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Holistic Healthcare Is Available Through EBSCO, a World Leader in Accessible Academic Library Databases JOURNAL OF holistic Contents healthcare Editorial. 2 News review. 3 ISSN 1743-9493 General practice – the future is integrated . 5 Michael Dixon Published by Complementary medicine helps patients . 7 British Holistic Medical Association The campaign against CAM – a reason to be proud . 8 PO Box 371 Harald Walach Bridgwater High costs, large disease burden . 14 Somerset TA6 9BG Jonathan Lord Tel:01278 722000 Email: [email protected] Challenges in interpreting and applying the evidence for complementary, alternative and www.bhma.org integrated medicine. 16 Catherine Zollman, Hugh MacPherson Reg. Charity No. 289459 Vested interests and the greater good . 23 Editor-in-chief William House David Peters More harm than good? . 26 [email protected] George Lewith Integration, long term disease and creating a Editorial Board sustainable NHS. 29 Jan Alcoe, Richard James, David Peters Willliam House Approaches to healthcare: connectedness and spirituality . 32 Editor Denise Peerbhoy Edwina Rowling [email protected] On becoming a ‘recovery ally’ for people with depression . 38 Administrator Damien Ridge Di Brown Nursing in partnership with patients means [email protected] embracing integrated healthcare. 42 Donna Kinnair Advertising Rates An integrated approach to gynaecology. 44 1/4 page £110; 1/2 page £185; Michael Dooley full page £330; loose inserts £120. The challenge of obesity . 48 Rates are exclusive of origination Chris Drinkwater where applicable.To advertise, call Di Brown on 01278 722000 Students’ health matters . 51 or email [email protected] Krisna Steedhar From the frontline . 53 Products and services offered by William House advertisers in these pages are not Research summaries . 54 necessarily endorsed by the BHMA. Reviews . 55 Design www.3scompany.org.uk The Journal of Holistic Healthcare is available through EBSCO, a world leader in accessible academic library databases. Printing Ashford Press The journal is indexed, abstracted and/or published online in the following media: MANTIS, Zetoc. Cover photo: M.C.Escher’s Sky and Water 1 © 2009 The M.C.Escher Unless otherwise stated, material is copyright BHMA and reproduction for educational, non-profit purposes is welcomed. However we do ask that you credit Company-Holland.All rights reserved. the journal.With this exception no part of this publication may be reproduced in www.mcescher.com any form or by any other means – graphically, electronically, or mechanically, including photocopying, recording, taping or information storage and retrieval systems – This issue has been sponsored by without the prior written permission from the British Holistic Medical Association. Every effort is made to ensure the accuracy of material published in the Journal of The Prince’s Foundation for Holistic Healthcare. However, the publishers will not be liable for any inaccuracies.The Integrated Health views expressed by contributors are not necessarily those of the editor or publisher. Volume 6 G Issue 1 G May 2009 1 Editorial David Peters Editor-in-chief This edition of JHH celebrates and collects several papers complementary medicine’s appeal lies in its being biomedi- from The Prince’s Foundation for Integrated Health’s cine’s counterpart: personal and small scale, low-tech, low- national conference Putting People First. Although widely risk, and conscious of context and meaning; encouraging of interpreted as weaving complementary therapies into self-healing processes and participation, heavily reliant on conventional healthcare, integrated medicine implies far the therapeutic alliance, aware of the mind and body more, because – as Michael Dixon puts it in his leader connection, and of our relatedness to the natural world; article – medicine, as it stands, may be in danger of disinte- above all, non-corporate. In so many ways complementary grating. It needs a new big idea: the concept of holism. medicine is proudly counter-cultural in an age when so The biomedical model at its most radical assumes we much of mainstream culture appears to be in freefall. can understand the living human organism in terms of its In this issue Jonathan Lord proclaims that the main- parts. Holism on the contrary insists that unpredictable stream has much to learn from complementary medicine’s qualities emerge as the parts come together, that the whole perspectives. Articles from Professors Harald Walach and changes the way the parts function and therefore, in line George Lewith observe the current anti-complementary with Engel’s biopsychosocial model, that the study of every medicine campaign: Walach reminding us that complemen- disease must include the individual, as well as their tary medicine has become a significant economic and social body and