“Out beyond ideas of wrongdoing and rightdoing there is a field.
I’ll meet you there” – Rumi
I have always had a fascination with Chinese traditions and philosophy, being of Chinese origin but with a Westernised upbringing. So I decided, after three years of residency, that the time was right to try a different path, just for a while, but before I became too “stuck in my ways”. I handed my pager in and enrolled in a Bachelor of Applied Science (Chinese Medicine). I was looking for more to being a healer than acute stabilisation of people in a hospital.
This path opened my eyes to a completely different perspective on health. Health and disease were a delicate balance between external forces – described 2000 years ago as “heat” and “wind” but clearly describing infectious disease and inflammation – emotions and lifestyle (diet, exercise, overwork).
Some of the concepts seemed alien at first but I soon saw the parallels with biomedicine. “Qi” referred to physiological function: immunological, cardiovascular, metabolic. Yin and Yang were the parasympathetic and sympathetic system. After all we were talking about the same human body, but with a different lens and language.
After I graduated, I completed my FRACGP and began working as an “integrative GP”. This meant I combined my understanding of Western and Chinese medicine in clinical practice. Although the two paradigms melded beautifully in my brain, and patients loved having a GP who understood a different health system, it hasn’t always been easy.
Increasingly, there is skepticism amongst my medical colleagues about the value of complementary treatments. I then became a researcher and published a negative trial on acupuncture for menopausal hot flushes, and received hate mail from acupuncturists. Trying to build a bridge between two health systems can sometimes feel impossible. A bridge is meant to span an obstacle; occasionally, this obstacle seemed too formidable.
I have learned to build this bridge on a patient-centred foundation. I draw strength and encouragement from the perspectives of my patients, who, like me, appreciate the wonders of Western medicine, and the wisdom of traditional medicine. I have learned so much from them, about the reasons why they fear medical procedures, pharmaceuticals, or doctors as a whole; their values and preferences and beliefs; the way they view health and disease. And I have been able to emphasise the enormous value of biomedicine to them – the medical breakthroughs, the wonderful screening programs we have, the simple and effective drugs that can improve their quality of life.
I am able to put risk into context for them – just because a medication may cause a side effect, doesn’t mean that it will; nothing is without risk; and we discuss the risk vs benefit ratio of each treatment, whether conventional or non-conventional. I am firmly against alternative therapies, which by definition are a rejection of biomedicine. And I constantly have wins.
A patient who was firmly against cervical screening, believing it would be a “self fulfilling prophecy” and that she used “intuition” to scan for cancer in her body instead, agreed to have a cervical screening test after we discussed the huge benefits of making the most of the advances in modern medicine and having the best of both worlds. The same patient suffered hay fever terribly, and finally agreed to use a nasal corticosteroid (being typically “anti pharmaceutical”) and later said she chided herself for waiting so long, the effects were so marvellous!
My patients and I have spanned the obstacle between conventional and complementary medicine. We have managed to meet in the middle to find a common ground. We have created a safe space to discuss fears, challenges, and to allow for informed decisions in healthcare – something I am passionate about.
I feel the time is right for this to happen between health care professionals, whether medical or non-medical. Imagine what we could achieve if we worked together as a team instead of having our patients use two parallel healthcare systems. We all know that more than 50% of patients do not “disclose” use of complementary therapies to their doctors.
Imagine if we talked to each other – picked up the phone, wrote letters, or had a face to face meeting over lunch or at a conference. Recent research I have conducted demonstrates that complementary therapy users are not rejecting conventional medicine – rather, they embrace it and the assurance it brings them that “checks and balances” have been applied. But they also want a broader approach to healthcare than being handed a prescription, and they want teamwork and integration. The call to action is clear: “Why can’t youse (sic) just work together?”
I have realised that in order to do this, we need psychological safety. Both sides need to leave prejudices, judgements, and preconceived notions of how the other side is practising “pseudoscience”, peddling “snake oil”, or are in the pockets of Big Pharma. We need to meet in the middle, as respectful adults, as people, as fellow human beings who have the same intention – for our patients to achieve the best health that they can.
If we work together, we can truly offer our patients the best of both worlds, in a transparent, controlled, and well-informed way.