Posted on | March 23, 2009 | 1 Comment
Any combination of “medicine” and “philosophy” often is cause for deep skepticism. But a philosophy of medicine and, more importantly, health, need not seem so strange or incompatible with the evidence-based medicine with which we tend to be more comfortable. For integrative medicine, this philosophy is a strategy—a way to view and approach the public and one’s own well-being. The philosophy behind integrative medicine is a focus on all stages and aspects of an individual’s care, placing the patient at the center and making the individual responsible for and involved in one’s own health. The physical, mental, social, spiritual, environmental, and other states of being must be considered to ensure that patients receive the highest quality and most comprehensive and coordinated care possible. Ultimately, this is what we all hope for in our own care and the care of those we love. Personalized, predictive, and preventive—watchwords for truly integrative care.
The philosophy of integrative medicine is not simply a hope for what medicine could be, but an approach to make it what it should be. Integrative medicine encourages coordination across institutions and caregivers—cardiologists, general practitioners, psychiatrists, and others working together for the good of their shared patient. And there must be a solid evidence base for whatever health strategies or interventions are employed. Just as no medicine should be accepted simply because it is common if there is no evidence of its efficacy, no option should be rejected if there is strong evidence to support it.
This openness to multiple modalities of care is what often maligns integrative medicine, and it is often wrongly equated with “alternative” therapies. Our earliest effective treatment for malaria, quinine, is derived from a tree bark in the Amazon—and a contemporary malaria treatment, artemisini, is derived from Chinese herbal medicine. This is not to say we must adopt—or reject—all traditional treatments. Rather, we should apply the same standards of evidence to all care, be it the newest pill from the pharmaceutical industry or tai chi to prevent falls in the elderly. If the evidence is strong that a specific strategy helps maintain, recover, and restore health, then we have every reason to employ it.
This conversation and many related topics were the basis for a recent gathering at the Institute of Medicine on February 25-27 in Washington, DC, attended by more than 600 people from all quarters of health and medicine. Participants were knowledgeable and passionate about improving our approach to patient care and partnering with patients to advance their health. The summit’s success promises great things for a future in which health care, from birth to death, is directed toward health and well-being rather than toward a strict orientation to disease management. Speeches and presentations from the Summit on Integrative Medicine and the Health of the Public are available online, and I invite you to click here to watch.