Yesterday I read a smear piece on a holistic doctor who is “anti-medicine” according to the journalist because she is critical of conventional approaches to mental illness. I’m not even going to share the piece as I think it’s a classic example of tabloid style click bait not even worthy of linking to in a blog post. In my opinion many holistic or integrative doctors are actually more like medical minimalists rather than anti-medicine practitioners, and I think there’s an important difference.
What is medical minimalism? It’s a cautious, critical and big picture approach to the use of pharmaceutical medicines. Medical minimalists use drugs only when they believe they are truly needed or helpful. When they do use medicines they use the lowest dose possible to get the desired result because they acknowledge the risks involved. They openly embrace lifestyle interventions as valid, and sometimes preferable to drugs and continuously apply a big picture cost benefit mentality to all their recommendations.
Medical minimalists are not against the use of drugs across the board but they use sparingly, or not at all depending on the illness or patient in question. They don’t believe drugs are necessarily bad but that the use of them can be destructive if better options are ignored. Just like minimalists believe less is more, medical minimalist believe less medicine can sometimes mean greater health. Since there isn’t research into the effects of prescribing a cocktail of different meds at once medical minimalists tend to avoid cocktail scenarios. They prescribe one thing at a time or give their patients a pep talk about lifestyle and diet.
Here’s an example of a very honest psychiatrist I came across on youtube who discusses the limitations of his prescriptions. Whilst he still prescribes at times when he believes it’s needed (always at the lowest dose possible) his aim is to get people off medications eventually and offer talk therapy and other strategies that he believe are more effective at helping people thrive for the long haul rather than just “getting through.”