There is only one medicine: one that prevents, cures or gives the patient quality of life. Integrative or integrative medicine thus breaks the distinction between conventional and alternative approaches, bringing together the best of each.
Sometimes the future is in the present. It is increasingly common to find health professionals who practice so-called integrative or comprehensive medicine. It is a vision of health that is not interested in positioning itself exclusively in favor of conventional medicine or natural or alternative medicines.
For professionals who practice integrative medicine there is only one medicine: the one that cures. The objective is to apply at all times the technique or therapy that is most useful for the well-being of the patient. In addition, they put patients ahead as people, treating them both physically and emotionally, not just as a nameless body with nothing to say that has fallen ill.
PATIENTS WANT TO PARTICIPATE IN TREATMENT
Integrated medicine has emerged as a logical response to two growing trends. The first is carried out by patients who naturally resort to treatments that have institutional support and, at the same time, to therapies whose effectiveness is still officially questioned, such as acupuncture or homeopathy.
Let us remember that, according to a study carried out by Alex Molassiotis, from the University School of Nursing and Social Work in Manchester (United Kingdom), one in three European cancer patients currently resorts to therapies such as herbal medicine and homeopathy. 50% of them seek to increase their defenses against disease, 40% want to improve their physical condition and 35%, the emotional one.
The second trend is manifested through doctors with a solid academic training who are interested in natural medicines. A tangible proof of this fact is that more than 2,000 graduates throughout Spain today have some type of training in unconventional therapies.
For Dr. Andrew Weil, one of the main popularizers of integrative medicine through his books and his work as a professor at the University of Arizona (United States), “integrative medicine is the way of the future, not only because it is the kind of medicine that most patients demand, but also the kind that more and more doctors want to practice.”
Citizens and health professionals are building a new model of health care that is offered as a better option than the current health systems, dominated by bureaucracy and economic interests.
It also presents itself as a horizon for natural therapists who work in isolation and who seem at odds with modern scientific medicine. It is a model that is currently being tested with different formulas in small clinics, advanced health centers or some departments of large public hospitals.
WHAT IS INTEGRATIVE MEDICINE?
Integrative medicine is more than just good intentions. Experts have defined a series of principles that characterize it:
- It is a patient-centered practice. It means that you take into account your decisions and your ability to manage the disease.
- It also means that, in addition to providing the appropriate treatment, it considers aspects such as your emotional state or your beliefs about the disease. In this way, it is possible for the doctor and the patient to build a quality relationship, based on trust and empathy, which influences the outcome of the treatment.
- Consequently, the consultations marked by the stopwatch are not admissible and the treatments are not the protocols for each disease, but are personalized. Integrated medicine recovers the human factor in the art of healing, something that could not be quantified in clinical trials and that threatened to disappear in the face of the diagnostic capacity of analyzes and scans.
- A combination of therapies is used. The body”s ability to heal itself is considered to need to be stimulated, something that can be done through homeopathy, diet, or relaxation techniques. Whenever possible, interventions with fewer side effects and less invasive are preferred, but the utility of resorting to synthetic drugs, surgery or chemotherapy is also recognized. In the integrative medicine of the future, for example, stem cell therapy and medicinal plants could be combined.
TRADITION AND RESEARCH
Another feature is the synthesis of science and common sense. Natural therapies are often criticized because they supposedly do not undergo the scrutiny of the rigorous scientific method. And at the same time, they look the other way to habitual medical practices that are not justified, such as the prescription of antibiotics when it is not necessary.
Integrative medicine is open to traditional views of health that are supported by experience, although they do not have conclusive clinical trials, but it also appreciates the scientific evidence on the effectiveness of each treatment. Integrative medicine professionals use three parameters:
- Effectiveness. With a scale they evaluate the effectiveness of the treatments that can be applied. Thus, they have verified that diet and orthomolecular nutrition, and physical disciplines – such as osteopathy, chiropractic or certain massages – have scientific publications that support their results. Rigorous studies on herbal medicine and mind-body therapies have also been published. Then there is a series of treatments that could be defined as “energetic”, such as kinesiology, reiki or Bach flowers, on which there is no scientific agreement, but which generally lack side effects and which have a place in a practice. Open and tolerant clinic, as many patients feel that it benefits them.
- Innocuousness. The second parameter is important in this regard, since it establishes a law: the greater the risks and side effects involved in a treatment, the greater the demand for scientific evidence in its favor. And on the contrary, the safer it is, the less difficulties it should encounter for its application.
- Saving. Finally, the third parameter takes into account the economic cost of the treatments. Betting on a rational analysis of efficacy, safety and price means practically a revolution in current sanitary practices.
