are driving our medical system … What happened to Dr. Oz is a public attack on all integrative physicians, and it shows the desperation of the established medical system to try to keep things as they are, rather than allowing medicine to go through a necessary evolution. We should be embracing meaningful debate, armed with existing research as our tools, and not resorting to public shaming.”

There was a time in history, Chaudhary concludes, “that physicians embodied the highest morality of a culture. These recent attacks are a very public show that those times are past.”

In the interest of transparency, please note that Oz is a colleague of mine and may be a colleague of some or all of the people interviewed for this article.

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