Integrating integrative medicine

I appreciate the positive and upbeat note of the article by Willms and St Pierre-Hansen about integrative medicine.1 We need to promote this agenda vigorously in the undergraduate medical school curriculum.

After graduating in 1977 (and receiving Certification from the College in 1979), I quickly came to realize that medical school, as taught primarily by the “hospitalists,” prepared me for the 10% of the population that they diagnosed and treated. I honour and respect their integrity and the passion with which they sought to define “single-cell medicine” and “microsurgery.” I was totally unprepared, however, for the complaints of the 90% of people that they didn’t see, the “walking wounded” and the “worried well.”

The commentary articulated very clearly the dichotomy between what medicine purports to be and what it has become. We should be the listeners, the supporters, the guiders (when necessary), and the providers of care when we know that the benefit outweighs the risk.

How can we integrate all this into an already-stuffed curriculum? I don’t have an answer. Once, when asked how many years of schooling I had, it took me a while to count out that I had 24 years of academic education, not including continuing medical education. The questioner put down his pen, looked at me, and laughed. I’d spent over half my lifetime learning and still hadn’t got it right! He’d left school after Grade 10, was older than me, had a house, grandchildren, and a pension plan.

We can’t learn it all, and I agree that what we have learned in medical school is a bit skewed—cock-eyed if you will. “We’ve got to get ourselves back to the garden,” in the words of Joni Mitchell. I hope that the integration of complementary and alternative medicine and integrative medicine into our mainline thinking will help us along the way.

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