In the context of integrative medicine, promoting healthy habits and prevention are more than just pretty words. While conventional medicine investigates diseases, integrative medicine is interested in maintaining health or a state of balance between all the systems that make up the body.
In this sense, the doctor must not only display great academic knowledge, but must try to be an example of the attitudes and behaviors that favor health.
Health centers inspired by integrative medicine attempt to offer continuity of care. That is, as far as possible, patients should carry out consultations, tests and treatments in the same place, at the hands of doctors who follow their evolution and have access to all the information about their case.
The patient should not have the feeling that he is passing from expert to expert, but rather that he is welcomed by a reference doctor and a group of professionals who know him and work as a team.
For Dr. Josepha Rigau, a specialist in immunology, trained in Germany, “working with a team of professionals with the criteria of integrative medicine is like a dream” that allows, for example, to combine immunological therapy and nutritional therapy with surgery, chemotherapy and radiation therapy in cancer patients.
Emilio Alba, former president of the Spanish Society of Medical Oncology, points out that his organization is not against alternative therapies, especially those that do not involve taking any type of substance. “We are convinced that acupuncture, yoga or meditation can be positive in cancer patients. But when it comes to taking a compound, you should always consult your doctor,” he says.
A MORE EFFECTIVE APPROACH TO CHRONIC DISEASES
The conventional medicine model has proven to be very useful in treating acute and serious illnesses, especially through surgery and technological means. In many cases, there is no better option to save your life.
However, it is not as effective in improving the condition and meeting the needs of many chronically ill patients or those with still poorly understood disorders. In the first cases, integrative medicine can promote recovery and, in the second, it offers the possibility of improving the quality of life and even healing.
Dr. José Francisco Tinao, director of the Integrative Medicine Clinic, explains that it is characterized by the preventive and therapeutic approach to chronic conditions. In fact, the Clinic has specialized in chronic and environmental diseases, such as obesity, food intolerances, fibromyalgia, chronic fatigue, autoimmune diseases, multiple chemical syndrome, dermatitis or migraines.
The treatment of osteoarthritis – a disease that affects a high percentage of people over 50 years of age – can serve as an example. The patients fill out the outpatient consultations where they will collect the prescriptions for the protocol treatment: analgesics, anti-inflammatories and stomach protectors that prevent the side effects of the former. Using natural therapies can also reduce discomfort, as well as the risk of side effects, and improve evolution.
- The phytotherapist would prescribe plant extracts with anti-inflammatory properties, such as ginger, pineapple and turmeric, in addition to depurative plants, since the origin of osteoarthritis can be an accumulation of metabolic residues due to insufficient functioning of the body”s elimination systems, an inadequate diet and sedentary habits.
- The nutritional therapist would add a fish oil supplement rich in omega-3 fatty acids, and recommend an anti-inflammatory diet, low in sugar, salt, and saturated animal fats, and rich in cereals, fruit, vegetables, and oily fish.
- The naturopathic doctor would prescribe regular hydrotherapy treatments, and the acupuncturist would relieve pain with needles or moxibustion.
STARTING AT THE UNIVERSITY
For patients to receive comprehensive treatment, there must be health centers with specialists in different therapies and that they work as a team. But first it would be convenient for this way of working to be taught in universities.
In the United States, since 2000, there has been a consortium of academic centers – some of great prestige, such as the universities of Arizona, Yale or Harvard – whose objective is to introduce integrative medicine into the curricula.
In Mexico, Chile and Argentina there are university initiatives in the same direction. In Europe, there is a European Society of Integrative Medicine, and in Spain we have several professional organizations, such as the Spanish Society of Health and Integrative Medicine, the Spanish Association of Integrative Doctors and the Spanish Federation of Integrative Medicine.
SOCIAL SECURITY AND INTEGRATIVE MEDICINE
Within the Spanish Social Security, some health centers are taking the first steps towards integrative medicine, such as the Virgen de las Nieves University Hospital in Granada, which includes acupuncture in its pain unit; the Mataró Hospital, near Barcelona, which offers acupuncture and homeopathy services; the Sagrada Familia primary care center in Barcelona, where patients have the opportunity to consult with experts in Bach flower, homeopathy, acupuncture and osteopathy at a reduced price.
However, for now it is in small private clinics where the service that best suits the definition of integrated medicine is offered, although the lack of means does not always allow incorporating the most advanced technologies. Something that the MD Anderson Cancer Center in Houston (United States) can do, where the most sophisticated therapies for each type of cancer are combined with the resources of its Integrative Medicine Clinic, with acupuncturists, homeopaths, nutritionists, physical therapists and experts in natural remedies, relaxation techniques or music therapy.
The future of medicine will be what people want. Every day patients have more knowledge and access to different therapies. It will be they who will exert their influence so that private and public centers offer integrated treatments.
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