Here's an interesting article in today's news:AP IMPACT: Alternative medicine goes mainstream. Alternative medicine in some of its forms has been around a lot longer than modern science, but it seems to be being rediscovered. About 10 or 15 years ago, we spent some time in our Journal Club/Study Group at the Medical School looking at some of its forms with some care. One of our members, a nurse, actually gave us some demonstration of Therapeutic Touch. We did a lot of study and were impressed by the things we learned. We were also impressed by the very emotional response that some of our colleagues had to what we were doing. My own personal world view is both holistic and existential so I was not as encumbered by prejudice as some. Please read on below the break and I will tell you some of what we learned so you can form your own conclusion.
Among the things listed in the wikipedia presentation on alternative medicine is Traditional Chinese Medicine. I start here because the Chinese still practice what they have for thousands of years. Either they are really conservative about change or they have reason to go on using these practices. On of them, acupuncture, has become both popular and studied extensively here in the United States. The Chinese, Native Americans, and other cultures that go back thousands of years have mastered the use of herbs and other natural substances.
So what is it about modern science and its applications in modern medical practice that makes room for these other approaches? I have a very strong prejudice here so please don't think I am trying to be "objective". I have written and published in peer reviewed science journals about "the myth of scientific objectivity" so you won't find me pretending I believe anyone can pull that off.
In the last twenty years of my scientific career I have become a specialist in the new field of Complexity Science. This was the setting for the study group I mentioned above. The reason Complexity Science has become an integral part of our academic spectrum is that it addresses certain limitations of the Cartesian reductionism and its use of the machine metaphor. One place where this Cartesian blind spot has become very dominant is in medical science. The ultimate form of this is "molecular biology" which is a term that is at best an oxymoron. There is no life at the molecular level of organization and biology is the study of living systems. Once we break a living system apart into molecules to study it, it is no longer alive. That should be very obvious, but technology drives what we do and we can do so much with molecules thanks to technology.
Some years ago the Flexner Reort
called on American medical schools to enact higher admission and graduation standards, and to adhere strictly to the protocols of mainstream science in their teaching and research. Many American medical schools fell short of the standard advocated in the Report, and subsequent to its publication, nearly half of such schools merged or were closed outright. The Report also concluded that there were too many medical schools in the USA, and that too many doctors were being trained. A repercussion of the Flexner Report resulting from the closure or consolidation of university training, was reversion of American universities to male-only admittance programs to accommodate a smaller admission pool. Universities had begun opening and expanding female admissions as part of women's and co-educational facilities only in the mid-to-latter part of the 19th century with the founding of co-educational Oberlin College in 1833 and private colleges such as Vassar College and Pembroke College.
This report has shaped our medical education here in the US and elsewhere:
To a remarkable extent, the following present-day aspects of the medical profession in North America are consequences of the Flexner Report:
A physician receives at least six, and preferably eight, years of post-secondary formal instruction, nearly always in a university setting;
Medical training adheres closely to the scientific method and is thoroughly grounded in human physiology and biochemistry. Medical research adheres fully to the protocols of scientific research;
Average physician quality has increased significantly;
No medical school can be created without the permission of the state government. Likewise, the size of existing medical schools is subject to state regulation;
Each state branch of the American Medical Association has oversight over the conventional medical schools located within the state;
Medicine in the USA and Canada becomes a highly paid and well-respected profession;
The annual number of medical school graduates sharply declined, and the resulting reduction in the supply of doctors makes the availability and affordability of medical care problematic. The Report led to the closure of the sort of medical schools that trained doctors willing to charge their patients less. Moreover, before the Report, high quality doctors varied their fees according to what they believed their patients could afford, a practice known as price discrimination. The extent of price discrimination in American medicine declined in the aftermath of the Report;
Kessel (1958) argued that the Flexner Report in effect began the cartelization of the American medical profession, a cartelization enforced by the American Medical Association and backed by the police power of each American state. This de facto cartel restricted the supply of physicians, and raised the incomes of the remaining practitioners.
The Report is now remembered because it succeeded in creating a single model of medical education, characterized by a philosophy that has largely survived to the present day. "An education in medicine," wrote Flexner, "involves both learning and learning how; the student cannot effectively know, unless he knows how." Although the report is more than 90 years old, many of its recommendations are still relevant—particularly those concerning the physician as a "social instrument... whose function is fast becoming social and preventive, rather than individual and curative."
This account of the legacy of the Flexner Report is at best incomplete, if not very biased. Roughly at the point in my career as a teacher of physicians where we studied alternative medicine in our own group , there was a recoil against the machine like treatment of the human body and the magic bullet approach to the use of prescription drugs.
The latter could be a book, but suffice it to say that every chemical we introduce into our bodies has a spectrum of effects, In the case of prescription drugs we have created the myth of "side effects". A drug is prescribed as a "magic bullet" and then all its other effects are labeled "side effects". This is so well framed in our minds that we accept this labeling without question.
There is much more to say about these matters, but it would take volumes. Suffice it to say that it is refreshing that "alternative medicine" is being treated with the respect that thousands of years of human experience should be. I hope we can progress further to reframe medicine as the treatment of living systems rather than the repair shop for machines.