Four Medical Futures: A Framework for Dialogue

If you had to choose, which Future would you prefer?

FUTURE ONE: HI-TECH MEDICINE

It is twenty years in the future. Over the past two decades, Americans have come to appreciate allopathic medicine--the medicine of pharmaceuticals and surgery--more and more. Stunning advances in painkillers, surgical techniques, gene therapy and neurological drugs have done much to combat cancer, AIDS, heart disease, depression, and a host of chronic illness, including those stress-related. New technologies in diagnostics, telemedicine, and informatics have also allowed great improvements in the ability to provide care and its quality. As these strides were made, Americans began to grow disenchanted with alternative medicine and saw it more for what it was--a fad, with little strong evidence of its effectiveness.

As a result, today, although allopathic techniques and technologies have advanced greatly and brought relief to the suffering of many, little has changed in the fundamental way medicine is understood: it is our tools have dramatically improved.

FUTURE TWO: EVIDENCE-BASED MEDICINE

It is twenty years in the future Over the past two decades, Americans have come to realize that while allopathic medicine has been a fantastically successful science, “alternative” medicine offers some useful new techniques. For situations where they have been proven in clinical trials to be effective, alternative therapies such as acupuncture, meditation, and massage have entered the medical mainstream.

As a result, today most health centers now have some alternative therapists on their staff, although the core of medical practice has remained the same. Schools teaching complementary/alternative therapies have proliferated and these professions have become licensed and regulated, with strict quality standards.

Today, we have grown to respect our qualified alternative therapists as legitimate partners in health care.

FUTURE THREE: DEEPLY INTEGRATIVE MEDICINE

It is twenty years in the future. Over past two decades, we have come to accept that allopathic medicine is not the only effective type of medicine, and cannot always succeed in making us healthy. At times, it has failed outright. Our doctors gradually began to acknowledge that alternative schools of thought--such as Oriental medicine, ayurveda, and indigenous healing traditions--have equal validity, and should be incorporated into standard medical practice. Clinical trials are a western invention, so we have dropped our insistence on them as a condition for accepting these therapies.

As a result, today new primary care physicians entering the profession are as comfortable at prescribing Chinese herbs and faith healing as they are at ordering CAT scans and performing surgery. They are as comfortable at diagnosing "deficient chi" as they are of diagnosing appendicitis. Standards of practice are set and maintained by the acknowledged experts in these various medical traditions. Today, "alternative" medicine is alternative no longer.

FUTURE FOUR: HOLISTIC MEDICINE

It is twenty years in the future. Over the past two decades our conventional health care system has suffered a deep crisis of public confidence. With its overreliance on drugs and expensive technology, and decades of rigid thinking and institutional inertia, the medical establishment refused to accept alternative medicine as its equal. So over the years, Americans increasingly abandoned conventional medicine for alternative approaches that suited them better. We have come to realize that to be healthy means being strong not only in body but also in mind and spirit. We now believe that many illnesses are symptoms of a deeper spiritual and environmental crisis that comes from a society out of balance. We have made our planet, and ourselves, sick.

As a result, today there are fewer doctors because we have become our own healers. Of course, there are still emergency rooms for when we need them. But now, when we fall ill, we are far less likely to go to a hospital, where the symptoms might be relieved but not the causes. Instead, we are more likely to try to heal ourselves first through personal actions (such as prayer, home remedies or lifestyle change), or by seeking the support of a spiritual counselor or an alternative therapist of our choice. Ironically, the medicine that years ago was sidelined as "alternative" is now at the center of our lives.

2009 Karlo Berger. Some rights reserved. Website Design by Solid Uncoated.
Thanks to Hannah Burr, Kristin Granli, and Jim Kelly.

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Four Medical Futures: A Framework for Dialogue