Let’s Talk Terminology: What is Integrative Medicine?
One of the most common questions I get is “what is integrative medicine?” People use many different terms to talk about medicine or healing that differs from the conventional medical approach including integrative medicine, functional medicine, alternative therapies, and complementary therapies. So, what do these different terms mean.
I’ll start with integrative medicine. I like the definition that Andrew Weil uses which says that “integrative medicine is healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between the practitioner and the patient, is informed by evidence, and makes use of all appropriate therapies.”
One of the most important pieces of this definition for me are that it is healing-oriented meaning that in the practice of integrative medicine we are trying to facilitate healing. Sometimes that healing shows up primarily in the physical body. And sometimes that healing is primarily emotional or spiritual. Sometimes healing is “cure” and sometimes it's not, but it is moving us in the direction of wholeness and whole health.
It’s also important to me that it emphasizes the therapeutic relationship between practitioner and patient. Why? Because your relationship with your practitioners and physicians is tremendously important. You need to feel safe in that relationship and you need to trust those guiding you. In fact, studies show that your relationship with your practitioner affects your health outcomes. Positive relationships facilitate positive health outcomes. So having a practitioner that doesn’t make you feel good (perhaps you don’t feel heard, or respected, or remembered, or safe) may actually make your treatment less effective. Relationships matter and may even be the foundation of healing.
Lastly, it’s important to me that integrative medicine is evidence-informed and makes use of all appropriate therapies. Evidence-informed is different than evidence-based which is the buzz word in conventional medicine. We do not have double-blind randomized controlled trials for every possible intervention. And frankly, not all interventions lend themselves to these types of studies. Especially whole systems of healing like Ayurveda and Traditional Chinese Medicine or therapies that are very individualized to a person (and take into account body, mind, and spirit). So while we have evidence that specific herbs are effective for specific conditions, we don’t study combinations of herbs tailored specifically to you. My job as an integrative physician is to use the evidence and information we do have about effectiveness and safety and tailor it to you. Furthermore, some therapies may have minimal to no evidence but if the potential benefit is high and the potential risk is low, we may discuss with you and together decide it’s worth incorporating into your treatment plan. Lastly, so much of conventional medicine is very focused on the physical body and modifying a process (or structure) in the physical body. As an integrative physician, I do not believe that lasting healing happens without attending to the mental, emotional, energy, and/or spiritual bodies as well. So, in using all appropriate therapies, we get to use therapies that help create lasting change by working on all layers of the body.
How does one become an Integrative Medicine Practitioner?
To become an integrative physician, we complete our conventional medical training. I trained in internal medicine completing a three-year internal medicine residency after finishing medical school. Other integrative physicians that I know are family medicine physicians or surgeons or oncologists (you can enter the integrative medicine space from any field in medicine). After completing my conventional training, I completed a two-year training program in integrative medicine through the Andrew Weil Center for Integrative Medicine at the University of Arizona. (there is also a training program through the Academy of Integrative Health and Medicine). The fellowship that I completed focused on nutrition, botanicals and dietary supplements, mind body medicine, traditional healing systems, and integrative approaches to specific conditions.
Functional Medicine
Next let’s briefly talk about functional medicine. Functional medicine is a “systems biology-based approach that focuses on identifying and addressing the root cause of disease… the precise manifestation of each cause depends on the individual’s genes, environment, and lifestyle, and only treatments that address the right cause will having lasting benefit beyond symptom suppression.” (from the Institute of Functional Medicine) Functional medicine also uses a whole person approach and is looking for root cause and triggers of illness. In my experience, functional medicine tends to use more lab testing to identify deficiencies, toxins (like mold), or allergies and often focuses on biochemistry of what is happening. Functional medicine uses lifestyle including diet (and often an elimination diet), stress management, and dietary supplements to address the cause of illness. To become a functional medicine practitioner, you have to complete your primary training first (as a physician, nurse practitioner, chiropractor, or acupuncturist) and then you complete trainings on functional medicine (if you’re interested in learning more about the specifics, you can always visit the website for the Institute of Functional Medicine which is at the bottom of this page).
Alternative versus complementary versus integrative?
Alternative therapies are those used in place of conventional medical therapy. For example, someone who declines conventional treatment for a diagnosis of cancer and uses other therapies instead (diet, spiritual healing, energy medicine…whatever modality). Complementary means that someone is using conventional medical care with additional therapies alongside their conventional care. For example, someone undergoing conventional therapy for cancer who also visits a reiki practitioner for wellness and symptom relief is utilizing a complementary modality. An integrative approach is someone trained in conventional medicine and other modalities to help navigate bringing together conventional medicine and other modalities for improved outcomes.
How do you know which approach is best for you?
I believe there are many ways to approach the same problem. I had this insight a few years ago after doing a visit with my acupuncturist and then a session with my shamanic teacher. The acupuncturist was trying to support my adrenal system with acupuncture and herbs. My shamanic teacher was also trying to support my adrenal system with visualization, energy medicine, and essential oils. They were using different approaches to address an imbalance that they both noticed. So, when you’re trying to decide what kind of practitioner to visit, I would tune into what resonates most with you. Relationship also really matters so reading about the practitioner that you’re thinking of seeing (or watching videos, seeing their social media messaging) and checking in with yourself about whether this person feels like a good fit (your intuition can really help here). You want to know what their training is and to be ready to interview them when you see them for the first time. How do they work? How do they tailor their approach? What outcomes have they had and do they think you can have? And pay attention to how you feel after the visit… was there anything in the visit that didn’t land well in your body? Or do you feel supported and seen?
I also believe we need different people and approaches at different points in our healing journeys and sometimes we need a whole team along the way. So don’t be afraid to try different people along the way and create your own team of healers for your unique healing journey.
References:
https://www.ifm.org/functional-medicine/what-is-functional-medicine/
https://integrativemedicine.arizona.edu/about/definition.html
