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Practitioner Corner
Essays By and About Practitioners
The
Integrative Medicine Alliance makes no endorsement of any business,
organization, practitioner, therapy, or product described within
this newsletter, nor is the information contained herein intended to
be a substitute for medical advice. The following essays are solely
the opinions of our members. We urge you to contact your physician
and/or health team before trying any new therapy or healthcare
product.
THE HEALING GIFT OF TIME
By Harvey Zarren,
M.D., IMA President
Healthcare in the
United States in 2005 is confronted with a lot of quality issues and
quality initiatives theoretically aimed at correcting the issues. Few
if any of the initiatives are addressing a fundamental defect of
modern conventional healthcare. Currently, conventional healthcare
practitioners do not have adequate time with patients. Physicians do
not get adequate time in the office or in the hospital with patients
and nurses do not get adequate time at the bedside with patients.
Time is the single
most essential aspect of healing. Each part of the human body, down to
the DNA molecules, has mechanisms for repair and healing. These
mechanisms take time to work properly. A wound takes time to heal.
Broken bones take time to mend. Broken psyches and emotions and
spirits need time to heal.
Human relationships
take time to develop and grow. It takes time to know someone, to
develop trust, to facilitate hope. It takes time to teach people
skills for healthy living: proper nutrition, methods of exercise and
relationship skills among others. A white coat or uniform is no
longer, by itself, a symbol of trust in our culture. Human caregivers
need time to relate to patients so that trust can develop, so that
each can be truly heard, so that each has an opportunity to move on
the journey towards wellness.
Systems analysis,
business language about "customers" and time-efficiency methods are
some of the current ways that institutions seek to improve
healthcare quality. High technology tools are seen as the answers to
dangerously abbreviated physician and nurse time with patients. In
some cases less-well-trained personnel are “plugged in” to try to fill
the quality gaps created by lack of sufficient caregiver-patient
interaction time.
For some reason, we
have decided to live with less time for healing, with less time for
each patient, with less time for anything but generation of dollars.
We have decided that it's O.K. to have less time to notice, less time
to feel, less time to listen. We have substituted testing for
listening, hoping that the laboratory will reveal what lack of time in
listening and noticing has kept hidden from our knowledge. We have
decided to limit hospital time for patients, limit resting and healing
time, limit rehabilitation time, limit home care resources, limit
everything except bottom line economics.
The results are
ominous: missed diagnoses, missed opportunities to prevent accidents
and medical emergencies, poor-quality pre-operative evaluations
leading to post-operative complications, and on and on. The single most
important missing element is time. Well- trained practitioners need
adequate time to do what they are trained to do. Computers, bar codes,
check-off lists, and systems are useful, but they will never make up
for adequate time given to competent physicians and nurses to
evaluate, treat and support patients.
Our healthcare is
practiced in the fashion of our entire culture. We behave in health
care only in the way in which we behave in our national life, There is
no help in department stores; people in markets and gas stations are
often rushed and surly. School teachers spend shortened periods with
students and school children are fed the food that prevents learning
in very rushed lunch periods. We appear to have harnessed our human
efforts to the buying, selling and acquisition of things. Time is not
valued for itself in our culture, so time is not allowed in our
healthcare.
We need time...time
to slow...time to listen, quietly...time to rest...time to heal...time
to think...time to feel...time to play. We must have time to
teach...to learn...to practice...to be. We need time for the healing
interactions that are the foundation of good medical care and human
caring.
Complementary
medicine practitioners still understand about time. Massage takes
time, acupuncture takes time, an herbalist’s evaluation takes time,
yoga takes time, a naturopathic physician takes lots of time. Patients
seek these practices because they work, but also because they allow
time for quality experiences. Complementary practitioners who fall
under the “efficiency-spell” of conventional care are at risk of
giving up the key healing element of time.
Let us insist that
conventional medicine practitioners get the time needed to properly
hear our histories, notice our diagnoses, use the rich knowledge of
clinical history and physical oriented medical practice. Let us insist
that in and out-patient care get the time to really allow patients to
heal. Let us give people the resources to really heal, the most
important of which is time.
