Reflections from an Integrative Medicine Panel

I had the pleasure of moderating a panel on integrative medicine that included Drs. Andrew Weil, Victoria Maizes, and Adi Haramati.

This panel was a “dream team” of integrative medicine, as it included the founder of the  integrative medicine movement (Andrew Weil), an innovator in integrative medicine education (Victoria Maizes) and a leading integrative medicine researcher (Adi Haramati).

Following are the reflections on the discussion that ensued:

How can integrative medicine be incorporated into 15-minute clinic visits that have become (unfortunately) the norm?

• Even 1 or 2 good minutes devoted to nutrition and lifestyle would be a major step forward from the status quo, where these critical topics are often ignored.
• The ultimate solution rests in pushing for longer clinic visits. Short visits, often mandated by healthcare systems, frustrate both patients and their health care providers.

Integrative medicine is often accused of lacking a solid scientific basis. What is the principle for deciding what to incorporate and what to reject?

• The greater the potential for harm, the greater the weight of evidence that is required to recommend a treatment. For example, breath work for stress management does not need the same level of supporting evidence as an herbal therapy for a potentially serious disorder.

Since integrative medicine approaches are typically multi-modality, isn’t it difficult to apply the typical scientific process that requires all variables to be held constant so that one intervention at a time can be tested?

• Integrative medicine treatment plans are often multi-modality, directed at both mind and body. Accordingly, several treatment recommendations are often made simultaneously, making the mechanism of action difficult to determine. However, in integrative medicine research, the panel believed that the most important consideration is whether the entire treatment package is found to beneficial or not.
• For example, if an integrative approach to back pain that includes acupuncture, exercise, and stress management is found to be superior to conventional approaches, that finding is extremely valuable even if the impact that each modality contributed to the final outcome is unknown.

Proponents of integrative medicine are often “swimming upstream” in a traditional medical system. What aspects of leadership are required to help bring about change?

• The panelists relayed stories about how they were successful in opening doors to integrative medicine by identifying champions in positions of power within their organizations who believed in their work and supported them during periods of initial resistance.
• It was also mentioned that openings for greater utilization of integrative medicine can often be found in health care providers and administrators who make use of integrative approaches for their own self care, but who have not yet adopted them in patient care.