Introduction to the concept of integrative medicine

Published on 17/03/2015 by admin

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chapter 1 Introduction to the concept of integrative medicine

Professor Kerryn Phelps

Dr Craig Hassed

This is a general practice textbook with a difference. It is designed to be a practical guide to integrative general practice.

We have been general practitioners (GPs) for over two decades. In that time a GP will have seen and heard just about every clinical scenario. We have also seen many medical fads come and go, such as the fashion for prescribing hormone replacement therapy to every perimenopausal woman because it was supposed to improve her future health, the rise and fall of non-steroidal anti-inflammatory drugs for managing arthritis pain, and the passing epidemic of repetitive strain injury. We have similarly seen many natural therapy and dietary fads come and go. Many experienced practitioners will remember the era when every other patient arrived with the news that they had ‘hypoglycaemia’, and then there was the ‘systemic candida’ phase.

We have experienced the intellectual excitement of the ‘clever’ diagnosis, the sadness of delivering bad news to a patient, the delight of guiding a patient back to health, and the frustration of hitting a brick wall when our Western medical training left us feeling there was nothing further we could offer.

The emergence of evidence-based medicine and, more recently, evidence-based complementary medicine is challenging many previously held notions of best practice. As evidence emerges, many Western medical therapies are being confirmed as correct, or challenged as ineffective or harmful. Similarly, many complementary therapies are being confirmed as correct, while others are being found ineffective or harmful. Such is the inevitable evolution of healthcare.

It is also important that evidence-based healthcare at every level be considered a ‘work-in-progress’, whether it is in the discovery of the genetic basis of disease, the development of previously untested technology or the clinical application of a treatment. The nature of scientific research is such that new information becomes available at a great rate, and that knowledge often changes the status quo.

It is in the GP’s consulting room that patients ideally have the opportunity to explore what is likely to be the best option for their healthcare. We see the gamut of health concerns, from a person wanting a check-up and interested in doing more to maintain good health, to a patient who is symptomatic and wanting a diagnosis and treatment, or a patient with an established diagnosis who is looking for either a cure or a way of optimising their wellbeing as they live with their illness.

Like that of our colleagues, our medical training was in the allopathic model. Through a combination of professional and personal experience and further study, our practice paradigm has gradually evolved into an integrative model of healthcare.

We do not expect to become proficient in every modality of therapy. However, we do believe that patients should expect their doctor to be familiar with a comprehensive range of therapies likely to work in their circumstances, and what the risks and benefits are likely to be. In this way general practice will be enriched and patient outcomes enhanced. Patients are increasingly looking for an integrated model of healthcare and much prefer it to be delivered, or at least coordinated and supervised, by their family doctor rather than having to fly blind, often without their doctor’s knowledge or approval.

Western medical practice coexists with many other healing traditions, whether doctors are aware of it or not. And just as GPs work in partnership with other medical specialties, so we can also work more effectively with appropriately qualified complementary and alternative healthcare providers.

One of the impediments to working in an integrative model is the lack of a common language between practitioners of different persuasions. For example, the concepts of ‘yin and yang’ and ‘chakra’ are not easily explained in medical school language. However, the fact that we may not understand the language, mechanisms or concepts of these therapies and modalities does not mean that they do not have a great deal to offer. As doctors become more familiar with different therapeutic options, so their familiarity with these terms will increase. Similarly, as doctors and other healthcare practitioners increasingly work together in teams or ‘virtual teams’, a common form of communication is emerging.

WHAT IS INTEGRATIVE MEDICINE?

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