Melbourne Holistic Health Group

Published in Clinic Information on 30 December 2009 by Melbourne Holistic Health Group

In a collaborative model of health care, orthodox and complementary health professions work together in providing the most effective patient care. It is unlikely that the individual needs of every patient and their medical condition can be met by only one practitioner. In a collaborative model of health care there is recognition of the scope and limitations of any one practitioner, an awareness of other available health care services, and a referral to these services where appropriate. In a collaborative model of health it is the best interests of the patient that are always put first. 

A well established referral system is integral to a collaborative model of health. Although complementary therapists are trained in various types of diagnosis according to their discipline, some diagnostic procedures or investigations are outside the sphere of complementary therapies. Examples of examinations that require referral to GP’s and specialists include:

• Routine screening procedures such as breast examination and Pap smears. Cervical screening for dysplasia or cervical cancer will also detect sexually transmitted infections (except Chlamydia) as well as vaginal infections.
• Gynaecological examinations which are performed vaginally and involve internal palpation of the pelvic organs.
• Pathology tests such as blood tests, swabs and some urine tests; and radiological examinations such as ultrasounds and X rays.

Orthodox or biomedicine is undeniably the first line of treatment in cases of acute and emergency medical situations. However, this is only a small percentage of medical issues. Often medical cases are complex and chronic and require ongoing management in both treatment and prevention. Naturopathic medicine has a strong emphasis on prevention and is particularly effective in the treatment of chronic diseases. Naturopathic physicians are often referred to where a detailed dietary history and specific nutritional advice may be required, for example where there are suspected food intolerances, chronic skin conditions, or digestive health issues. Functional disorders are another common type of medical referral to naturopaths. A functional disorder is a disorder that exists despite no diagnosable pathology, such as in the case of irritable bowel syndrome (IBS). Reproductive issues such as infertility, and gynaecological disorders such as premenstrual tension, are other examples of where there may be a number of underlying causes and a holistic approach is effective in restoring health and function.

A collaborative model of health care may involve the combined use of biomedical and complementary health care. For example, in order to diagnose a patient with IBS, a number of diagnostic tests must be performed that rule out serious pathology. Depending on the presenting symptoms, this would necessarily involve a consultation with a GP and a referral to a specialist. Once a diagnosis of exclusion has been made, a naturopathic practitioner may prescribe a number of dietary and lifestyle changes, as well as herbal medicines that would benefit a sufferer of IBS. Endometriosis may be treated in some cases both with the oral contraceptive pill to alleviate pain and control growth of endometrial cells, as well as herbal and nutritional support that aims to improve uterine tone and reduce inflammation in the body. Likewise in cancer therapy, a patient may be undergoing surgery, radiation or chemotherapy, but benefiting from complementary care that optimises nutrition and assists in minimising and alleviating drug and treatment side effects.

Within the collaborative health model, patient treatment is individualised and interactive. An interactive consultation involves the patient being part of the decision making process. This may involve listing possible options of treatment both from biomedical and complementary health care perspective. It also involves the patient in the understanding of treatment strategies, a process which not only improves compliance, but also assists positive outcomes and allows people to intervene on their own behalf when or if the condition arises again.

Effective treatment is also individualised. We are each unique in our genetics, environmental exposures and various medical conditions, and as such are our nutrient requirements and reactions to medicines will be different. Research from the Human Genome Project in the field of nutrigenomics and pharmacogenetics has shed new light on the importance of individualised treatment approaches. These research areas emphasise individualised response of medicines and nutrients as well as the role of dietary and genetic interactions. There is no one system of intervention that will work for every person; neither is it reasonable to expect that a condition will always respond favourably to a treatment, even if this has been the case for other individuals many times in the past.

Complementary medicine is continuing to grow in its public use, research and government funding. Research into nutritional and herbal medicines is expanding the knowledge basis and scientific validity of complementary health care. Integration of complementary medicine with biomedicine is slowly but surely becoming part of mainstream health care. In order for a collaborative health care model to be effective, practitioners need to be aware of the limitations of their area of expertise with referrals being made across disciplines where appropriate. Practitioners must also be aware of what medicines their patients are taking and the potential interactions between nutritional, herbal and pharmaceutical medications. It is clear that for a collaborative model of health care to be viable there must be informed and open communication between patients and their practitioners, as well as between health care professionals.

Although we have a women’s health focus, we in fact operate as a general practice and see everyone from the very young to the very old and for the full range of medical conditions.

Sources

Ferguson, M. 1980. The Aquarian Conspiracy, Paladin, London, pp. 270.
Baum, M. 1998. ‘What is holism? The view of a well-known critic of alternative medicine’, Complementary Therapies in Medicine 6, pp. 42-44.
Pert, C. 1997. Molecules of Emotion, Scribner, New York, pp. 187.
AANP (American Association of Naturopathic Physicians) 1989. ‘AANP Definition of Natural Medicine’, <http://www.naturopathic.org/positions/definition_naturopathic_medicine.html>, accessed 11 March 2009.
World Health Organisation, 2003. ‘WHO definition of health’, <http://www.who.int/about/definition/en/print.html> accessed 11 March 2009.