The Therapist Conundrum
The United Kingdom boasts, to my mind, one of the most incredible health services on the planet. Free at the point of delivery, the amount we pay in our National Insurance Contributions isn’t arduous and for most, a year’s payments would barely cover an overnight stay in a hospital let alone any extended treatment.
The pressures on staff and resources that we are currently witnessing, is placing an enormous strain on this, the crown jewel of our country. Various parties have played political football with the NHS over the years and we are at crisis point in many areas.
This is not a political or social comment on the state of the NHS by the way. There are good things and bad things about any system, but I know from visiting other countries, we will miss it when its gone! The strains on the service in the UK combined with certain underlying principles of approach, have prompted many to go in search of private health care, and private health insurance is a growing market.
There is however a third tier to the health system. Unregulated for the most part, yet with millions of adherents and customers and turning over billions of pounds. It is of course complementary medicine. Those with half an ounce of previous experience will know that going to the GP with aches and pains is, quite rightly going to get you with nothing more than advice to take some paracetamol and keep moving about.
The evidence suggests that this isn’t bad advice, but for many, there are longer term issues that they feel only a visit to a non-pmary health care provider will address. The list is endless. Chiropractic, Osteopathy all kinds of massage, Bowen, Reflexology, Cranio Sacral and so forth. One of the largest associations in the UK, the Federation of Holistic Therapists, has over 20,000 members, all of whom one assumes has some degree of work going on from week to week.
The cri de coeur of the medical profession is that there is little or no evidence for these therapies and that they have no credence from a health perspective. Whilst the ‘no evidence’ claim is out dated and tired, much of what is on offer on the high street could be seen as questionable. Yet there is a mountain of evidence relating to hands on and manual therapies, as well as the role that guided movement therapies have for a whole range of issues.
Although CAM therapies are often criticized for being used despite a lack of evidence, hundreds of systematic reviews have, in fact, evaluated specific CAM therapies; of these, some have been well conducted and have shown that the CAM therapy offers a clear benefit. State of Emerging Evidence of CAM
More to the point however is the role that this industry plays as a sticking plaster to the NHS. Imagine a scenario where all therapies were banned tomorrow and anyone with any kind of ache or pain had to report to their GP. A system strained to capacity already would collapse before lunchtime.
Dr Phil Hammond, he of MD in Private Eye, has never been an advocate of Complementary Medicine, but argues the case for this third tier being taken seriously. So are ALL doctors agains CM? While there is a large degree of scepticism from them, there is also an acceptance that therapies play a role in the overall management of patients and their ailments.
The industry is, for the most part unregulated. Chiropractors and Osteopaths being the exception are regulated in the same way as doctors, dentists and pharmacists, being part of the nine health care regulators in the UK alongside the General Medical Council and the HPC, which is the body regulating social care.
The question in this forum is; should Comp Med practitioners have access to educational dissection classes that enhance their knowledge? It seems obvious that any further training or anatomical education is only going to enhance the skill set of these practitioners, as well as by extension, increasing the protection offered to the public.
The die hard, old school academics out there might disagree and there have been many (successful) attempts to keep the doors closed to those who they personally consider unworthy. Dr Ian Scott of Nottingham University Hospital is one such academic who is happy fabricating evidence to support his own personal views, closing down a wider engagement.
Ultimately a bonafide interest in anatomy and the human body, based on a daily practice and with good reasons to wish to study, seems good enough reason to engage in a dissection class. Those who want to attend my classes are asked to provide a CV and a brief personal statement, explaining why attending a class would be of benefit to their work. Their work is checked and they are sometimes interviewed over the phone as well.
Times are changing and the hope is that eventually we can bring a wider knowledge base to bear across all health disciplines.