An Internist’s Defense of Traditional Medicine

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As an internist with an open mind to natural medicine I often have to defend my views of it to my colleagues. However, I also have to defend my field against many of those who devoutly believe in natural medicine alone. They often feel traditional medicine is nothing more than a profit driven industry geared towards symptom relief and no interest in cure or true wellness. Although there is a grain of truth to this criticism it misses the bigger picture by leaps and bounds.

Traditional medicine has for ages concentrated more on symptoms or treating disease after it has already progressed to late stages because these are the patients who present themselves for treatment to a physician. Those without symptoms rarely suffer the cost or inconvenience of seeking physician care merely in the interest of staving off a possible future disease. Due to this selection bias in our patient population this has been the focus of our attention, and we have become quite good at treating these maladies. I have made my support of natural medicine well-known and documented in this blog, however if you have an acute onset of chest pain, shortness of breath, or find a mass on your body somewhere I would argue that the place for you is the local urgent care clinic or hospital and NOT the office of a natural medicine practitioner (and a vast majority of natural medicine practitioners would agree).

We in traditional medicine have made immense progress in opening up acutely occluded blood vessels in the heart or brain, cutting out cancers before they have metastasized, treating overwhelming infections that have progressed to the point of sepsis. Natural medicine in all its millennia of experience and broad focus on overall health has little to offer is such situations.

With treatments such as the cardiac catheterization for heart attack, TPA for strokes, surgery for localized solid tumors, chemotherapy for leukemia, lymphoma or testicular cancer, antibiotics for overwhelming infections, modern traditional medicine has taken diagnoses that were certain death sentences just a few decades ago to being very curable disease. No herbal medicine, vitamin supplement, or mindfulness practice could ever come close to replacing these remedies.

It is true that traditional medicine in the chronic disease phase all too often concentrates on the symptoms of the disease and not the underlying cause of the disease. You have high blood glucose? We have medicine to decrease the glucose. You have high blood pressure? We have medicine to decrease your blood pressure. You have a rash? We have a cream to suppress the rash. Your body’s immune-system is attacking your body? we have a medicine to suppress the immune system so it will stop. Granted we are treating many of these because we have recognized them as risk factors for other diseases such as vascular disease that lead to heart attacks and strokes. However, we have stopped at the risk factors and have not asked enough questions as to what causes the high blood pressure, cholesterol and glucose. We have not marched it back a step further to truly find out what causes these imbalances in the body and instead have resigned ourselves to treating these secondary manifestations.

However, I know of no natural remedy that can bring a blood pressure over 200 into the normal range. I know of no vitamin supplement that can bring a glucose of over 400 down to less than 200. This is where traditional medicine thrives, in the acute and the extreme. Natural medicine spends so much more time and energy toward prevention, understanding of underlying issues, and long-term goals where traditional medicine is so often lacking. But natural medicine lacks the arsenal needed to deal with acute, extreme disease.

As for the profit driven nature of traditional medicine in the United States, this is not an entirely bad thing. The free market capitalist system has been shown over centuries and through countless national experiments with socialism to be the best system for prosperity and innovation. Without the continuous feedback to supply and demand the need for medicines and medical care would certainly be either in overabundance and the waste of countless tax dollars or, more likely, in extreme short supply such as in every industrialized country that has socialized medicine. The allowance of capitalism in our medical system has given us a quite delicate balance of supply and demand. We may have slightly too much demand and therefore too much supply to those with money and too little supply due to too little demand with those who lack the resources to afford medical care but this is more a fault of legislative issues and not a direct result of the profit driven nature of our medical system per se. Also, the profit driven capitalist nature of our current medical system allows for the only proven driver of innovation, creative destruction. Without creative destruction as created by the capitalist system there is no way medical care could keep up with the ever changing and developing research and breakthroughs. This is certainly who so many of the world’s medical breakthroughs and innovations are developed here in the United States. However, as I have agued throughout my blog, this needs to be supplemented in areas either by the government or by private business that has a financial interest in decreasing the cost of medical care by researching non-patentable herbal medicines, vitamin supplements, or dietary changes which do not hold enough profit incentive to warrant vast amounts of money being put in to the necessary research.

If we can only we could get the two sides to talk to each other in order to come together at some middle ground. Let natural medicine practitioners teach traditional medicine about true preventative care and treating the underlying causes of disease instead of concentrating on its manifestations and suppressing them. And let traditional medicine teach natural practitioners how to approach acute illness and see where herbs and supplements may fit in to the goals of acute care management

For far too long we have struggled in the “either or” world where we are treated as if we cannot have both. Patients, doctors and society as a whole would be best served by a collaboration of both fields. It is time we start talking and join the same team.

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3 thoughts on “An Internist’s Defense of Traditional Medicine

  1. As ever you touch to the core of it, reality is not either or, but and and – as the yin yang symbol shows – this is contained within that. I think the only point I would query is nomenclature – traditional medicine IS of course ‘natural medcine’ ‘modern medicine is the upstart!

    • As always your comment is very insightful. I struggled for quite some time to decide what to call the medicine I learned in Medical School and residency. I decided not to use modern medicine as I was not only referring to modern day medicine but to what the general medical community has been doing for hundreds of years. Much of this concentration on symptoms instead of underlying causes and on drugs instead of plants has been going on for hundreds of years and is not a modern phenomenon. I also thought about using the term western medicine however the divide between general accepted university based medicine and natural medicine exists today in the east just as much as the west. But you point is well taken. One should refer to natural medicine as traditional before what we call medicine today. I am left really with no acceptable term to encompass the approach to medicine I was taught in medical school. Allopathic is often used by natural practitioners but this is a derogatory term so I did not want to use it in a defense of this medicine. Evidenced based medicine is often used by those in my field but that infers that there is no evidence behind natural medicine which those who have learned from thousands of years of experience would argue that is more evidence than any drug on the market today. I am at a loss.

      • And what YOU say is insightful too – language is so loaded. I tend to equate ‘modern’ with simpler pharmaceuticals rather than the more complex chemistry of natural medicine – you are quite right that the term allopathic is now loaded with abuse by natural medicine practitioners, though i assume it came into being in the nineteenth century to distinguish it properly from the ‘like treating like’ medicine of homeoepathy (why on earth was a term used that those of us who are not trained in classical languages can never spell!)

        Mind you, ‘traditional’ medicine (which is what i think of as being what i practice) also will sometimes treat symptoms – for example, an acute presentation but if the presentation becomes chronic, then of course underlying causes should be treated. So…….I tend you choose to use the term modern, or pharmaceutically based – but inevitably, the term pharmaceutical is now negatively loaded, and you are quite right that it would be arrogant and wrong to equate pharmaceutical medicine with ‘wrong’ medicine. it’s all horses for courses. That is why I’m pleased that the term complementary medicine, rather than ‘alternative’ medicine is in place, indicating something more joined up, less hostile, between the two – and, less dangerous – there are practitioners (and patients) who are stupidly and implacably set against pharmaceutically based medicine, which of course saves lives, even if the overprescription of antibiotics means that there may well come a time soon when the infections which killed, may do so again!

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