Friday, 15 December 2017
Starting the Conversation - By Robin Daly, founder of Yes to Life
In any conflict, there are forces at work maintaining division, suspicion and mistrust in order to keep the sides fighting and true to the cause. There are a myriad of ways to do this with propaganda, disinformation, fear-mongering and more. It’s really not that hard to create division in the world.
And then there are forces working to bring peace, resolution and reconciliation. For these there really is only one tool at their disposal: dialogue. It may seem a poor balance of odds, but this one strategy really is a powerful one. If the foot soldiers on either side of a struggle should ever get to talk to each other, they quickly find that, contrary to the propaganda, the enemy are simply other people with similar concerns, needs and hopes to their own. They quickly discover that both sides have been puppets of powerful forces at work to actually gain in some way from the continued struggle, and for whom they have been paying a high price, at times the highest price - their life.
Medicine is one such conflict, with the forces of conventional medicine ranged against ‘natural’ approaches in a struggle that seeks to force people into taking sides, to box them into the simplistic black and white, propaganda-driven world of good versus bad, science-based versus ‘dangerous’, proven versus ‘no evidence’. And people are paying a high price, sometimes the highest, for forsaking all the resources only available from the ‘opposition’. For example, conventional techniques can be life-saving for people with cancer, but all too often the accompanying side effects create new forms of suffering both in the short term and sometimes for life, for which there is little on offer. In contrast, the world of ‘natural’ and ‘lifestyle’ medicine excels at protection against damage, and prevention and management of side effects.
As in war, dialogue is the only way out of this tragic state of affairs. As long as nutritionists and oncologists keep each other at a safe distance, then they can continue believing the quackbusters’ tabloid-style characterisation of nutritional science as ‘nutribollocks’ (yes that is a direct quote!) and the conspiracy theorist’s labelling of conventional oncology as just ‘cut, burn and poison’. But start a constructive conversation, one that centres on the common ground they share - the wellbeing of patients - and you could soon be generating some mutual respect that might even lead to useful collaboration.
A constructive conversation is exactly what we had in mind for this year’s Yes to Life Annual Conference, ‘Starting the Conversation - exploring ways in which integrating conventional cancer care and lifestyle medicine can improve outcomes’. The morning sessions featured a formidable lineup of forward-thinking NHS health specialists, people who have themselves already started to explore the wealth of resources for patients that sit outside of conventional thinking and practice. And the afternoon showcased many of those resources, alongside some inspiring projects where collaboration is already well under way.
‘Integration’ is the aim of the conversation and the collaboration. Integrative Medicine, or, in the specific area of cancer, Integrative Oncology, aims to bring together the best resources from the widest possible spectrum of approaches, and to combine them in ways that exceed the potential of any one approach alone. It’s a powerful formula that has the potential to fill some of the most glaring ‘gaps in care’ that our NHS suffers from. Successive governments have, for decades, been pressing for ‘patient-centred care’ and ‘patient choice’. But step into a modern oncology unit, and you’ll be hard-pressed to find anything even vaguely approaching this. It seems that, on its own, the NHS simply can’t escape the old ‘Doctor as God’ model. In contrast, approaches such as Naturopathy or Functional Medicine are the very embodiment of a person-centred approach. Here you will find ready antidotes to the criticisms most often levelled at the health service: scarcity of time and attention, lack of care and compassion, conveyor belt treatments, toxicities and side-effects of treatments, and so on.
In Britain, we are shockingly far behind some other countries in embracing integration. The ability to stoically resist this patient-driven revolution seems to be a negative aspect of our national healthcare system. We may pay for our care in the UK, but we are far from being customers with expectations of personal service. Fortunately though, we are blessed with some pioneering doctors who are paving the way towards a new kind of medicine in which patients are equal partners in the quest for health and wellbeing. Leading the vanguard is Dr Rangan Chatterjee, GP, Functional Medicine Practitioner, and BBC TV Doctor in the House. Dr Chatterjee is singlehandedly opening up new avenues to health for viewers across the nation and simultaneously inspiring GPs to respond to their patients’ needs in an entirely different way. We were extremely fortunate to be able to interview him for an exclusive video for the conference.
The conference ‘hit the ground running’ with a talk from the passionate and inspirational patient advocate and bestselling author Sophie Sabbage, giving the patient perspective on the need for integration. Her talk titled ‘Caught in the Crossfire’ outlined clearly how it is patients who pay the price for the continued hostilities between professionals.
We were also fortunate to be host to the UK oncologist who is leading the field in the adoption of lifestyle medicine, Professor Robert Thomas. A genuine trailblazer, Prof Thomas offers all his NHS patients a lifestyle consultation. In his presentation, he demonstrated his clear understanding of, and support for nutritional and lifestyle approaches, bemoaned the unscientific messages from mainstream medicine regarding the role of sugar in cancer, and introduced us to some of the high quality trials of natural approaches he has initiated.
Two other GPs presenting at the conference are also engaged in tackling the status quo. Dr Rupy Aujla is passionate about cooking and nutrition and is starting an approved training course for GPs to raise their understanding of the direct relationship between food and health. Dr Malcolm Kendrick chooses to ignore the divide between conventional and other approaches, instead relying on his own assessment of the evidence and the balance of risk to benefit, a position that is entirely in tune with patient-centred care and patient choice.
The potential for integration was laid out in the afternoon sessions, with expert input from Nutritional Therapist Liz Butler, Medical Herbalist Claudia Manchanda, Food and Environment Scientist Dr Robert Verkerk, Functional Medicine Practitioner Meleni Aldridge, and a presentation on the benefits of Hyperbaric Oxygen Therapy (HBOT) by Mark Boscher of Herts MS Therapy.
Alongside these presentations we were introduced to two examples of integration at work, clearly to the benefit and the approval of patients:
The NHS PREPARE for Surgery programme is a collaboration between exercise specialists and oncology staff to improve the results and the experience of surgery. Lizzy Davis of CanExercise joined NHS colleagues Hayley Osborn and Maria Halley to share their passion for the scheme and its successes.
Dr Catherine Zollman, Medical Director of Penny Brohn UK and Oncology Nurse Susie Budd introduced us to the working partnership developing between the charity and oncology services in Bristol that is bringing a marked improvement to the patient experience of undergoing conventional care.
The conference set out to demonstrate that the aims of integration are directly in line with established government policy, that integration works for everyone involved, and that movement towards integration is finally under way. It was also to provide inspiration to the many who have yet to experience firsthand any progress towards those elusive goals of patient-centred care and patient choice, from some real-world pioneers and working examples within the NHS. Change is indeed afoot, and we are all needed to maintain the momentum that has been generated. The battle certainly isn’t over yet, but the conversation has begun.