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We have to educate to integrate

by Dr David Peters(more info)

listed in complementary medicine, originally published in issue 34 - November 1998

The Integration Debate

Integration is the new buzz-word: the argument being that non-conventional therapies are here to stay, so why not put them to work in the mainstream?

An obvious notion for those who see the possibilities of NHS posts and career paths, research opportunities and the chance to offer their valuable work without having to worry about fees. But do we feel some doubts too?

Those with a long history in the field do. They see a scene so changed that it is hard to remember when acupuncture and homeopathy were the preserve of the radical, the eccentric and the religious fundamentalist.

Facing a Brick Wall

In the 60s they were 'fringe', in the seventies 'alternative'. Old hands might recall these times with nostalgia. Back then if you practised 'alternative' medicine you were in outlaw territory, even when working in the NHS. A few of us began to infiltrate it during the late seventies and spent the eighties trying to convince the world that this stuff was not alternative but 'complementary'.

Hoping to break down the wall between conventional medicine and what we believed were more holistic approaches - including important aspects of complementary medicine - we pushed hard. But there was no way through. Only when we found the door labelled 'science' and realised that research was the key, did we tumble unprepared through the barrier, to find the bolts had actually been freed from the other side by a wave of mainstream practitioners critical of biotechnical medicine's magic bullets approach.

Is complementary medicine a new set of magic bullets? There are those who would like it to be. And others who would like to apply the 'magic bullets' style of research to it. Yet others think complementary medicine will transform medicine.

The Benefits of Integration

Within all these groups there is a misunderstanding about complementary medicine's significance and its limitations, but their existence has created a great deal of goodwill for clinical co-operation, and a hunger for joint learning, innovation and reflective practice.

Authentic integration is still rare, but those teams that manage to stay together sense that the effort is worthwhile; that patients like having wider options; that sometimes remarkable results can be achieved. The view from this leading edge is interesting all the time, challenging mostly, and pretty consistently uncertain. Integration demands that we appreciate the perspective of another profession; an extra-ordinarily difficult thing to do. Professions are like tribes; schooled in different temples and worshipping diverse gods, they use diverse languages and have incompatible ideas. It is even more problematic to integrate the perspectives of modern science with the medieval systems of thought which underpin traditional systems or to make sense of 'new science' and New Age explanations commonly.

How will Complementary Medicine Survive?

Will complementary medicine survive in the mainstream - rather than as a counter-culture in the private sector where it has always thrived and will continue to? Ultimately that depends on 'professionalisation'. But how long will it take before complementary medicine is grown up enough to fight its corner in complex and difficult academic and service delivery systems? The agents of change will be senior practitioners who can see through the 'orthodox-alternative' language games, and rise to the challenge of post-graduate learning.

The new generation of reflective practitioners will be competent to inquire rigorously into their work with an understanding that mind and heart are involved. Emerging university programmes will help the process along. Given time, and the context of academic learning communities, appropriate research programmes can be built up to fund the practitioner development, inter-professional learning and the outcome research needed. So if you want to see complementary medicine bloom in the NHS - if you hope to see it complementing conventional treatment or you believe it can help create a more holistic style of NHS healthcare - then you may want to join in this effort.

Eventually I believe we will demonstrate for sure that integration works; that it is part of a process which is evolving the healthcare of the twenty-first Century.

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About Dr David Peters

Prof David Peters is Chair of the British Holistic Medical Association (BHMA.org), an open association for everyone concerned to develop medicine as if people matter. David is the Clinical Director and Professor of Integrated Healthcare at the University of Westminster (U of W), is on the Board of Directors of the U of W Institute of Health and Wellbeing, a transdisciplinary research and training group exploring biopsychosocial approaches to health creation and treatment. He may be contacted via petersd@westminster.ac.uk

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