Integrative Medicine

What is Integrative Medicine?

The word integrate has been used to describe a variety of ideas.

  • Integrate: to combine one thing with another so that they become a whole (mind, body, spirit)
  • Integrate: to connect different parts for the purpose of working successfully together
  • Integrate: to bring people or groups into equal participation in an institution

Integrative Medicine has been adopted to replace the term Complementary and Alternative Medicine (CAM), which had given CAM therapies the impression of being “less than” or inferior. For many, the word integrative is simply a marketing tactic for adding complementary and alternative options. The real promise of integrative medicine is twofold: to view the body holistically and preserve health rather than simply fighting disease, and to integrate a variety of healing modalities together in a way that ultimately benefits patient health as its primary goal.

 

Why do patients seek integrative medicine?

  • They want less risky treatment options
  • Their complex and difficult condition does not tend to respond well to biomedicine
  • Their particular case isn’t responding to typical care
  • They are interested in the holistic perspective which characterizes a number of the complementary approaches
  • They are interested in preventive care – staying well and not just fighting disease.
  • They are interested in healing and not simply managing symptoms 

There are a few different avenues being taken on the road to integrative medicine. While scientific research and knowledge of business logistics are important elements in making integrative medicine a reality, they are not the most crucial considerations for patient care. 

What's wrong with the Business model

Integrative clinics are springing up everywhere, from simple partnerships between two individuals practicing different health care modalities, to complex large clinics within academic medical centers. The basic business model is to put practitioners with varied skills and knowledge together in the same space assuming that magic will happen.

In using a business model to integrate medical care, patient success can be foiled by a number of obstacles:

  • Patients may not know which modalities may be most helpful to them
  • Practitioners may not know when to refer or how to collaborate
  • The clinic owner’s personal beliefs may influence what treatments patients receive
  • The clinic may not create adequate time or space for meeting or discussion
  • Difficulties in extending hospital privileges may result in the hire of non-acupuncturists to perform acupuncture
Doctors in discussion

What's wrong with the scientific model

Some integrative clinics allow only acupuncture protocols and mechanisms proven by scientific study to be used. Some integrative medicine texts attempt to define or translate traditional acupuncture concepts into biomedical terminology to make it accessible.

The caveats to this approach:

  • Study protocols tend to be inflexible and not patient-centered
  • Traditional theory not explainable through modern science may be rejected even though they may be useful in practice
  • Incorrect or inadequate translation or interpretation of classical texts may lead to poor effectiveness
  • The collective experience of thousands of years of practice is discarded in favor of a biomedical interpretation

The Patient Care Model of integrative medicine

Integrating acupuncture with biomedicine should first and foremost benefit the patient. Actual examples of how integrative practitioners work together to benefit patients can provide a model for others to follow. These examples are most easily communicated in the context of a case report.

There are three ways that multiple modalities can be integrated to improve the care of an individual patient:

  • Referral: Prioritizing a treatment modality in individual cases, according to its strengths.
  • Synergy: Applying two modalities concurrently or in sequence to combine the strengths for better outcomes (e.g., for infertility, using acupuncture’s ability to regulate the menses, and advanced biomedicine techniques of IVF for implantation)
  • Leveraging: Using the strength of one modality to counterbalance the weakness of another (e.g., for cancer care, using acupuncture’s supplementing and harmonizing properties to ease side effects of chemotherapy and radiation).

Integrative case reports, with detailed descriptions of how various modalities are applied to solve patients’ individual problems, can be used to identify and discuss the specifics about how integrating therapies can benefit a patient. Actual examples of how referral, synergy, and leveraging can be attained in practice may be repeatable and adjustable to benefit patient outcomes.  This will make referral and collaboration more reliable in practice, and this type of case report can also stimulate further research to explore these benefits on a larger scale. Advantages of using a case report approach to integrative care:

  • Views the paradigm of traditional acupuncture as a strong and equal player with a complementary understanding of health and healing
  • Describes specific ways to collaborate, rather than simply putting people in the same building and hoping they’ll figure out how to work together
  • Makes the most of all strengths, while minimizing weaknesses
  • Is truly patient-centered

For a deeper look at the role of acupuncture case reports in integrative medicine, click here.