Medical Marriage is the concept of an integrated health care system where doctors work hand in hand with practitioners of complementary therapies. Through the meeting of two very different paradigms – the so-called reductionist and the holistic – a new way of operating can develop and the best of both worlds may become available to everyone: the doctor, the complementary practitioner and the patient.

Arguments for Change

Patients are already using both orthodox and complementary medicine for their health care: 30% of people have used complementary therapies with a great degree of satisfaction and would use them again in the future.[1] This can lead to fragmentation of care which does not allow for the highest quality of health care. Now the time is right for the professionals to honour the lead that has been taken by those they are endeavouring to serve. Professionals from the complementary and orthodox fields have to engage in a concerted effort to provide patients with the integrated care they want.

Modern medicine has made tremendous progress in the treatment of certain conditions. Its contribution to increased life quality of many individuals is invaluable. However, the general level of health of the population has not increased to a degree that might be expected considering the enormous efforts which sustain modern health care systems.

The treatment modalities currently available to doctors, namely’ allopathic drugs and surgery, have proven to be dangerous through their side effects and of dubious benefit in the long term in many cases. There is a long list of iatrogenic conditions
caused by medical interventions.

Complementary therapies, on the other hand, use treatment modalities which are less invasive and appear to be effective much of the time. In order to provide these to the patient, doctors do not have to study them in depth or practise all the complementary therapies themselves. They do, however, need to know enough to be able to make referrals and co-operate as colleagues.

Medical Marriage promotes a model of equal partnership between doctors and complementary practitioners who are skilled and experienced in their own field of specialisation. Respecting each other’s unique contribution to health care, communicating openly, thus educating and supporting each other on a personal level, and doing what is best for each patient is the ideal of multidisciplinary co-operation.

For this integration to occur, openness, trust, non-defensiveness and respect on all sides are required. Doctors and complementary practitioners have to recognise and honour the part each plays in ensuring the overall well-being of the patient and the community. It is important for this integration to occur slowly to allow a synthesis of the two approaches to emerge, so that the best in each is preserved to create a viable model of health care for the twenty-first century.

Who Stands to Gain from This Model?

The patients are the most obvious beneficiaries. Their interest in a new form of health care is already evidenced by the enormous increase in popularity of complementary therapies. In a model of multidisciplinary co-operation they do not have to feel torn in their loyalties or be secretive about seeing a complementary practitioner. They can expect their health care professionals to co-operate and communicate to provide the best care for them in all circumstances, enhancing each other’s skills and contributions. Education empowers patients to take an active role in their own care which emphasises life quality and self-responsibility.

Doctors benefit from an increased range of therapeutic interventions available for patient care which carry fewer side effects and improve patients’ quality of life, as well as engaging patients in their own care. The complementary therapies offer elements of care which are difficult to provide in a busy surgery with seven-minute appointments – namely time, attention, caring touch and consideration of all aspects of the patient’s life. This frees the doctor to give more time and attention to those cases which require their specialist help. The stress in doctors’ working lives can therefore be dramatically reduced as they are no longer expected to provide the magic cure in all cases.

Complementary practitioners have the opportunity to expand their practice to cater for a broader spectrum of cases, making their work more varied, challenging and relevant to society. Through multidisciplinary co-operation the professions stand to gain acceptance and validation. They have access to more resources, not only financial, but more importantly to academic support and research opportunities which are essential for the further development of their disciplines. Complementary practitioners are included as partners in the patient’s care and therefore have the backup of the established medical system (with 24-hour cover, specialists’ care and in-patient facilities).

Core Elements for Medical Marriage

The following premises are essential for the concept of integrated health care:

  •  In Medical Marriage the principles of holism are understood, embraced and applied in practice. Patients are treated as whole people, taking into account their physical, emotional and mental health. They are seen as a product of their family, social and cultural context, as well as their natural environment. The whole spectrum of approaches to health care, complementary and orthodox, are offered for the patient to choose from. The relationship aspect of the therapeutic interaction is of high import. Practitioners’ dedication to their own health is a crucial aspect of the equation.
  •  Health and wellness are the focus of health care and the treatment of disease is only one small aspect of that. Rather than concentrating on the removal of symptoms the health care professionals support patients in helping themselves to increase their life quality. Education is a major tool to facilitate health enhancement. Life quality is more important than quantity – in the form of longevity; death becomes an integral part of the life process.
  •  Patients are in charge of their own care. People have the right to take responsibility for their lives as much as they want to, and they have the right to receive all the information they need in order to do that. They are the experts in their own lives and being a patient is only a minor and hopefully temporary role.
  • In disease care the least harmful intervention has to be provided first. Only if that fails to solve the problem are more invasive treatments justified. This means in most cases that complementary modalities should be applied first with the technology of orthodox medicine being a back-up or last resort.
  • Multidisciplinary co-operation is the strategy which best provides this effectively and safely. This means a team consisting of a medical doctor and complementary practitioners of various disciplines working together within a framework of clear communication and respectful co-operation for the optimal care of the patient.
  • Education is the core for understanding. In the same way as doctors have an understanding of the many different aspects of contemporary medicine everyone working within the model of Medical Marriage needs to have a basic knowledge of the theory, practice and application of the wide range of complementary therapies.

Reference

  1. D M Eisenberg, et al., Unconventional Medicine in the United States: prevalence, costs and patterns of use, N Eng J Med, 1993; 328: 246-52.
    S J Fulder; R E Munro, Complementary medicine in the UK: patients, practitioners, and consultations, Lancet, 1985;
    542-5.
  2. M Emslie; M Campbell; K Walker, Complementary therapies in a local health care setting, Compl. Therapies in .Med,
    1996, 4:39-42.

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This post was previously published as a chapter in the book Medical Marriage, the New Partnership Between Orthodox and Complementary Medicine, Dr Cornelia Featherstone and Lori Forsyth, published by Findhorn Press, 1997.