...Continued from Preliminary Thoughts on Interdisciplinary Health So would I go see a chiropractor or a naturopath or a DO? Right now, probably not. Would I recommend patients see one? At this point, I don't think so. Based on my impression of them (admittedly based on anecdotal comments and impressions from friends) I haven't been convinced they do more good than harm. But would I recommend against a patient seeing one, or try to stop a friend from going to see one? Nope. I might pass on the paraplegic story, but I'm not against people finding what works for them, and I haven't been entirely convinced that these other practitioners do more harm than good. And if my smart friend is convinced enough about naturopathy to pursue a career in it, there's gotta be some merit to it. Like I said, while the conceptions I hold now may be misinformed or even grossly incorrect, I do believe there's value to be gained from interdisciplinarity, and I consider myself open-minded and willing to change should I be proven wrong.
For interdisciplinarity being the newfangled wave in health care, throughout my time in hospitals and med school, I sure haven't gotten the sentiment that it's put into action very much.
After reading my previous post, my naturopath-student buddy asked if I'm for or against interdisciplinarity. I want to be clear: I'm not against it at all; I think that there's a lot to gain from it, if implemented properly ... i.e. not in the forced way described by the "Anonymous Therapist" commenter on my previous post.
My point is simply, I haven't seen much interdisciplinarity in action or even in theory at this point in my medical training, despite its lauded usefulness.
In fact, even though I'm only less than a quarter of the way in, to date I've felt the sentiment actually leans toward the opposite, almost against interdisciplinarity. I haven't felt much like we're being told to consider all those other professions as peers, equally-valuable limbs and body parts of the conglomerate, undoubtedly creepy-lookin' monster that is the health care industry. Can't function without the others, you can't live without one body part, so the interdisciplinarists might say (I'm abusing that word, aren't I?).
So how might the average medical student who has gone through the same training I have respond to this equal-value-body-part-organism metaphor? They'd probably say, "hey, you can actually live without some body parts. Naturopaths - they'd be the tail! Better off without 'em. You don't need a tail. You can function just fine without one. Humans, the smartest beings on earth: no tail. And we're better off for it...even the dumbest of us can't run in circles chasing it, which makes them look smart, because some people I know probably would chase their tails, if they had one."
Note that I said the average medical student - again let me point out this is not my opinion. In all honesty, I do feel myself and my profession could stand to learn some things from her and her profession. What I am talking about is the sentiment that I've felt to this point in medical school. Given the lack of interdisciplinary discussion at this point in our training, I wouldn't be surprised if a good number of my classmates thought like this.
Where do I get this impression? Experiences like, say, the time when one of my professors actually mentioned naturopaths directly in one lecture: "Sprinkle some herbs over a bunch of white beads and give that to a patient to eat? How will that help the patient?!" Yep, interdisciplinarity in action. That's what we've learned about naturopaths to date in medical school. And you wonder why some doctors look down on naturopaths.
Chiropractors? There's a whole other topic. Based on how some of my colleagues view chiropractors, in this organism of equally-valuable parts they'd rank chiropractors as, say, the appendix (ie. another organ of no known usefulness). One med student asked me, "How come chiropractors get to call themselves doctors?" Clearly subtle hints of superiority are more than evident in that statement. Another med student told me about her experience volunteering in a rehabilitation ward, and told me, "I was shocked at how many of the patients there were rendered paraplegics because of a chiropractic adjustment." Not a shining commendation by any means.
Moving away from hearsay: my limited experience with chiropractors, when I accompanied a friend on an chiropractic visit, was that the adjustments were very much aggressive, near-violent; and the doctor was very much like a salesman, near-slimy. My honest opinion of them, however, is I have yet to see first-hand any harm they have done, and I have read testimonials saying that they have made a huge positive difference in some patient's lives (but so have miracle healers...hmm).
And what about the ol' D.O., or Doctor of Osteopathy? Thanks to ads at test-prep courses and in pre-med literature aimed at pre-professional students and mostly worded along the lines of "Have you considered D.O.?" (which actually come across as "Hey eager pre-med student, have you considered D.O. as a backup plan should you be too dumb to get into med school and yet still crave the feeling of being called 'doctor?'") an impression of this profession among medical students as being a profession for pre-meds not smart enough to get into med school might be understandable. Fortunately, in a random encounter starting a conversation with a stranger on a park bench in London last year, I have met a D.O. student and know that to not be true.
D.O.s claim that they are another type of doctor, "equal to M.D.s in the eyes of the law." So why aren't D.O.s mentioned in medical school then? Maybe it's just because I'm in a Canadian medical school, but I think there's more to it than that...
Would my preferences change if I were taught the merits and capabilities of these professionals and believed that evidence showed they are medically indicated and make a significant positive difference in certain conditions? Definitely.
The thing is, at this point, I haven't had the chance to go look up this evidence on my own. Not because I'm lazy, but because I've been too busy learning the things my medical has deemed important... and this isn't one of those things. But supposing I take the initiative to look this up on my own; what about the other students in my class? How will they know what to think about chiropractors and naturopaths and DOs other than what they've heard from their friends or seen on YouTube? Hopefully you can see why I think that training future doctors should involve discussions about these other healthcare professionals, because I do think that medical professionals have a lot to gain from an interdisciplinary mindset and from each other.
I honestly hope that my school starts touching on these other important parts of the health-care profession as I proceed through the curriculum. But if med school keeps on going the way they've been going so far, and don't explain to future doctors what each of these other healthcare professionals do, "interdisciplinary health care" will just be another Utopian ideal with no manifestation in this world... another untapped gold mine.
So would I go see a chiropractor or a naturopath or a DO? Right now, probably not.
Would I recommend patients see one? At this point, I don't think so.
Based on my impression of them (admittedly based on anecdotal comments and impressions from friends) I haven't been convinced they do more good than harm. But would I recommend against a patient seeing one, or try to stop a friend from going to see one? Nope. I might pass on the paraplegic story, but I'm not against people finding what works for them, and I haven't been entirely convinced that these other practitioners do more harm than good. And if my smart friend is convinced enough about naturopathy to pursue a career in it, there's gotta be some merit to it.
Like I said, while the conceptions I hold now may be misinformed or even grossly incorrect, I do believe there's value to be gained from interdisciplinarity, and I consider myself open-minded and willing to change should I be proven wrong.