POLARIZATION IS EVERYWHERE, large scale and small. The whole country is split between red and blue, and that gets reflected in our families and communities in different ways. Even healthcare is polarized. There are people who swear by Western medicine and others who stick to alternative options. Some think vaccines are essential; others say they’re dangerous. Some believe fluoride in public water reduces tooth decay and cavities; others say it harms children’s cognitive development. It’s almost like we’re in a war zone. Healthcare is especially important because it helps us care for ourselves in these crazy times.
We’re doing battle on so many fronts—polarization is a familiar pattern. This “either/or” thinking is quicksand; how can we move to “both/and” and get on with our lives?
With healthcare, we can’t pull ourselves out of the trap until we know what the options are. The big choice is between Western and alternative medical systems—more specific polarized opinions usually align with one system or the other. So far we can choose practitioners from either or both. But healthcare is on the governmental chopping block in different ways. Not only are Medicaid and Medicare targeted for cuts, but the government is also attacking healthcare options and research programs. It could eliminate vaccines. What would that mean for us? To figure it out, let’s look at the context. It’s all around us, but it’s seldom spelled out. We’re going to do that here.
Western medicine is mainstream, while alternative medicine is not. The long arms of Western medicine reach everywhere, to hospitals, ads for prescription medicine on TV, and pronouncements about recent research findings. In this mainstream system, also known as conventional or allopathic medicine, insurance partially covers treatment—appointments, drugs, etc. This system is both regulated and supported by the federal government; it has a rich history of major achievements such as germ theory, discovery of the need for sanitation, anesthesia, antibiotics, and cancer protocols.
In contrast, alternative care (also known as natural or holistic medicine) doesn’t take place in hospitals and isn’t promoted as much on TV. Additionally, it is not covered as extensively by health insurance, making it a financial stretch for many people. And yet alternative medicine offers an array of pathways toward good health, and it attracts a wide following.
The two systems differ in another way as well. When a patient has a complaint, Western medicine narrows its focus to pinpoint the cause. A doctor will try to identify the specific abdominal organ responsible for a patient’s stomach ache, for example. Moving in the opposite direction, alternative medicine typically expands the view to see patients in their context, believing that context—a patient’s family, workplace, or community—can affect a person’s health.
Historically, these two systems have been seen as opposites: the conventional, science-based, medical practice vs. the “pseudoscientific reliance on folk medicine” and “wishful thinking.” Today, perceptions of these two alternatives are shifting. Western medicine has fallen a bit off its pedestal, and alternative medicine is seen as becoming more professional and is widely accepted.
As these two systems evolved, their business models deviated. Western medicine is no longer independent. Currently, equity investors have bought up most of the medical practices, including hospitals, and the insurance and drug companies control much of what can be prescribed and for how long. It’s clear that money drives some of the changes taking place. Lower salaried practitioners have begun replacing MDs as primary care providers (PCPs), and MDs are in short supply and often choose higher paying specializations. In the past, family doctors spent as much time as needed with their patients. Now, since time is money, consultation time is usually limited, no matter who you’re seeing.
On the other hand, alternative medicine isn’t as constrained by these external pressures; each practice has more freedom to determine its fee structure and business protocols. As of now, equity investors do not have a heavy interest in alternative medicine. Alternative practitioners are apt to spend more time with patients, which may be helping to drive their increasing popularity. Furthermore, patients often get good results with these practices and tell their friends.
Patients have long had to consider the benefits and disadvantages of the different types of medical practices when choosing which to use. Western medicine’s goal has been to cure disease and heal what’s broken or wounded, whereas alternative medicine’s primary focus was and is on prevention. Western medicine is notable for its enormous medical machinery: the various types of practitioners, specialties, wide range of treatments, and insurance coverage. Patients’ freedom can be limited in this system. A chosen practitioner may not be taking new patients or may not see their patients if they are hospitalized, insurance may not cover the desired treatment, or a patient’s co-pay and deductible might be prohibitive. This system involves a lot of people in the decision-making process and can seem impersonal.
Alternative medical practitioners typically do accept new patients. Without the layers of hospitals and specialists, alternative practices can seem more direct and personal. And yet, this system is not regulated the way Western medicine is, so patients must rely on the experiences of friends or results of their research when choosing a practice.
There’s been a similar split between body and mind. Focusing on the body is easier because it’s physical. If you break your leg, your doctor can see it and operate on it. But the mind is not physical—it is not the brain—and in fact, there is no agreement about what it is, although many think it’s generated by the brain and lived experiences. This qualitative difference led people to see them as separate non-interacting aspects of a person.
Early in her therapy practice, Jo Vanderkloot had a patient explain that he made the appointment with her because his doctor told him his medical issue was in his head—it was emotional and not physical. He made the appointment against his better judgment: he didn’t believe his mind had anything to do with what was wrong. Jo told him, “Well, if you come back for your next appointment carrying your head under your arm, we’re good to go—I’ll see that you’re right. But if it’s still attached, we’ve got a problem to solve.” He came back.
Increasingly people recognize that these two parts of us interact all the time.
Background
Western medicine gained momentum in the 19th century when medical education became more formal, resulting in standardized, evidence-based practices. It relies on scientific research and focuses on using drugs, surgery, and technology. This medical approach was shaped by the industrial paradigm’s* focus on individual parts: thus branches of medicine grew up around the treatment of each part of the body. That structure is still in place with our cardiologists, ophthalmologists, orthopedists, nephrologists, psychiatrists, etc. alongside more old-fashioned general practitioners. GP’s do an initial assessment and then refer their patients to specialists if needed. The mind/body split mirrors Western medicine’s fragmented focus on separate physical organs.
