The divide between alternative and allopathic medicine dates back to the 1800s and, albeit shrinking, is still very much present today. 

As much as public interest in alternative medicine seems to have grown outside of clinic doors, the irritation and dismissive avoidance of the matter among healthcare providers seems to have intensified behind them. 

As a friend and family member to several people who struggle with chronic conditions and have an interest in alternative medicine, I have seen them time after time return from appointments feeling dismissed, disappointed, and ever-more distrustful of the allopathic medical community. 

I am also, however, a part of that medical community as a medical student myself, and so I have also seen (and experienced firsthand) the frustration toward patients who come to clinic with persistent skepticism of allopathic medicine and a strong, almost exclusive preference for alternative treatment. 

Standing between these two very different head-spaces, I would like to make the argument that thoroughly addressing patients’ concerns and preferences around issues like these is an integral component of a physician’s work that is far too frequently overlooked; considering the relationships, patient outcomes, and medical ethical virtues at risk, the discussion of these issues is not something to be swept aside. 

To judge the legitimacy of a treatment modality solely based on its categorization between allopathic versus alternative medicine is to make an emotional decision more so than a rational one, and therefore to put our scientific integrity (and, by extension, our patients’ well-being) at risk. If this sounds extreme, consider how allopathic medicine garners its authority — from consistent and rigorous application of the scientific method.  

To dismiss (practically or conversationally) any treatment method without first adequately studying it by truthful and thorough implementation of the scientific method is nothing short of unscientific and in direct opposition with three of the four virtues that we hold central to western allopathic medical ethics: beneficence, nonmaleficence, and patient autonomy. 

 Beneficence — the virtue of maximizing benefit to the patient — is put at risk when we overlook any potentially helpful intervention.  

Nonmaleficence — the virtue of minimizing harm to the patient — is put at risk when we fail to consider potentially less invasive/aggressive treatments that could pose fewer risks to the patient, or when shutting down the conversation around alternative medicine leads to an unfavorable and/or dangerous interaction between pharmacologic agents and herbal supplements that a patient may be taking. 

Patient autonomy — the virtue of facilitating the patient’s ability to make informed decisions about their own healthcare and protecting their right to do so — is put at risk when we deny the patient access to informed conversations and resources (i.e. patient education) about the potential benefits and risks of pursuing alternative treatments. 

 Ultimately, concerns and preferences around the issue of alternative treatments will find their way into the clinic regardless of whether or not said treatment has been adequately studied. In the face of repetitive shutdowns of communication from the physician’s end, these concerns and preferences may be channeled into unfavorable changes to the patient-provider relationship. It may manifest as a patient’s reluctance to be completely honest in conversations about their daily practices and preferences of care for fear of being condescended to, and/or – in its end-stage – a flat refusal to cooperate with screenings and diagnostics, treatment plans, or allopathic medicine altogether. 

 In keeping with the movement towards “holistic” medicine and the central principles of western medical ethics, these concerns and questions are just as much deserving of the physician’s attention as anything else a patient brings into the clinic that has a significant impact on their well-being. 

 I would urge all practicing and future physicians to take this into consideration. Addressing these issues may be irritating, but it’s an important part of our work and the Hippocratic Oath that we took to get here. 

— Kelsey Adler, M.D. Candidate, UI Carver College of Medicine