Alternative,complementary or Integrated Medicine?

Complementary and Alternative Medicine are two terms used synonymously fot practical purposes.Whenwe ask the question Complementary to what ? Or alternative to what ?We get the answer to Western Allopathic practice of Medicine.This term therefore takes western modern medicine as the principal method of treatment .A better term is Integrated Medicine where we can use all types of medical practices simultaneously or side by side depending upon the need and the situation concerned .
In India if we take a survey ,we will find that over the past 400 years western medicine is taken by population in general,but still the ways of life,the food and the systems of indigenous medical practices go hand in hand in each and every province and it has never been disrespected by people ,whatever the Modern Medicine doctors think or say about these practices.In 1995 a survey in UK showed 9000 subscribers (surveyed)were taking alternative medicine at least once in their lifetime and a survey in 1995 showed people wanted complementary medicine introduced in NHS .The several reasons for the popularity included the side effects of modern drugs like NSAIDS (nonsteroidal anti-inflammatory drugs)to relieve simple pain.Another source of dissatisfaction was long waiting time for treatment and lack of time of busy medical practitioners and their attitude to patients.That is both the type of treatment and the approach of the practitioner were causes for its unpopularity in Britain.The same was true of America.But the main reason for acceptance of other systems of medicine in these developed countries was the research which showed that they are equally able to heal several disorders.It was not just disillusionment with modern medicine but also the effectiveness of the other systems in real life practice that made it very popular in developed countries.A holistic approach to nature,energy and integration developed as a result.
In 1986 BMA had dismissed all modes of treatment other than modern medicine as “primitive beliefs,outmoded practices,almost all without basis.”.But 7 years later BMA was thinking about new approach of accepting other types of treatments also for good practice.In 1991 NHS had complementary medicine accepted into its practice.Foundation of Integrated Medicine (FIM)analysed primary care group(PCG)plans for complementary medicine from 1999-2000.As more and more PCGs became PCTs or primary care trusts that manage and control their own budgets more opportunities for such integrated medical practices opened up.In 65 % of British hospitals doctors have accepted the role of other modalities of treatment in mainstream medicine.In residential homes this has been of much use.
Integrated services are set up and run as collaborative for people ,that is both types of therapies are given side by side .The initiative of establishing a learning collaborative and in participation with a university provides a support and information network.Its aims are to support joint learning between a set of projects representing different models ,to find out the steps and resources,to develop resources that can be used by others seeking to develop integrated primary care (especially knowledge and information about the several modalities and how to use them in integrated practice),to gather evidence about successful models and development strategies and to share the learning from that work with a wider network of people.
The Foundation will have to provide support to the various projects taking part in the collaborative in a number of ways.
These include among others:
Funding for participation in seminars
Towards cost of development activities and their evaluation
Expert advice on service development
Models of integrated working and evaluation strategies
Information about possible sources of funding
Relevant research on effectiveness of complementary therapy in primary care.

Stardardising ,accrediting ,validating the training courses with an ethics and code of practice
Continueing professional development
The best organizations should haveet of validated ,accredited,educational training standards,a code of practice and ethics,an accessible fair and effective complaints procedure,open disciplinery procedures and a requirement for indemnity insurance.
FIM was established in UK in 1997 as a result of initiative of Prince of Wales.NCCAM is the national center for complementary and alternative medicine in USA.In our own Kerala ,it is proposed to have an integrated medical practice quite recently .

WHAT A THERAPIST SHOULD KNOW
1 what are methods that one use
2.What is the basis of the process with which the treatment works
3.what type of disorders have effect with this
4.How many sessions one needs depending upon one’s condition and one’s temperament to the treatment modality
5 Am I having enough training in the process to start treating a patient and have I got attached to an educational training institute for the purpose
6.Is the modality that I give cost effective and free of side effects

If these questions are analysed by oneself and if one is able to answer these from experience and practice one can be considered a good practitioner.One has to understand the limitations of one’s profession,of oneself as a human being and also about the differences in each patient/individual as a unique one.What works well for one need not work for another and therefore a variety of treatment modalities under a common umbrella of institution helps a lot.The Umbrella organization under which the modalities come has to give definite directives for all these.
We must understand that western medicine evolved after Europe had access to India directly.The Portuguese,the Dutch and the French came and learned a lot of Indian medicine and its regulated nature .Then there was a renaissance in entire Europe .The first Medical Act of 1512 was the attempt to regulate the medical profession.It is also interesting that the license was first given by the bishop of the Diocese in which the practitioner lived.(Just like the Indian system of the Brahmin Guru of a region).In 1542 it was amended and is called the Herbalist’s charter supported by Henry V111 .This was designed in protest to physicians and surgeons who allowed the patients to rot,unless they pay heavily.(That shows the business mercenary attitude of the first western doctors ).The charter allowed any one to practice if they have knowledge and experience of nature of Herbs,roots and waters according to their cunning(meant ability)experience and knowledge .This right of practice freely and legally was guarded and by herbalists and supported by Government.For four hundred years this persisted .In 1977 The Herbal remedies order defined the circumstances under which a herbalist can prescribe certain toxic drugs like belladonna.
Herbal medicines are of three category
Licensed
Unlicensed
Food supplements
In India all herbs are used as medicines .And most of tehm are food ingredients and fod supplements .Therefore only a few prepared mixtures come under the licensed category .If we insist that all herbs should come under license ,even rice and wheat will have to be licensed because Ayurveda use each and every food item as Oushadi.The argument that each drug should be submitted to a RCT is therefore inapplicable in India .Then people wont be able to take any food and will die of starvation before the Government certify and give a licence for it.Therefore we have to be practical in devising rules.

There is no problem in finding a theoretical issue and experimental design for research in complementary medicine .The most important issue is the lack of funding and the lack of research skill as far as music therapy in India is concerned.This I say from several years of experience .People are interested in the discipline but do not know where to find an institution where they can do proper research under a proper guide .And the so-called self-proclaimed music therapists are not able to answer the several questions the students ask or the doubts the public have.Systematic reviews and metaanalysis are not coming up simply because of this barrier.I have been trying to give awareness on these matters both to students and public through several communication media .
What we need is an environment that supports and values the development of research skills and experience ,enable access to research training opportunities and resources to undertake research activity ,provide secure and attractive career pathways for our new generations and encourages development of high quality research projects.
An important point I want to stress is Music research and music therapy research are different .Training in classical music or light music singing is not training in music therapy.It is only part of the entire integrated process.Just as one limb cannot make up our entire body ,music alone does not make up music therapy .But that limb is definitely very very important .Everything has a place and a design in our system.Just like that recognize each knowledge system in its own unique way and give it its share .