Current Status of Health Care and Medical Education in Canada
Health care in North America is dominated by allopathic (Western) medicine, while other treatment modalities, such as chiropractic, massage, naturopathic, reiki, traditional Chinese medicine/acupuncture are considered by the main-stream sector as complementary medicine. The training of medical students at the 16 medical schools in Canada is based on an evidence-based principle, although more recently the patient-centered approach has been introduced. Although inter-professionalism has been introduced to include nurses, physiotherapists, and social workers in the team work concept, but other health care practitioners (“complementary medicine”) have not been involved. More recently, the concept of integrative healthcare has been addressed in the US medical schools, but the development in Canadian medical schools are rather limited if not at all. The Complementary Alternative Medicine for Undergraduate medicine (CAM UME) project ran from 2003- 2015 in Canada, but was not that successful. Currently a new project entitled Can Academic Consortium for Integrative Health Education is being organized. However, all these activities were centered in medical schools and does not involve any CAM colleges and professionals. It is hypothesized this is because there is significant peer pressure on medical faculties and medical professional associations against advocating for CAM.
Changes in Public Attitude Towards Health Care
With the advent of the internet, the publics are exposed to a wide range of digital information about health, consequently it has empowered them to take charge of their own health. Some patients have lost confidence in what the allopathic establishment has to offer, due to lack of effectiveness of the therapy and/or the adverse side effects of the treatment. Accordingly, some have turned to complementary therapies. Unfortunately, some of the decisions were made in the absence of creditable evidence. Medical educators have recognized this shift in public altitude and have attempted to address this with the introduction of some integrative health aspects in the curriculum. However, there is no attempt to encourage real integration, no CAM practitioners are directly involved, and there no concept of shared treatment.
Challenges in delivering integrative health care. It is expected that physicians will remain as the primary gate-keeper of health care. What we would like to address is how to deliver the essential elements of what is considered as “medicine for the future”, which is stated as “Patent-centered, evidence-based, comprehensive and shared treatment”. There are clinics advertised as integrative medical centers”. Basically, practitioner of different disciplines have offices in the same site but working independently, and there is little collaboration in patient care to deliver “shared treatment”. It is apparent that changes are needed for better patient-centered health care.