Positive Health Online

I am starting this brief article by looking at boundaries between some complementary professions, but where this takes us is revolutionary – so please read on even if the words osteopathy and chiropractic make you glaze over!

It is ironic that even as the trend towards a degree of integration between mainstream and complementary medicine evolves, there remain so many defensive obstacles to the integration of complementary medicine within its own boundaries.

It is true that when groups of, say, osteopaths, insist that post graduate courses be restricted to osteopaths only, this may be to guarantee that a homogenous background can be assured, with no terminology or conceptual difficulties. On the other hand this reason for maintaining exclusivity seems unnecessarily rigid, not to say perverse, in the light of current standards in, say, chiropractic training.

So while many courses, run by both these professions, are open to graduates of the other – by no means all are, and so there remain strong political and professional defences between these two most accepted and 'integrated' complementary professions.

And when it comes to allowing, say, sports massage therapists to join such study programmes, the barriers are even more difficult to cross.

When the theories and concepts which underpin osteopathy and chiropractic are examined it is easy to see that historical differences have largely been dissipated as research validates aspects of these, and modifies others, so that an analysis of what the two groups of professional bodyworkers believe is now very much the same (although the language used to describe these beliefs is not always the same which can be confusing) and the techniques used in treatment and rehabilitation, is ever more uniform.

Indeed, in my personal experience of teaching groups of all of these professionals, when physiotherapists who have been trained in modern manipulative methods, are compared with osteopaths and/or chiropractors or, also in my experience, with well trained massage therapists who have learned advanced soft tissue manipulation, there is very little difference, one from the other, except for the letters they use after their names!

And what of integration by individual practitioners and therapists?

It is clearly possible to integrate various beliefs and techniques within one practitioner's scope of practice. There are many who use both manipulative methods, acupuncture, herbal approaches and nutrition in helping their patients towards better health by removing obstacles to recovery, and improving function, in one way or another.

This is a form of integration which, in the UK at least, is only possible logistically if post-graduate training is available, since full time training in all these approaches would mean that the individual would not start to see patients until early middle-age!

But there is a single discipline which encompasses, in its training, all of these – and other – disciplines – American Naturopathic Medicine, as taught at one of the three, 5 year training establishments in the USA (in Washington State, Oregon and Arizona). These graduate doctors of naturopathy who are licensed to practice as primary care physicians in about a dozen of the US states, with almost equivalent scope of practice to MDs. And what do they learn during their five years: apart from an identical premedical training to that studied by prospective MDs they learn nutritional, herbal and homoeopathic medicine, manipulation, acupuncture (and Chinese herbal medicine), psychotherapy and counselling, as well as hydrotherapy and, as an option, midwifery.

That's what I call integrated medicine!

Is there an equivalent training in the UK? Well at this time it is largely a matter of individual practitioners learning what appeals to them, after they graduate with a first qualification, building up their armamentarium, so to speak.

This is what I did after graduating as a naturopath and osteopath almost 40 years ago, by training in acupuncture, cranial osteopathy, aspects of psychotherapy as well as orthomolecular nutrition and many forms of manipulation not included in my original training – a process which continues to this day.

There is one full time degree course (BSc Hons.) in naturopathy, in the UK.

However, the British model of naturopathy is a watered down version of the more eclectic US (or the German) model. Nevertheless this training (at the British College of Naturopathy and Osteopathy with the degree validated by the University of Westminster) provides a way into this broadest of healing approaches, in which the lifestyle and habits of the individual are evaluated and the innate healing potential of the body is encouraged.

As outlined in previous articles in this series, a number of UK universities now run complementary medicine degree courses and it is now possible, by careful selection of modules and pathways, to emerge with a degree which is, in all but name, a naturopathic one.

This together with further postgraduate training – at present to masters level, but within a few years hopefully to PhD level, will allow an individual to learn a clutch of disciplines which complement each other, and which allow for truly holistic practice.

But how long will it take to train enough people in these ways to make a significant difference?

Is there another way forwards?

Heretical as it may seem, the way forward might be to offer GPs the chance to learn to teach their patients the basics of nutritional medicine, enhanced stress coping skills, simple herbal and (non-constitutional) homeopathic prescribing (as examples), basic acupuncture and bodywork skills.

Many GPs are interested, and an example which is worth reflecting on is the fact that over the past 10 years or so the team led by David Taylor Reilly, at Glasgow's Royal Homoeopathic Hospital has been able to offer basic homeopathic training to fully 20% of Scotland's GPs. This phenomenal achievement shows what can be done, and might well indicate the way forward – to teach GPs to be naturopaths!

Now that would be integration, and would put those osteopaths and chiropractors, who maintain their petty boundaries, to shame.