Doctors urged to take holistic approach

The Jakarta Post, Jakarta

Medical doctors are being advised to take a holistic approach when diagnosing their patients, especially those possibly suffering from heart disease, in order to ensure more effective medication and to minimize incorrect diagnoses.

Cardiologist Lukman Hakim Makmun, the chair of a symposium titled the Holistic Approach to Cardiovascular Disease, said on Friday a holistic approach to diagnosis took into account all aspects of the patient, including all of the patient's organs and any psychological conditions and social problems that might trigger stress.

Supporting Lukman's statement, Miftah Suryadipradja, a cardiologist and one of the speakers at the symposium, said heart disease never stood alone.

"It is usually related to other organs like the brain, blood vessels, the kidney, lungs or stomach. Medication, therefore, should not be given before considering the condition of the other organs," Miftah said at a media conference after the opening of the three-day symposium.

"For example, a doctor may give aspirin to treat a case of heart disease, but the doctor must consider the condition of the stomach. If a patient has a stomach problem then aspirin must not be given to him because it will worsen his condition," said Lukman.

"It cannot be assumed that a pain on the left side of the chest indicates something wrong with the heart; it could be caused by a strained chest muscle.

"A problem with the heart might also be caused by external factors like stress. A doctor, therefore, must consider external problems to deliver efficient medication," he said.

Focusing only on the heart could make a doctor miss the real cause of a disease, he added.

Another medical expert, Iskandar Zulkarnaen, who chairs the Continuing Medical Education (CME) program at the Internal Medicine Division of the University of Indonesia/Cipto Mangunkusumo Hospital, said holism was not a new method.

Indonesian medical students are taught to take a holistic approach early in their studies, Iskandar said.

"It is strongly advised that doctors specializing in internal medicine, who have sub-specialties like heart or lung diseases, consult with doctors from different sub-specialities for the sake of effective medication," Iskandar said.

This is the second time the symposium has been held by the Indonesian Cardiocerebrovascular Association (IKKI), in cooperation with CME.

"We are considering inviting public health experts next year to promote a thoroughly holistic approach," he said.