Preconceived notions on healthcare.... help or hindrance?

[Guest will]

I used to have quite a time dealing with colitis, with the typical symptoms making it hard to live and work.

And would never have considered applying to medical school in my previous state.

 

But now I have it completely under control, I work 70hrs a week and have no trouble doing so (before I was lucky to have the strength and time to handle a part-time workload [25 BMs/day and the pain really lowers your productivity])

 

I was hospitalized and put on prednisone and after I was weaned off that I started the typical pentasa course.

This got me out of the running for a bowel resection,

but I was still feeling pretty bad (about 7-8 BMs/day)

 

I got sick of being sick, and now that I knew what was wrong with me, I started to read everything in any journal that spoke of the condition. It seems that practitioners in Germany take a more holistic view of the healing process, often indicating therapy which was never suggested to me (sugarless diet, various herbs, etc) I have found similar suggestions from other MDs on the net, even North American Drs.

 

I used a complete dietary change (0 sugar, eating only natural and unprocessed food, dropped alcohol and basically became a hippie )

Now here is the weird part, my specialist told me to eat whatever I please (since this condition is not helped by diet modification)

 

And when I tell my specialist (or my family practitioner, and a few friends of mine who are Drs) about the success I have had managing my condition this way, they look at me with an odd smirk, and I sense they think diet changes are akin to something like a religious healing. They are happy I feel better but have said that it was merely a coincidence.

 

So what I am wondering is this.

Do doctors and medical students usually consider alternative therapies hokey?

(Often because empirical evidence is lacking on this form of treatment, and indications that this actually works are usually anecdotal in nature [like my story])

 

I like a blended view of medicine, where I am willing to use what works. Combining traditional therapies and non-traditional really seems to have worked for me, but I wouldn’t want to be stereotyped as a superstitious, non-scientific individual, especially in the eyes of someone evaluating my suitability for medical school. Any thoughts? Would I come off this way if I mentioned any of this in an application, or should I keep my opinions to myself?

 

Advice appreciated.

-will

[Guest Liana]

Hi will,

 

I think that a lot of older physicians tend to be fairly narrowminded about the benefits of so-called alternative therapies, but I know that you are seeing more and more serious practitioners with open minds to these areas. Certain schools tend to be more open to research in these areas (for instance, I believe that Mac tends to have a holistic approach to medicine and does tend to be fairly open minded with respect to a lot of things, so this may translate well into the area of alternative medicine; whereas, more traditional schools like U of T may, in general, be more skeptical), and even certain doctors will vary in their level of skepticism/belief. Physicians definitely believe in the power of the placebo effect, so I doubt that even the firmest disbeliever would discourage the use of alternative therapy if it didn't interfere with traditional treatment.

 

Whether or not you emphasize your beliefs in your application is up to you. If I were you, I might mention my success with my own disease, emphasizing my belief that healthcare in the future is in for some changes due to this new found balance between traditional and non-traditional ways of healing (particularly the recent emphasis on the patient as a person, rather than just a disease), but also emphasize that you recognize the dangers of some alternative treatments (eg, the use & abuse of herbal medicines, the dangers of ignoring any form of traditional healthcare in exchange for a questionable holistic regime, etc). Ultimately, the fact that you illustrate that you are knowledgeable in the benefits & disadvantages of this area of medicine, that you recognize an area of healthcare that many are too narrow minded to accept (remember, Columbus was once doubted, too), and that you ultimately recognize that the patient is the one who must make the decisions for him/herself should illustrate you as scientifically knowledgeable, compassionate, and open-minded, three great characteristics for a physician.

 

Congratulations on your recovery & new way of life!

[Guest Carolyn]

There are a lot of physicians who are pretty cynical about alternative ways of treating conditions but there are also a heck of a lot of physicians who respect alternative treatments. Many physicians just believe that until there are good trials, they shouldn't fully support any specific treatment. However, I have met some amazing physicians who regularly prescribe cranberry juice or glucosamine citing some large trials...

 

It is great to hear that nutritional changes worked well for you - that is fantastic. I would think that some nutritional studies have been done and perhaps not shown any benefit but that doesn't mean that changes in nutrition can't show benefit - just the specific dietary changes that were studied!

 

In terms of bringing it up in an interview, I would only bring it up if it were applicable and perhaps use it as an example of how there is still so much that we really don't know about. There are so many topics where there really hasn't been a lot of research done etc. etc. etc...

 

Take care and good luck on the interview.

 

Carolyn

[Guest MDWannabe]

Hi Will,

 

A relative close to me had almost exactly the same experience as you, although he was diagnosed with what was clearly a milder case of ulcerative colitis than yours. Asacol and Cortenema helped to clear up the worst part of the problem, but it didn't completely clear up and he was kept on Asacol. His specialist and family doctor also insisted that diet made no difference to the condition. I believe the thought was that diet could affect the feeling of symptoms, but not the actual condition.

 

My relative did some reading as well, but really started to observe his own responses to various foods, and found that a small change in his diet, ie reduction in fried food consumption and certain types of junk food, had a huge effect on his condition, to the point that he has been symptom free for 5 years.

