I and others of like mind have been railing against the hopelessly divided systems of “orthodox” and “complementary” medicine for more than a decade. Now, finally, the new buzzword is ‘integrative medicine’, and not a day too soon in my opinion.

There are some hopeful tentative signs alluded to in this issue that the Great Divide between Complementary and Allopathic Medicine is slowly being bridged, although serious issues illustrating mutual distrust and ignorance still remain.

First the good news. Certain health insurers are now starting to reimburse policy holders for various complementary treatments such as osteopathy, chiropractic, acupuncture and homoeopathy, using criteria of training, experience and GP referrals to define the status of eligible complementary practitioners. (See the Health Insurance Special Feature, pages 36–46.) The process of integrating complementary medicine and therapists into the wider health care system has been proceeding for some years; the exposure of conventional doctors to complementary therapies and of therapists to the realities of general practice has led to a useful “rubbing of shoulders”.

Now for the bad news. According to research published in Italy, although Italian oncologists estimate that some 84% of cancer patients use complementary therapies, fully twenty percent of Italian oncologists admitted that they had no knowledge of complementary medicine. (See Crocetti et al, page 53.) Obviously these physicians will be of little or no help to their cancer patients in their choice of therapy. In the USA, while almost 60% of people use complementary medicine, barely 50% of these people actually tell their physician, preferring not to be subjected to judgmental attitudes or narrow mindedness of some conventional doctors (see Elder et al, page 53). It is encouraging that in the UK a majority of British medical students indicate that they want to learn about complementary medicine (see Rampes et al, page 53), foretelling of a rosier future where complementary therapies are introduced to medical students, and perhaps at a later date made available to study as an elective speciality.

After all, despite complaints made by some complementary therapists regarding the lack of openness to novel approaches by conventional medics, most therapists are very respectful of the solid clinical training and experience in anatomy, physiology, biochemistry and pathology provided to medical practitioners and allied professions. It is in large part this training that enables medical doctors to diagnose as well as treat medical conditions. Since most complementary practitioners are not currently trained to the same clinical standard as medical doctors, the majority of complementary therapists require a diagnosis and referral from a medically trained doctor.

The torturous issues of training, standards and qualifications have by now arrived on the doorstep of virtually every complementary therapy. Each discipline is now in the process of setting standards for their training curriculum. This is not particularly easy, given the wide diversity of training schools, traditions and practitioners, even within each profession. However, the difficulty of the task should not put us off holding the vision of a future integrated healthcare system, where every therapist is solidly trained to a rigorous standard. This will only enhance our confidence in the therapist and the therapy.

This issue also features a sobering article regarding the potentially explosive time bomb of a Hepatitis C epidemic (see page 47). While about 250–500 million people worldwide are estimated to have been exposed to the hepatitis C virus, about 500,000 in the UK where only 6000 have been diagnosed, a majority of these individuals are completely unaware of their infection, due to its complicated clinical picture and difficult diagnostic procedures.

Whichever features capture your attention:  Mind – The Enneagram, Autogenic Therapy, NLP; Healing – Reiki, Feng Shui; Herbal Medicine; Bodywork – Chiropractic and McTimoney Chiropractic and Neuroskeletal Dynamics, this issue provides substantial food for thought, digestion and pleasure.