| Great question. The first thing I’d say is that it’s happening now, but it’s either being driven by the patient floundering around from one practitioner to another and getting uncoordinated care and different pieces of advice, or in rare circumstances you have practitioners who are actually talking to each other. It’s a startling concept! Imagine that medical pain specialists and non-MD specialists could actually work together. I joke about this because everything we do is supposed to be about the patient, not about us and our inability to communicate or our little pet territories or our pet theories about what fixes everybody. It’s about the patient. So if we’re truly going to be patient-centric, then we need to talk to each other, we need to respect each other. And I think increasingly more and more medical doctors are getting off their high horses.
There are three categories of medical doctors and pain specialists relative to the whole complementary medicine world. I’m going to loosely include chiropractic although chiropractic in many ways is more mainstream than the rest of the complementary medicine world. There’s a small group way out on the right fringe of MD pain specialists who hate anything other than their drugs and their injections and their surgery. They won’t cooperate. There’s another small group on the left side of the scale that actively works with chiropractors, acupuncturists, mindfulness-based stress reduction programs, understanding the value of those kinds of things. Then in the middle (I’d say it’s between 70 and 75 percent) are the agnostics. These are pain docs who have seen a lot of patients have good results with non-pharmacological and nonconventional therapies. But they don’t know that much about it and they’re kind of busy. Some are interested while others are not so interested. When we launched the integrative pain medical conference at Columbia six years ago, we had no way to gauge how many people would attend. Often at a place like Columbia or Harvard or Stanford, you’ll launch a CME [continuing medical education] course and you’ll have 12 people show up to do a review of the diseases of the pineal gland, or whatever. But our conference was standing room only. My conclusion is that medical doctors, nurses and pain psychologists are very hungry to understand how to integrate these approaches.
It’s a very heartening development.
They don’t want to live in a world of either/or. Many of them want to be able to work together for the benefit of the patient. It’s a clear trend. The American Pain Society annual meetings often have a session on complementary and alternative therapies. I’ve done those presentations for APS and for other big conventional pain courses. So I think it’s there, I think it’s growing. But the mainstream media misrepresents this area, misrepresents chiropractic, and misrepresents many of the natural healing technologies.
They always want some kind of nuclear weapon, because that will really sell a lot of copies. But that that’s not actually how you help people. For example, there’s a new medication, pregabalin, a drug that Merck spent over $700 million developing and bringing to market.
$700 million! It would seem that they have something of a stake in its success.
Correct, they’ve got a lot of skin in the game. Let’s just say that a new chiropractic technique usually doesn’t require $700 million to develop. Like many other new drugs, this is sold to us as being the cat’s meow. For all these medications, some people respond to it well, some people hate it, for some people it won’t do anything at all, and some will feel like a zombie and say, “My God, why did you ever want me to take that.” Everybody’s going to respond a little differently.
Unfortunately, the real work of helping people is a long, slow, tedious process of establishing the doctor-patient relationship, working through everything that’s going on with the person including a real focus on who they are, what’s going on in their life. Ultimately, we have to take stock of that individual. The drug companies and the injection manufacturers would love to have us believe that there’s a way to bypass that long, slow, tedious procedure. In chiropractic as well, some would have us believe that there’s one simple answer that can bypass this work.
Something I particularly enjoyed about your book is that while you do an excellent job translating scientific information into plain English, you also look beyond the scientific facts, searching for broader life applications. You wrote at one point that many great historical figures, including Florence Nightingale and Charles Darwin, appeared to develop illness in order to cordon off enough quiet, isolated time to create their great works. Do we doctors sometimes suffer from tunnel vision and lose sight of the broader picture, the wider meaning? How can we do better?
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