If you agree that prenatal vitamins can help promote a healthy pregnancy, reducing sodium can reduce blood pressure, and exercise can alleviate stress, then you are already receptive to the tenants of integrative medicine. If you hear of integrative medicine in passing, it may trigger thoughts of acupuncture, herbal supplements and chiropractors. While it's true that the blending of Eastern and Western medicine is part of what defines the approach, integrative medicine (like the patients it treats) is more than just a sum of its parts.
Integrative medicine's driving philosophy is to treat the whole person with considerating all facets of his or her lifestyle. In addition to a patient's symptoms, integrative physicians take into account personal history, stressors, eating habits, social interactions and sleep patterns before coordinating a treatment plan. Originally met with skepticism within the medical community, the field is rapidly gaining support across the country.
As defined by The Consortium of Academic Health Centers for Integrative Medicine, integrative medicine is "the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, health care professionals and disciplines to achieve optimal health and healing."
Gordon Magonet, a family medicine doctor with East Jefferson General Hospital, recently completed a fellowship in integrative medicine at the Arizona Center for Integrative Medicine at the University of Arizona. "The word healing is important because it's inherent in what we are taught in our fellowship," Gordon says. "Human beings are naturally able to heal themselves, and our role is to foster that. People see that a cut heals on their hand, but they don't necessarily think they can heal their depression. I think a lot of it is harnessing natural healing. That's a big part of the philosophy."
Integrative medicine physicians do not see Eastern and Western medical practices as mutually exclusive. Treatment plans may run the gamut of medical procedures (including prescriptions and surgery) combined with holistic therapies like massage, acupuncture, supplements, counseling, meditation, and nutrition. The goal is to work with the patient to find the best possible treatment within the realms of what that patient wants.
Magonet explains hypothetically what a patient suffering from depression might expect during a visit to his office: "I would ask all the standard questions related to their symptoms such as what is their past history, are they taking drugs and alcohol, what are the current stressors in their life, etc. Then I would push it a bit more: What's your diet like? Are you exercising? What's your sleep like? Are you taking any supplements? What's your social support like?
"At the end of the conversation, you do a sort of dance between what you think and what the patient wants. So yes, I might think the patient will benefit from medication or from counseling, but some patients are averse to (those treatments). We strive to find solutions that can accomplish our clinical goals while also fitting in with the wishes of our patients. That might include supplements that have been used to treat depression, exercise to alter mood, getting them involved socially, or focusing on sleep, which can have a huge impact on mood."
Integrative medicine skeptics in the medical community argue that integrative medicine waters down the evidence-based practice of Western medicine with largely unproven treatments and therapies, attributing positive results from these practices to the placebo effect.
Magonet has heard the criticism voiced by some colleagues. "Critics ... say it is belief-based rather than reality-based or that there is a large impact from the placebo effect, but I would say all medicine is influenced by the placebo effect," says Magonet, a graduate of Harvard Medical School, which has a research center for integrative medical therapies. "There is acceptance if you look at a variety of medical centers that now have centers for integrated medicine like Harvard, Duke and the University of California at San Francisco."
An increasing number of scientific studies point to benefits of holistic treatments. Acupuncture appears to lessen symptoms of nausea in cancer patients receiving chemotherapy. The National Cancer Institute reports, "Of all the investigated effects of acupuncture on cancer-related or chemotherapy-related symptoms and disorders, the positive effect of acupuncture on chemotherapy-induced nausea and vomiting (N/V) is the most convincing, as demonstrated by the consistency of the results of a variety of clinical study types ..."
Perhaps the most revolutionary aspect of integrative medicine is the way physician-patient relationships are viewed. Because the goal is to treat the person as a whole instead of responding only to symptoms, physicians spend considerable time talking to their patients, hearing what they want for themselves and their health and learning what motivates them.
"I see more patients who want to take control of their health and their life," Magonet says. "It is our job to acknowledge the desire on the part of the patient to be proactive in their health, rather than have the physician as a paternal kind of figure. It's a collaboration."