Tuesday, October 03, 2006

Rural Woo

The September/October 2006 issue of The Journal of Complementary Medicine discusses the issue of "Rural Integrative Medicine".

Interest in natural therapies is not confined to cities and suburbs - rural GPs face as many, if not more, queries on CM. How do they manage?

While rural GPs generally face a lot of issues, not the least being the remoteness of many communities, lack of facilities and higher workloads (and the communities themselves often have no local GP for these reasons) it seems woo is doing quite nicely in the outback, thank you very much:

One study, conducted by the Royal Australian College of General Practitioners in 2000, found rural patients had slightly more personal experience with complementary therapies (45 per cent) than urban patients (43 per cent). Rural patients were also significantly more likely to use chiropractic services than their city counterparts (42 per cent vs. 35 per cent). In 2003, a paper published in the Medical Journal of Australia showed that rural women were more likely than urban women to use complementary medicine (CM) though they did so in parallel with conventional health services.

EoR would be interested to know the reason for the higher usage (of chiropracters - does this also apply to kinesiologists, reikiists, acupuncturists etc etc)? Since medical services are very often limited in rural areas, could it be a case of the only therapy available?

The Journal of Complementary Medicine chatted to four doctors who have "travelled the CM path".

The first is a doctor in Victoria's south east who also practises "nutritional medicine". For the life of him, EoR can't really see what the "complementary" aspect of this is (unless you agree with the alties that doctor's know nothing about nutrition and diet, are not "holistic", and only "treat the symptoms").

A solo practitioner, Dr van Leerdam is not averse to prescribing pharmaceuticals. But her journey towards CM saw her questioning the pharmaceutical model. "There is a place for them but there are often better ways of dealing with things," she says.

Which, EoR expects, the vast majority of GPs (CM or non-CM) would wholeheartedly agree with.

The second GP uses "integrative medicine" in the form of two naturopaths and two osteopaths in his practise in Byron Bay. Apparently, the team "share consultations" and "take a consensus approach" though they "don't always agree on everything" and "tend to stick to their respective roles". It must be hell in those meetings... This GP also loves acupuncture, and uses it in his Aboriginal community clinic.

He says Aboriginal patients are very open to acupuncture, although he doesn't use it for many of their chronic health problems, such as diabetes.

No, such chronic health problems need an "integrative and holistic approach" with a team of specialists: the GP, a physician, podiatrist, eye specialist and scientist. The scientist's speciality isn't stated, but it appears no homeopaths are on the team.

The third GP case study practices four hours out of Brisbane, using chiropracty, acupuncture and massage as he "tries to get inside their [the patient's] head".

The final GP is EOR's pick of the bunch, however. Dr John Gillett "is regarded as a specialist in the UK but a quack in Australia" because, yes, he's a homeopath. Eor would be prepared to compromise here, and call him a specialist in quackery.

Dr Gillett says the field is far more accepted [in the UK] because of patronage by the Royal Family. 'Charlie and Queenie have their own naturopaths,' he says.

Strangely, he suspects his colleagues believe there's a "little bit of quack in him" but, luckily, he knows "normal medicine" as well. And he doesn't get to use his special not-quackery-at-all speciality as often as he'd like:

But the rigours of country practice mean you have to 'get a handle on the life-saving things' before you can even contemplate new horizons. Such demands mean the CM component of even his practice is restricted.

So, use the real medicine first, and then start applying the woo?

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