Wk9 Models Of Medicine

Question 1

How does treatment work?

Answer 1

1. Doctor has to believe
2. Patient has to believe
3. Society has to sanction it

Question 2

Defining CAMs

Answer 2

• “There is no universally agreed definition of CAMs.
• Although “complementary and alternative” is often used as a single category, it can be useful to make a distinction between the two terms.
• The US National Center for Complementary and Integrative Health (NCCIH) uses this distinction:
• When a non-mainstream practice is used together with conventional medicine, it’s considered “complementary”.
• When a non-mainstream practice is used instead of conventional medicine, it’s considered “alternative”.
• There can be overlap between these two categories. For example, aromatherapy may sometimes be used as a complementary treatment, and in other circumstances is used as an alternative treatment”.

Question 3

Most commonly used CAM?

Answer 3

• Acupuncture

- followed narrowly by homeopathy and relaxation therapy

Question 4

What factors facilitate the growth of interest in and use of complementary & alternative medicine?

Answer 4

• Popular dissatisfaction with orthodox medicine
• Post-modern philosophy-rejection of (scientific authority, increase in consumerism, importance of individual responsibility for health)
• Widespread availability and access to health information

Question 5

NCCIH

Answer 5

• Alternative Medical Systems-built upon complete systems of theory and practice e.g homeopathic medicine, naturopathic medicine, traditional Chinese medicine, ayurveda
• Mind-Body Therapies -uses a variety of techniques designed to enhance the mind’s capacity to affect bodily function and symptoms e.g. meditation, prayer, music therapy
• Natural products -use natural substances e.g.dietary supplements, herbal products
• Manipulative and Body-Based Methods -movement of one or more parts of the body e.g. chiropractic, osteopathy, massage
• Energy Therapies involves the use of energy fields. Biofield therapies are intended to affect energy fields that purportedly surround and penetrate the human body e.g.qi gong, Reiki, Therapeutic Touch. Bioelectromagnetic-based therapies involve the unconventional use of electromagnetic fields

Question 6

How are House of Lords report classified?

Answer 6

Group 1: acupuncture
Group 2: Alexander technique
Group 3: a. Chinese herbal medicine
B. Crystal therapy

Question 7

What are the most popular alternative therapies?

Answer 7

Herbal medicine - 32.4%
Homeopathy - 10.8%
Aromatherapy - 8.1%
Massage - 8.1%
Reflexology - 5.4%

Question 8

What are recognised patterns of use of complementary medicine?

Answer 8

Earnest seekers: have an intractable health problem for which they try many forms of treatment
Stable users: Either use one type of therapy for most of their healthcare problems or have one main problem for which they use a regular package of one or more complementary therapies Eclectic users: Choose and use different forms of therapy depending on individual problems and circumstances
One-off users: Discontinue complementary treatment after limited experimentation

Question 9

Positive reasons behind CAM

Answer 9

• Perceived effectiveness
• Perceived safety
• Philosophical congruence
• Control over treatment
• ‘high touch / low tech’
• good patient / therapist relationship
(enough time available, on equal terms, emotional
factors, empathy)
• non-invasive nature
• accessibility
• pleasant therapeutic experience
• affluence

Question 10

Negative reasons behind CAM

Answer 10

• Dissatisfaction with (some aspects of) conventional healthcare: ineffective for certain conditions, serious adverse effects, poor dr/patient relationship, insufficient time with dr, waiting lists, ‘high-tech, low touch’
• Rejection of science and technology
• Rejection of ‘the establishment’
• Desperation

Question 11

What are common concerns of doctors about complementary medicine?

Answer 11

• Patients may see unqualified complementary practitioners
• Patients may risk missed or delayed diagnosis
• Patients may stop or refuse effective conventional treatment
• Patients may waste money on ineffective treatments
• Patients may experience dangerous adverse effects from treatment
• The mechanism of some complementary treatments is so implausible they cannot possibly work

Question 12

What are areas of potential controversy?

Answer 12

• Rise in popularity of CAM (patients/healthcare practitioners/lay therapists)
• Information widely available to the lay public (internet, pharmacists, media)
• Treatment widely available to the lay public OTC, lay/therapists who have orthodox healthcare qualifications
• Training in CAM: in-depth lay therapist training v short course for drs
• Effects on dr/patient relationship (health beliefs, disclosure, patient may know more than dr, dr may recommend but patient may be unwilling, patient may want treatment but dr may be unwilling)
• Adverse effects/interactions with orthodox treatment
• Evidence base: types of evifd3ence/ cure v ‘feeling better’