Alternative Medicine and Complementary Therapies: An Interview Guide
During your medical interview you may be asked questions on alternative medicine and complementary therapy. This is a quick guide to these concepts and the pros and cons of these therapies, as well as how to answer a question on whether the NHS should provide them.
Firstly, it’s important to distinguish between alternative medicine and complementary therapy. Alternative medicine is therapy taken instead of conventional treatment, whilst complementary medicine is taken alongside conventional treatment. This is quite an important distinction! Most therapies can be taken alternatively or alongside treatment, so it’s important to know a patient’s intentions when it comes to seeking non-conventional treatment.
Some of the forms of alternative medicine and complementary therapies include:
Homeopathy (trace amounts of a substance used therapeutically)
Acupuncture (needles inserted into skin)
Aromatherapy (essential oils and aromas)
Reflexology (a system of massage)
Hypnosis (induced suggestive semiconscious state)
Herbalism (therapeutic use of plants)
Chinese Medicine (a combination of the above originating from China)
Chiropractic Care (diagnosis and manipulative treatment of joints)
Some of these therapies have been studied and are no better than placebo (homeopathy), some have some limited evidence for them (chiropractic), and many can be dangerous depending on what the therapy is and how the therapy is given. For instance, acupuncture may be harmless, or it could cause transmission of blood borne diseases if needles are not sterile or are reused between patients. Additionally some of these are already used controversially in conventional medicine, such as hypnosis in psychiatry.
What are the advantages of complementary therapies?
Advantages of complementary therapies include a high level of contact time between therapist and patient, which can be therapeutic in itself. There are often limited side effects or physical components to the therapy, so it does not do physical harm to the patient. If there is a spiritual component, this may help fulfil a more holistic role in the patient’s needs. Even if they don’t treat underlying conditions, they may have a role in reducing side effects. Additionally, they may simply be safe forms of placebo, which does have an influence on treatment and can be powerfully effective in reducing symptoms by itself.
What are the disadvantages of complementary therapies?
Disadvantages of complementary therapies include the fact that they are not evidence based. They are often poorly understood, and some involve taking substances that may be toxic or interact with conventional treatments. An example of this would be St John’s Wort, which is often taken for depression and may be effective at treating this, but has interactions with many common medications including warfarin, antihistamines, statins and migraine drugs. Additionally with complementary therapies, poor regulation allows abuse of patients by untrained practitioners and those simply looking to earn money. Training is not standardised or medical, which can result in harm to patients.
What kinds of questions might I be asked on complementary therapies?
Should the NHS provide complementary therapies? Why/why not?
What is your opinion on alternative medicine and complementary therapy?
Would you recommend complementary therapy to a patient?
How should I answer questions on complementary therapies?
For a question on whether the NHS should provide complementary therapies, it’s possible to argue yes or no, but be prepared to justify your answer either way. If you argue yes, you should note the current problems with complementary therapies and be prepared to provide solutions for these problems. For instance, osteopaths and chiropractors now need to be registered in the UK in order to practice, and can be recommended by GPs. This legitimises the profession and standardises the care given.
It’s worth noting that some therapies are already provided. Osteopathy is recommended by NICE for back pain, and Royal London Hospital for Integrated Medicine offers treatments including acupuncture, aromatherapy (massage using essential oils), chiropractic, homeopathy, massage, osteopathy and clinical hypnotherapy to deal with the psychological problems caused by illness. GPs may choose to offer complementary therapies themselves, thus reducing problems associated with poor regulation and lack of medical training.