By Dr. Nicole Cotter
Several years ago, I was feeling frustrated with medicine. I found myself sitting with patients unable to answer a simple question that was repeatedly asked: what should I be eating? My usual medical answer of a balanced, healthy diet all of a sudden seemed inadequate. At the time, I had small children and was becoming more and more concerned about what they were consuming and the effect it would have on their long term health. I was also consistently asked about common supplements and, aside from the very few we occasionally use in rheumatology, I was not familiar enough with them to give an educated response as to whether they were appropriate. Medical school does not teach us these things. In conventional (or “traditional”) medicine, I was well-trained to diagnose medical illness and prescribe appropriate medication. In a field of medicine that had so long been without adequate therapies, I had witnessed novel pharmaceuticals revolutionize the field of rheumatology, helping our patients live better and longer lives. Yet still I was frustrated. I kept thinking that something was missing. In addition to these life-saving treatments we as physicians prescribe every day, was there not more that I could be doing to care for my patients? Were other aspects of health, such as lifestyle, as important as the medicine we are taught in medical school?
Integrative Medicine is defined by the Arizona Center for Integrative Medicine as “healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies.”
Years later, I can confidently say the answer is YES. I went on a quest to learn about complementary practices, leading me to a community of physicians who are practicing something called Integrative Medicine. This community, to which I now claim to be a part, includes physicians from every specialty returning the focus of medicine to health and healing. Not only do we utilize conventional treatments, we blend the best of complementary therapies to take care of the whole person. We are using all the tools in the medical armamentarium, whether it comes in the form of a prescription medication, a supplement, a plant, a food, a mind-body practice, or one of the many other therapies we have available. What is even more exceptional is that these doctors are bringing integrative principles to the mainstream and are changing the face of medicine.
Integrative Medicine is defined by the Arizona Center for Integrative Medicine as “healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies.” It is medicine that focuses on the patient, integrates conventional and complementary methods for treatment and prevention, removes barriers that get in the way of a person’s innate healing response, uses less-invasive interventions before costly and invasive ones, and engages the mind/body/spirit/community to facilitate healing(1). Integrative Medicine is rooted in evidence, is effective, and simply makes sense for the patient and the physician. Although Integrative Medicine may make use of evidence-based alternative practices, it is not alternative medicine. Alternative medicine refers to the use of a non-mainstream approach in place of conventional medicine. Integrative Medicine is not a rejection of conventional medicine whatsoever but rather an embracing of all therapies that are safe and rooted in science. Why not use everything we have? That does not sound alternative to me. It sounds smart.
Let me illustrate with an oversimplified example. Let’s pretend we are talking about Mrs. Hypertension, a fifty-five year old woman who has had an elevated blood pressure for the past three months. In scenario one, she goes to visit her well-qualified, conventional doctor to talk about treatment. After a thorough evaluation in the limited time available, this doctor appropriately starts a blood pressure medication, also mentioning in passing that she should decrease her salt intake, eat a balanced diet, and get some exercise. In scenario two, Mrs. Hypertension goes to visit her integrative medicine doctor. After a lengthy discussion about her history, lifestyle, nutrition, family, stress, and spirituality, Mrs. Hypertension leaves with a prescription for an exercise program that includes aerobic exercise and yoga, comprehensive guidance for following the DASH (Dietary Approaches to Stop Hypertension) diet, instructions for progressive muscle relaxation (a mind-body therapy), and answers to whether the chinese herbal blend that was recommended by her cousin is an appropriate choice for her. Can you see the difference? The integrative medicine approach is comprehensive, taking into account all aspects of Mrs. Hypertension’s lifestyle and focuses on personal healing rather than just symptom management.
There is a movement towards health and healing in the world today and people are taking more active roles. Like the patients I described asking me about diet and supplements, people want to know “what else can I do”? Approximately 40% of the US population is using complementary and alternative medicine in some form. People are asking “why do I have this disease and can I reverse it?” Their children are asking “how can I prevent it?” It makes sense to me that we physicians are the ideal people to help patients navigate complementary medicine while continuing to apply the knowledge we gained in medical school. This is Integrative Medicine. Dr. Andrew Weil, the physician who coined the term, has said that one day we will stop calling it integrative medicine and just call it good medicine. I believe he is right.
1. Rakel, David. Integrative Medicine. Third ed. Philadelphia, PA: Elsevier, 2012.
Dr. Nicole Cotter is a rheumatologist and integrative medicine doctor practicing in Shreveport, Louisiana. She graduated from LSU School of Medicine in Shreveport, did an Internal Medicine residency at Baylor College of Medicine in Houston, and has completed fellowships in Rheumatology at LSU and Integrative Medicine through the Arizona Center for Integrative Medicine. She is the owner of Integrative Medicine of Shreveport-Bossier. Dr. Cotter believes that an integrative approach to health is ideal. When not in clinic, you can find her reading, running, cooking with her husband or chasing her two kids.