Medical Knowledge Systems

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

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

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

Traditional MedicineCharacteristics 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)

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 process1. 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

Complimentary• Include a wide variety of healing approaches and therapies

• Combined with conventional (evidence based) medicine

• Examples: Chiropractor Massage Therapy

Alternative• Often fall outside of the boundaries of mainstream medicine

• Ex. Instead of chemotherapy using a special diet to fight cancer.

Which is the “right” one?• What do you think?

• Are any of them infalliable?

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