Monthly Archives: September 2016

Experts explore new ways to treat the mind, body, and spirit -- all at the same time.

At age 68, Martha McInnis has had her share of health woes: breast cancer, high cholesterol, clogged arteries, osteoporosis, and scoliosis -- curvature of the spine. Once a year she journeys from her home in Alabama to the Duke University Medical Center in North Carolina where an internist, endocrinologist, and other specialists monitor her with blood tests, X-rays, bone scans, and other tests.

But McInnis knows that she's more than the sum of her illnesses. When her checkup ends, she heads for the Duke Center for Integrative Medicine, where she has learned about nutrition, fitness, yoga, tai chi, meditation, and other practices she says have helped her to live better. "I became an avid tai chi person," she says. "I'm a type A personality. I knew I had to do something about my lifestyle. I had to bring myself down to a type B."

Many Americans have never heard of integrative medicine, but this holistic movement has left its imprint on many of the nation's hospitals, universities, and medical schools.

Both doctors and patients alike are bonding with the philosophy of integrative medicine and its whole-person approach -- designed to treat the person, not just the disease.

IM, as it's often called, depends on a partnership between the patient and the doctor, where the goal is to treat the mind, body, and spirit, all at the same time.

While some of the therapies used may be nonconventional, a guiding principle within integrative medicine is to use therapies that have some high-quality evidence to support them.

The Duke Center for Integrative Medicine is a classic model of integrative care. It combines conventional Western medicine with alternative or complementary treatments, such as herbal medicine, acupuncture, massage, biofeedback, yoga, and stress reduction techniques -- all in the effort to treat the whole person. Proponents prefer the term "complementary" to emphasize that such treatments are used with mainstream medicine, not as replacements or alternatives.

Integrative medicine got a boost of greater public awareness -- and funding -- after a landmark 1993 study. That study showed that one in three Americans had used an alternative therapy, often under the medical radar.

In the past decade, integrative medicine centers have opened across the country. According to the American Hospital Association, the percentage of U.S. hospitals that offer complementary therapies has more than doubled in less than a decade, from 8.6% in 1998 to almost 20% in 2004. Another 24% of hospitals said they planned to add complementary therapies in the future. Patients usually pay out of pocket, although some services -- such as nutritional counseling, chiropractic treatments, and biofeedback -- are more likely to be reimbursed by insurance.

What makes integrative medicine appealing? Advocates point to deep dissatisfaction with a health care system that often leaves doctors feeling rushed and overwhelmed and patients feeling as if they're nothing more than diseased livers or damaged joints. Integrative medicine seems to promise more time, more attention, and a broader approach to healing -- one that is not based solely on the Western biomedical model, but also draws from other cultures.

"Patients want to be considered whole human beings in the context of their world," says Esther Sternberg, MD, a National Institutes of Health senior scientist and author of The Balance Within: The Science Connecting Health and Emotions.

Sternberg, a researcher who has done groundbreaking work on interactions between the brain and the immune system, says technological breakthroughs in science during the past decade have convinced even skeptics that the mind-body connection is real.

"Physicians and academic researchers finally have the science to understand the connection between the brain and the immune system, emotions and disease," she says. "All of that we can now finally understand in terms of sophisticated biology."

That newfound knowledge may help doctors to see why an integrative approach is important, she says.

"It's no longer considered fringe," Sternberg says. "Medical students are being taught to think in an integrated way about the patient, and ultimately, that will improve the management of illness at all levels."

The Osher Center for Integrative Medicine at the University of California, San Francisco, takes a similarly broad view of health and disease. The center, which includes a patient clinic, says on its web site: "Integrative medicine seeks to incorporate treatment options from conventional and alternative approaches, taking into account not only physical symptoms, but also psychological, social and spiritual aspects of health and illness."

To promote integrative medicine at the national level, the Osher Center and Duke have joined with 42 other academic medical centers -- including those at Harvard, Columbia, Georgetown, and the University of Pennsylvania -- to form the Consortium of Academic Health Centers for Integrative Medicine.

Even medical schools have added courses on nontraditional therapies, although doing so can sometimes be a point of contention among faculty.

At the University of California, San Francisco, medical students can augment their coursework in infectious disease and immunology with electives, such as "Herbs and Dietary Supplements" or "Massage and Meditation." They can even opt to study as exchange students at the American College of Traditional Chinese Medicine. In the world of integrative medicine, it's not unusual to see a Western-trained MD who also has credentials in acupuncture or hypnosis, or a registered nurse who is also a yoga teacher and massage therapist.

Not all doctors are jumping onboard, though. Some critics have charged that integrative medicine is driven largely by market forces, as well as public fascination and demand for alternative treatments.

"This is a very faddish country," says Tom Delbanco, MD, a Harvard Medical School professor and doctor at Beth Israel Deaconess Medical Center in Boston. In one national survey of hospitals that offer complementary therapies, 44% listed "physician resistance" as one of the top three hurdles in implementing programs, along with "budgetary constraints" (65%) and "lack of evidence-based research" (39%).

