1. Medical Knowledge Systems

2. What are they? As with many things in life there are a few different approaches to medical knowledge. Think of it like different political parties - different ways of viewing same general topic

3. Is there only one way? You wake up one morning with severe back pain. Pain killers take the edge off the pain but doesn’t get rid of it. What options do you have available to you? How do they make decisions regarding your treatment? 3 major types of knowledge systems studied in class:  Traditional  Evidence Based  Complimentary

4. Traditional Medicine The WHO defines traditional medicine as:  “the health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being

6. Traditional Medicine Characteristics of Western and Native American Medicine Western Medicine Focus on pathology and curing diseases Reductionistic: Diseases are biological. Treatment should produce measurable outcomes. Adversarial medicine: How can I destroy disease? Investigate disease with a “divide and conquer” causes and effects of disease in the physical realms. Health history focuses on patient and family Intellect is primary Physician is an authority Native American Medicine Focus on health and healing the person and community Complex: Diseases do not have a simple explanation. They are not always measurable. Teleological medicine: What can the disease teach the patient? Is there a message or story in the disease? Looks at the “big picture:” the emotional, environmental, social, and spiritual. Health history included the environment Intuition is primary; healing is based on spiritual truths Healer is a health counsellor and advisor Source: Cohen (2003). (adapted by Broome 2007)

7. Evidence Based Emerged in 1990 “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients” It involves tracking down the best external evidence with which to answer clinical questions. Based on a 5 step process 1.Asking Focused Questions: translation of uncertainty to an answerable question 2.Finding the Evidence: systematic retrieval of best evidence available 3.Critical Appraisal: testing evidence for validity, clinical relevance, and applicability 4.Making a Decision: application of results in practice 5.Evaluating Performance: auditing evidence-based decisions

8. Complimentary Include a wide variety of healing approaches and therapies Combined with conventional (evidence based) medicine Examples:  Chiropractor  Massage Therapy

9. Alternative Often fall outside of the boundaries of mainstream medicine Ex. Instead of chemotherapy using a special diet to fight cancer.

10. Which is the “right” one? What do you think? Are any of them infalliable?

11. Activity: How can each of these systems be implemented together to support the health and wellbeing of an individual?