Returning the soul to medicine
Dr Michael Dixon is a GP Principal at a rural practice in Collompton, Devon. A Trustee of this charity, he has been an advocate of integrated medicine for many years. Here he argues that we need to get away from 'doc in a box' medicine and that patients do better with a 'whole person' approach to treatment.
In my view modern general practice is divided on its future direction.
The first direction is an increasing demand for rapid patient access in the treatment of specific symptoms and diseases. This has been met, to some extent, by national rapid access targets. The recent Quality and Outcomes Framework of the GP contract has also encouraged this direction of travel, offering faster access and good quality treatment within a biomedical model based upon stringent definitions of evidence-based medicine. The focus is on rapid treatment of symptoms and diseases and identification and treatment of risk factors. However this approach is often not patient-centred and takes little account of the patient’s background, culture, and health beliefs.
The second is an interpretation of general practice, which aims deeper and wider than the symptom or disease. It treats the patient as a whole person and offers a broader range of therapies and interventions that are more sensitive to a patient’s wishes, beliefs and needs. This is a more personal and flexible method, which is less rigidly confined to the presenting symptom (which may sometimes be simply a metaphor for distress) or the disease (which may be the result of a given lifestyle). It is an approach that can provide more sustainable effects on a patient’s health and wellbeing. This is the integrated vision of general practice: a vision that is perceptive enough to acknowledge that health and wellbeing (i.e. the harmonisation of body, mind and soul) transcends provenance by randomised control trial methodologies only.
This second and more holistic approach has been neglected in recent years by a system that appears to value only the easily measurable. In my experience the growth of what could be called ‘Doc in the Box’ medicine has fuelled an equal and opposite demand by patients for a form of general practice that respects its roots in family medicine and emphasises personal care and continuity. These things seem to be particularly important for patients over 60, those with long term illnesses and those who develop a very serious illness.
I believe that an increasing number of patients and GPs are seeking to embrace a way of working which has the potential to offer a wider perspective on the patient (beyond their presenting symptom) and an expanded range of therapeutic approaches beyond the purely conventional. Three quarters of the British public would like to see complementary therapies available on the NHS (according to a 2006 poll conducted by ICM for The Prince's Foundation for Integrated Health) and over 50% of GP practices are now providing access to complementary medicine.
This document is about this second kind of general practice - the integrated approach.
I believe that an urgent redefinition of general practice is now required. One that better meets the needs of patients and practitioners but which also provides a more sustainable approach to the health and wellbeing of the local population generally. One that offers a wider choice of safe and effective therapies, while ensuring that patients do not turn their back on proven conventional treatment.
My aim is to define and describe how this integrated vision of general practice might look. It is 'work in progress' and to be used as a basis for discussion and debate. I, and The Prince’s Foundation for Integrated Health, hope that it will raise the profile of integrated practice and be of some use to GPs and patients struggling towards a wider vision of what is possible when the soul is returned to medicine.
Read the full paper here, then leave your own thoughts in the comment box below.
Comments
Susan Davidson
July 08, 2008
Your article was inspirational in its content and appears to have been born of many years of experience working with patients and health care systems. Thoughts are energy and one can only hope that those which you have expressed will find their way into physical reality for the benefit of all.
Susie Russell de Clifford
July 03, 2008
The Healing Touch Project is being funded by the Somerset NHS Partnership for a year within Mental Health Services. It is going extremely well. The clients complete an evaluation form for every time they receive a therapy which includes aromatherapy, massage, Indian Head Massage and even foot-spas are used as we have small groups at a time. The results show significant benefits to the clients. We continue this project with excitement and enthusiasm as well as gratitude for the funding which is allowing this to happen. I see an integrated health service in the future to be far more effective and beneficial for everyone in our society for all levels of our being and the true path leading to enlightened Holistic Health Care. Thankyou. Susie
Sarah Hews
June 13, 2008
I am a Reiki therapist working in a complementary therapy team within the NHS. Our team offers healing, massage, aromatherapy, reflexology and counselling to cancer patients in a large London teaching hospital. The feedback from patients is overwelming. People find that complementary therapy offers them relaxation, peace and helps them deal with the stressful regime of chemotherapy. Patients repeatedly tell us how the treatments have enabled them to relax,cope and feel positive while they are in hospital. The treatments also help alleviate symptoms such as nausea, pain, lethargy, constipation and headache. We give these therapies on the ward alongside the medical/surgical treatment. It works well, and patients are always amazed and delighted that this is available on the NHS.
Peny Pullen
June 12, 2008
Well done! At last the tide is turning and for the better. Of course holistic, integrative heatlh is the only way forward and after the traumas me and my close family have experienced - courtesy of our own creation ( I am aware of that) but enabled by a pharmaceutical company controlled health care system that relies so heavily on treating the symptoms with expensive and often damaging drugs. Also, because of the suppression of truths re dental mercury toxicity and its ability to pass down the generations - toxic body burden must be addressed and I am certain that this will happen. So, please address the all important 3 PS - Pollution Parasites and Ph (Plus self esteem of course and a belief that the body is intelligent and can heal itself with encouragement.)
Helen Allen
June 12, 2008
It has long been known that illness should be treated as a whole - mind, body and spirit (soul) which is sadly lacking in our medical care today. A great number of modern ailments are due to the stressful way we now live and drugs are really not the answer. Massage,reflexology, Reiki, healing, acupuncture - to name a few of the many therapies available, even the oft forgotten friendly chat (loneliness causes stress and can be helped so much with just a friendly presence) does much to ease stress, without recourse to drugs and their side effects - anti-depressants do not cure, they merely serve to hide the true cause of the problem, which then cannot be released by the patient. I am in favour of alternative therapies being used wherever possible - so many choices out there, let's use them.