Just Good Medicine

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, healthcare professionals and disciplines to achieve optimal health and healing.  (Definition by the Consortium of Academic Health Centers for Integrative Medicine.)

These may sound to some like lofty goals.  Others would insist that we already do this in the practice of medicine.  I think the answer is somewhere in between.  Over the last 50 years things have changed dramatically in medical practice.  When my parents went to the doctor, it was a direct doctor-patient relationship where the doctor knew all about you and your family—where you worked, what religion you practiced, whether you had financial problems and whether your children were troublemakers in school. The doctor knew what stresses existed in your life because he/she really knew you as a person.  This type of intimacy may be a thing of the past, but there is a way to reinstate even a small part of this again. 

The goal of Integrative Medicine is to return to the basics of viewing the patient as a whole person.  The patient is not their disease in isolation of other important factors in their life such as family, community, spirituality, and lifestyle.  Most doctors enter medicine for all the right reasons; they truly care for their patients.  Somewhere along the path, though, reality sets in when you realize medicine is run like a business, and businesses are about money.  Insurance companies, pharmaceutical companies and government all have a hand in squeezing doctors to the point that the average face-to-face time of a visit with your physician now lasts seven minutes.  This is enough time for a brief exam and to order tests, but not to get to really know your patient.  I won’t discuss the sad cascade of how medicine has come to this point, but doctors and patients are both frustrated.  There has to be a better way that is smart and cost-effective. 

Integrative Medicine is the answer.  It seeks a paradigm shift in medicine where patients are not just their diagnosis, and wellness is the goal. Wellness is not defined as just the absence of disease, but as general well-being and progress toward positive lifestyle changes even in the presence of disease.  Approaches include such therapeutic modalities as nutritional counseling, botanical medicine, meditation, yoga, energy medicine, acupuncture, and massage.  St. Charles Medical Center is dipping its toes into the world of Integrative Medicine at the Cancer Center, which offers traditional treatment with surgery, radiation and chemotherapy as well as acupuncture and reiki.   Evidence-based studies show that alternative approaches such as these help cancer patients with the symptoms of their disease as well as the side effects of treatment. 

Integrative Medicine may not be as glamorous as new drugs or new technologies, but it costs less and returns physicians to the root reasons they enter medicine—to care for the whole patient including mind, body and spirit.  Integrative Medicine is not alternative medicine.  It is merely open to all evidence-based treatment that may help the patient to achieve wellness.  Integrative Medicine is really just good medicine.  Someday we will call it just that.

This was written by me for The Bend Bulletin's "In My View" column and published today, August 15, 2013.

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