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 Interviews with People Who Make a Difference: Natural Health, Natural Medicine 
 
Interview with Andrew Weil MD
   as interviewed by Daniel Redwood DC

Andrew Weil, M.D. has for the past two decades made a unique contribution to the mainstreaming of natural medicine. He has set a high standard in a field that needs high standards, presenting a well reasoned, impeccably documented and intriguingly creative body of work. He is one of a small number of holistic physicians to hold a faculty position at a major medical school, and is an internationally recognized expert on medicinal plants, drugs and drug abuse, altered states of consciousness, and alternative and natural medicine.

Born in Philadelphia in 1942, Dr. Weil received an A.B. degree in biology (botany) from Harvard in 1964, and an M.D. from Harvard Medical School in 1968. After completing a medical internship at Mt. Zion Hospital in San Francisco, he worked for a year at the National Institute of Mental Health, and then wrote his first book, The Natural Mind.

From 1971-75, as a Fellow of the Institute of Current World Affairs, Dr. Weil traveled widely in North and South America and Africa collecting information on drug use in other cultures, medicinal plants, and alternative methods of treating disease. From 1971-84, he was on the research staff of Harvard Botanical Museum and conducted investigations of medicinal and psychoactive plants.

At present, Dr. Weil is Associate Directory of the Division of Social Perspectives in Medicine of the College of Medicine at the University of Arizona, where he teaches alternative medicine, mind-body interactions, and medical botany. He has a general practice in Tucson, focusing exclusively on natural and preventive medicine and diagnosis of difficult health problems. He is the President of the Center for Integrative Medicine and the Beneficial Plant Institute.

Dr. Weil writes a regular column for Natural Health magazine, and is the author of many scientific and popular articles and five books: The Natural Mind, The Marriage of the Sun and Moon, Chocolate to Morphine (with Winifred Rosen), Health and Healing, and Natural Health, Natural Medicine. His website can be viewed at: www.drweil.com and his email is nathealth@aol.com




Interview with Andrew Weil, M.D.

Dr. Redwood:
What led you into the Healing Arts in the first place?

Dr. Weil: I was always interested in things biological. I went to medical school with the idea of getting a medical education, not of becoming a doctor. I had an intuition that a medical degree would be very useful to me, and I wanted that education. It also put off making a decision about what I wanted to do. So I really didn't see myself as practicing the healing arts for a long time. I became very disillusioned with the kind of medicine that I was being taught, so when I finished my basic clinical training, I really dropped out of that world, and found ways to travel around. I was mostly living as a writer, and observing other kinds of healing practices. It was only after some time that very gradually I was drawn into practicing.

DR: if you were to briefly summarize the principles of natural health, what would you say they are?

AW: The first is that the body has a healing system, an innate healing potential that can be accessed in many different ways. That is the foremost principle of natural health and natural medicine. Secondly, that the optimal treatment is that which minimally impacts the physical body and maximally accesses the healing system.

DR: To what degree has our knowledge of body-mind interactions grown in recent years, and how much of this knowledge is being well-utilized by physicians and other health practitioners on a daily basis?

AW: There has been a tremendous increase in public consciousness of mind-body interactions, but I'm not sure we know any more about it than we ever did. You can look back to the last century and people obviously had a lot of observations about mind-body interactions. The problem is building these into our conceptual framework of health and healing. My sense is that in conventional medicine today, although there is lip service given to the mind and mind-body interactions, despite all of these books and television programs, there is very little use being made on a practical level of that theoretical knowledge.

DR: What kind of changes in medical education and practice do you think could improve that?

AW: I think they would have to be sweeping. And sometimes, at my most cynical, I think the only way we'll see that is if alternative kinds of medical schools start. I really am deeply pessimistic about the prospect of curriculum reform. They are constantly talking about reforming the medical curriculum, and all it is is reshuffling the deck and dealing it out in a different order. I don't see fundamental change happening.

