During the question-and-answer period of a recent alternative medicine forum sponsored by Advocate Health Care, Dr. Donald W. Novey did some nifty refereeing.
Several patients in the audience were venting about how little their own doctors knew about alternative therapies. Then Novey stopped the discussion, silencing everybody, for a moment.
“This may sound heretical,” said Novey, medical director of the Center for Complementary Medicine affiliated with Lutheran General Hospital in Park Ridge. “But there is a thing called kindness that doctors can extend to their patients and patients can extend to the clinicians. We need to let people move (toward alternative medical therapies) at their own pace.
“We can all benefit from having a little patience with each other.”
Novey’s point provides an excellent starting point for any relationship with a physician. Put yourself in the doctor’s place and you will communicate better.
Dr. David Eisenberg, director of the Center for Alternative Medicine Research and Education at Beth Israel Deaconess Medical Center and assistant professor at Harvard Medical Center in Boston, has conducted two landmark studies about the use of alternative medicine by Americans. His latest findings show 6 of every 10 patients still don’t discuss such treatments with their medical doctors.
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“Don’t ask, don’t tell is old thinking,” said Eisenberg, keynote speaker at the Advocate forum that attracted more than 200 people.
Eisenberg drew some laughs when he suggested what physicians themselves think-but won’t say-when they hear the question, “So, doctor, what do you think about alternative medicine?”
“Scotty, beam me up!”
“I think it’s worthless.”
“I don’t know.”
“Please, please don’t ask me that.”
All Harvard medical students spend a week with Eisenberg and private tutors (who are resident physicians) learning how to discuss complementary medicine with patients. Eisenberg said a better opening question by a patient is “I’m really interested in (fill in the blank); can you tell me any medical references that can help me learn more?”
Dr. Andrew Weil, founder of the Program in Integrative Medicine at the University of Arizona and bestselling author, offers several tips for better communication between patients and doctors about alternative therapies: 1. Assemble an integrated team of health practitioners before you get sick if possible; 2. Be open about your desire to try a therapy, offer to provide information to the physician; 3. Listen to your physician’s reasons, but if alternative medicine is dismissed simply as quackery, it’s time to find another doctor; 4. Ask if your doctor is willing to conduct a phone consultation with your alternative practitioner, so they can compare notes; 5. Always tell your doctors about your plans for alternative medical treatments.
Eisenberg suggests keeping a daily symptom diary. It helps track any changes from alternative or conventional therapies.
What worries Eisenberg most is the lack of discussion about possible counterreactions between drugs, herbs and other dietary supplements.
To both his and Novey’s delight, the federal Food and Drug Administration has established a committee on drug, herb and vitamin interactions. In another positive move, President Clinton has appointed a special commission to explore access and reimbursement issues for alternative medicine, including whether Medicare/Medicaid patients and government employees should be covered for such services.
“I think all physicians need to have a basic understanding of herbs and supplements,” said Novey, author of the newly published “Clinician’s Complete Reference to Complementary & Alternative Medicine” (Mosby, $49). “But it’s less important to know everything than it is to learn how to refer patients to the right alternative practitioners.”
To contact Bob Condor or find an archive of his columns, visit chicagotribune.com/go/health
His e-mail is [email protected]