Thursday, May 14, 2009

What is Integrative Medicine

Some of my best friends will ask the question. Without getting too boring, I could tell them the life and times of Andrew Weil. That usually is the long winded approach. I find myself trying to justify my endeavors by speaking of the mans credentials. Harvard College, Harvard Medicine, NIH, Botanist, Author and world cultural traveler, founder of the University of Arizona's Program of Integrative Medicine and Fellowship with graduating classes since 1994. By this time, most time efficient doctors will be answering other questions. Most lay-people will have tuned out after the Harvard names. If I say, he's the founder of a branch of medicine that gets people off perscription drugs, then ears perk up. Most people envision and doctor that will say "ok, the data is out there that medicines dont help so stop everything and go about your normal routine". Little do folks know, the concept he sticks to is to add the physical, mental, spiritual aspects of medicine in addition to special attention to nutrition. Using food as medicine is a old concept but with all the RCT's (randomized controlled trials) that are being quoted, referenced and repeated in medical circles and magazines, basic nutrition really doesn't make the trillion dollar profits for small organizations so it's not spoken of. Doctors don't have the time for nutrition counseling and in many cases, one's medical insurance will not cover a referal to a "dietician" unless the disease is already being manifested. I uses to always refer my patients to the dietician in my building back in the 90's and I distinctly remember when Sandy Gifford had to turn away petients due to poor coverage. (she would still see my patients and educate as best as possible on her own time because of our relationship) fact, doing things on personal time seemed to be what I always had to result in for getting around the limitations of insurance. Up until the time I stepped away from a 10 year practice with retirement just to send a message to the hospital that the patient is the bottom line not the dollar.
I know I was right mostly because of the feedback I still receive from old patients...even until now and I left my practice in 05. Patients are still feeling short changed from the time constraints of conventional insurance based medicine. Patients are also being given bigger and stronger drugs and several of them. I was aware of "laundry lists of medical problems and perscriptions for the elderly in nursing homes in the early 90's but now I am seeing it in 40-50 year olds(hypertension, diabetes, cholesterol). I am also seeing it in 10-20 year olds (adhd, diabetes, asthma). Now within the first year of life (reflux!).
As usual, there has to be a coexistence, modern medicine is great and very powerful. Trauma, rapid reversal of heart disease, cancer, kidney failure, premature birth, having 8 babies. But I think we are forgetting about nutrition, exercise and stress relief. This is how I see what I do is correct. To integrate old fashion health care with modern disease care is a must. Health care has to be individualized. Humans are so dynamic that everyone can't be labeled as a hypertensive or diabetic. I like what Chopra says regarding a new paradigm in medicine. The last few decades, medicine was so boastful to think if we knew the pathophysiologic pathway to a disease, then we could fix the disease by treating the pathway. Obviously this was the wrong thinking and now there are small fixes for every symptom in the world without fixing the mindset of the indiviual coming to us for the ailment/symptom. When I used to hear the term holistic medicine, I would think of someone who had little training in healing that people were going to in desperation of a better answer than what the doctor would tell them. Now I understand more about the best approach to healthcare and through the efforts of Dr Weil and others, the volume of people (healthcare and non medical) are "buying" into treating more than just a symptom or test result. Thus the idea of "integrating" mind, body, spiritual, environmental and nutritional thinking into the treatment plan. Hippocrates, the father of medicine said to use food as medicine, funny that its getting back to this!