Modern
pharmaceuticals are incredible; their problems do not outweigh their
benefits; they just need to be used more appropriately. Modern
technology is amazing: bypass surgery and angioplasty of coronary
arteries are incredible ways to give people the time they need for
lifestyle changes to allow wellness. Computers are incredible tools
for handling information. We must not denigrate or dismiss these
modern tools for health care. The modern tools are only tools; they do
not replace the healing effects of human relationships given adequate
time.
We must continue to
call sick and needy people "patients." We must be patient with them.
We must give them time to tell their stories. We must give ourselves
time to notice and evaluate their problems. We must give ourselves
time to provide the tools for healing. We must give patients the time
to heal, to use the appropriate tools, to absorb the knowledge, to
hear over and over what is needed for healing.
It is time that is
the key to healing! Time is not expensive, not costly by itself.
Perhaps that is why it is not valued by bankers and insurance
companies. When insurance plans understand and pay adequately for
time, the quality of healthcare can improve significantly!
Take the time to
think about this. Take the time to teach it, model it, to insist on
it. Take the time of human “being.”
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IS INTEGRATIVE
MEDICINE ALIVE AND WELL IN NEW ENGLAND?
IMA recently
invited the IMA community to share brief stories focusing on how
integrative medicine is alive in New England, including success and
challenges. We heard from several readers, and present these stories
for your information and inspiration!
As
a former Registered Nurse, a Reiki Master and secular Franciscan
living with multiple sclerosis, a graceful blend of holistic
measures keeps me healthy. My “Holistic Balance Initiative” and
personal variations have been utilized with great success on my
homebound visits. This personal guide to activities of daily living
has allowed many to actively participate in their self-care.
Medication and treatment schedules, dietary recommendations, exercise
as tolerated, communication to combat loneliness (via internet, email,
telephone, letter writing), brain and mental stimulation (reading,
listening to books on tape, crossword puzzles, creative writing and
research), inner peace and spiritual enlightenment through prayer,
Reiki, meditation and journaling are basic measures that keep
shut-ins productive members of society.
Diana M. Amadeo.
dianaamadeo@adelphia.net
Natural Standard is an international research
collaboration that collects and synthesizes data on complementary and
alternative therapies. Using a comprehensive methodology and
reproducible grading scales, we create herb, supplement and
complementary practice summaries that are evidence-based and
peer-reviewed. The mission of this collaboration is to provide
objective, reliable information that aids clinicians, patients, and
healthcare institutions to make more informed and safer therapeutic
decisions. Natural Standard is widely recognized as one of the world’s
premier sources of information in this area, and contributes to
numerous books, special reports, newsletters and websites.
Nicole Giese,
Editorial Assistant,
Natural Standard Research Collaboration
www.naturalstandard.com
I am a nurse at
MetroHealth Medical Center in Cleveland. I developed a personal
interest in integrated therapies and suggested formation of a
hospital committee in 2000 which consists of myself (registered nurse
with Masters of Science in Natural Health from Clayton College,)
psychiatric clinical nurse specialist, and a hospital chaplain. Our
goal has been to educate hospital staff about integrated therapies. Our committee is small and we all have other jobs, however we feel
very strongly that integrated therapies need to be part of a hospital
environment. Currently, we are offering Reiki classes to hospital
staff. Our committee also participated in development of staff
relaxation rooms in the hospital. We would also like to develop a
Guided Imagery program in the Cancer Chemo Outpatient Clinic. My goal
is to become an Integrated Therapies Consultant for the hospital. We
have been lacking physician support but have excellent support from
the Chief Nursing Officer and Chaplain's Office. Recently, we have
been assigned a physician from the Palliative Care Dept and we are
excited. I would like to see a multidisciplinary team, which would
consist of pharmacists, nutritionists etc. I have many ideas, its
just tough to get them accepted in the hospital environment. I would
like to see a comprehensive list of all hospitals and what they are
doing, both formally and informally or grass roots on the web.
Buddy Ann Ross, RN, BSN, MS, Reiki Master
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If you have
ideas or comments about these articles, please contact us at: admin@integrativemedalliance.org.
If you have not yet joined the IMA and wish to join and to
participate in these discussions go online at:
www.integrativemedalliance.org.
Become a member/donor or a business partner. You can be part of
the effort to deepen the quality of the human experience in
healthcare!
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