What is Integrative Medicine?
Conventional, alternative, complimentary, and integrative are all terms for different types of medicine. They are thrown around a lot, but what do they really mean? First of all, conventional medicine is the core of western medicine and it is the use of synthetic drugs and surgery to treat health conditions. Alternative medicine, on the other hand, is any therapy that is typically excluded by conventional medicine. Both of these types of medicine have some methods that are supported by scientific evidence and some methods that are not.
Complimentary medicine is when an alternative medicine therapy is used in conjunction with a conventional therapy. An example of this is the use of ginger syrup to prevent nausea associated with chemotherapy treatments. This is sometimes represented by the acronym CAM which stands for complimentary and alternative medicine.
So, what is integrative medicine? Integrative medicine, as defined by the National Institute of Health: “combines mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness”. Dr. Weil, a well known medical doctor (MD) who has made his career and fame around integrative medicine defines integrative medicine as a healing-oriented medicine that takes account of the whole person (body, mind and spirit) including all aspects of lifestyle. The principles of integrative medicine include appropriate use of conventional and alternative methods to facilitate the body’s innate healing response. Consideration of all factors that influence health, wellness and disease, including mind, spirit,community and body. Recognition that good medicine should be based in good science, be inquiry driven, and be open to new paradigms. And, the use of natural, effective, less-invasive interventions whenever possible.
As an osteopathic physician trained in internal medicine and now a specialist in neuromusculoskeletal medicine and osteopathic manipulative medicine I definitely categorize myself as an integrative medicine physician. The principals of osteopathic medicine have been around since Andrew Taylor Still, who was originally trained as a medical doctor (MD),broke off from conventional medicine and developed osteopathic medicine. The principals of osteopathic medicine are that a person is a unit of body, mind and spirit; the body has self-healing and self-regulating mechanisms; structure and function are inter-related; and rational treatment is based on these principals. These principles have been around since the origin of osteopathic medicine in the 1890’s, long before the modern term of integrative medicine was ever used.
Now, let’s present some evidence in support of integrative medicine. The American College of Rheumatology recently released new recommendations for the treatment of osteoarthritis (OA) to replace those issued in 2000. The lead author of the expert panel stated that the recommendations “were derived using a state-of-the-art approach utilizing evidence from the most recent and best methodological quality systematic review of the individual treatment modalities in patients with osteoarthritis of the hand, hip, or knee and as a result place new emphasis on early use of non-pharmacologic therapies.” No strong pharmacologic recommendations were made for the initial treatment of hand, knee or hip OA. Strong non-pharmacologic recommendations for hip and knee OA included participation in aerobic and/or resistance land based exercise, water exercise and weight loss. They conditionally recommend manual therapy, psychosocial intervention, thermal agents, walking aides as needed, tai chi programs and Chinese acupuncture. These new recommendations for the most common form of arthritis from an expert panel of the American College of Rheumatology definitely demonstrate that there is now quality scientific evidence to support alternative and integrative medical therapies.
And, the American College of Lifestyle Medicine in a report that summarizes a literature review of the effect of lifestyle medicine on hypertension and high cholesterol demonstrates that there is an enormous amount of evidence behind changing one’s lifestyle to treat these diseases. Ameta-analysis of 105 randomized controlled trials (RCT) of lifestyle interventions for hypertension found “robust statistically significant effects for diet, aerobic exercise, alcohol restriction,salt restriction, and fish oil supplements”. Also, the seventh report of the Joint National Committee on the prevention, detection,evaluation and treatment of high blood pressure and the Adult Treatment Panel III (ATP III) which is an expert panel for the treatment of cholesterol both recommend as the first line treatment for hypertension and high cholesterol weight loss in the overweight, a diet that is plant based, low in sodium and saturated fats and high in fiber, increasing fish and omega 3 fatty acids, regular physical activity, no smoking, and moderate if any alcohol. A randomized controlled trial of this ATP III recommended diet against a statin drug and a control group showed that the LDL cholesterol was lowered by 29% in the diet group, 31% in the statin drug group and 8% in the control group.
So,there are a number of different terms thrown around for different types of medicine, but integrative medicine combines the best of all forms of medicine based on scientific study and evidence and for the optimal treatment of chronic disease I feel it is the future of medicine.