their surrounding environment, as essential presence, Lewith taking up the cudgels against those who, components of the total system.1 So the territory of holistic flying in the face of research evidence, tell the media that biopsychosocial healthcare is vast, and integrated complementary medicine does more harm than good. In a medicine’s task will be to manifest its theories in practice. related vein Hugh MacPherson and Catherine Zollman ask A broad and potentially united front – drawn from what we mean by ‘evidence’ for complementary medicine, practitioners, politicians and the public – understands the and Karol Sikora and Michael Dixon – clinicians with front- need to reshape twenty-first century medicine. Perhaps we line experience of integrating it into general and oncology should take heart from George Engel then who, observing practice – express distrust in the ‘armchair physicians’ who the shortcomings of biomedicine 30 years ago, wrote that oppose efforts for higher education, regulation and more ‘nothing will change unless or until those who control research for complementary medicine. Your editor argues resources have the wisdom to venture off the beaten path that sustainable healthcare means we must find new of exclusive reliance on biomedicine as the only approach directions. But diving deeper, William House maps some to health care’. For surely Engel foresaw a time when faced conceptual, organisational and economic currents that will with undeniable economic, ethical and public health make changing course more difficult. Background contribu- challenges, those who control resources would finally wise tions from researchers Denise Peerbhoy and Damien Ridge up. In this issue of JHH we argue that the time has come offer examples of how community effort can create non- when those who control resources have little alternative but biomedical narratives to support wellbeing and recovery; a to steer away from the biomedical model and set the course of theme taken up by Chris Drinkwater in his deconstruction policy and practice in a more holistic and integrated direction. of obesity as a biomedical problem. Finally, Donna Kinnair Integrated medicine is not about bolting complemen- and Michael Dooley consider how nursing and gynaecology tary therapies onto biomedicine, but it sees their will have to learn to embrace patient preference. significance; not only their potential clinical importance, but The range of contributors to the FIH conference also how they might be a signpost. Do they not remind us confirms that outside the world of complementary of what biomedicine has forgotten or neglected, failed to medicine, many colleagues are exploring holistic solutions incorporate or even perhaps even to comprehend? Writing to the deepening crises of cost, cure and care that in 1980 about a ‘rebellion against the philosophical and healthcare faces. If our medical system is to pull out of its clinical orientations of scientific medicine [that] has high-tech nosedive and become more sustainable it will occurred in the United States during the 1970s, Warren have to develop a new model of health, somehow find ways Salmon, curious about why people were turning away from to de-industrialise and perhaps re-orient itself around mainstream medicine, suggested it was because they felt medicine’s timeless values. The great potential of integrated biomedicine was about parts rather than persons, that its medicine will be realised as it finds ways of expressing practitioners too often discouraged power-sharing, and that these vital ways forward. 2 patients feared its treatments put them at risk. References Thirty years on, when biomedicine has become even 1 Fava GA and Sonino N. The biopsychosocial model thirty years later. more corporate, impersonal, biotechnical, and fraught with Journal of Psychotherapy and Psychosomatics 2008;77:1–2. risk than when Salmon and Engel were writing, their words 2 Warren Salmon J and Berliner HS. Health policy implications of the seem all the more relevant. It is clearer too that holistic health movement. Journal of Health Politics, Policy and Law 1980; 5(3):535–553. 2 © Journal of holistic healthcare G Volume 6 Issue 1 May 2009 News review FIH launches GP Despite initial scepticism, the GPs Health services and social membership scheme involved were almost unanimously in benefits favour after seeing tangible results. • 24% of patients who used health In 99% of patient cases GPs said they NHS GP practices committed to services prior to treatment (ie would refer the patient, or a different providing an integrated approach to primary and secondary care, patient, to the scheme again and in health and care will soon be applying accident and emergency) reported 98% of cases GPs said they would for The Prince’s Foundation for using the services less after
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