Sylvia Thompson talks to Dr David Reilly about combining orthodox and complementary medicine
A survey of more than 200 patients in a National Health Service (NHS) general practice where homeopathic treatments were prescribed found the number of consultations with GPs were reduced by 70 per cent in a one-year period and in the same period, expenses for medication were reduced by 50 per cent.
Another study of some 800 patients treated with homeopathic medicines, where conventional treatment had been unsatisfactory or contraindicated, found that 61 per cent of patients showed substantial improvement.
These examples of the benefits of integrating complementary therapies into mainstream medical practice form part of an emerging model of medicine which will be discussed by Dr David Reilly, consultant physician at the Centre for Integrative Care, Glasgow Homoeopathic Hospital at a talk in Dublin tomorrow.
Even while still at medical school in Glasgow University, Scotland, David Reilly began to question "the mechanical and disease oriented medicine" he was being taught.
But, rather than give up, he vowed to try to change things and over the past 25 years, he has worked to advance the concept of "individualised whole person care" and the importance of the "therapeutic consultation".
Following his graduation in medicine in 1978, he studied a range of "healing systems" including homeopathy, acupuncture and hypnosis. He became lead consultant at Glasgow's NHS Homoeopathic Hospital (GHH) 10 years ago. His postgraduate courses in homeopathy attract 20 per cent of Scotland's GPs. He also teaches a module on human healing (which examines the divide between mind and body and between art and science) to third- year medical students at Glasgow University.
"One of the biggest problems is that patients are falling through the cracks in an over-specialised system. Through my training as a hospital doctor, a general practitioner and now as consultant physician at the Glasgow Homoeopathic Hospital, I am meeting patients for whom the best of orthodox medical care has failed.
"You have to take the whole person into consideration and look at what emotional or psychological processes can be impairing progress and the management of their condition. There are often cases when patients are in secondary care [seeing specialists] showing psychological or emotional problems which were overlooked in primary care," he says.
"Many doctors have a desire to engage with their patients but the system design is mitigating against them. If you consider that the average GP consultation here is about nine minutes and that in Japan, it is four minutes, you can see where things are going," he says. Dr Reilly believes the answer lies in breaking the cycle of fragmented medical care and keeping more patients in primary care.
"A survey of GPs in Scotland found that only one in five think they succeed in giving acceptable holistic care and more than 70 per cent admit that they prescribe in cases when they would otherwise not have needed to prescribe because of constraints of time and pressure. Sixty-seven per cent of these doctors admit to referring patients to hospital specialists when they think in other circumstances they wouldn't have needed to. And, if you add in a drugs bill that is up 50 per cent in three years, I see a relationship between a secondary care system which is overloaded and individual patients who are moved from specialist to specialist and prescription to prescription."
Dr Reilly believes the solution is not only in more patients being treated in primary care but also, a firm emphasis on the therapeutic encounter or consultation. While visiting Dublin this week, he will give a workshop on the importance of the therapeutic encounter to health professionals here.
"Much of the therapeutic encounter is founded on good human engagement and relationship. The current system design is failing to give opportunities for ordinary human engagement.
"I believe many healthcare practitioners study complementary therapies as a response to the dehumanisation of medicine and because these therapies re-legitimise the value of the human encounter.
"When I talk to doctors after they have trained in complementary medicine, they say things like 'it has rekindled in me the whole person approach to treating patients', or 'I now see the whole person and not a biochemical puzzle to be solved'," he explains.
Dr Reilly believes that within the medical model itself, the relatively new field of psychoneuroimmunology recognises the unity of the human being, rather than the mind/body split of traditional orthodox medical theory.
So what is behind the concept of integrative care? At GHH, patients can be treated using orthodox medicine, homeopathy, acupuncture and herbalism and physical therapies such as massage, the Alexander Technique and pilates. Good nutrition and self-help approaches such as meditation are also available.
"All of our team - doctors, nurses, physiotherapists and occupational therapists - are medically trained but they have expanded their skills through a range of complementary medical approaches. There is no conflict between the therapies and the team members don't hold to the traditional mind/body divisions of orthodox medicine," he explains.
The architect and artist designed hospital, which has a 14-bed inpatient unit, a day centre, outpatient unit and a landscaped garden, has won accolades as a contemporary model of excellence of a healing environment (See also www.ghh.info).
However, Dr Reilly cautions that the use of complementary medicine in and of themselves doesn't always guarantee a more holistic approach. "Indeed, the individual could end up with more fragmented care. We need something in the middle - a whole person approach which is neither just orthodox medicine or complementary and the primary care system is the traditional repository of this," he says.
Dr David Reilly will speak on Emerging Models of Medicine from the Centre for Integrative Care, Glasgow Homoeopathic Hospital, at the Concert Hall, RDS, Ballsbridge, Dublin on Wednesday at 6pm. This is part of a series of talks marking the international celebrations commemorating the 250th anniversary of the birth of the founder of modern day homeopathy, Dr Samuel Hahnemann. Admission free but reservations are essential on tel: 01 2407256 or email lectures@rds.ie