What is Integrative and Collaborative Medicine and How Does it Work?
After recently attending a conference in Philadelphia, Pennsylvania, I found myself in conversation at the airport with a retired pediatrician. She asked me what I was doing at my conference and I explained I was at a Quantum Leap meeting learning how to spread my message that integrative medicine, or combining the best of conventional Western medicine with the best of complementary therapies, creates a win-win scenario for patients. When I said “integrative medicine” her faced scoffed. I have seen that face before, so I was not alarmed, though my heart sank as it always does knowing that this woman simply had not been exposed to quality complementary medicine.
I went on to explain I am a Doctor of Acupuncture and Oriental Medicine. As I did so, I noticed her hands trembling from what seemed to be a non-essential tremor. She mentioned her daughter strongly encourages her to get acupuncture, as her daughter praises acupuncture regularly for being very calming to the nervous system, among other things. She admitted she did try acupuncture, but only twice. She reported, “it didn’t work.” I did not ask her what her chief complaint (the primary symptom/illness a patient would like to be addressed) was for the visits. However, if it was for her tremors, she would likely need a series of acupuncture treatments, many more than two treatments, along with Chinese herbs and using food as medicine to see results.
I chose to ask her how I could spread my message in a non-threatening way to people like her who turns a cold shoulder to the idea of integrative medicine. Trembling as she picked up her coffee, she said that she is disgusted with people no longer valuing science as they used to. She said she prefers evidence-based medicine. This woman came from a regimented background. I got it. I got her.
After all, if you are a person who has spent upwards of $200,000 and the majority of your life immersing yourself in the education, thought processes and rigors of Western medical science, opening yourself to other paradigms of care would not be easy. Fortunately, there is enough clinical research to point out that acupuncture and other complementary therapies actually cause physiological changes in the body. If she were my patient, I would list some of the studies and their clinical results to help her feel more comfortable. For example, studies show that in response to acupuncture needles being placed under the skin, the fascia (connective tissue that surrounds our muscles, ligaments, organs, etc) stretches in response, showing that there are synapses between the cells of the fascia. That suggests that the fascia may be a whole other communication system in the body. Also, under MRI, the brain lights up in response to needle stimulation, but no scientist has been able to understand the how or why.
That said, research is not designed to account for the intricacies of the make-up of each, unique individual patient. For scientific people like me, that reason alone has me questioning the current gold standards of research that are associated with randomized, double-blinded research studies.
It is has been my head-strong philosophy to reach as many people as possible with my message by taking the “woo-woo” out of complementary medicine approaches like acupuncture, chiropractic, homeopathy and functional medicine. It is important to meet each person where they are in terms of their knowledge and belief systems. In my everyday practice, I go from patient to patient with the intention of having an open mind and HEARING what the patient has to say. What does the patient believe to be true about his or her health (after all, the patient does know best). In essence, doing just that captures the essence of integrative medicine. For me, practicing integrative medicine means working hand in hand with and for the patient by considering the whole person as one complex being. Mind, body and spirit are addressed by combining various methods of care that effectively get to the root of patients’ chief complaints.
My 14 years of clinical experience have taught me that each modality of care has something useful, practical and beneficial to offer the patient. Furthermore, not one doctor can cover all the bases necessary to achieve complete and total healing within a patient because none of us have that much time in the day or the ability to be an expert in all areas of health. The power of integrative care lays in cherry picking the best each therapy has to offer each patient in a way that solves the patient’s chief complaint in the most efficient manner as possible.
It would be curious to find out how the retired pediatrician may change her thinking if acupuncture resolved her tremor like I have seen happen with several of my own patients. Likely, her disbelief and resistance would melt away, as I have seen happen a myriad of times for patients, which would create space for more healing.
~Dr. April Schulte
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