Medical Treatments and Cures: Changing Perceptions May Help Us All

Medicine is undergoing a quiet revolution. Only a few years ago, most mainstream physicians and practitioners of alternative therapies tended to view each other with suspicion, if not disdain. Physicians often charged that alternative practitioners were charlatans; in turn, therapists outside of the mainstream claimed that doctors relied too much on potentially dangerous drugs and surgery, and were so overly specialized that they failed to treat the patient as a whole.

Increasingly, both camps are recognizing that each has a place in the healing process — a trend that is being embraced by a growing number of patients. For example, at least one-third of respondents in a 1990 Harvard Medical School survey said that they had been to alternative practitioners. Most patients also saw physicians, but the researchers estimated that visits to alternative practitioners actually exceeded those to primary-care physicians. In keeping with the trend, some insurance policies now cover certain alternative therapies, especially if the treatments are recommended by a physician.

The Historic Perspective

Until the early part of the 20th century, physicians and alternative practitioners competed more or less on equal footing in America, because there were few standards or regulations. Thus, the traveling medicine man could legally call himself a doctor and peddle worthless patent medicines.

This changed dramatically in 1910, when strict standards, based on scientific principles, were adopted for medical schools. Within a few years, only graduates of accredited medical schools could join the American Medical Association, and practitioners of homeopathy, chiropractic, naturopathy, and other "unorthodox" disciplines were shunned by scientific medicine. If the benefits of a therapy could not be documented scientifically, it was discounted as worthless. Some, such as homeopathy, virtually disappeared, and others, such as chiropractic, were relegated to a questionable gray area. Of course, real quackery did not disappear, but government agencies and regulations made life more difficult for charlatans as well as for legitimate alternative practitioners.

Searching for a Common Ground

The pendulum began to swing back with the development of osteopathy and psychiatry as recognized medical specialties, and acceptance of the ancient observation that emotional factors play an important role in health and illness. The 1960s brought renewed interest in Eastern philosophy and healing practices, as well as growing polarization between scientific medicine and alternative therapies. Still, it became increasingly difficult for physicians to discount benefits of certain alternative practices, and conventional medicine started to embrace some of them. In particular, pain clinics began to incorporate such therapies as acupuncture, meditation, and biofeedback training into their therapeutic regimens.

As college graduates of the sixties matured and some entered medical school, a middle ground began to emerge between the two opposing groups. There are still diehards at each extreme, but their numbers are decreasing as more physicians and alternative practitioners recognize that neither has all of the answers but both have things to offer.

Medical System in Transition

A few decades ago, most families relied upon a general practitioner to look after most of their medical needs. This doctor delivered babies, treated childhood illnesses, set broken bones, performed surgery, and comforted the aged and dying. But lacking vaccines, antibiotics, and other modem medications and daring surgical procedures, these doctors were helpless against many diseases that are now easily cured.

Today, with the growing complexity of conventional medicine, more doctors are specializing in specific parts of the body. Consequently, families are likely to be attended by several doctors, either individual practitioners or members of a prepaid health maintenance organization (HMO).

Faced with a rapidly changing health care system, skyrocketing health-care costs, and so many medical specialists and subspecialists, patients often don't know where to start when they have medical problems. They are baffled by the technology and complexity of modern medicine, and may feel alienated from their physicians, who perhaps don't take the time to explain various procedures.

Experts agree that it's essential in this era of medical specialization and group care for individuals to have a primary physician to oversee and coordinate care. Most primary-care physicians are trained in family practice, internal medicine, pediatrics, or gynecology. If you have a chronic disorder such as heart disease, diabetes, or arthritis, your primary doctor may specialize in that area, and still oversee your care for other problems. Whenever sickness strikes, you should start by seeing your primary doctor, who can, if appropriate, refer you to specialists.

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