I am working on a project now which I'll give my best shot. We have a unique chance at the University of Arizona College of Medicine to make some change. We're going to start a fellowship program in "Integrative Medicine." We'll start by offering one year fellowships to people who have completed family practice and internal medicine residencies. This will be a one-year fellowship in training on how to combine the best ideas and practices of conventional and alternative medicine, with a strong emphasis on healing, natural healing, mind-body interactions, and so forth. Our hope is that this will grow into a residency program, and eventually into a track that will begin in the first year of medical school. So we're going to try.

DR: Are there other such pilot projects taking place elsewhere in the medical education world?

AW: There are individuals like me at various schools, mostly teaching elective courses. Columbia University was just given a large grant to start a center in alternative medicine. I don't know of any place that has the full institutional support of a medical school, with good prospects for financial backing, that we have at the University of Arizona. We really have a very large vision of trying to start a residency training program in a new kind of medicine.

DR: What were the circumstances at Arizona that brought this about?

AW: Well, an odd combination of things. I am here by pure chance--my car broke down here 21 years ago. It took six weeks to get fixed, and I never left.

DR: What a great story.

AW: I would never have thought I would be living in Arizona. I always had a vision of Arizona being very politically conservative...

DR: Which in some ways it is.

AW: Yes, although Tucson is a liberal pole of it. But the regulatory laws in Arizona, including the medical licensing laws, have a kind of Wild West laissez faire flavor which is unique, except for Nevada. Nevada and Arizona are the only two states that have a Homeopathic Board of Medical Examiners under which people doing unusual practices can get licensure, that rivals the regular Board of Medical Examiners. So Arizona has been a kind of haven for people practicing alternative medicine. The third naturopathic college in the United States just opened here in Phoenix. Canyon Ranch is here, which is the spa that has the greatest commitment to preventive and alternative medicine. And I'm here, and have been teaching courses in alternative medicine. It's just a continuing set of favorable circumstances that have made this possible.

DR: Some holistic medical physicians are pressured by their state boards to discontinue some or all of their unconventional practices. Some have lost their licenses. What do you think is a fair way for boards to both protect the public and allow for something other than lowest common denominator care?

AW: I think that boards should have consultants who are experts in alternative medicine, that they should inform themselves about what is legitimate and what might not be legitimate in alternative medicine. I think the first criterion always has to be whether there is a potential for harm. In general, boards are unlikely to take action against physicians unless there are complaints by patients. A lot of this comes down to the relationship that doctors form with patients, rather than what they're doing. But I think there is great need for education of medical boards.

DR: I want to ask your opinion of the Clinton Administration's health reform proposals, and the other health reform plans in congress.

AW: I am delighted that at long last the federal government is looking at this issue, which should have been addressed a long time ago. It seems unconscionable to me that the richest nation in the world can't provide basic access to health care for all its citizens. At the same time, having seen a little bit of Medicare, I am not very enthusiastic about the prospect of having the federal government run this. And also, I think that the Clinton proposals don't go to the level at which change needs to happen.

DR: What is that level?

AW: I think there really has to be complete rethinking of the nature of medicine, and people's expectations of it. Not simply worrying about who pays for it, as it's now set up.

DR: Tell me more about the deeper level at which public policy should address this.

AW: I think we have an economic crisis in health care because this is an outward sign that the paradigm from which medicine operates has really reached the end of the line. The philosophy of medicine that's in place now is one that says diseases mostly have external causes, that you deal with diseases by developing weapons against agents of diseases, that there's extensive reliance on technology, and that we don't look at the natural healing mechanisms of the body. All of that has led us in a direction that has us on the edge of bankruptcy. And we're not going to change that just by figuring out different ways of reimbursing.

DR: Do you believe that modern Western medicine is a sustainable system for the long run? And if not, why not?

AW: No just because it's too expensive. For that simple fact it just cannot be delivered to the people who need it. And it has become so wedded to technology and so ignoring of natural healing potentials of other methods of intervention which are much more cost-effective.

