Modern medicine, evidence based practice and holistic healing

I have to tell you that once again this was an article that absolutely frustrated me to write from beginning to end. Most recently my mother was hospitalized and (thankfully) she is now home and on the mend. But this was a scary experience, to say the very least. Looking back on the past 2 months we had many signs that things were not right but she is a very active person and continues to go to yoga weekly, cook dinner for us many nights and take care of my son as well as generally help run the household so I think all of us (herself included) just didn’t see the signs. Modern medicine is what saved her life. And I am incredibly thankful for it. I have been a clinician in healthcare for more than 17 years and I have seen healthcare change a lot in that time period. That is almost 2 decades of care. When I started treating patients I had never heard of a naturopath and had only a slight understanding of ancillary treatments such as acupuncture. I was firmly rooted in Western medicine and the terms ‘evidence-based practice’ were drilled into me for the 3 years I was in PT school. This was the dawn of proof. Having good research to back up our practice is what has made physical therapy the respected field that it is today. But over the years I became frustrated with my practice. While I have always loved being a PT, I was frustrated at the number of patients I didn’t feel I was helping. Many of them continued to have pain and I continued to try to find a biomechanical reason for their pain. Eventually I stopped trying to explain and looked to other treatments to try to just give patients relief.

So this is where my ‘evidence-based practice’ started to become less rooted in the evidence and more rooted in just trying to help people with their pain. I started doing treatments that were considered ‘fringe’ treatments in our field and I didn’t always understand how what I was doing was changing pain but it seemed to have an effect. There were many in my field (and still are today) who are so adamant that these treatments work but their research is not “peer-reviewed” and certainly suspect. I had a colleague who swore she could tell where a patient’s “energy” was “stuck” just by putting her hand on their head—now how is that evidence based practice? Yet I wanted to learn and understand what she was doing and learned some techniques from her (never got to the point where I can put a hand on someone’s head and figure out where their energy was stuck though—that one has remained elusive).   I was referring patients out a lot more to other practitioners and making recommendations for MRIs, injections, acupuncture, massage therapy, chiropractic and even surgery. I began to see the limitations of PT and was frustrated at the lack of progress some of my patients were having so I was willing to go outside the evidence to find it. You could say I swung from one end of the pendulum to the other.

Today I believe I am more in the middle of the pendulum swing although definitely going back the other direction to a more evidence-based approach. Finally after 15 years of pain science research there is enough of this information getting into the mainstream of medicine that doctors no longer look at me like I have 2 heads when I tell them about ‘pain science’, ‘pain education’ and ‘graded motor imagery.’ I am still encouraging patients to see their naturopath, acupuncturist, massage therapist and chiropractor for all the things they want to, but I am challenging patients and asking them why? Why do you see all of these practitioners? Do they make you feel good? Are you getting better? Or are they simply helping you maintain a status quo that you don’t like but feel you have no choice but to be there? When I talk to patients about pain I address medication. Many patients don’t want to take them (which I completely understand) but medication is not the enemy—lack of understanding, fear and strong beliefs that you have no control over what is happening with your pain system—is the enemy. Modern medicine is also not the enemy. It can heal us from cancer, cure us from severe illness and generally allow our population to live longer and healthier lives. Trying to tease out what information to believe and understand is a challenge but using peer-reviewed research is the first step at learning what is good and what is bad information.   Having a good physician to guide you is another step in figuring out what is the right path to take for care of your health. But overall having a balance between the use of modern medicine and more holistic treatments seems to be the best approach. In the end I will continue to back my practice with the strongest evidence I can find but I also want to include holistic treatment by looking at the whole patient and guiding them in other care and practices that might help them get to their end goals.