John A. Patterson MD MSPH FAAFP
May 20, 2022
Conventional Western biomedicine has its limits.
Health professionals and consumers are both interested in safe, effective, low-cost, high-quality approaches to promote health, prevent disease, manage symptoms and relieve suffering. In particular, conventional medicine’s limited effectiveness in managing chronic diseases has been an important factor in the exploration of alternative options by health professionals and the public. These options have been described by several terms, including alternative, complementary, holistic, integrative, humanistic, biopsychosocial, behavioral, new, mind-body and mind-body-spirit.
Complementary medicine generally refers to approaches that are used along with and complement conventional medicine. Alternative medicine generally refers to approaches that are used to replace, or used instead of, conventional medicine. The term integrative medicine has become the most widely accepted name for this combination of conventional medicine with complementary and alternative medicine (CAM).
Health professionals are increasingly interested in integrative medicine as research has demonstrated safety and effectiveness of CAM use for many conditions that are inadequately controlled by conventional approaches. When confronted with patients whose chronic conditions are poorly controlled by conventional medicine, most health professionals are more interested in helping relieve suffering than remaining committed to treatments that give only partial relief. They want options as much as their patients do.
Consumers and health professionals can both rely on the National Institutes of Health (NIH) for current, scientifically-validated advice on the integration of conventional medicine with CAM approaches. The congressionally-funded National Center for Complementary and Alternative Medicine (NCCAM) was established at NIH in 1992. It’s name is now National Center for Complementary and Integrative Health (NCCIH), whose mission is to “determine, through rigorous scientific investigation, the fundamental science, usefulness, and safety of complementary and integrative health approaches and their roles in improving health and health care.” NCCIH’s vision is that “scientific evidence informs decision making by the public, health care professionals, and health policymakers regarding the integrated use of complementary health approaches in a whole person health framework.”
The NCCIH web site allows you to search by health topic (such as sleep disorders or sinus infections) or by treatment approaches (such as melatonin or sinus irrigation). The information presented is based on current scientific evidence, some of which has been generated by research funded by NCCIH itself. The recommendations are free of any commercial bias and allow you to make sense of advertising claims and testimonials that you encounter in the media, online and in conversation with friends and family.
A question that often arises regards the level of evidence required in order to justify recommending a particular treatment. This concern applies equally to CAM and conventional medicine. Scientific research seeks to explain ‘how and why’ any approach works- whether CAM or conventional. Often, however, despite a treatment approach’s safety and effectiveness, answering these ‘how and why’ questions is not possible. We simply know it works. We don’t yet know ‘how or why.’ For many CAM and conventional approaches, research demonstrates safety, effectiveness and acceptance based on affordability and congruence with values and beliefs. This is sufficient to recommend selected treatment approaches, while we continue to investigate the ‘how and why’ of mechanisms of action.
One potential advantage of this ‘new’ integrative medicine is the reduction in the use of prescription medication. Integrative medicine can sometimes permit the substitution of non-pharmacologic approaches for pharmacologic, prescription medication. Such reductions can sometimes result when a CAM approach is carefully selected and delivered by a well-trained CAM provider with respectful, open communication between the consumer, their CAM provider and the conventional health professional that has prescribed medication.
In addition to their desire to relieve suffering, all health professionals (conventional as well as CAM) seek to avoid doing harm. Despite the life-saving potential of modern medicine, treatments can sometimes cause serious harm, side effects, drug interactions, financial strain, allergic reactions and even death. Integrative medicine is providing consumers, their CAM providers and their conventional practitioners ways to individualize care that promotes health, prevents disease and relieves suffering.
National Center for Complementary and Integrative Health (NCCIH)
About the Author-
Dr Patterson is past president of the Kentucky Academy of Family Physicians and is certified in family medicine, integrative holistic medicine, mind body medicine, mindfulness-based stress reduction (MBSR), Mindful Practice in Medicine, yoga therapy and physician coaching. He is on the faculty of Saybrook College of Integrative Medicine and Health Sciences (Pasadena) and the Center for Mind Body Medicine (Washington, DC). He teaches stress management for the University of Kentucky Health and Wellness Program and operates the Mind Body Studio in Lexington, where he offers integrative medicine consultations and group classes. He can be reached through his website at www.mindbodystudio.org