Add as bookmark

How We Should Practise Medicine

by Dr Sam Shohet(more info)

listed in clinical practice, originally published in issue 100 - June 2004

The Ideal Healthcare System

I should like you to picture an ideal system of healthcare where the patient is king or queen. A system so refined the only thing we need to worry about is to make sure that we have completed a medical questionnaire. A system of the 21st Century where the doctor looks through our files, completes a thorough examination using both Eastern and Western techniques, then puts in motion a series of bespoke treatments most suited for our complaints, drawn from what is best and most suitable in conventional and complementary medicine. For instance: a homeopath for the migraine headache, an acupuncturist for the eczema, an osteopath and massage therapist for the bad back, a herbalist for the digestive problems and a nutritionist for the weight control, and even a surgeon for that curious lump. In this wonderful system, not only is the doctor well informed about all the disciplines at his/her disposal, all the practitioners on the list of referral are also very well informed in all the modalities.

Our exclusive reliance on conventional medicine to treat anything and everything does not take into account that it is simply no longer equipped to do that. Today's medicine is a far cry from that which was practised some fifty years ago when practitioners not only cared for their patients' physical needs but also for their biochemical, emotional and spiritual states. They carried out procedures we now rate as complementary or alternative as well as some off the wall procedures (all of which are now back in use!) such as cupping, bleeding, the use of maggots and leeches. All in all, they were what I would call holistic practitioners.

The medicine of today has become sophisticated and image-conscious, relentlessly pursuing what it perceives as scientific methods with their tests and procedures, complicated instruments and drugs, all having to be approved by double blind clinical trials. Gone is the meticulous questioning, the observation, colour of the skin, state of the tongue, the smell of the breath or the quality of the pulse in order to arrive at a comprehensive diagnosis. These were the traits of real doctoring.

Make no mistake; the saving of life and limb should always command the best that we can offer by way of drugs and technology. There is no way, shape or form we can put a broken body back together again using acupuncture or homeopathy. Yet, although this life-saving technology only constitutes about 10% of our total health needs and should only be used to save life and limb, we make no distinctions and use it 100% of the time and for everything we consider to be a health issue.

The Present State of Play

Conventional Medicine

Last December in London, the vice president of one of the largest pharmaceutical companies in the world made a statement to his shareholders that their drugs don't work and, for that matter, neither do those of any other company. You would think that this news would be of great concern to everyone, especially those health managers who spend billions of pounds every year on miracle drugs for the treatment of a host of conditions. Conditions which lie at the root of long hospital waiting lists and patient and practitioner unrest. But, all that happened at this astonishing news was that there was a fall in the company's share value of 19 points, only for this to climb up again some three days later!

This may not seem significant in itself, but when taken alongside the EU intended legislation to outlaw our freedom of choice in vitamins, minerals and herbs as well as the introduction of sweeping powers to restrict the practice without a medical licence of anything remotely medicinal, should send shock waves to all who care about their health and welfare. This episode highlights how we could all be forced to seek out medical therapies whose very creators have denounced as useless, simply because they are licensed, regardless of pedigree or record of efficacy and success.

I use this only as an illustration of the state of our conventional system which, in its current form is fragmented and does not give patients access or choice to the other far more effective therapeutic modalities such as acupuncture, homeopathy, massage, hypnotherapy and many others. The system relies too heavily on the physical appearance of signs and symptoms to make a diagnosis, which is then followed by a treatment aimed solely at the masking or alteration of these physical markers. This is then seen as proof of success or efficacy. When symptoms return, this is regarded as another condition for which yet another treatment must be found.

Unfortunately the whole culture in conventional medicine has shifted over the past few decades away from the skill/enterprise/ingenuity of the practitioner – right brain function, and has become more reductionist and left brain in an attempt to make it scientific. This might go some way to explain the resistance of the medical profession to recognize the validity and worth of other treatment modalities, especially since these are in the main based on energy systems and beliefs which are very difficult to prove scientifically. Or at least what we understand as scientific using the methods we currently use to test mainly drugs.

