Let's face it, we have created an increasingly divided medical system that resembles a form of apartheid. This medical apartheid is, not surprisingly, a reflection the polarized society in which we live. The etymology of the term "apart-heid" essentially translates into "separate" "hood." The unnatural divide has reached extreme proportions as the balance of power tips more in favor of modern technological medicine with each passing decade. The pervasive influence of the medical-industrial complex has become so routine that we tend to equate medicalization (the expansion of medical authority into almost all aspects of our lives) with good medicine. The medical profession, once a personal calling to soothe the suffering and heal the sick, has instead become a profit-seeking corporate conglomerate whose primary purpose is to sustain itself.
Our current medical apartheid found its beginnings in the early 1900's at a time when there were multiple distinct schools of medical thought, including the eclectic, osteopathic, homeopathic and naturopathic schools. In 1910, the Carnegie Foundation published a critique of all existing medical schools called the Flexner Report. (1) The Federation of State Medical Boards was subsequently founded in 1912 and this organization took its marching orders from the AMA Council on Medical Education. (2) The net result was the virtual abolition of all schools that did not conform to conventional biomedical standards. Ever since the Flexner Report gave the upper hand to the "regular" school, as it was known at the time, the deck has been stacked against those who choose to look for answers beyond the politically sanctioned boundaries of conventional heath care.
There are a variety of forms of medical apartheid:
Certainly, one cannot overlook the medical apartheid that took the reprehensible form of medical experimentation on blacks throughout American history as documented by Harriet Washington in her book, "Medical Apartheid." Another glimpse of this stain on the American medical soul was recently spotlighted when evidence was uncovered that U.S. sponsored medical experimentation took place in Guatemala where subjects in prisons and mental hospitals were intentionally infected with gonorrhea and syphilis. Please note that I am in no way comparing the forms of medical apartheid discussed in this article with these dark chapters in our medical history.
With that said, medical apartheid exists on a number of other levels, first and foremost at the level of the haves and have-nots. The number of Americans without health insurance currently stands at 50 million--a number that is beginning to approach 20 percent of the U.S. population. This disgraceful state of affairs is, in actuality, a function of a pyramid scheme wherein monetary resources are funneled away from doctors, patients and other health care professionals, toward the insurance industry, pharmaceutical companies, medical technology companies, administrators and CEO's. Keith Olbermann's television coverage of the forsaken throngs of regular Americans seeking health care from the traveling free clinics designed to serve the have-nots depicts a stunning and sad spectacle that should make one's stomach turn.
On a more fundamental level, the same medical apartheid that became systematized in 1910 continues to exist between conventional and alternative forms of medical treatment. The unprecedented power and influence of the modern regular school and the American Medical Association makes it a near impossibility to introduce new and innovative ideas, other than the enormously expensive technological advances that characterize much of modern medicine. The net effect is to deprive patients of methods of healing that can be safer, more effective, less invasive and less expensive. Modalities such as acupuncture, homeopathy, chiropractic, herbal medicine, Ayurveda, energy medicine, Chinese medicine and spiritual healing, in addition to various forms of self help such as nutrition, yoga, meditation and tai chi, are just a few of the low-tech healing resources that the conventional medical system fails to consider for membership in its exclusive pharmaceutical-surgical club. The pervasive intolerance and discriminatory policies perpetuated by the medical establishment are clear and undeniable.
At an even deeper level, we are divided by a philosophical form of medical apartheid. While modern medicine continues to cling to its outdated mechanistic and materialistic conceptions of human health and illness, many holistic forms of healing strive to incorporate the reality that there is more to medicine than the simple mechanical repair of the physical body. The very foundation of this reality includes a much more expansive conception of the mental, emotional, spiritual, energetic, social and ecological dimensions of human health, all of which are inextricably interrelated and can have a profound impact upon each other--and upon the physical body.
On a practical level, there is also a methodological form of medical apartheid. Conventional medicine relies heavily upon a rational, quantitative approach that emphasizes lab values, diagnostic imaging, statistical analyses and other measurable data. Many holistic approaches, in contrast, place greater importance upon first-hand, empirical, experiential information. The rational approach tends to demand explanations before it will believe that something is possible. Holistic approaches tend to emphasize tried and true methods that work, regardless of whether they can be explained in terms of the biases of a conventional medical worldview.
The bias of conventional medicine prevents it from understanding how insensitive its practitioners can be, for example, when they dismiss the first-hand reports of patients as irrelevant "anecdotal" evidence. The very same "anecdotal" information may be invaluable to the practitioner of an alternative healing modality.
Other forms of medical apartheid include separate medical schools, separate medical journals, and separate medical societies. The interests of alternative practitioners are often calculatedly excluded from these entities. The irony here is that adherents of mainstream medicine frequently call for "proof" as to the value of a particular alternative therapy, only to turn around and reject the validity of relevant research when it is presented to them. This hypocritical double standard becomes abundantly clear when we hear frequent faux cries of concern about the safety of supplements and nutritionals while certain pharmaceuticals that are documented to have taken many lives remain on the medical market.
Medical apartheid even influences the way different categories of patients seek different forms of care. Most patients that patronize alternative practitioners tend to be relatively well-off individuals (they can afford therapies not covered by insurance), women (men tend to be more skeptical), and the well-educated (many people are simply uninformed about the existence of other medical options). On the other hand, we are aware of the tendency for the poor to seek routine acute care in very expensive emergency hospital settings. A more level playing field would allow all citizens access to the benefits of both conventional and unconventional therapies.
The time for meaningful change is long overdue:
In spite of overwhelming evidence as to the value of alternative modalities, practitioners and their patients remain second-class citizens for no rational reason other than that they do not conform to the materialistic bias of mainstream medicine, and the unconventional therapies that they choose are not seen as profitable enterprises that can be exploited by corporate interests. To be sure, there are extremists on both sides of the fence that work hard to maintain the separate and unequal status quo. However, there is absolutely no reason why the two worldviews cannot find a middle ground--a synergistic relationship that would benefit patients and that might relieve some of the pressure that conventional patients and practitioners feel to conform to medical authority, and some of the isolation that alternative patients and practitioners can experience when they choose the road less traveled.
It is time to bring down the walls of medical apartheid. The divide is unnecessary, unproductive and unbecoming of the medical profession. Medical apartheid serves neither patient nor practitioner. It keeps us all hostage to a form of state sanctioned corporate medicine that, like the financial industry, serves mostly its masters. Democracy, diversity and freedom of access and choice are the features that characterize the emerging green medical revolution, which will allow all parties to exist side by side with mutual respect and appreciation for the value that they bring to the integrated medical whole. We must aspire to a system that incorporates the best of all medical worlds for the betterment of all citizens.
(2) Starr, Paul, The Social Transformation of American Medicine: The rise of a sovereign profession and the marketing of a vast industry, Basic Books, 1982, p. 121
Coulter, Harris, Divided Legacy: A History of the Schism in Medical Thought, (4 volume set), 1975 - 1994
Larry Malerba, DO, DHt is the author of GREEN MEDICINE: Challenging the Assumptions of Conventional Health Care, published by North Atlantic Books and distributed by Random House. He has been a practitioner, educator and leader in the field of holistic medicine for more than 20 years.
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