Can we think otherwise for the good of all?

79% of Canadians seeking better health have used at least one service in complementary approaches, (sometimes called alternative approaches) in addition to, or rather than, conventional care offered free of charge in the current health system[1]. Astonishing?

No, inspiring!

As physicians, we have learned an immeasurable amount of information about human health and homeostasis during our training. Long academic studies, and particularly clinical exposure to patients, have taught us to become excellent clinicians. We are skillfully able to list the clinical signs and symptoms experienced by the patient and then develop a refined differential diagnosis. Once the patient is put in the diagnostic “box”, we are the experts in controlling the first-, second-, or third-line treatment and its supposed clinical effects. On the other hand, when this approach does not work, when the patient is still in pain, two things can happen: either we try to change the patient from the diagnostic “box” and try another drug treatment (by crossing our fingers!), or we admit that current medicine can do nothing for them (with a little empathy, we hope!). At this point, the patient may lack patience, but especially answers.

Our guidelines that support screening for many conditions at the first-line (cancer, metabolic disease, or other) have been developed so that one is able to prescribe pharmacological or surgical treatment at the time of diagnosis with the aim of preventing a complication or a death related to the condition in question which would, at the same time, generate significant costs for the health system. However, there is no indication for systematic first-line screening to guide the management of our patients’ lifestyle habits in a personalized way so that they never develop these diseases. As long as a patient is not placed in the “box” of any diagnosis, there is no need to intervene (this is where we put our heads in the sand!). Just because a patient has no diagnosis does not mean they are in excellent health, quite the contrary!

And yet, the immense power of our intervention, as a physician, would be particularly observed at this exact moment, even before the criteria of illness manifested itself. We could cleverly succeed in improving behaviors or lifestyle habits that have the potential to promote a better balance of human health. Real prevention is much more than detecting the disease early and catching it at an early stage of development. It is the art of directing and influencing the patient’s lifestyle, among other things, by personalizing the most favorable advice for each individual, but also, and above all, succeeding in mobilizing the patient, so that they are at the forefront in this process of creating better health by being the main actor.

Is it time to question the relevance of our current methods of our approaches with the patient in the era of epidemics of chronic diseases? Conventional medicine is spectacularly effective in the management of acute and/or life-threatening illnesses, but the same cannot be said for our performance in the management of chronic diseases, the incidence of which is steadily increasing, as new therapies become available to treat them (paradoxically!). These diseases, all resulting from unhealthy daily behavior, could be prevented in the majority if we knew how to better support patients more effectively, by avoiding the usual medical paternalism and by mobilizing the patient to make their health the leitmotif of their actions. The guideline recommended drug choices for the management of many chronic diseases now outnumber the minutes we have to spend on communication, education, patient engagement, and patient empowerment when looking at their health when they are in our office. And then after one patient comes the other… then the other.

What is the patient looking for outside of the doctor’s office? Could it be that the pharmacological approach that we all value and that we apply quite easily in the care of our patients is not really how the patient wants to support their health and what they really need? Medicines seldomly restore health, they simply slow the progression of a disease. As defined by WHO, health is a state of complete physical, mental and social well-being, and is not just the absence of disease or infirmity. But in reality, what would the doctor do if there was no more disease in their patient? Are we really able, as doctors, with our current knowledge, to address and optimize this state of complete well-being, even if there is no disease? Could it be that other professionals have the complementary skills and knowledge that doctors lack or know little about in order to effectively support health in line with patient values?

The patient shows us that they want to feel healthier by investing in complementary approaches. I dream of the moment when the patient will really be at the center of their health care and when we will be able to present all their well-being options to them and accompany them in this direction, without judgment, with openness and respect, while helping them to reclaim their health and the know-how of maintaining it. Let us all be health professionals and practitioners in complementary approaches, collaborating rigorously and equipping ourselves with protective structures for the public, but without depriving them of the possibility of having to choose between conventional medicines or complementary approaches. Health involves listening and supporting to optimize nutrition, movement, stress management, sleep, spirituality, social relationships, the quality of the environment, etc. It is not absolutely necessary to be a doctor to do this, but it is definitely in this direction that we will create better health!

Dr. Anne-Isabelle Dionne, MD

Dr. Dionne has been a general practitioner since 2014 and practices in intensive care at Honoré-Mercier Hospital in Saint-Hyacinthe as well as in a family medicine group on the South Shore of Montreal. In 2018, she founded a preventive medicine center specializing in supporting people suffering from various health problems in improving their daily living habits through diet, physical activity, as well as stress and sleep management. Le Centre Axis is an NPO that offers multidisciplinary preventive care to the general population wishing to improve their health, prevent or reverse a known chronic disease while reducing the need for associated medication.

Dr. Raphaëlle Leroux-Lévesque, MD

Dr. Leroux-Lévesque graduated from the Faculty of Medicine at the University of Sherbrooke in 2004. She completed training at the Moncton Family Medicine Unit in New Brunswick in addition to supplementary training in emergency medicine. Since 2007, she has been practicing in the emergency room and intensive care unit at Honoré-Mercier Hospital in Saint-Hyacinthe. Her interest in integrative health, physical activity, and nutrition naturally led her to get involved with Le Centre Axis. Recipient of the 2004 University of Sherbrooke Leadership Award for Medical Student, she wishes to use this quality to contribute to the development of Le Centre Axis in the CISSS Richelieu-Yamaska.



Other MD co-signatories:

  • Anne-Isabelle Dionne MD, General Practitioner
  • Raphaëlle Leroux-Lévesque MD, General Practitioner
  • Catherine Bouchard MD, General Practitioner
  • Marie-Ève ​​Bouchard Rochette MD, General Practitioner
  • Jane Omer MD, General Practitioner
  • Sophie Stavrinidis MD, Cardiologist
  • Émilie Boisvert MD, General Practitioner
  • Alexandra Albert MD, Rheumatologist
  • Éric Sauvageau MD, General Practitioner
  • Anne-Marie Bédard MD, General Practitioner
  • Anne Levesque MD, General Practitioner
  • Marion Dumais MD, General Practitioner
  • Évelyne Borduas Roy MD, General Practitioner
  • Lyne Desautels MD, General Practitioner
  • Pascale Hudon MD, General Practitioner
  • Pierre Cloutier MD, General Practitioner
  • Hugo Viens MD, Orthopedic Surgeon
  • Alain Bédard MD, General Practitioner
  • Gaétan Brouillard MD, General Practitioner
  • Bernard Bassleer MD (Belgium), Cardiologist
  • Peggy Pères MD (France), General Practitioner


[1] ESMAIL, NADEEM (2017), Complementary and Alternative Medicine : Use and Public Attitutes 1997, 2006, and 2016, Fraser Institute, Alberta, 79 p. (en ligne consulté le 18 septembre 2017 https://