The Specialist

The specialist is one of the major routes a practitioner has to refer a patient, either to confirm a diagnosis or when completely at a loss with the diagnosis and/or treatment.

The specialist is the approved route for mainstream medicine and is at the pinnacle of conventional thinking, serving to underline the very way the system regards the body as being made up of different parts and compartments put together by various means to make up the person.

Personally, I find nothing fundamentally wrong in specialism so long as it is not used in isolation or to the detriment of the patient. Our present system encourages the promotion of what might be deemed turf mentality, where one specialist has to be so careful and blinkered in case there is any hint of infringing on another specialist's field. This was very well illustrated by a well-publicized case of a businessman who, desperately waiting for a bypass operation, sold his house to raise the finances necessary for a private intervention. On the day of the operation and as he was being prepared for surgery, he collapsed and had to be taken to the nearby general hospital where he had to undergo emergency surgery to stem a massive haemorrhage from a burst gastric ulcer which nearly cost him his life. After the operation, the businessman noted that all the symptoms that had plagued him for years and were attributed to his coronary arteries' state of demise, had completely disappeared.

When the surgeon who carried out the operation and saved the businessman's life was asked in an interview how a fulminating stomach ulcer could be missed by another specialist for so long and be attributed to something else, he replied that there was no way a heart specialist could have known that there was a stomach ulcer since this was the field of a gastro-enterologist!

I am sure that, like me, you find this story disturbing and, like me, I am sure you wish it were an isolated incident. The sad fact is that it is one of many such stories and this is only for surgery. If we were to take mortality (yes death!) for instance and only from drugs in hospital – where we have access to all sorts of means to sustain life, we find that there are over 25,000 deaths each year making it the 4th biggest cause of death after heart disease, cancer and stroke. Sobering statistics considering every one of those prescriptions was signed by someone licensed to practise.

All in all though and the reason we should be encouraging the role of specialists in medicine is that complementary health practitioners are specialists in their own right.

Complementary/Alternative

Most of the complementary therapies at our disposal have been around for millennia. They form the backbone of medicine for over 80% of the inhabitants of this globe.

They have the advantage of not only being effective, but also cheap to administer. On the whole, practitioners of complementary medicine are under no illusions as to the part they play within our healthcare system, and most are not aware just how important that part is! This is understandable in our Western culture, but is improving constantly with the introduction of recognized and acknowledged centres of excellence and university faculties in almost all the major modalities. Osteopathy has already acquired professional status, with acupuncture close behind. This hopefully should not alter the basic concepts, but make conventional medicine more aware of their existence and as such, their acceptance as worthy of consideration in the treatment of patients. The only fears I have on the present day teachings and practice of Eastern philosophies in the West is that they tend to be on conventional lines. This weakens the efficacy of most of the options on offer which then gives poor results and as such affects their reputation. The basis of all complementary modalities is to take the whole patient into account rather than named conditions they are suffering from such as asthma, eczema and diabetes; yet we all seem to be treating conditions much in the same way as drugs by having set prescriptions, only with different tools such as herbs and homoeopathic remedies without much regard to the rest.

Complementary medicine practitioners do not fare any better than their conventional colleagues when it comes to integration within their system. The system is just as fragmented if not more so and even referral within it, for example between acupuncturists and homeopaths is to my knowledge rare, if it takes place at all. Practitioners are naturally suspicious and insecure, especially since there isn't any real understanding of what modality would benefit what patient the most.

Integrated Health Care System

The Integrated Approach

All healthcare practitioners should receive a core education of biology and medical sciences – anatomy, physiology, chemistry, pathology prior to their specialization into their given disciplines. They all strive to help those who need help using the best at their disposal. So the more tools they are equipped with, the better they are at dealing with patients. Although this does not mean that all practitioners should be able to do all the therapies which is impractical, it does mean that all practitioners should be able to draw on the expertise of other practitioners in the care of their patients according to a hierarchy of 'first do no harm', depending upon the nature and severity of their complaints.