With some health-related concerns, if we seek a medical opinion, the practitioner will decide whether the malady is physical or mental. If it’s judged to be mental, a patient can choose among a variety of treatment techniques and types of practitioners. Psychiatrists are medical doctors who can prescribe drugs. The fact that they engage in talk therapy and also have a medical degree that allows them to prescribe drugs indicates a belief that there can be physical aspects of mental disorders—this field helps erode belief in a mind/body split. Psychologists and social workers are trained to treat mental issues without drugs by exploring patients’ personal histories and experiences using different techniques as part of their talk-therapy approach.
Recognizing that the mind and body are two aspects of one being is similar to the holistic quality of alternative medicine, which sees the person as a whole organism whose parts, both physical and mental, communicate with and affect each other. The holistic nature of this approach expands the eliminates the need for specialists. However, many practices fall under the alternative umbrella.
Naturopaths earn degrees at their own medical schools that emphasize natural remedies for prevention and healing. They recommend other practices to their patients: massage therapy, yoga, and other modalities, as well as changes in exercise and diet. They spend time getting to know their patients and view each individual as a whole person.
Herbalism is similar to naturopathy, but it is less formalized, requires less education, and is more limited. It dates back centuries: witches were often women who used plants to heal people.
Homeopathic doctors believe in remedies created by repeatedly distilling elements of a disease-inducing component until few or no molecules of it remain. They believe that these homeopathic remedies lead the body to heal itself by reacting to a distilled threat. It’s based on the belief that “like cures like.” Since this practice isn’t evidence-based in the traditional sense, it’s sometimes considered to be pseudoscientific. However, it has a dedicated following and repeatedly produces desired results. Naturopaths will sometimes prescribe homeopathic remedies as well as herbal infusions.
Both naturopathy and homeopathy are generally more accepted in Europe than in the US, and are sometimes covered by insurance.
Some branches of alternative medicine have been practiced for centuries: acupuncture dates back to 3000 BCE as a part of traditional Chinese medicine. It involves inserting thin needles under the skin to arouse a physical response, and it’s well-respected. Ayurveda is an ancient Indian healing method that involves herbs, diet, and lifestyle changes as a pathway to health. Both acupuncture and ayurveda are still popular today around the world.
Stylized movements and postures also have a long history, as in yoga, Taichi, and qigong. Taichi originated as a Chinese martial art but continues today because of its health benefits. Qigong, also Chinese, uses specific movements to stimulate qi, the essential energy in the mind/body, and to move it from place to place. The two practices use similar slow, purposeful movements and postures designed to improve health. Yoga is a spiritual, meditative practice developed in ancient India. It uses patterned movements and mental exercises to build strength, focus, and mental stability leading to the highest level of yoga: meditation. The word, “yoga,” means “union,” and the practice is designed to foster union of mind and body, and ultimately, union with God. It is aligned with ayurveda medicine.
A more modern alternative medical practice is chiropractic medicine, which dates back to 1895, when Daniel David Packer, a magnetic healer in Iowa, gave what is thought to be the first chiropractic adjustment, which restored hearing to a man named Harvey Lillard. Packer founded his Packer School of Chiropractic in 1897. Chiropractors train extensively in techniques for adjusting the spine and other muscle/bone connections; the practice is widespread and respected for healing muscular/skeletal misalignment and pain throughout the body.
In today’s world, other alternative practices are evolving. Now it’s possible to find wellness counselors, aromatherapy practices, biofeedback, and Reiki treatments, to name a few.
One practice that bridges both Western and alternative perspectives is osteopathy. An osteopath is trained and licensed in Western medicine but from a holistic viewpoint. They use an osteopathic, manipulative treatment to diagnose and treat musculoskeletal and other health issues, similar to but different from chiropractic adjustments.
There’s a lovely story that illustrates how the rigorous scientific aura around Western medicine fosters distrust of alternative medicine. A Chinese pharmacist practicing in New York’s Chinatown was being interviewed by a reporter. He was licensed in both Chinese and American pharmacy practices, and his pharmacy carried both types of remedies. The reporter asked him, “Aren’t you a little nervous selling these Chinese remedies to people?” The pharmacist smiled and answered, “Don’t you think after 2000 years we might get it right?”
From “Either/Or” to “Both/And”
When illness or deterioration strikes, Americans have many treatment options. The higher status of Western medicine is eroding as more people try alternative practices and tell friends about their positive experiences. Furthermore, belief plays a role. The placebo effect is real, and it exemplifies the way mind and body are intertwined. While in the past alternative medicine was less common, now more people are beginning to adopt a “both/and” perspective when it comes to their medical preferences. Some practices are better for certain ailments. Few people would choose an herbalist over an orthopedic surgeon to treat their broken leg, for example. But many would check with both a chiropractor and an orthopedist regarding chronic hip pain. And many people regularly see both a naturopath and a Western medicine primary care provider.
The holistic nature of one’s being is especially evident from a mental illness perspective. Therapists treating patients with talk therapy may recommend that some consult with a psychiatrist to obtain drugs when the combination would be most effective. The drug may help a patient move beyond a particular rough spot during the continuing exploration of past traumas as the therapist helps a patient recover from an emotional impasse. The drug provides physical support to the mental/emotional work done in therapy.
Healthcare in the US now offers us many treatment possibilities. We are free to choose which to use, although our choices are limited by our geographical location, insurance policies, and income. People are moving away from thinking that we should use practitioners within only one of the main systems and toward choosing from all available options. Each option has a place, and each has benefits and drawbacks. Some will fit our individual needs better than others, so we are fortunate to be able to choose to the extent we can. Any reduction in polarization in our lives and in our society is always welcome.
*For more information about the industrial paradigm, see blog posts on www.chaosinstitute.org.