Spiritual Principles

Pitfalls In Integrative Medicine & Medical Ministry

March 13, 2019

I attended Loma Linda’s School of Medicine 87th Annual Postgraduate Convention. One of the keynote speakers was Robert Saper, MD who is the Director of Integrative Medicine for the Boston Medical Center Department of Family Medicine. Saper came to present on the topic of Integrative Medicine, a relatively new field in medicine. Saper, who was previously not familiar with Loma Linda or Adventism, studied these areas upon receiving the invitation to speak. He immediately noted the over lap between the two fields. Here are some qualities of Integrative Medicine he presented:

  • Emphasizes relationship between practitioner and patient
  • Focuses on the whole person
  • Informed by the evidence
  • Uses all appropriate therapeutic and lifestyle approaches, healthcare professionals and disciplines
  • Not a specialty, an approach/model to medicine

The field of integrative medicine arose when a 1993 New England Journal of Medicine article[1] found that 1/3 of Americans were using “unconventional therapy.” These same patients were also seeing their primary care doctor but just not informing him or her of the use of alternative therapies. Integrative medicine was thus born to better understand how best to incorporate unconventional therapies.

Since that time Integrative medicine seems to have advanced. For example, here are the guidelines by the American College of Physicians for acute and chronic low back pain.

Acute Low Back Pain:[2]

  • Use nonpharmacologic treatment first
    • Heat
    • Massage
    • Acupuncture
    • Spinal Manipulation
  • If pharmacologic treatment desired, select NSAIDS and/or muscle relaxants

 

Chronic Low back pain:

  • Use nonpharmacologic treatment first
    • Exercise (self-care or physical therapy)
    • Spinal manipulation (chiropractic or physical therapy)
    • Acupuncture
    • Yoga
    • Mindfulness Based Stress Reduction
    • Cognitive Behavioral Therapy
    • Tai Chi
    • Massage
    • Progressive Muscle Relaxation
    • Low level laser therapy
    • Multidisciplinary rehabilitation

As I look at this list of treatments it’s humbling to know my opus operandi – medicines – are not the first line therapy. This is likely due to its side effect profile and minimal benefit. The ineffectiveness and risks of pills have thus given way to other nonconventional ways of treating back pain such as Tai chi or Cognitive Behavioral therapy. Turns out we do need ways to integrate both conventional and nonconventional therapies.

 

Here are a few thoughts I had on his presentation.

 

1.The rise of modern medicine has de-emphasized the role of the therapeutic relationship. Integrative Medicine serves as a corrective. The trend of modern medicine is more technology and specialization. While this has resulted in better treatment of disease, it has the unintended side effect of sucking the humanity out of medicine. Returning again to the importance of the therapeutic relationship will benefit both the field of medicine and patients.

2. Before the birth of modern medicine, the founders of Loma Linda saw the importance of whole person care. Therefore the focus on the therapeutic relationship has always been a focus of ours. The motto “To Make Man Whole” means the relationship with the patient is an integral part of what we do. Now the world is returning to the essence of Loma Linda’s mission in the first place.

3. We must be aware of two pitfalls. The first pitfall is to close ourselves off from listening to others. The presenter, Robert Saper, comes from Jewish background and spent time at a commune in the 1970’s which altered his worldview. Since that time his research focused on yoga and its scientific benefits. As a physician, I need to pay attention to those benefits and how they are getting such benefits. As a Christian, I recognize truth can come from anywhere, even unexpected places. Romans 1:20 says, For the since the creation of the world God’s invisible qualities – his eternal power and divine nature – have been clearly seen, being understood from what has been made, so that men are without excuse.

I don’t gain anything from not listening to others. However, I can learn and engage others after paying attention to what they have said.

The second pitfall is to be ashamed of my Adventist roots as a Christian Physician. We may have religious values that contradict spiritual teachings of yoga. I don’t need to accept those teachings or find some way to integrate them into my practice. The mission and vision of Loma Linda made me the physician I am today. It has given me the success I have today. So I can hold onto that unique identity. If I lose that mission and vision, if I water it down, then we have lost the value we offer to the world.

We have a unique way of approaching medicine but it by no means is the only way. Because of modern medicine’s tendency toward fractured care, there will be other efforts to bring about wholeness. I can listen to those efforts while remaining strong in my identity.

 

 

[1] https://www.nejm.org/doi/full/10.1056/NEJM199301283280406

[2] https://annals.org/aim/fullarticle/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice?_ga=2.257547534.403787831.1552395524-2063328597.1552395524

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4 Comments

  • Reply Placido Roquiz April 6, 2019 at 5:20 am

    Integrated medicine has flourished because conventional medicine is fractured.
    The” wholistic” approach to” make man whole” may use many unconventional ways; but the true compass points to the Creator as the ultimate Healer.!

  • Reply Andrew Roquiz April 12, 2019 at 11:19 am

    Thanks Dad. I believe it too!

  • Reply John Torquato May 1, 2019 at 3:55 am

    Yes, Placido, I am also in agreement with you.

  • Reply Emily October 1, 2020 at 3:21 pm

    Thank you for this article/blog. It’s challenging to find an integrative/functional doctor who doesn’t integrate Eastern religious practices of some sort. As a Christian, I am very sensitive to any spiritual belief/practice that is contradictory to those of Jesus–especially when there is proximity or touch involved. I admire your stand to not integrate them into your practice.

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