One Sunday morning, during my morning radio talk show, Dr. Bill Pawluk and I began our program for the day with a discussion on the philosophy of holistic medicine as it compares to conventional medicine. This discussion preceded a viscous sneak attack by a physician who happened to be listening and decided to call in disguised as a listener who enjoyed the discussion
Our opening discussion had a few key points:
- Conventional medicine works to get you to a point in your health continuum where you are “asymptomatic”, meaning “without symptoms, discomfort or suffering.” In other words, conventional medicine is called into action when you are sick and its mission is to get you to feel “average.” There is nothing wrong with this approach, as long as your goal is to feel like the majority of the population. When you are sick, all that you want is to feel “normal.” This is illustrated by the simple fact that you typically go to a doctor when you feel sick or ill. When was the last time that you went to the doctor and said, “I feel great doctor, can you make me feel better?” It doesn’t happen, and if it did, their answer would likely be to write a prescription for Prozac or Zoloft.
- Holistic medicine, although it does play a role in treating illness, its ultimate goal is to get you to a point where your health is optimal or extraordinary. The holistic practitioner looks at you as a complex system governed by simple rules and laws of nature.
- Conventional medicine, is cookie cutter medicine. Medicine is governed by what is called the “standard of practice.” This basically means, if you have symptom X then the appropriate course of action is Y. In case of a malpractice lawsuit, the doctor will win or lose based on whether or not the doctor followed the “standard of practice.” These standards are built on statistical medicine and thus limit the level of individualization of treatment. The problem is not the existence and utilization of a “standard of practice.” The problem lies with the fact that the “standards” are severely flawed.
As the show went on, there were a number of callers and we finally got to George whose topic was “Wonderful Information,” meaning that he wanted to complement us on our show. Well, when we clicked him on we were surprised by a sneak attack on holistic medicine…After greeting George, he quickly began a passionate dissertation about how we were spreading falsehoods and doing the listeners a great injustice by badmouthing conventional medicine and giving advice that is not founded in science. This caught us by surprise but I let him speak his mind. Here were his arguments:
- There is no scientific basis for recommending natural products
- Natural products are not FDA approved and thus are not effective
- By recommending natural products, we are preventing people from seeking “proper care” and thus we are doing them harm.
- We are misrepresenting conventional medicine because conventional medicine is holistic.
- “Holistic medicine” is not “evidence based medicine” like conventional pharmaceuticals and surgery.
After allowing him to talk and waiting for him to take a breath, my first question for him was “what type of doctor are you?” to which he responded, “I’m an internist.” I continued to ask him questions which he continued to answer and contradict his own arguments. At one point, I asked if he had actually done a literature search to assess the validity of natural products for health, his response…”No, I haven’t” He continued to yell and I had to put him on hold to be able to discuss the subject.
So let’s take each point and give a brief rebuttal…
- There’s no scientific basis for recommending natural products. First, he himself admitted that he has recommended natural products when he stated that he ordered vitamin D blood tests. This is an important point because many opponents of natural medicine will use an “all or none” argument, lumping the reputable natural therapies with such products as shady bodybuilding supplements and useless one-a-days. This is the proverbial, “throwing the baby away with the bath water” and a few simple questions easily poke holes in this argument. During the debate, Dr. “George” brought up Linus Pauling and his statement regarding Vitamin C as a treatment for such conditions as the common cold and cancer. He said, that this link has been disproven. First, that statement is not true. Second, Dr. Pauling has been dead for 14 years (at the age of 93, I may add) do you think he could find some more recent research? Let me tell you, I do evaluate the research available in regards to natural approaches to health and the amount of literature being published today can make your head spin! If Dr. George had searched the literature, he would know this.
