Over a plate of grilled octopus, salad, linguine, and red wine at Trattoria, some friends and I were discussing the topic of integrative medicine. One friend, a longtime patient, asked a core question, “What is integrative medicine?” As her primary care provider, I take care of her overall health using my personal style of practice. I have also provided acupuncture for some joint problems. However, the term integrative medicine was not one she recognized.

I realized it was time to clarify this approach to medical care. There has always been a parallel column of care to conventional medicine. Over the centuries, herbalists, acupuncturists, homeopaths, chiropractors, massage therapists, naturopaths, energy workers, mind-body therapists, midwives, various culturally-based medical systems such as Ayurveda traditional Chinese medicine and others have provided care outside the standard medical system. Nutrition, lifestyle changes, and prevention are highly emphasized in most of these approaches.

Generally these methods were safer than standard practices, which in the past included such rough approaches as leeching, bloodletting, purgatives, toxic chemicals, emetics, and various potions that were a standard part of the traveling medicine show.

As modern medicine became more scientifically based with such profound discoveries as antibiotics, anesthesia, improved surgical methods, and an ever-expanding array of pharmaceuticals, the role of such alternative practitioners became somewhat less clear and even suspect. To some extent this was justified, as there were and still are some dangerous quacks among them.

On the other hand, the latest medical discovery or method or drug may not always solve a person’s problem. Over my career, I have seen multiple FDA approved drugs removed from the market after they were found to be harmful or even deadly. Standard of care surgical techniques have often been displaced by safer, more effective ones, or even recommendations to avoid an operation entirely.

The role of holistic practitioners has thus remained a robust one in helping those who do not respond to or tolerate standard treatments. As we discover more about the human genome through pharmacogenomics, nutrigenomics, and metabolomics, we are finding that many people have issues preventing them from metabolizing some common and standard of care medications or chemotherapy.

Holistic practitioners have long appreciated that individualized therapies are often preferable and more effective than standardized, clinical trial based treatments.

So back to our question of just what is integrative medicine? Many people recognize the term holistic medicine, an approach that addresses physical, mental, and spiritual dimensions of health. Integrative medicine is similar and offers the best of both standard and complementary therapies.

As defined by the Academic Consortium for Integrative Medicine and Health (https://www.imconsortium.org/) a group of over 70 medical schools and health care systems that provide clinical care, education and research in this area, integrative medicine is: “The practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence and makes use of all appropriate therapeutic approaches, providers and disciplines to achieve optimal health and healing.”

More to come in upcoming columns from my fellow colleagues practicing integrative medicine at UTMB.

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