In Praise of the Lowly Clinician
In an Acupuncture Today article by Jake Paul Fratkin, "In Praise of the Lowly Clinician," he states "In no case will I take cases that I feel I have little chance for improvement, and for me, this includes neurological conditions such as Parkinson's, stroke, Alzheimer's or problems due to genetic defects.I also try not to take on patients whose problems are due to over-medication with Western pharmaceuticals, unless they are willing to wean themselves off."
This statement is problematic in several ways. First, as an acupuncture provider, Mr. Fratkin is not in the best position to ascertain when a patient is over-medicated. Such a determination should be made by the patient's biomedical providers trained to assess the need for and impact of pharmaceutical based treatment. Second, by in essence "walking away" from patients that he feels are over-medicated, Mr. Fratkin is not providing help to those who may most be able to benefit from his services, such as patients undergoing treatment for cancer, the elderly, or those living with HIV or in hospice. In each case, these patients may in fact be highly medicated, but still benefit from the care Mr. Fratkin provides. Lastly, if we, as providers, only treat patients who do not have serious medical problems (such as Parkinson's, stroke or Alzheimer's) and avoid patients who are heavily medicated, then we are not providing services to all patients who could benefit from our care.
As an acupuncture provider, I understand that I cannot "cure" all of my patients. There will be patients for whom acupuncture, herbs and the other components of the care I provide will be palliative, and in some cases, unsuccessful. This is not a justification for avoiding challenging cases; those patients whom I may not "cure." I may be able to palliate their symptoms, help them feel more comfortable and reduce their need for medications used on an "as-needed" basis. I understand that there will be patients who should not receive acupuncture care because they are medically unstable or require a level of care that I cannot safely provide. If I can safely and effectively work with a patient, then I want to help. Aren't those whose medical status is the most difficult deserving of our care?
Steve Given, DAOM, LAc