Integrative Medicine: An Overview

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Integrative MedicineAn Overview

• Debra G. Bell, MD
• 4/18/2007

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Integrative Medicine

• Term coined about 15 years ago
• Integrate natural therapies with conventional
  medicine
• Practitioner is someone trained in conventional
  medicine as well as natural therapies.

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Terminology

• Complementary and Alternative Medicine (CAM) this
  is the term used amongst most medical
  professionals.
• Alternative Medicine therapies are an
  alternative to conventional medicine
• Complementary Medicine therapies complement the
  care given in conventional medicine
• Holistic refers to philosophy of looking at the
  whole person and not necessarily the type of
  therapy utilized
• .

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Holistic approach

• The human being is greater than the sum of its
  parts. James Gordon M.D.
• Allopathic (conventional) medicine focuses on
  treating diseases.
• Holistic medicine focuses on healing the
  individual

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History

• Prior to early 1900s many different types of
  medicine
• 1910 Flexner report - Allopathic medicine becomes
  conventional medicine. Report condemned
  second rate schools. All medical schools
  except allopathic ones lost state funds and
  support of licensing boards.

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Homeopathy

• Dr. Samuel Hahnemann - early 1800s
• Symptoms are the adaptive response to stress - an
  attempt to heal. Homeopathic remedy helps to
  develop a more effective healing response
• Like cures like

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Osteopathy

• Structure is related to function of the body
• Restoring structural balance to the
  musculoskeletal system allows for a healing
  response in the body

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Chiropractic

• Alignment of spine and joints influence the
  nervous system
• Nervous system is the key to the bodys potential
  to heal itself
• Spinal column is the switchboard to the nervous
  system

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Naturopathy

• Belief in healing power of nature, education of
  the patient and holistic approach
• Not a single modality - nutritional medicine,
  botanical medicine (herbs), manipulation,
  homeopathy, acupuncture

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Herbal medicine

• Practiced for hundreds of years
• Can at times be explained using western
  biochemistry and physiology
• Herbs are used individually or in combination for
  a synergistic effect.

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Chinese Medicine

• Five thousand years old
• Based on the principle of qi, (chi), a vital life
  energy in all living organisms. It circulates in
  the body along certain energy
• Qi circulates in pathways called meridians, each
  of which are linked to specific physiologic
  functions.
• Chinese medicine believes that health is
  determined by a
• balance in the flow of qi through these
  meridians.
• Treatment modalities include acupuncture,
  acupressure - over 1000
• points along the meridian - use of Chinese
  herbs, manipulation of diet and exercise (Qi
  Gong)

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CAM Practitioners

• Integrative medicine professional - M.D., PA, NP,
  RN, LPN, D.C., D.O.
• Professionally trained in one modalityacupuncture
  , homeopathy, chiropractor, naturopath
• Non medically trained in a specific modality
• Non professionals no formal training or
  schooling

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Practice Settings

• Individual private practice
• Individual in conventional practice
• Shared rental space
• Center where care is collaborative
• Business practices with mostly a financial
  incentive as a priority vs. healing

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Types of care

• Parallel one or more health care providers that
  do not communicate about the patients health and
  healing. May not even know they share a patient.
• Integrated even if all care is not all in one
  center, make point o be aware of other healing
  modalities so that all care can be integrated.

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Legitimacy/Professionalism

• Follow standard charting History and physical,
  S.O.A.P format.
• Make sure patient aware of standard of care
• Make informed decisions
• Diplomatic and educational interactions with
  other medical providers

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Why bother with integrative medicine?

• It is Popular
• 36 of adults n the US are using some form of
  CAM. When megavitamin therapy and prayer
  specifically for health reasons are included in
  the definition of CAM, that number rises to 62.
• The U.S. public spent an estimated 36 billion to
  47 billion on CAM therapies in 1997.
• In the UK homeopathy has remained a component of
  the health care system and recently has become
  accessible through the national health care
  system.
• Asia, acupuncture and Chinese medicine integrated
  in to their health care system.

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Why

• Now that there have been advances in
  science,why use
• something so crude as some of these other
  modalities?
• By dropping them we are losing an additional
  valuable resource
• that can contribute to our health.
• Overuse and misuse.
• The use of more technology and the constraints
  applied
• by the current reimbursement system has
  decreased the
• amount of time spent to assess the basic
  concerns
• and needs of the patient.

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Incorporation of Preventive MedicineIn
Integrative care

• What conventional medicine calls preventive care
  today involves
• collections of screening tests to try to
  rule out existing disease.
• There are many aspects to wellness that are not
  being addressed
• by conventional medicine.
• We have much scientific data documenting negative
  effects of
• obesity, poor diet, stress and sedentary
  lifestyle on our health.
• Integrative medicine provides so much more to
  look at and work
• with to truly address this aspect of health.
  

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• Why Not
• No FDA regulations
• Waste of money
• Scientific Proof

• Because
• Even with FDA regulations we still approve drugs
  that end up causing harm and later have to be
  removed from the market. More voluntary
  regulatory systems in place
• Good quality supplements that have merit. High
  health care costs
• Acupuncture best studied. NIH.
• German Commission E Monograph.
• Proof is sometimes only a theory

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Riverview Family Practice andIntegrative
Medicine Center

• Combines conventional medicine and obstetrics
  with complementary and alternative medicine
• The center is a cooperative effort between
  RiverviewHealth, Altru Health System and the
  Minnesota Institute of Contemplation and Healing

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Services Offered

• Family Practice
• Bio-identical Hormone replacement therapy
• Complementary and Alternative Medicine
• Massage Therapy
• Acupuncture
• Psychotherapy
• Spiritual Direction
• Health and spirituality education

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Team Approach

• MD, LPN, LMT, LAC, Psychologist, Spiritual
  Director, receptionist, health and spirituality
  advisor
• All staff are important components of clinic
• Monthly Team Meetings

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Philosophy

• Empowering people to become and stay healthy
• Focus on the patient as a whole, addressing all
  factors that affect health (mind, body, spirit
  and lifestyle)
• The patient and practitioner partner to seek
  health and healing
• There are many valuable resources in nature as
  well as effective ancient healing techniques
• Acknowledges the wisdom and usefulness of both
  conventional medicine as well as alternative
  therapies

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• People have better compliance if they are
  personally committed to a treatment regimen.
• There must be a willingness and interest to
  embrace the philosophy of the importance of
  taking care of oneself.

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Health and Spirituality

• The basis of Holistic medicine -acknowledging and
  nurturing the connection between mind, body, and
  spirit.
• Authentic healing and wholeness comes from paying
  attention to the complete self.

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Spirituality

• Spirituality - attention to the source of our
  being.
• Bring about health and wholeness by integrating
  spirituality into the healing process.
• Learn various prayer practices.

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Prayer

• Research supports the effectiveness of prayer on
  health.
• Prayer practices
• Silence, Repetitive prayer, music, scripture,
  labyrinth

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Spiritual Leadership

• Health care providers as spiritual leaders
• Personal spiritual growth

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• Each individual has unique needs for their sense
  of wellness.
• By using an integrative approach one stays
  mindful of the relationship between mind, body
  and spirit and can utilize the wisdoms of both
  modern technology and natural therapies.

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Resources

• Creating a Life With God by Daniel Wolpert.
  Upper Room Books 2003
• Leading a Life With God by Daniel Wolpert. Upper
  Room Books 2006
• www.micahprays.org
• dbell_at_riverviewhealth.org