Ever so often someone writes NYT to push self-health over academic medicine. Below is the origial letter May 14, 2014
Forty years ago, as a researcher at the National Institute of Mental Health, I began to study inexpensive self-care strategies — then called “alternative therapies” — that might address the underlying biological and psychological imbalances that contribute to chronic conditions. These included nutrition, exercise and “mind-body” techniques like meditation, guided mental imagery and biofeedback.
Since then, research has demonstrated that mind-body approaches reduce stress and improve mood and immunity. They decrease blood pressure in hypertensives, blood sugar in diabetics and pain. Dietary modification can play a major role in preventing breast, prostate and colon cancer, as well as in diabetes and heart disease. And exercise, which can help prevent all of these, can also alleviate depression.
We spend about twice as much as many other industrialized nations on health care, often with inferior outcomes. Three-quarters of that spending is on chronic conditions, including heart disease, diabetes, cancer, arthritis, depression and chronic pain — exactly the ones for which self-care is best suited. Comprehensive programs that offer self-care in a supportive group are even more promising, for both treatment and prevention. This approach is also proving effective for psychological trauma. What was unexamined and alternative 40 years ago is now well researched. It should be fundamental. If we are going to reduce our ruinous costs and improve our declining national health, we must make self-care and group support central to all care.
JAMES S. GORDON Washington, May 12, 2014
The writer, a psychiatrist, directs the Center for Mind-Body Medicine and was chairman of the White House Commission on Complementary and Alternative Medicine Policy appointed by President Bill Clinton.
On May 18 NYTimes publishes the best letters. See letters in Sunday Review. The original letter writer aptly addresses the letters. All these letters, but the response, happened the same day (May 14).
The Writer Replies It’s heartening to read the responses to my letter. Dr. Rosenthal and Dr. London clearly recognize the importance of integrating self-care and group support in medical practice; Ms. Broner describes a clinic where this is happening; and Ms. Roman exemplifies active engagement in one’s own care. Each year my colleagues and I train many hundreds of physicians and other health professionals who are moving in this direction. So there is progress.
Formidable obstacles remain, as some of the writers suggest. Powerful financial incentives urge the ordering of superfluous diagnostic tests, hasten the performance of surgeries that may be unnecessary, and push physicians to quickly write prescriptions rather than patiently teach self-care. Though the Affordable Care Act may, as Ms. Broner observes, encourage more self-care, it does not give it the central place it deserves.
Like Mr. Erwin, many physicians continue to question results of scientific studies they haven’t examined. Meanwhile, only a tiny percentage of research dollars is devoted to nonpatentable, low-cost self-care approaches. Even the more open-minded tend to confuse therapies like acupuncture, which requires a professional to administer, with the more fundamental self-care, whose implementation is in the hands of patients.
Perhaps this shouldn’t be surprising. A medical establishment that continues to ignore the ancient injunction for physicians to heal themselves cannot be expected to help its patients to heal themselves. It’s time for all of us to act on this life-enhancing, money-saving wisdom.
JAMES S. GORDON Washington, May 15, 2014