Delbanco says he's concerned that there's not enough scientific evidence to justify the amount of resources spent on integrative medicine and complementary therapies. "I worry that people are making claims in the context of scientific medicine that they cannot really justify. I think there have been few rigorously controlled, scientifically sound studies in the area, and when they have been done, the vast majority have shown these medicines to be no different from placebo."

"I have no trouble with offering hope," he adds. "I think people need hope and optimism. Where I have trouble is when we promise things to people that aren't real."

The search for solid evidence is key: which therapies help and which don't? "There's a clamoring for understanding the biology of this," Sternberg says. Many proponents of integrative care say that it's crucial to hold alternative therapies up to scientific scrutiny, rather than dismissing them outright, because doctors and patients alike need answers. For example, a patient may be taking an herb that is harmful or may interfere with prescription drugs.

As a result, researchers across the country are studying complementary and alternative therapies for safety and effectiveness. Duke is studying whether stress-reduction techniques, such as meditation and writing in a journal, can help prevent preterm labor, which can be precipitated by stress-related hormones. In other clinical trials, researchers are trying to determine, among other things, how acupuncture affects brain activity, how biofeedback can better treat incontinence, and whether the medicinal herb valerian improves sleep in patients with Parkinson's disease.

With the large numbers of people using nontraditional therapies, even finding out what doesn't work can be valuable. For example, researchers affiliated with the Osher Center at the University of California, San Francisco, completed a study that showed that saw palmetto did not improve benign prostate hyperplasia, a noncancerous enlargement of the prostate gland. More than 2 million men in the U.S. take saw palmetto as an alternative to drugs. The results were published in The New England Journal of Medicine.

Tracy Gaudet, MD, director of the Duke Center for Integrative Medicine, says she encounters little resistance once fellow doctors understand that integrative medicine doesn't entail "blindly advocating for alternative approaches and rejecting conventional ones."

"That's not what we're about," she says. "There's a lot of quackery out there and a lot of dangerous therapies. Our first priority is to guide people away from them."

"We all want the same thing: the best care for patients," Gaudet says.

SOURCES: Esther Sternberg, MD, director, Integrative Neural Immune Program; chief of section on neuroendocrine immunology and behavior, National Institute of Mental Health and National Institutes of Health. Tracy Gaudet, MD, director, Duke Center for Integrative Medicine, Duke University. Susan Folkman, PhD, director, Osher Center for Integrative Medicine, University of California, San Francisco; chairwoman, Consortium of Academic Health Centers for Integrative Medicine. Tom Delbanco, MD, professor of general medicine and primary care, Harvard Medical School. Eisenberg, D.M. The New England Journal of Medicine, Jan. 28, 1993; vol 328: pp 246-252. Bent, S. The New England Journal of Medicine, Feb. 9, 2006; vol 354: pp 557-566. American Hospital Association statistics book, 2004. Osher Center for Integrative Medicine web site. ClinicalTrials.gov web site: "Effect of Acupuncture on Human Brain Activity;" "Enhancing Non-Pharmacologic Therapy for Incontinence;" Valerian to Improve Sleep in Patients With Parkinson's Disease."

Original post:
What Is Integrative Medicine? - WebMD

Integrative medicine, sometimes referred to as holistic medicine or complementary medicine, combines conventional and alternative approaches to address the biological, psychological, social and spiritual aspects of health and illness. Our services are available for both adults and children.

Beaumont's Integrative Medicine Program focuses on healing the whole person, with the goal of improving quality of life for patients, their families and others close to them.

We offer clinical massage, acupuncture, naturopathy, guided imagery, reflexology, energy balancing with Reiki, scar therapy, lymphatic wellness massage, Indian Head Massage, hydrotherapy, Cranial Sacral Therapy, neuromuscular therapy, meditation and yoga which combine the best of Eastern traditions while complimenting traditional Western medical practice.

The goal of any successful integrative medicine program is to truly "integrate" allopathic medicine with mind-body-spirit modalities with the ultimate goal of helping patients adapt to traditional medical treatments. Our modalities directly affect the body's physiological healing process while gently awakening the mind-body-spirit connection needed to enhance the healing process.

Beaumont is also one of only a few centers in the United States who offers oncology/hospital massage training. This graduate program, overseen by Beaumont's integrative medicine department is offered through Beaumont's School of Allied Health.

Patients, their caregivers and the hospital staff need both private and group programs therefore we have structured our offerings around their stated needs. Individual treatments (regardless of hospital affiliation) include:

Our Medical Director, Maureen Anderson M.D., is board certified by the American Board of Integrative and Holistic Medicine, with additional education in the functional medicine approach. Her primary training and board certifications are in emergency medicine and general pediatrics. Over the years, Dr. Anderson has cared for patients of every age, presenting with a whole constellation of symptoms and diseases.

