What is Integrative Medicine?

 Integrative medicine is ideally encompasses all healing and treatment methods that are shown to work, and aims more to address the root of a health problem rather than just masking the symptoms with prescription medication.

Integrative medicine approaches have been shown to be more cost effective in the long run, and prevention is as much a focus as cure.

Integrative Medicine as a specialty

Integrative Medicine as a medical specialty is relatively new, and there is recently a fairly new official Board certification available through the American Board of Integrative Medicine (ABOIM). Fellowship training is available at KUMC Integrative Medicine (University of Kansas Medical Center) and several other places. Integrative Medicine training programs can vary in quality, and many require an MD or DO degree.

Sub-specialties of Integrative Medicine

Integrative Medicine embraces all the healing arts that can potentially help a patient. Because of the broadness of this field, many practitioners tend to sub-specialize. Sub-specialties in Integrative Medicine can include energy medicine, orthomolecular medicine, and environmental medicine.

Some practitioners will be more knowledgeable in their special areas of interest. You will find practitioners who specialize in treating chronic Lyme disease, thyroid problems, autoimmune issues, and such. Some practitioners have several areas of expertise.

Energy Medicine

Energy medicine encompasses modalities such as acupuncture, homeopathy, reiki, shiatsu, micro-current therapy, etc. Because we are only just beginning to have the instruments to measure these energies, and because results can often vary widely between practitioners, it is more difficult for conventional science to accept these methods of healing.

Orthomolecular Medicine

Orthomolecular medicine is based on hard science and research studies. The foundation of this science is the basic biochemical pathways of the human body. Pathways such as the Krebs cycle that are memorized then forgotten as soon as most doctors graduate from medical school are the basis of orthomolecular medicine. Individual genetic weaknesses are tested for and treatment is individualized. The importance of proper nutrition is recognized. Comprehensive vitamin and mineral testing identifies deficiencies that can then be addressed.

We use a combination of knowledge of biochemical pathways, individual genetics, and vitamin and mineral testing to deliver targeted therapy. With this approach, using testing instead of guessing, one is likely to walk out my office with only a short list of supplements to take, as opposed to the "Let's throw all these supplements at you and see what sticks" approach, which has practitioners largely guessing, practicing cookbook medicine, and people having to take 2 bags of supplements and still not feeling better.

Environmental Medicine

In Environmental medicine, the effect of environmental toxins on biological function is recognized, and an individual's detoxification pathways can be supported in various ways to better enable them to function in a toxic world.

How Integrative Medicine is different

Because Integrative Medicine attempts to dig deeper than conventional medicine, very specialized lab work is often ordered.

For example, instead of just getting an IgE (immediate reaction) food allergy panel, IgG (delayed reaction) food intolerance panels and IgA (mucosal) stool testing can be done. Instead of testing only B12 and folate levels, all B vitamins are important, and the full panel may sometimes be tested for.

The Integrative Medicine physician ideally asks: 'why", and keeps asking and peeling back the layers of the onion until the root cause is found.

What conventional medicine is good for

Conventional medicine excels at treating acute diseases such as appendicitis, strep throat, bacterial pneumonia, and most conditions that one would go to the emergency room for.

Where conventional medicine falls short

Conventional medicine, however, tends to fall somewhat short when faced with more chronic disease such as GERD (gastroesophageal reflux), fibromyalgia, cancer, chronic fatigue, and such.

The main focus of conventional medicine tends to be just to treat the end symptom(s) often without addressing the real root of the problem.

This does not necessarily reflect a lack of caring or skill on part of the conventional doctor, but is more a function of the financial reality of private practice: 12 minutes per patient is simply not enough time to delve deeply enough.

Example of the Integrative approach

For example, the conventional medicine approach to GERD is usually to simply put a patient on acid-suppressors, sometimes for years.

Many people actually produce less stomach acid as they age. Long term acid-suppression simply takes away what little stomach acid the patient had, further worsening the pre-existing problem of insufficient digestion.

Furthermore, decreasing a person's ability to digest food in the stomach actually can promote the development of food allergies and intolerances. It can also promote micronutrient deficiencies that can then contribute to poorer health. Calcium and vitamin B12 are examples of nutrients that are better absorbed with acid.

Instead of acid-suppression for GERD, Integrative Medicine attempts to discern the root of the individual's problem, be it food intolerances, not drinking enough water, not making enough stomach acid, having too much yeast or dysbiotic flora in the gut, etc.

Instead of acid-suppressors, additional Betaine HCL, digestive enzymes, and probiotics might be given.

Personalized medicine

The personalized aspect of delivering Integrative medical care rejects the 'one size fits none' approach. People are biochemically individual, and must be treated as such. Doses of bio-identical hormones and other supplements and medications should be individualized where appropriate.

With the advent of affordable genetic testing, I use 23andme genetic testing clinically to make personalized recommendations for someone.

Integrative Medicine gives more time to the patient

The average primary care office visit may only be 5 to 14 minutes...

In this amount of time, it is near impossible to deliver the quality and depth of care required by Integrative Medicine.

My typical new patient visit is often about 1 hour long, and follow up visits are typically 30 mins or so. I have had initial consultations take as long as 2 hours, and this was not the time my patient spend sitting waiting for me.. this was my personal face to face time with my patient.

Integrative Medicine and reimbursement

Unfortunately, because Integrative Medicine has yet to be fully accepted by mainstream insurance companies, patients getting integrative treatments often have to pay out of pocket for doctor visits and lab testing.

Some less scrupulous clinics may also tack on extra fees for testing (if you pay the office instead of the lab this is likely to be the case) and over charge for supplements.

Quality of Integrative Medicine practitioners

Because training in Integrative Medicine is not uniform, quality of practitioners can vary. Some Integrative Medicine practitioners have just taken weekend courses here and there, while others have undergone formal 1 or even 2 year Fellowships under the close tutelage of an experienced practitioner, who was themselves previously taught by another. Some practitioners dabble in a myriad of things, while others specialize.

Because the field is so broad, no one practitioner can possibly know everything. Someone specializing more in orthomolecular or functional medicine may not be as well versed in energy or manual medicine and vice versa.

The future of medicine

The Integrative approach is the medicine of the future as it tends to give better results especially for chronic medical conditions. It is a superior approach for prevention as well as for the maintenance and optimization of health.

With the rise of environmental toxicity as well as the increase in illness caused by toxins around us, environmental medicine is critical and is likely to become required knowledge for the physician of the future.

Source:  What is Integrative Medicine?