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The Greatvine project – offering advice at a distance…and the problems of offering advice at a distance





A couple of years ago I was contacted and asked to become an ‘expert’ on a new website project – Greatvine.com

The idea was simple but innovative.
Greatvine was recruiting a wide range of ‘experts’ in a plethora of areas of interest.
Each expert would have a dedicated page to which they could upload articles and information sheets, that could either be downloaded by visitors at no cost, or for a modest fee (determined by the expert).
There would also be a system whereby experts could be contacted by phone – (for a fee set by the expert, per minute) – at prearranged times.
The process had teething problems but these have now been overcome, and the site is operational, with hundreds of experts (areas range from health & wellbeing, to finance, parenting, writing and more, with thousands of articles available to download.

The site carries this particular notification about my presence on Greatvine:

Leon would be pleased to advise individuals on any questions involving osteopathy, naturopathic medicine, soft-tissue manipulation, complementary and alternative medicine, chronic pelvic pain disorders, fibromyalgia or chronic fatigue syndrome.

My contact details for Greatvine are: www.greatvine.com/leon-chaitow and my advice line number (UK only) is 0906 194 9628
This is only ‘active’ when I switch on my ‘availability’ button on the site, signifying that I can receive calls to its dedicated number that finds me anywhere in the world. It’s easy to see whether I’m available to chat, as a thumbnail picture appears on the right of the home-page under a heading “Experts Available Now”
At present that ‘available’ button is not switched on much of the time, as I have a variety of writing and editing deadlines to meet…..but given a few spare hours, I will activate it to test out just how many people are interested in actually contacting me for advice —- at a cost. —– as distinct from the many who ask for advice for free.

Advice at a distance….?
When I placed the Greatvine information on my Facebook page, I almost instantly started receiving emails asking for health advice – something I actively discourage on my website – www.leonchaitow.com– as there is no way that meaningful, responsible, specific advice can be offered via that medium.
And even offering general advice, and referral information, requires a greater awareness of the individual’s background than can be easily gleaned by email correspondence!

One such email, that arrived yesterday, detailed a truly heart-rending catalog of chronic health problems.
I am copying the non-personal sections of my response – see below – as it represents a summary of the philosophical approach I adopt when considering complex chronic health issues (whether at a distance, or in person) – and I hope it is of some interest:?

Thank you for your detailed summary of your history and current health problems One thing I’ve learned in trying to advise people with complex problems is to avoid trying to ‘fix’ anything. The way to best deal with complexity is through a lens that evaluates three possible intervention approaches – built on a foundational recognition that self-regulation/homeostasis is constantly operating, and that the most effective role of health intervention is to provide that inbuilt feature (self-regulation) with the best possible chance of manifesting, without creating additional adaptation demands.
An additional lens requires an appreciation of both inherited and acquired features within the orbits of the biochemical, biomechanical and psychosocial aspects of the individuals makeup.

The first way of trying to reduce complexity via simple initiatives, lies in establishing, as best possible, whether functional improvement can be achieved – possibly not in the most obvious or affected areas/system/tissues. For example in many cases, by focusing on breathing function (possibly, not certainly – as this is an example only).
Other broadly influential areas that always require consideration, and sometimes modification, are nutrition, sleep, posture, exercise and mento-emotional balance.

Functional improvement in all and any of these areas can permeate into improved clinical presentations, even though they may not immediately be recognisable as being part of the etiology.

Secondly, there is a need to focus on what obstacles there may be to enhanced function/symptom reduction, that might be modified or modulated. The idea of removal of obstacles to recovery/improvement, works on the principle that health issues represent failed or failing adaptation (based on Selye’s General Adaptation Syndrome concepts) – which calls for attention to whatever adaptive demands can be minimised i.e. ‘reduce the load’.

Thirdly, there is the strategy that aims at easing symptoms, without adding to the adaptive load.
This is in contrast to methods that:
a/ try to fix something and/or
b/ impose a new set of adaptive demands, that actually make matters worse
This highlights the fallacy of an ‘ideal structural state’ which some manual practitioners attempt to restore. There are probably as many people who have multiple structural anomalies (as compared to text-book ideals), and yet who have no symptoms whatever, as there are individuals who are text-book ideal – but with multiple symptoms.! Symptom relief is a reasonable approach, when the first and second objectives, listed above, are not achievable (i.e. enhance function and reduce the adaptive load), or are only marginally successful. Easing of symptoms, even though underlying features are unaltered, can contribute significantly to well-being.

So, with that philosophical (but I believe extremely practical) background, my particular advice for people seeking help for complex health conditions (where regular health-care fails) is to broaden perspectives in seeking help. – by paying attention to diet, exercise, sleep, breathing, stress management etc. It also pays to seek professional advice that evaluates the whole complex story, rather than small pieces of it.
Osteopathic and naturopathic (and TCM) practitioners tend towards looking at the big picture, rather than at the obvious.

My best wishes for 2011


3 Comments

  1. This doctor has been very frank in informing his followers on what to expect and what not to from him. He is also very clear on when and for what topic he is available to solve people’s queries on medical issues.
    But, I personally feel doctors should not post their availability on social networks, because this is going to kill the doctor’s time and make people take advantage of him.

  2. The fact is I am semi-retired, and the way the Greatvine advice line works is that I can decide to ‘be available’ for a few hours, whenever my other work (writing/editing etc) allows this.
    Unless I click on the ‘available’ button on the website, my direct line does not function.
    My main reason for explaining the problems of giving advice at a distance was because people need to realise that such advice can usually only be general – and not specific.

  3. Hi

    Are you aware of any studies which do show inter -examiner reliability as well as any peer-reviewed literature confirming the effectiveness of cranial osteopathy. Particularly in light of the following article and similar: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1564028/

    Thanks

    Gary

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