CME credits and reality

Thank you to Dr Lloyd Oppel for stimulating me to respond to and put into context his very one-sided article entitled “Reality check needed for CME credits” (BCMJ 2007;49[3]:109), which included a partial, out-of-context reference to the workshops I have been presenting to doctors for the past 15 years.

Firstly, Dr Oppel is losing credibility by using his position as chair of the BCMA’s Alternative Therapies and Allied Health Committee to espouse his personal anti-complementary and integrative medicine beliefs (see Globe and Mail, May 1999). His involvement in the very unscientific “harm study” on complementary medicine reviewed recently in the BCMJ is a classic example of his bias. Fortunately, powers wiser than Dr Oppel have seen it very fit to maintain an open and curious mind regarding complementary approaches to medicine including the University of Toronto, University of Victoria, and the Canadian College of Family Physicians of Canada, to name just a few who have invited me to present workshops over the years.

The main theme of my workshops is the “Spirit of Medicine” or “Spirituality and Healing.” Many physicians have found it extremely rewarding to sit in a “talking circle” with fellow physicians and share their often poignant stories in an open and nonjudgmental way (viz Dr Rachel Remen, professor of family practice, University of San Francisco). I have seen discouraged and exhausted physicians who were on the brink of quitting the profession gain new insights and awareness and return to medicine with a renewed enthusiasm. The techniques and exercises (holotropic breathing, meditation, etc.) that I include in the workshops come from an eclectic range of spiritual and bio-energetic techniques including Native North American tradition (I have facilitated sweat lodges for many years), Tibetan Buddhism, modern group psychotherapeutic techniques (men’s groups in particular), Christianity (music of Taize, France), Islamic culture (prayer techniques) and biblio-therapy (the writings, art, and poetry of William Blake). 

Over the years I have evolved a “generic” form of spirituality which enables all spiritual beliefs and practices to be accommodated while respecting the boundaries of one’s own traditions. Participants leave with a reawakened sense of “what works for them.” They remember that “feelings” and “intuition” are just as important as “thinking” and “reason.” I have come to realize over the years that we as physicians are stumbling into a potential new role as “spiritual guides” in the 21st century—we were never trained for this but society sometimes expects it from us. Physicians are the most grounded and least gullible group of individuals I have had the pleasure of working with and any fear that CME credits are going to turn us into “quacks” as Dr Oppel fears is groundless. I have always maintained that the scientific method is supreme in the dyad of art and science but that it cannot stand alone. We must always embrace them both in our daily lives.

With regard to the work of Adam, the young man with healing gifts that Dr Oppel partially quotes, those interested should read his books or attend a workshop before expressing an opinion. We have nothing to fear from him and perhaps can gain some insights into other ways of perceiving—ways that we once understood but have since forgotten. His workshop, incidentally, was not eligible for CME credits as Dr Oppel implied.

—Stephen Faulkner, MBChB
Past President,
Association of Complementary and Integrated Physicians of BC

Dr Oppel replies

Dr Faulkner identifies Adam Dreamhealer as a “young man with healing gifts” and feels readers should read his books or attend his workshops before coming to an opinion about his alleged ability to cure cancer from a distance using quantum healing. While some people may agree that this kind of homework is necessary, others may be more interested in reading some of the skeptical accounts of this issue ( e.g., http://dreamhealer.blogspot.com/).

Dr Faulkner is right to call for open-mindedness in this area, but this should not be translated into gullibility. Modern medicine has quickly adopted as mainstream any proven therapy, and quantum healing would be no exception. Critical observers will be disappointed to discover that Adam Dreamhealer has declined offers to have his abilities objectively tested. While the “Dreamhealer” workshop was not specifically awarded Mainpro CME credits, it was a major part of an event that was. More interesting is that credits for this were given both in 2005 and then again this year.

As much as I admire Dr Faulkner’s efforts to “evolve a generic form of spirituality” and as much as I agree that the practices he espouses address many people’s unmet psychological needs, I must point out that similar efforts have long been underway in all cultures and have typically and appropriately found a home in departments of theology or religious institutions. What would be of interest from a CME perspective is an understanding of why people have these needs, how these beliefs can help people cope with fear, uncertainty and illness, and what drives patients to perceive inert therapies as being effective.

Dr Faulkner refers to a study on advice from CAM providers I helped conduct. The survey sought to determine the views of BC physicians on the effect and quality of medical advice from CAM providers. Unlike most literature on CAM, this survey gave respondents an equal opportunity to identify both positive and negative aspects in a variety of areas. The study presents some striking information about CAM providers (especially negative messages about immunizations). Positive responses were also obtained, although physicians in this survey overwhelmingly felt the medical advice given by CAM providers was of poor quality. I was disappointed that Dr Faulkner felt this study was biased, because I agree with Dr Faulkner’s view that “Physicians are the most grounded and least gullible group of individuals.” 

—Lloyd Oppel, MD
Chair, Allied Health and Alternative Therapies Committee