Each patient would be assessed for:
• Physical: including structure, stature, trauma, etc;
• Chemical: including enzymes, diet, lifestyle and environment and not forgetting genetic predispositions;
• Energetic: including emotional and spiritual states, meridians, chakras.

A GP for instance could see the patients and offer a range of treatment options by referring them to the appropriate practitioner. This, of course, has to work both ways and a complementary practitioner should refer patients to other practitioners skilled in other therapies.

This requires all practitioners to be conversant with all the major therapies which places a large burden on the teaching establishments and those of further education. Naturally the onus of greatest commitment is on the individual practitioner to ensure that he/she keeps up with the latest developments and knowledge in all fields of medical science. This should be done by attending courses on a regular basis, and not necessarily in their own field, as well as subscribe to reputable journals such as Positive Health which features articles from all the disciplines in healthcare.

Case Studies

Rachel

Rachel, a 3 week old baby had a natural uncomplicated birth but started vomiting every time she was breast fed. Her stomach was also bloated and she suffered lose stools.

Her mother brought her in to see me because the baby was constantly crying and drawing her knees up obviously in distress and her GP had prescribed antibiotics which made the situation worse.

With babies, time is of the essence and we had to get to the root cause of the problem very quickly. What made things easier was the fact that Rachel was obviously keeping some milk down since she was filling her nappies regularly and she was not losing weight.

Physical

Careful examination using both conventional and Chinese methods revealed that Rachel was suffering from a gastro-intestinal infection but there was still the nagging feeling she could have an obstruction or even a twist in the gut. The referral had to be made carefully since in the wrong hands Rachel would end up in theatre having an unnecessary exploratory operation. A paediatric physician confirmed there might be a twist and, using applied kinesiology the area of the twist was pinpointed. Rachel was then referred to a cranial osteopath who reduced the twist.

Chemical

Again using applied kinesiology, it was found that the infecting organism was a fungus and Rachel was referred to a homeopath to control that, together with the most suitable herbs for her.

Controlling the condition was only the first step, but we still had to establish where Rachel could have contracted such a bad infection considering she was on breast milk. (For those screaming out antibiotics, the fungal infection came on before the antibiotics were prescribed.) On examination of the mother, it was found that she had an area of fungal overgrowth around both nipples. This meant that the breast feeding had to be stopped until after the mother's fungus was cleared, and the baby only given expressed breast milk from a bottle.

It was evident within a very short period of time that we would have to look to alternatives for breast milk. Most powdered milk is based on cow's milk and with a high proportion of sugar which would not be ideal for anyone with a fungal overgrowth. A sample of Rachel's hair taken from the root was sent for a test analysis and a list of foods which could prove troublesome and to which there was a chance of intolerance, was obtained. As it happened, dairy was not a suitable alternative, so we had to find a formula which was Soya based. The logical step to ensure individualization of the treatment was to select the most suitable product from the three that were easily available.

[On a personal note: I try to avoid goat and sheep milk in cases of intolerance to dairy since I find that sooner or late intolerances to these develop and they are much worse than with cow's milk. Also, it is not advisable to give goat or sheep milk to infants under 2 years of age.]

Energetic

In this case we had to enlist the services of a homeopath in order to help both Rachel and her mother deal with the emotional side of this traumatic experience. Even if this is not obvious with a baby, there is always an emotional component to pain which must be addressed. And remember also to treat the mother.

Rachel is now 9 months old and thriving. She is totally unaware of the teamwork that helped her during the first few weeks of her young life.

Russell

Russell was fifty seven when he first came to see me for a bad back some six years ago. He has had a bad back for as long as he could remember and has done the rounds of pain killers, massage, osteopaths and even orthopaedic surgeons who recommended an operation on his back after an epidural and a series of steroid injections failed to curb his symptoms. I remember what Russell told me on his first visit that he wanted most now that he 'made it' after a life of hard work as a builder: he wanted to be able to get in and out of his new sports car!