The wisdom and experience gained during years as an emergency physician have afforded her a unique and broad perspective, which nicely complements her integrative medicine skills and expertise. Dr. Anderson brings all of this, along with a passion for wellness, and a genuine interest in the total well-being of others to her integrative medicine practice

Link:
Integrative Medicine at Beaumont

Integrative medicine avoids the false dichotomy between conventional and complementary medicine. New therapies are selected on the basis of their scientifically proven safety and effectiveness, regardless of their origin. The result is an array of services intended to tackle the complex dynamics contributing to your health. Often, the physical state is symptomatic of mental, emotional, social, spiritual, or environmental factors that only a comprehensive, personalized health plan can resolve.

At the core of integrative medicine is the concept of the partnership between patient and healthcare practitioner. With a preference for the least invasive and most natural therapies, the full range of the healing sciences is brought to bear on strengthening your innate healing response by physicians and providers trained in both conventional and integrative medicine. When you have recovered your health and vitality, we will help you maintain your wellness and prevent the onset or recurrence of disease.

To learn more, see our Patient Bill of Rights.

At Duke Integrative Medicine, we operate our practice at the highest possible standards of excellence in a world-class facility Duke Universitys Center for Living Campus. Nestled in the woodlands of Duke Forest, and surrounded by serene meditation gardens, we offer quiet, soothing, contemplative spaces designed to calm and focus your senses and rejuvenate your spirit. Find your answers in our library under a cathedral ceiling, surrounded by walls of glass and views of nature, or visit with like-minded souls in our Integrative Caf. Every feature of the environment is designed to nourish the wellness within.

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About - Duke Integrative Medicine

Cleveland Clinic Childrens Center for Pediatric Integrative Medicine is dedicated to addressing the increasing demand for integrative healthcare by researching and providing access to practices that address the physical as well as lifestyle, emotional, and spiritual needs of children.

As the body of evidence for integrative medicine grows, we remain at the forefront of providing the most updated education and practices to our patients. We are able to care for children through their mid-20s, then provide seamless transition to adult providers.

Integrative Medicine services have become very popular in the United States, with more than 70 percent of Americans using them in some form.

Your child may benefit from integrative medicine as a complement to the care they are already receiving to treat chronic illness. Integrative medicine may help to reduce the severity or frequency of disease episodes, decrease stress related to chronic disease, and enjoy a better quality of life.

Our team members can coordinate appointments together to provide the patient with the best care.

Our team of dedicated pediatric physicians and therapists are certified to perform a number of complementary therapies, including:

Conditions that are commonly treated with integrative medicine include:

Increasingly, research shows that how we live, what we think, and how we feel affect our health. While conventional medicine can help diminish the consequences of unhealthy lifestyles, integrative medicine can reverse those consequences, prevent illness and reduce symptoms, resulting in:

Our team of dedicated pediatric physicians and therapists are certified to perform a number of complementary therapies, including:

The Center for Pediatric Integrative Medicine looks into the role of mind, body, spirit and lifestyle changes and how they can affect chronic disease. Studies yield evidence-based results that continue to encourage medical schools, hospitals and physicians to accept and incorporate these methods.

For example, research at Cleveland Clinic has shown that integrative medicine, including guided imagery, massage or Reiki, can help patients reduce their anxiety before surgery, to cope better with postoperative pain and to maximize their recovery.

To learn more, we invite you to explore research from the:

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Pediatric Integrative Medicine | Cleveland Clinic Children's

Integrative medicine is an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a persons health. Employing a personalized strategy that considers the patients unique conditions, needs and circumstances, it uses the most appropriate interventions from an array of scientific disciplines to heal illness and disease and help people regain and maintain optimum health.

Integrative medicine is grounded in the definition of health. The World Health Organization (WHO) defines health as a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.

Integrative medicine seeks to restore and maintain health and wellness across a persons lifespan by understanding the patients unique set of circumstances and addressing the full range of physical, emotional, mental, social, spiritual and environmental influences that affect health. Through personalizing care, integrative medicine goes beyond the treatment of symptoms to address all the causes of an illness. In doing so, the patients immediate health needs as well as the effects of the long-term and complex interplay between biological, behavioral, psychosocial and environmental influences are taken into account.

Integrative medicine is not the same as alternative medicine, which refers to an approach to healing that is utilized in place of conventional therapies, or complementary medicine, which refers to healing modalities that are used to complement allopathic approaches. If the defining principles are applied, care can be integrative regardless of which modalities are utilized.

The defining principles of integrative medicine are:

In addition to addressing and handling the immediate health problem(s) as well as the deeper causes of the disease or illness, integrative medicine strategies also focus on prevention and foster the development of healthy behaviors and skills for effective self-care that patients can use throughout their lives.

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What is Integrative Medicine? - Duke Integrative Medicine