At its essence, integrative medicine is a patient-centered philosophy of personalized care that integrates evidenced-informed Western medical services and complementary modalities. Those include: traditional Chinese medicine (acupuncture and herbs); mind-body practices such as yoga and tai chi; meditation in various forms; and massage therapy. The general goal is to provide healing with less-invasive interventions whenever possible. Also, integrative medicine is not always about treating diseases; it’s about helping healthy people maintain and optimize their health.
Though anyone can hang a sign outside their door claiming to be an integrative healthcare practitioner, there is a major guiding association, the Academic Consortium for Integrative Medicine and Health (ACIMH), to which most major medical centers subscribe. Its mission includes establishing standards for research in integrative medicine and integrating complementary treatments into clinical care within academic institutions. Among its members are UCLA, Harvard, Johns Hopkins, Duke, Cleveland Clinic and many others nationwide.
Justin Laube, MD, is an integrative primary care physician at the UCLA’s Center for East-West Medicine who works with senior patients and finds that many benefit from the integrative approach. “Many patients feel overwhelmed by the complexity of medical care and are often struggling with polypharmacy, or excessive use of prescription medications,” explains Dr. Laube. “At our clinic, we help patients find lower risk, low-cost options to manage medical concerns, and offer a variety of methods to optimize their wellbeing.”
For some patients that may mean prioritizing the prescription medications that are truly essential, and reducing extraneous medications that are increasing risk without providing long-term benefit. For all patients, healthy lifestyle choices are part of the treatment plan.
Defining the Ailment and Treatment
Discovering what’s really wrong with a patient is akin to solving a mystery. Sometimes the symptoms are clear-cut and the treatments choices are obvious. Others are not so easy.
Such was the case with one of Dr. Laube’s patients, a 60-year-old woman who recently emigrated from Iran. Her chart detailed a long list of medications for chronic migraines, none of which provided much relief. When asked about her symptoms, she described feeling heaviness in her head. “She couldn’t really open her eyes,” explains Dr. Laube. “When we asked her about her life, we discovered she was a caregiver to a husband with complex medical issues. She also has a lot of stressors related to the move from Iran. Most of her symptoms came from that complex stress.”
Dr. Laube encouraged her to see a psychologist and to try the resources available through UCLA’s MARC (Mindful Awareness Research Center). She took his advice. Sometime thereafter she reported that her vision was less blurred and was pleased that she had tools for stress that didn’t involve frequent trips to the doctor or taking prescription medications.
Finding Integrative Providers
An online search will result in a plethora of integrative medicine clinics. Many are run by internal medicine, family medicine and preventive medicine doctors who are board certified in their fields. They may or may not be aligning with the ACIMH definition. According to Laube, some clinics are cash only and may sell supplements, vitamin infusions, and other services that can be controversial. “For now, I recommend integrative medicine providers who take insurance and are not trying to sell you anything beyond good health and medical management advice,” says Dr. Laube. “It is best to see a board certified integrative MD or DO (doctor of osteopathy) who will coordinate your care across multiple providers.”
Other integrative healthcare practitioners that may be part of a care team include: acupuncturists, chiropractors, health coaches, psychologists, and mind-body practitioners. In a major medical center, many of those providers are located within the same department or nearby building. As part of the integrative medical doctor’s network, they will likely be vetted for the quality of their services as well. Insurance coverage for these additional healthcare services may or may not be covered by all insurance plans, but there are national movements to improve this issue, such as the Integrative Health Policy Consortium.
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