To Teach or Not to Teach: The Role of Alternative Medicine in Philippine Medical

 The trend away from traditional or allopathic medicine is borne by the following statistics and facts:

1. It has been estimated that the US public spent between $36 and $47 B on CAM therapies.

2. There are now states with naturopathic licensing laws and licensure of Naturopathic physicians is expanding into new states.

3. Legitimacy and significance of CAM has been recognized by public and private authorities, i.e. In the US, the NIH’s Office of Alternative Medicine was created by an act of Congress, and in the Philippines, the TAMA law created the Philippine Institute of Traditional and Alternative Health Care (PITAHC)

4. One out of every two baby boomers uses non-conventional therapies. Boomers seem to facor safe and noninvasive alternative treatments.]

5. 42.1 % of Americans surveyed used therapies outside of mainstream medicine like acupuncture, chiropractics and homeopathy. This figure is up by almost 25% from a survey done seven years before.

6. The Instittute for Alternative Futures predicts that be 2010 at least 66% of Americans will be using one or more approaches now considered alternative or complementary.

7. In the Philippines, more than 80 % of the population in rural areas depend on alternative or complementary forms of medical treatment.

8. The increasing cost of drugs and medical care, the side effects from pharmaceuticals and the desire of patients to be actively involved with medical decision making are reasons for increasing trend of CAM use.

9. Recent WHO statistics show the following:

a. In China, traditional medicine accounts for around 40% of all health

b. In Chile 71% of the population, and in Colombia 40% of the population, have used such medicine.

c. In India, 65% of the populations in rural areas use traditional medicine to help meet their primary health care needs.

d. In developed countries, traditional, complementary and alternative medicines are becoming more popular. For example, the percentage of the population that has used such medicines at least once is 48% in Australia, 31% in Belgium, 70% in Canada, 49% in France and 42% in the United States of America.

e. Traditional medicine has also been used in the treatment and care of such life-threatening illnesses as malaria and AIDS. In Ghana, Mali, Nigeria and Zambia, herbal medicines are the first line treatment for more than 60% of children with high fever. Studies in Africa and North America have shown that up to 75% of people living with HIV/AIDS use traditional medicine alone or in combination with other medicines for various symptoms or conditions

These reasons and the overwhelming increase in recent years of health care consumer visits to alternative medicine practitioners have forced the question: Should complementary and alternative medicine (CAM) be included in conventional medical school curricula? In America, medical schools are responding with a small but growing number of courses that address healing methods historically dismissed as incompatible with the scientific rigors of Western medicine. In the Philippines, certain institutions such as the University of the East, Ateneo and De La Salle University are looking to offer or are now offering complementary or integrative medical courses. But although many medical educators agree that CAM can no longer be absent from their curricula, there is heated debate over how CAM modalities should be presented to the future physician work force.

Should CAM topics be taught as stand-alone electives or part of required courses in a longitudinal program (such as that offered by the University of Wisconsin). In the Philippines, all courses are being given as electives and there is yet no longitudinal four year degree course leading to a Doctor of Naturopathy or Master of Oriental Medicine as in China or Korea. Some suggestions that policy makers should include when they write the final implementing rules and regulations:

1. Teachings of alternative medicine should be held to the same standards of safety and efficacy as conventional medicine. The elements of conventional medicine taught in medical schools are evidence-based and consistent with scientific knowledge about the workings of the human body. Many elements of alternative medicine are not well supported by scientific evidence. Some are scientifically implausible and contradict what we know about how the body works. Rather than encouraging these healing modalities, we should encourage critical thinking about them. Thus students should be taught to carefully examine scientific evidence evaluating the claims of proponents of alternative medicine. There should be critical readings combined with presentations from guest speakers who practice CAM methods.

2. The courses should be a comprehensive model of medicine that is patient-centered, that emphasizes the centrality of the doctor-patient relationship, and that incorporates all healing methods for which there is reasonable evidence, whether they're from the conventional or alternative side. Integrative medicine has much larger goals than just looking at CAM modalities.

3. The teachings and training should include critical analysis of research findings on alternative medical methods.

4. Students alternative medicine must be taught and trained in integrative treatment plans in concert with a panel of health care practitioners who represent a comprehensive cross-section of conventional and alternative specialties from pharmacology to Chinese medicine. Treatment plans are then implemented and patient outcomes monitored to ensure that the treatment is scientific and evidence based.

Although currently marginalized , CAM is clearly beginning to permeate the Philippine curricula from which it has been historically excluded and it is probably just a matter of time before it is included as part of standard teachings in medical schools. Now is the time for educators to do the necessary work and ensure quality programs for a better medical work force in the country.