 

I have since talked to quite a number of doctor friends about the merits of alternative medicine, and clearly there is a lot of hostility out there towards the notion. I believe the concern comes down to the 'hit and miss' approach applied by many who practice in the alternative medicine area, which flies in the face of an evidence-based approach preferred by medical doctors. The concern is that in the absence of established evidence, using herbs and other 'natural' products may cause harm. And just that possibility is clearly a violation of the "above all do no harm" tenet. One ID specialist friend of mine, for example, pointed out that the only reliable data on Echinacea was in the context of AIDs patients - and in that case, patients were found to die earlier than expected using that treatment.

 

Another notion is that some alternative medicine specialists provide a whole barrage of diet changes and herbal remedies and other treatments, when maybe only one factor, ie a healthy diet, is responsible for the whole improvement. In such a case, the patient whose condition improves might swear by the herbal remedies when in fact they play no role at all. Again, all this is a function of the hit and miss approach.

 

I believe that an open mind is key to the practice of medicine. There have certainly been cases when even illogical solutions turn out to be the right ones, so it would be wrong to rule out cures supported by anecdotal evidence. I don't think it's wrong, however, to insist that any remedy a doctor prescribes must be proven and tested, and sure to do no harm. That, I believe, is a responsibility that a doctor cannot fail to live up to.

[Guest bc guy]

DO NOT mention it........a lot of bias out there....

[Guest onionsneakers]

i agree with bc guy. too much bias to make it worth debating in the interview. and i'm from ontario.

[Guest Liana]

I concede..

 

If they directly ask you your views on the emerging area of nontraditional healthcare, then, by all means, voice your opinions (with as much emphasis as possible on your focus on proven benefits and integration of nontraditional + traditional techniques). If it doesn't come up in the conversation, you may not want to grate against any biases; however, if they ask you about your greatest achievement in life, I would still be inclined to mention your complete turn around in your life, if you had no other social breakthroughs to first emphasize (eg, curing cancer or whatnot).

 

If you get accepted, you have three years in which to debate your views with the faculty and fellow med students, and the rest of your life in which to pursue this area of focus. It's usually better to err on the side of conservatism in the interview situation (unless you're feeling daring).

[Guest will]

No sense rubbing anyone the wrong way while being evaluated.

[Guest AniyaSG]

A similar issue came up in one of my interviews... Question was: "Discuss the Bio-medical healthcare model Vs the Bio-Social healthcare model." Yikes! Turns out the interviewer, like myself, really believed in a wider view of patient care. Was good to take it slow to watch his reactions... I'm sure if you take that approach, without getting too detailed about 'alternative' therapies, such as "treating the patient, not the disease", that it can be positive to your interview. Knowing people such as yourself will, that have also had similar problems and found similar solutions, I personally find it impossible to ignore certain alternatives or complements to pharmaceutical treatment of disease.

 

Good luck in your application!

[Guest Ian Wong]

In my UBC application essay, my first paragraph was dedicated in part to my belief that alternative therapies have a part in healthcare. I got into a pretty cool debate with the "bad guy" interviewer at UBC regarding it. When it got right down to him accusing me that alternative medications were hokey, I turned around and asked him about aspirin. Sure, it originally came from willow bark, but even this most popular medication is poorly understood. We still aren't aware of how it really works (sure, it inhibits a key active site on a prostaglandin synthase), but what really happens after that? What happens to all of that reagent that can't be processed now through the enzyme. Does it just sit around and do nothing at all?

 

No one knows.

 

I'm willing to take it on faith that diet, exercise, and a healthy positive attitude with a reasonably unstressful lifestyle is good for you. It sounds as certain to me as the fact that aspirin can decrease pain and inflammation, even though we might not necessarily understand all the steps that lead up to that end goal.

 

Of note is that the past-president of the UBC AIMS Student organization (Alternative and Integrative Medical Society) is in the first year UBC Med class. He was a huge part of that club, setting up annual conferences (which are now ongoing), arranging sponsorship and weekly lectures, etc.

 

If you feel strongly about something, and more importantly can back up your assertions and defend them in an appropriate manner, I say go for it. I think my "bad guy" interviewer respected me a lot more after our debate. He might not have agreed with me, but respect goes a really long way in an interview.

 

Ian

UBC, Med 3

[Guest onionsneakers]

AniyaSG, just out of interest, would you mind elaborating a little on the "Bio-medical healthcare model" vs the "Bio-Social healthcare model?" The word "social" in the second term implies a model of health care that emphasizes societal accessability and which I presume has an inclusive definition of necessary medical care and which would use mostly public funding. The meaning of the word "medical" in the first term is less obvious, although I suspect it's meant to refer to a model that would allow greater privatisation and/or multiple tiers of healthcare..

[Guest AniyaSG]

Onionsneakers: What I guessed at the interview, and what was backed up by my interviewer (which may have little to do with the actual definition but was simply used for interview purposes) was that the bio-social model took into account the "whole person" including social interactions, emotions, etc.. whereas the bio-medical model adressed to a great extent only the problem/disease. For the "Bio-social" model I was instantly reminded of the WHO definition of health which states: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." which I had actually used in my essay for that school... I love that definition! Back to the point, I have no idea what the formal definition is, but the doc that interviewed me certainly believed in the "Bio-social" model, however it is defined. It was a pretty scary question though, made my eyes real big I'm sure...