- Natural products are not FDA approved and thus are not safe and effective. Again he is not accurate in this statement. The FDA has given their stamp of approval to fish oil, soy, folic acid and phtyosterols for various purposes. With that said, FDA approval means very little to me as it pertains to natural products. It is no secret that the FDA has fallen short in its original mandate to protect the public from pharmaceutical harm. The proof is in the regular recalls of medicines and the removal of medications that had once received the gleaming praise of this highly biased and bureaucratic organization. Examples include: Baycol, Propulsid, Seldane, Vioxx and Bextra, to name a few. I could write an entire article on medications that were removed from the market for increasing the risk of life threatening complications. How many hospitalizations and deaths occur every year from the use of supposedly the safest of medication? Those which have been approved for over-the-counter, non-prescription use, such as aspirin, ibuprofen, naproxen, etc. Thousands of people are either injured or killed by these medications that don’t even require a prescription. A recent study by the Florida Medical Examiners Commission found deaths from prescription drugs were 300 percent higher than deaths from illegal street drugs. Acetaminophen (generic of Tylenol) is the leading cause of liver failure in the United States and the most common form of reported poisoning. These are just a small sampling of the data that proves that FDA approval is no guarantee of safety.
- By recommending natural products you are preventing people from seeking proper medical care. I have a tremendous amount of faith in people’s intelligence. Anyone who listens to our show or interacts with us knows that we are very responsible with our recommendations. We want people to have a healthy interaction with their health care provider, we want them to be forthcoming with whatever treatment they may pursue. With that said, it is no wonder that many people have difficulty talking to their doctor about natural products when they are met with an attitude such as the one displayed by Dr. George. The bottom line is, conventional medicine has its place as does natural medicine. I feel that a lot of Dr. George’s anger comes from our offering people options. Many doctors continue to hold onto the “Doctor should be God” mentality on matters of health. I feel that people are coming around and realizing that the biased nature of the medical industry does not allow doctors to protect them and Dr. George could be the poster-child for this thought process.
- We are misrepresenting conventional medicine because conventional medicine is holistic. Dr. George said that from day one, medical students are taught to look at the person as a whole person. I am not debating that this statement is false, I am suggesting that there is great dissonance between the statement “treat the whole patient” and the education and practice that follows. Medicine is specialized and segmented. You have doctors that specialize in heart, kidney, lung, brain, skin, bones, endocrine glands, breasts, prostate, infection, etc. Conventional medicine is simply not holistic. That is not good or bad, it just is the way it is right now. If I was born with a hole in my heart, I am glad that cardiologists exist. Primary care physicians just simply cannot keep up with everything. In defense of primary care physicians, the way insurance runs the show, it is impossible to take a holistic view of a patient given the 7 minutes the doctor is given for each patient visit. This is why we bring in the ultimate specialist, the holistic care specialist. These practitioners take the time to sit with patients and find out all about them. They evaluate mind, body, nutrition, fitness, spirit and everything else that may play a role in health. They typically sit with a patient for as long as it takes to piece together an accurate picture of health and work to move them towards energy, comfort, vitality and overall wellness. That is true holistic medicine.
- Holistic medicine is not evidence based medicine. Pubmed is the online database of research articles used by most doctors and health care practitioners. You can search it yourself at www.pubmed.com. Here is a sampling of a few items that I searched for just to give you a taste:
- Vitamin C – 40,262 studies
- Vitamin E – 29,114 studies
- Omega-3 – 11,494 studies
- Vitamin D – 43,474 studies
- Nutritional medicine IS evidence based medicine. You need to critically evaluate each study as you do with all research, but there is good, solid, peer-reviewed research on nutritional products. To say otherwise is just plain ignorant. If you were to evaluate the prescribing habits of conventional doctors, you would find that many prescriptions are not evidence-based treatments. Many are off-label, meaning they are prescribing medications that have been FDA approved for specific conditions to patients who have other non-approved illnesses or conditions. Said another way, they are prescribing medications to people who have illnesses or symptoms which do not have sufficient evidence to support the prescribing practice. In addition, the sterile environment of clinical trials make any finding suspect as it pertains to the real world.
In summary, I’m not angry at George for his unfounded comments. Attitudes and beliefs like his are common among conventional doctors. His outrage at the work that we do does have a silver lining, it reminds me of an old saying…”At first a new truth is laughed at, then it is violently apposed and then it is accepted.” If George is any indication of the timeline of this statement, then we are at the cusp of a new realization in medicine. Let’s welcome it in.