DR: When there's an emergency situation that requires high-tech care, I don't think anyone I know would be in favor of withholding it. But how do we break out of this cycle where we lurch from crisis to crisis?

AW: First of all, I think a lot of hospitals are going to go bankrupt, and we're going to be left with regional centers at which all the high-tech stuff is done. The main problem is to teach both doctors and patients to sort out those conditions which should go to conventional medicine. You know, of the total number of sick people going to doctors, maybe 20 percent of them have conditions for which conventional allopathic medicine is appropriate. If we restricted that kind of medicine to that percent, we would not be in the kind of economic trouble we're in now. But we're trying to use this for every thing, and it doesn't work for the vast majority of problems.

DR: What do you think are the pros and cons of managed care and HMOs with regard to these questions?

AW: A major con is that doctors who work in them lose all autonomy. They are essentially told how to practice, how much time to spend with patients, what to do in certain conditions. It really has taken away all of the individual autonomy that has made the practice of medicine very interesting and very rewarding. I guess on the pro side, as a stopgap measure it has made the delivery of care economically viable, at least for a time.

DR: Do you see any way in which HMOs could become true wellness centers?

AW: That would be nice. I don't know. One idea that I have that I'd like to see happen, something that I'm going to work at, is that I would like to see a new kind of institution that's somewhere between a spa and a hospital coming into existence. I think a lot of people now go as inpatients to hospitals who could much more profitably be treated in centers of that sort, where they would learn about what healthy lifestyles is, how to do it, and come out knowing more than they went in with about how to keep themselves healthy.

DR: Is there any country whose health care system provides a good model both for holism and social justice?

AW: I would look at Germany and maybe Switzerland. There are definite areas in which they're ahead of us. There is much greater interest in natural medicine. There are more doctors who practice it, there are natural pharmaceutical companies, there is s system of reimbursement for stays in spas and healing centers. So there are certainly things there that we can learn. But with that possible exception, I don't know that there are any other models to look at.

DR: I know that you travel to Japan periodically. What is their health care system like and what lessons can we learn from the Japanese experience?

AW: A lot. We can see many of the faults of our own system blown up to even greater proportions. Japan has national health insurance--there are no competitors. National health insurance in Japan pays 100 percent for procedures and zero percent for consultations, so there is no incentive for a doctor to talk to a patient, and there's a great deal of incentive for doctors to do expensive tests. The average doctor may see 30 patients an hour. Two minutes with a patient--they're called "two-minute doctors." Patients never ask doctors questions. That's just not done. It's very authoritarian. There are enormously lengthy hospital stays.

DR: Why?

AW: Because everybody makes money from it. It's fully paid for by insurance. It's very common to put patients in hospitals for four months, or six months for things where we'd put them in for a few days. But this is fully reimbursable under Japanese health insurance.

DR: Is there no co-payment? Is it 100 percent reimbursement?

AW: Yes. There is also a very unhealthy relationship between doctors and pharmaceutical companies in Japan. A pharmaceutical company will often supply a new doctor in practice with a year's worth of free drugs, which the doctor then sells to patients.

DR: In our country we have historically had a division between the prescribing physician and the dispensing pharmacist, specifically to avoid this sort of conflict of interest.

AW: Exactly. You can see how that's a real area of abuse in Japan. The Japanese build a lot of the machines that we use in our medical centers, CAT scanners and MRI scanners. Every local Japanese hospital has one. The same problem exists here, but it's worse in Japan, because there are more of the machines around. And in order to recover the costs, there is enormous incentive to use them, and this is also payable through insurance. So there is a tremendous amount of [diagnostic] testing.

The rate of coronary heart disease in Japan is much lower than in the United States, probably because of diet primarily. But the rate of doing coronary angiograms is the same. So that means that if you have the misfortune to have chest pain anywhere in the vicinity of a Japanese hospital, they're going to do an angiogram on you, whether you need it or not. These are just some of the ways where you can see the kind of problems we have, blown up even bigger.