He did not smoke or drink and, according to him, ate very well. He was slightly overweight which is hardly surprising considering he found walking difficult and painful.

Physical

Russell walked with a marked limp; his right leg was some 2 inches shorter than the left. He assured me he has never had an accident or a fall and only remembered 'pulling a muscle' some twenty years previously when playing football in the park with some of his friends. He had never had his hip x-rayed although all the specialists who treated his back including the osteopath whom he had attended regularly, had examined his hip and had commented on the marked difference in the leg length – it seemed no-one wanted to make the connection, obvious as it was.

On referral to a radiographer, it was clear that Russell had dislocated his femur out of its socket and, as expected over the years, the head had degenerated. There was no way that we could reduce the injury without a new hip but we had to plan to ensure that was all that was needed and to ensure there were no disappointments later. Remember that every muscle is connected to bone and that every muscle is also associated with an organ. Should the organ not be functioning properly, the muscles related to it would be out of balance and therefore the bone they are attached to will be pulled by the more active muscle. The organ affected in Russell's case was the large intestine and the bone was the lower spine.

In the mean time, the pain was brought under control using acupuncture, massage and physiotherapy.

Chemical

Using pulse and tongue diagnosis together with a thorough history using both conventional and Eastern modalities, a diagnosis was made of dysbiosis or a badly functioning large intestine. Using applied kinesiology it was found that there was a parasitic overload that needed to be addressed. This was done using herbs and tinctures as well as homeopathy.

Since dysbiosis may also be caused by food intolerances, a test report was obtained using the DNA from the follicle of a hair shaft, and a diet and nutrition programme was devised to ensure that the immune system was boosted and the gut flora remained in balance.

Emotional

With back pain for so many years, together with the intrusive interventions all to no avail, there is bound to be some emotional trauma which, in this case, manifested itself in depressive episodes. Russell was seen by a psychologist specialising in hypnotherapy and all emotional issues were resolved within a few sessions.

Two years ago Russell was fitted with a new ball and socket joint. All materials used including the cement were tested beforehand to ensure they would cause minimal reactions, and with the help of an exercise and fitness physiologist he was literally up and running within 5 months of his operation.

And by the way, Russell was able to get in and out of his sports car within 4 months of his first visit with backache!

Discussion

The above case histories illustrate just what can be accomplished when all a patient has to do is to make an initial visit to a practitioner, any practitioner. It takes years of study and hard work to acquire the expertise needed to become a specialist. No one practitioner can be a specialist in all fields but, recognizing one's abilities and those of others and using these abilities to help our patients is to become a specialist in all fields. After all, the patient is king or queen and there is no room in 21st Century medicine for personal issues or interdisciplinary conflicts. This surely is the way we should practise medicine.

Comments:

  1. No Article Comments available

Post Your Comments:

About Dr Sam Shohet

Dr Sam Shohet BDS MGDS RCS(Eng) LiAc MBAcC ICAK is Technical and Clinical Director of Integral Health at 10 Harley Street, London.  Dr Shohet started in oral surgery and anaesthetics, then general practice; he was one of the first dental practitioners to qualify for Membership of the Royal College of Surgeons. He worked in orthodontics in Germany at a holistic group practice; on return to the UK he studied Acupuncture, Homeopathy, Biomagnetics, Nutrition, Functional Medicine and Applied Kinesiology. For details of the Integral Health Hair Test which establishes the root 'cause' of a health condition,, or if you are a practitioner and would like to use the hair test for your patients, contact Tel: 0207 467 8322/ 01483 522133; info@integralhealth.org     www.integralhealth.org

  • Beginner's Guide to ME

    Essential reading for people/carers with ME/CFS serious debilitating illness. Counteracts bad advice

    www.amazon.co.uk

  • hypnotherapy training

    A powerful way to make changes in your life, help others change theirs. Hands-on and expert tuition.

    hypnotherapytraininginternational.com

top of the page