N.B. You can find the first part of this segment here: Part 1 of 2
WHAT IF THE SOLUTION CAN BE FOUND ELSEWHERE?
A few years ago, Mario Proulx produced a series of radio programs for Radio-Canada that offered a more integrated vision on health and the means to either maintain a good quality life, or consider various preventive or curative means to recover when a physical or psychological illness occurred.
Indeed, pharmacological medicine often appears as the main reference when an imbalance appears in a person. However, if this medical approach is decisive for specific problems, it does not always appear as effective when the imbalance becomes chronic and results from inadequate lifestyle habits or environmental risk factors. The difficulties in understanding and treating degenerative diseases and mental disorders are examples that illustrate how medical treatments are limited towards their action in being effective.
Moreover, the rise of biomedical research has offered a promising vision in the last century and many people believe that there will always be a medication to maintain their health and independence without them having to be careful regarding their lifestyles. And, it is true that many people have had their lives saved thanks to pharmacological treatments or, sometimes, surgery. The other therapeutic approaches – whether they are called ancestral, soft, alternative or complementary – do not always have the same recognition both among clinicians and among individuals. On one hand, most know little about the usefulness of such approaches and they are often more effective when used in prevention. On the other hand, there are fewer scientific references, because the research protocols favored for 150 years were not suitable for exploring the effects of these practices.
However, more and more scientists invite individuals to consider health from a more holistic perspective. Without neglecting the therapeutic contribution of medication, it is thus a question of considering the actions to be taken in a preventive manner, but also for promoting healthy lifestyles. To illustrate this need, Proulx explained that “while the baby-boomer generation is in better shape than the previous generation, the way of life in Western societies is often synonymous with being overworked. The diet of the majority is deficient, and a good part of the population prefers sedentary leisure. With a healthcare system on the verge of bursting and rising cases of diabetes, hypertension and cancer, it is time to act. […] Living differently is above all a call for change, so that everyone can rediscover the pleasures of a balanced life.”
Among the testimonies presented, the psychiatrist David Servan-Schreiber explained why he was in favor of uniting the different practices of medicine. To illustrate his remarks, he shared that he had met different people to question them about their understanding of health and, consequently, about their curative or preventive choices in promoting a good quality way life. What had surprised him the most were the responses of the Tibetan monks of Dharamsala. He explained that he expected a refusal from Western medicine. However, they explained, in heart, that they were happy to have pharmacological resources in the event of a critical problem, but that they rather resort to Ayurvedic medicine or acupuncture as soon as it becomes a chronic problem.
In his book Guérir, this psychiatrist shared his own journey which led him to consider a more global approach to treating psychiatric conditions. This is how he realized the need to integrate both knowledge and practice. He often worried about the fact that it is sometimes so easy to oppose pharmacological medicine to ancestral medicines (acupuncture, Ayurvedic, herbalism, etc.) or to complementary practices (chiropractic, massage therapy, naturopathy, osteopathy, psychotherapy, etc.). Admittedly, this would require reconsidering the way we do research, but wouldn’t it be possible to explore the complementarity of these practices to really meet the needs of individuals, at least those who are in good health and who could find preventive methods?
I have no difficulty with the fact that professional orders ensure public safety, but shouldn’t they go further by encouraging dialogue between experts? When can corporatism become a form of attack on public safety? Are we protected from the risks that the lobbying of industries and universities could eventually keep the population in a situation of dependence on their products? Is it not time that citizens were taught the concrete means, and the scientific reasons or clinical hypotheses, to take care of their health in a preventive way?
Of course, there are obstacles, as with any challenge aimed at transforming stubborn habits. However, integrative medicine has the function of putting the patient back at the heart of their health and healing process, if a physical or psychological imbalance emerges, by using multiple resources offered through different forms of complementary medicine and practices. Recently, Éric Simard and I co-wrote an article outlining the application of this concept around three health (or disease) phenomena.
For example, we wrote that, “In the treatment of depression, numerous studies have shown that three strategies can reduce symptoms: (1) an antidepressant for 3 to 12 months; (2) psychotherapy for 3 to 12 months; (3) walking, at least 30 minutes 3 times a week, for 3 to 12 months. However, people practicing physical exercises are statistically less likely to relapse than those who had taken medication or had psychotherapy.” How many health professionals are aware of this data?
Similarly, I presented scientific information in my blog, relayed in particular by Richard Béliveau and Isabelle Huot, showing different ways to support the immune system through healthy lifestyle habits, including nutrition. In the context of the pandemic, on one hand, a continuously mutating virus and, on the other hand, a vaccine candidate based on a new biotechnology and the absence of effective treatment to counter the symptoms; why haven’t we taken advantage of the situation to encourage citizens to take care of their health well beyond respecting the recommended health measures? The problem is not in the camp of political figures, but that of professional orders and universities.
