You are cordially invited to attend the AUGUST 2010 health talk/workshop which will take place at the HEALTH FOR LIFE alternative health store and Deli at the Gardens shoppings centre Gardens on Wednesday night,25TH AUGUST ,2010 at 7.15pm.

Please RSVP as soon as possible so that correct catering and seating facilities can be arranged by phoning 021-4611450.

I look forward to seeing you there.

Kind regards
Allan

Does Current Research Methodology Pose an Obstacle to Integrated Health Care?

'There is a principle in scientific research that you must not distort the phenomena that you are trying to study.'
(David St George, 2000)

'When Newtonian science fails to yield a good enough answer, then it should be abandoned rather than pursued further in attempting to force a square peg into a round hole.'
(Richard Kradin, 2008)

After working for more than ten years as an editor-journalist, Sandra Cattich qualified as a Doctor of Acupuncture and Traditional Chinese Medicine (TCM) plus in an integrated Complementary Medicine degree at the University of the Western Cape, and is now working in private practice as an acupuncturist and herbalist. In her comparison of Western and Eastern diagnostic and treatment approaches, she highlights some of the key differences between Western and Chinese medicine, demonstrating how these play out in the field of modern Western medical research.

One of the obstacles to integration of Western and Eastern medicine lies in the research methodology adopted by Western medicine, namely, the randomised controlled trial (RCT), which remains situated at the top of an evidence hierarchy: 'RCTs are currently considered the gold standard for evaluating the effects of a medical intervention' (Sherman, 2008). Yet it is easy to find abundant literature to imply that both conventional and complementary medicine recognise the limitations of RCTs. So why do RCTs continue to hold sway over policy makers, health insurers and fund allocators?

The study of 'integrated' medicine presents us with an improbable marriage. On the one hand we study RCTs which try to eliminate observer, patient and doctor bias. These typically derive from a context in which 'science' attempts to understand biochemical cause and effect in pharmaceutical drug trails based on a reductive cellular-pathology model of disease (Walach, 2002). On the other hand we study the practice of Chinese medicine in which the doctor assesses, engages with and manipulates the patient's Qi in an attempt to stimulate the patient's innate self-healing, self-regulating abilities (Schnyer, 2008).

In the former, the hopes and expectations of patient and doctor potentially threaten to undermine the validity of experiments originally designed to discover biochemical pathways: mind and body must be separated not to obscure perfect understanding. In the latter, intent and awareness of doctor and patient play an active role in healing the body; they become powerful tools in a world where Qi
interacts with mind and body, where Qi is conceived as 'a generative matrix in which all things interact with all other things through the exchange of information' (Schnyer, 2008).

To ease these opposing tensions it seems necessary for any researcher of TCM to become more reflexive: to become aware of how we acquire knowledge from two vastly different cultures of medicine. This involves an epistemological analysis of what two broad cultures perceive as important.
In her talk, Sandra outlines the underlying assumptions of RCTs in conventional Western medical research and contrast these with some of the Chinese medical philosophies that underlie Chinese medicine practice, in order to show how poorly designed RCTs potentially reduce, distort and disrupt the philosophical and theoretical framework and practice of Chinese medicine.

Sandra shows that when we view the patient-doctor interaction as intrinsic to the Chinese medicine process, and use the theoretical framework of Chinese medicine as our starting point, we are still able to employ respectable and 'scientific' research methods to create essential groundwork for more systematic scientific research, opening the way for integrated health care in a primary health care setting.