Ask the Expert
What is integrative medicine, and when is it appropriate to use it with patients?
You wake up one day with swollen legs. Your doctor, like many physicians, might prescribe a pill to help your body get rid of the excess water.
But if you saw a naturopathic physician, she might prescribe dietary changes and hot and cold baths. If you lived in China, a traditional Chinese medicine physician might diagnose you as having a “yin deficiency” and prescribe acupuncture or certain herbs. A physician in India might look at your body type and suggest you eat and bathe in a specific way.
Integrating these different health-care approaches with conventional medicine is the basis of what is known as integrative medicine, a field that aims to use the best of these therapies to meet each patient’s needs.
Sound ambitious? It is. But this approach is how many physicians and patients feel medicine should be practiced. The more we learn about the mind-body connection, and about the effects of lifestyle and diet on health, the more integrative medicine makes sense as a way to look at all the factors causing a person to feel well or ill.
Much of conventional medicine does wonders to improve the health of people. Other approaches, though, also can be helpful and may be better, less expensive, safer or all three. Physicians trained to integrate approaches from all healing traditions often have more tools at their disposal to help you develop an individualized plan for your well-being.
You likely have already taken an “integrated” approach to your own care. Treating a cold with rest and fluids, along with cold medicine, is a start. To clear out your sinuses, you may try salt water nasal washes using a neti pot, readily available in pharmacies but originating in India. Zinc lozenges and the herb pelargonium, both naturopathic approaches, have been shown to decrease the length of the cold.
Integrative medicine focuses on staying well, not just treating illness. Research shows that techniques that quiet the mind and calm the nervous system also benefit the immune system, helping people stay healthy or even deal with illness better. Meditation, prayer, keeping a journal or breathing techniques are so good for you that many people don’t even consider this to be “alternative”—it’s just good wellness care. The same goes for basic nutrition and exercise. These give your body a solid foundation for functioning well and fighting illness.
Working with my patients, I try to find the appropriate tool in my “integrative toolbox” to meet their needs. For example, I’ve used an “elimination diet” to identify asthma triggers in a 5-year-old. Avoiding dairy in his diet resulted in far less coughing and wheezing, allowing him (and his parents) to sleep much better. An anxious patient of mine does really well on a combination of medication, homeopathic remedies and yoga. I use all of the best tools and treatments of conventional medicine when appropriate, but there are often other options that may be as effective and are as safe or safer.
Patients come to me as an integrative medicine physician because this approach fits with their values and beliefs about health and wellness. Others have tried conventional approaches without benefit or have read or heard about an alternative approach for their health and want more information before trying it.
Considering an integrative approach on your own? A couple rules of mine:
Make sure you know what you are trying and why. I often see people who are taking a handful of herbs or supplements, and they can’t tell me why, other than “my friend said it was good for me.” Find reliable information sources, not stores or websites that want to sell you something.
Keep your doctor informed. It is important that your doctor knows what you are using in addition to what she might recommend.
Don’t think “either-or.” Sometimes conventional medicine has a better track record for treating a problem. An urgent problem, such as an asthma attack or something very serious like cancer, may best be treated with a conventional approach that is proven to be most effective. Other approaches may be helpful, but I generally wouldn’t use them as the primary treatments until the emergency has passed.
My own criteria are to check whether the approach is safe and whether it is the best choice for my patient. This is the part where your relationship with your doctor can help you decide. Luckily, there are many ways to treat the common problems we experience, and you can choose more than one item off the health-care buffet.
Andrea Gordon is on the faculty at the Tufts/Cambridge Health Alliance Family Medicine Residency Program.
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