THE NEED TO CREATE A COMMON LANGUAGE
If the various health professionals learned a little more about the qualities and opportunities in terms of prevention or curative care of each corporation, oppositions would fade and true collaboration could take place for the benefit of people in pain. In addition, people affected by the disease do not always know the resources available to them to promote an optimal healing process. Both are thus invited on a journey to discover the riches, sometimes unsuspected, that arise in order to have a better-quality life.
Unfortunately, the reductionism imposed by quantitative studies, the hyper-powerful lobbies in the field of health – including the pharmaceutical industry – and the narcissism of many experts ensure that health is perceived in impermeable silos. However, this situation, which is becoming more complex year over year, represents a double danger for citizens and society at large, because we are headed directly into a wall!
On one hand, the person who sees their autonomy diminished, momentarily or chronically, loses all their power to really consent to the healing process. They lose their power over their health, leaving it up to others to decide what medications will be needed to regain health. Worse, it is often excluded from the necessary ethical dialogue.
On the other hand, there is the cost to public finances, while health spending has been increasing for years without necessarily having better care or better supervision of our health.
To get out of this downward spiral, it is urgent to recreate dialogue. First, it is necessary to put aside rivalries between health professionals. Each has its own place. Each is useful. Everyone contributes to finding pragmatic solutions to sustain health or recover, in the case of illness. It is absurd to think that one profession is worth more than others. Then, these professionals must have the courage to look at how they can collaborate in systemic thinking and in a collaborative organizational model. Finally, it is necessary to allow patients to rediscover the desire to take charge of their health. Too often, medical colleagues share with me, a bit like my grandmother’s reflex, that their patients explain to them “no, doctor, I will not change my way of life; you will give me pills when I am sick”.
To help recreate a dialogue to bring out protocols in integrative medicine and to encourage everyone’s sense of responsibility, we – two years ago – created an association which brings individuals from multiple health professions together. Some are supervised by a professional order; others, not as of yet. Although our exchanges have been slowed down by the health crisis, the essence of our approach remains a constant concern.
If you want to know more about the vision developed by the Association of Integrative Health Professionals, I suggest you listen to the interview given by Anne-Isabelle Dionne and Éric Simard (in French). I hope their words can inspire you.
Text originally published on www.joelmonzee.com
- Bernier, QS veut mettre fin aux listes d’attente en santé mentale, Journal de Montréal, 2022 [https://www.journaldemontreal.com/2022/04/16/qs-veut-mettre-fin-aux-listes-dattente-en-sante-mentale]
- Gagnon et A. Lacourcière, «Refondation» du système de santé: les six travaux de Christian Dubé, LaPresse, 2022 [https://www.lapresse.ca/contexte/2022-03-20/refondation-du-systeme-de-sante/les-six-travaux-de-christian-dube.php]
- Monzée et C. Bélanger, Recherche en santé : enjeux et perspectives. Montréal (Québec) Canada : Éds AEGSFM, 2001
- Monzée et A.M. Tassé. Droits d’auteurs des travaux de recherche: entre propriété intellectuelle, probité intellectuelle et plagiat. Revue Dire, 2001, vol. 11(1): 43-45
- Monzée, Dopage sportif: de la responsabilité des chercheurs et des entreprises pharmaceutiques. Revue internationale d’éthique sociétale et gouvernementale, 2005, vol. 7(2): 53-70
- Monzée, Médicaments et performance humaine: thérapie ou dopage? Montréal, Éditions Liber, 2010
- Monzée, Évolution des connaissances biotechnologiques et pratiques psychothérapeutiques, Revue québécoise de psychologie, 2012, vol. 33(2): 97-122
- World Health Organization, Data and Statistics[http://www.who.int/research]
- Statistical Institute of Quebec, Quebec Numbers (2006 edition) [www.stat.gouv.qc.ca]
- Agence Belga, 26% more doctors in the French Community, [http://www.rtbf.be/info/belgique/politique/26-pc-de-medecins-en-plus-en-communautefrancaise].
- Cirano, Evolution of the number of doctors per 100,000 inhabitants (updated data) [https://qe.cirano.qc.ca/theme/education-sante/sante/effectif-medical/graphique-evolution-nombre-medecins-100-000-habitants]
- Monzée (dir.), Neurosciences et psychothérapie: convergence ou divergence, Montréal, Éditions Liber, 2009 (re-printed in 2015)