Integrative Medicine: Here to Stay or Just a Trend?
The holistic movement has started the ripple effect across America that is changing the way healthcare delivery is being conducted. In many well-known institutions, the integrative care model is coming to life, in part due to public demand, but in truth because there is science discovered each day supporting its use. Integrative health care utilizes complementary and alternative medicine (CAM) modalities which have some high-quality evidence for support to enhance traditional medical care. Modalities being used in mainstream medicine are not used instead of, but in conjunction with, Western medicine.
So, what is integrative health care?
It is an approach to healthcare that combines Western medicine in tandem with the best of CAM. By providing a whole person approach to care (the patient is included in the decision-making process which empowers him/her to become an integral part of the treatment care plan) better doctor/ patient relationships are formed. The philosophy behind integrative health care, or integrative medicine (IM), is that it not only addresses the disease process taking place, but also encompasses the entire person in mind~body~spirit~soul.
What makes IM appealing? Many advocates state with the condition of the current healthcare system, doctors are feeling rushed and overwhelmed; fragmented care (specialization) impairs continuity; patients are feeling seen as a disease, and not a whole person. Integrative medicine appears to promise more of everything: time, attention and a broader approach to healing. Society wants a more comprehensive healthcare style. Consumers have a keen awareness of medical practices from other cultures and the growing scientific evidence linking disease to nutritional, emotional and lifestyle factors. Many patients are paying out of pocket for therapies they seek out, but some modalities like nutritional counseling, chiropractic treatments and biofeedback are becoming covered expenditures in many health care plans.
In the past 10 years, there has been groundbreaking work on how the mind and body communicate in neuro-transmitted and biochemical messages. Translation at the cell level influences the brain, body systems and the immune system. Even skeptics are becoming convinced that the mind-body connection exists. Evidence surrounding the study of psychoneuroimmunology (the influence of the brain to elicit changes through neuro molecular processes, altering the functioning of the immune system) reveals the “bodymind” interacts as a single network of molecules which interact to control our health. This exciting physiology is the work of Candace Pert, PhD, past professor of physiology and biophysics at Georgetown University Medical School, and author of Molecules of Emotion: the Science Behind Mindbody Medicine. In April of 2006, she was keynote presenter at the Western Michigan University College of Health and Human Services Holistic Health Care conference Holistic Health: Science and Practice.
How available is this approach to care in the United States? In a national survey, the American Hospital Association found the number of U.S. hospitals offering complementary therapies more than doubled in less than 10 years, from 8.6 percent in 1998 to almost 20 perceny in 2004. An additional 24 percent of hospitals were planning to add CAM therapies in the future (most of these are noted to be classes and education programs). In the report, hospitals offering complementary therapies stated that they had met physician resistance (44 percent), budgetary constraints (65 percent) and lack of evidence-based research (39 percent) as the three major roadblocks to implementing integrative and CAM programs.
Many medical schools are responding by adding studies of nontraditional therapies to their curriculum. Electives about herbs and dietary supplements, massage, meditation and traditional Chinese medicine are finding their way into coursework across the country. In today’s integrative healthcare arena, Western-trained MDs are becoming credentialed in acupuncture and hypnosis, and studying Reiki; nurses are involved at many levels teaching wellness and yoga classes, applying clinical aromatherapy techniques and becoming massage therapists.
Those who are embracing the new medicine have cited the growing body of scientific evidence becoming available due to diligence on the part of researchers conducting the studies and collecting data through agencies such as National Institutes of Health—National Center for Complementary and Integrative Medicine (NCCAM). Despite this, not everyone is jumping on the bandwagon—and that is OK. Those who are not are declaring integrative medicine has become a product of mass marketing and public demand which is driving interest, leading to fad or trends. Many proponents against the implementation of CAM and IM point to lack of “scientific evidence” to justify the amount of financial resources spent on integrative medicine and complementary therapies. It is good to have these people out there as they will create the balance needed to assure evidence-based therapies become the mainstay of integrative care.
Where is it going? Only time will tell as this paradigm shift slowly continues to evolve. Healing the whole person, through holistica evaluation of the client, offering alternative ways to treat a problem and providing education—in conjunction with traditional care will invoke improved compliance and better outcomes. By embracing the new range of CAM treatments, including many once considered fringe, IM is becoming a better way of looking at and treating patients and disease. Integrative medicine provides a basis for quality care and provides outstanding patient-centered outcomes and satisfaction.
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Kimberly M. Frayer, RN, BS, HHC is owner of Aurora Wellness Solutions, Holistic Wellness Coaching and Education, providing wellness programs to businesses, small groups and organizations. She is a Level II Reiki practitioner, and is available for speaking on wellness initiatives from a holistic perspective and consultant for wellness programs. She is a hospice nurse for Sparrow Health Systems. www.aurorawellness.net <http://www.aurorawellness.net