DR: Which traditional healing systems from other cultures do you have the most familiarity with, and how compatible are they with contemporary medical practice?

AW: I have a fair amount of familiarity with Chinese medicine, which I think at root is not very compatible with Western medicine. It's based on totally different conceptions of health, illness and energy. And yet it's odd that it has become one of the most established in this country. Acupuncture is practiced by many physicians in medical centers. There is increasing use of Chinese herbal medicine. It's become very accepted.

I'm a great fan of manipulative medicine [manual manipulation of the spine and other joints], and I see that beginning to be incorporated into more mainstream medicine. I think that's potentially very compatible with conventional medicine, as is naturopathic medicine.

I'm really interested in all the mind-body interventions, which I think are all potentially very compatible with standard medicine. It's just that most standard doctors don't know how they are used or don't think to use them.

DR: If you were to attempt to project a generation or two into the future, what kinds of changes would you anticipate in terms of the boundaries between the health professions?

AW: I certainly think we're going to see the appearance of wellness centers and healing centers. Some will be these inpatient facilities that I mentioned and others may be clinics where many kinds of practitioners work under the same roof. I think that's definitely going to happen. And we'll see about this effort that I'm making to create a field of integrative medicine. There's high potential there to turn out medical doctors who are familiar with these other techniques and willing to work with other practitioners.

DR: I've found your writings on the placebo effect to be both original and fascinating. What is your current thinking on placebos and on spontaneous remission from disease?

AW: I still think that placebos are really the meat of healing interactions. They are examples of pure healing responses from within that are triggered through the mind by belief. The mind is only on avenue to the healing system, but it's a very interesting one and the advantage of it is that it requires little external paraphernalia, and there's no [side effect of] toxicity involved. So I think the placebo response is the greatest ally that a practitioner has, and that the best kind of medicine is that which elicits the maximum placebo response with a minimum direct impact on the physical body. So I'm a big fan of placebo response, and I really try to get people to think differently about them.

DR: And remissions?

AW: I'm working on a new book called Spontaneous Healing, which should be published next year by Knopf. I'm not using the term "remission" in the title, for two reasons. First of all calling it remission implies that it's temporary, that it's going to come back. And in genuine healing, the problem is dealt with. Secondly, remission has a strong connotation of cancer, and I am interested in all healing responses, not just cancer. One of the problems I see made in the field (such as it is, it's a very tiny field) has been to look entirely at cancer. I think that's a mistake, because if you look only at cancer, you get very little sense of how powerful the body's healing system is, and how widespread are the kinds of conditions in which it operates.

I'm very much interested in the complete disappearance of back pain, autoimmunity, allergies, all sorts of conditions, including serious conditions. I'm looking at all of these examples of healing, I think that in general this is a field that has been just totally ignored by medical research. When doctors come across cases of it, they tend to wonder at it, maybe the ignore it, maybe they look at it, but they tend not to let these kinds of cases influence their general thinking about health and illness. And I think this should be a major focus, or the major focus, of medical research and practice as well.

Daniel Redwood is a chiropractor and writer who lives in Virginia Beach, Virginia. He is the author of A Time to Heal: How to Reap the Benefits of Holistic Health, and is a member of the editorial board of the Journal of Alternative and Complementary Medicine. He can be reached by e-mail at Redwoods@infi.net. A collection of his writing is available on the World Wide Web at http://www.doubleclickd.com, and also on the New Age Forum of the Microsoft Network.

©1995 Daniel Redwood, D.C.
   
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 About The Author
Daniel Redwood, DC, is a Professor at Cleveland Chiropractic College - Kansas City. He is editor-in-chief of Health Insights Today (www.healthinsightstoday.com) and serves on the editorial boards of the Journal of the......moreDaniel Redwood DC
 
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