Wall Street Journal: Alternative Medicine is Mainstream

JANUARY 9, 2009

Wall Street Journal has published an opinion written by Drs. Chopra, Ornish and Weil.

Below is my submission to the letters to the editor:

Dear Editor: The article by Chopra et. al summarizes my journey as a physician. I chose family medicine as my first specialty. The reactive nature of primary care where the system was overwhelmed with treating symptoms of patients precluded the possibility of providing a systematic proactive approach focusing on prevention.

I pursued further training through preventive medicine residency which included a master's degree in public health. The additonal training provided me with a valuable systems perspective. Our current health care model is largely based on social conditions prevailing in the early part of last century where infectious causes of diseases were most frequent. Today, the disease frequency has shifted to chronic illnesses where therapeutic lifestyle change has been shown to work.

As part of my residency, I also worked at Kaiser Permanente's Preventive Medicine Department and Positive Choice Wellness Center where health appraisal program identified individuals with high risk of developing chronic illnesses and therapeutic life style change was prescribed by physicians and implemented by nurses and counsellors. Another benefit of the preventive medicine training was academic training of evaluating evidence. The difficult part of evaluation of evidence is not evaluation but education of professionals and public of complexity of conditional truths rather a simple generalizable truth. I have written several review papers evaluating the effectiveness of acupuncture and other modalities for treating medical condition. The result is complex. While acupuncture does not appear to be effective as a sole therapy for addiction, there is a solid evidence for acupuncture for treating knee pain due to osteoarthritis.
Complexity is compounded by professional researchers who are not experts in the modality and experts in the modality who are not researchers collaborating.

After the preventive medicine residency, I was fortunate to be accepted to the residential integrative medicine fellowship program at University of Arizona founded by Dr. Andrew Weil. The program provided hands-on clinical training and academic training from evidence based medicine and complexity theory to total quality control. Since graduation, my attempts to help a healthcare system implement integrative medicine has been challenging. Most systems want a cosmetic integrative medicine program benefiting marketing position of the system. I have not yet found a system willing to use integrative medicine to revolutionize health care outcome.

Today I practice integrative medicine where I provide mindful choices to medicine. Patients needing medications are prescribed, patients needing specialists are referred, and the majority of patients needing healing are assisted with making the therapeutic life style change. To put it simply, it is common sense that we treat patients with cheaper and safer treatment modalities before exploring more expensive and risky procedures.

The quality of health care in the US has been deteriorating despite growing costs of health care. The burden on people are increasing and the access of healthcare is decreasing. We are in a desperate need for an overhaul of the system. The new system needs to take account of the fact that we need a new model based on current prevalence of chronic illnesses. I view the current economic crisis and the new administration a dangerous opportunity (characters combined meaning crisis in Chinese) for creating a model health care for the world in this century. Is there enough courage and political will to do so? For all of our sake, I hope so.

Yoon Hang "John" Kim, MD MPH FAAMA
Director
Georgia Integrative Medicine

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