CAM

I agree with Rakel’s assertion that calling everything except current Western medicine “complementary and alternative” relegates these therapies to a second-class status. Language is a powerful indicator of status, and can shape people’s expectations and perceptions of something. These therapies are not consistently “alternative” or "unconventional"-- from anecdotal experience, I know that in China, traditional Chinese medicine is preferred to Western medicine by a good proportion of people, especially for sensitive concerns such as reproductive health and chronic pain.

One of the most interesting issues for me in CAM is categorization. In my disability class, we discussed (and failed to find a satisfyingly concrete answer to) the question of how one can group together such disparate disabilities as multiple sclerosis, schizophrenia, paraplegia, and locked-in syndrome as “Disability.” Similarly, the question here arises: how can one group together therapies as diverse as spiritual healing, support groups, hypnosis, traditional Chinese medicine, and massage under the same heading of “CAM?” Many of these therapies share little in common.

That being said, many of these therapies do stress the importance of treating the whole person, not curing a person’s disease reductionistically. However, if CAM is to gain greater influence in medicine, it cannot be seen as a vague, floating entity of quasi-mystical and unscientific healing properties. Greater efforts need to be put into researching the effects of specific CAM therapies—just because these treatments are holistic doesn’t mean that they defy the methodical approach of science. This is important, because as the Eisenberg paper shows, those who seek alternative treatments are willing to pay out of pocket (and substantially so), which has huge financial implications. If the government can regulate the use of CAM in a federally managed healthcare system, it stands to benefit greatly.

I appreciate Rakel’s proposal for integrative medicine instead of the multi-pronged, subspecialist approach that makes up our current medical system. However, one cannot expect that 100% of patient’s health concerns will be met by the incorporation of CAM. CAM places more responsibility on the patient, perhaps more responsibility than some are willing to take at first after a lifetime of being told what to do by doctors. While I like to think that patients will be eager to take control of their own health, the additional education and responsibility that CAM requires are legitimate obstacles that need to be addressed in the future. What CAM begins to get at, but cannot fully treat, is the social fabric of a person’s life that impacts his/her health—doctors need to respect that while they should do everything in their power for a patient whom they perceive in need, certain social inequities will always confound completely satisfactory health outcomes. This is a matter of political action and advocacy that while obviously necessary, I think, goes beyond the realm of medicine.