Over the past several years, the country's healthcare system has been plagued by staff shortages — most notably a shortage of nurses and primary care providers. This has disrupted the continuity of care for patients and has resulted in fragmented care in which the patient's immediate physical needs are addressed, but not every care option is explored. Is integrative medicine the answer?
What is integrative medicine?
Integrative medicine is a well-coordinated effort between providers to combine traditional healthcare methods such as diagnostic testing, physical rehabilitation, and medication with evidence-based complementary and alternative medicine (CAM) therapies such as yoga, massage, and hypnotherapy.
It's a personalized approach that takes into consideration every aspect of a patient's being — mind, body, and spirit. According to Cleveland Clinic, integrative medicine focuses on the "whole person" and not just a patient's illness or affected organs.
Understanding illness, relieving symptoms, and helping the patient to physically heal remain the priorities. Yet integrative medicine also considers a patient's emotional, mental, social, and spiritual needs, as well as how they impact each other, affect a patient's overall health, and potentially bring on illness.
For the integrative approach to net positive results, patients need to have a collaborative relationship with their care providers that allows for discovery of every variable that can negatively affect a patient's health and find solutions.
During a recent podcast that explored integrative medicine, Cara Lunsford, RN, Vice President of Community for Relias and host of NurseDot Podcast, said healthcare providers need to be better about integrating other healthcare disciplines and complementary medicine specialists into a patient's treatment journey.
Those might include a reiki master, an acupuncture specialist, or someone else who could help a patient heal from an acute illness, manage a chronic illness, or meet long-term wellness goals.
"In our current system, we're not very good at communicating among disciplines, having a plan, having somebody who's quarterbacking that plan and bringing all the [disciplines] together," which can lead to the successful collaboration patients need, she said.
The mind-body connection
Complementary and alternative medicine therapies are used worldwide. According to a study on CAM usage in 32 countries, at least 27% of patients use them. Complementary medicine therapies include:
- Acupuncture
- Aromatherapy
- Biofeedback
- Hypnotherapy
- Yoga
- Massage therapy
- Tai chi
- Meditation
- Music therapy
- Resilience training
- Vitamins, minerals, probiotics, and other dietary supplements
Many people already embrace these therapies -- or at least attempt to use them — as part of overall fitness or wellness plans they create themselves. Yoga, for instance, is practiced by 10% of the U.S. population. And at least 14% of Americans have tried meditation at least once.
As part of an integrative medicine plan, complementary therapies can provide relief from symptoms such as pain, anxiety, stress, nausea, and fatigue in patients with cancer, chronic fatigue, chronic pain, fibromyalgia, diabetes, depression, and many other conditions, according to the Mayo Clinic.
A look at two CAMs
Given concerns over substance use, including the opioid epidemic, and the reliance on medications in general to relieve pain, healthcare providers often consider alternative methods for pain relief. Two of the main antagonists to pain relief and promoting healing are stress and anxiety, which is where CAMs can make an impact.
A study found that evidence supports incorporating non-pharmacologic integrative approaches such as hypnosis, acupuncture, and music therapy into a multidisciplinary pain management plan for cancer or chronic conditions like fibromyalgia or arthritis.
According to the Arthritis Foundation, "Hypnosis isn't about convincing you that you don't feel pain; it's about helping you manage the fear and anxiety you feel related to that pain. It relaxes you, and it redirects your attention from the sensation of pain."
Hypnotherapy, along with other complementary therapies, may also benefit migraine sufferers and those prone to addiction. The great thing about music therapy is that it can be used with patients of any age, from pediatric patients to older adults. It can help patients relax, distract them from pain, and positively affect mood.
Under the guidance of a music therapist, patients create, listen to, or perform music. According to choosingtherapy.com, not only can music therapy reduce anxiety, stress, and depression, it can also regulate respiration, blood pressure, and heart rate. Music therapy has also been shown to be effective in relieving symptoms in post-op patients.
"We observed greater same-day improvements of pain, emotional status, and nausea with MT sessions, compared to usual care, in patients hospitalized after elective orthopaedic surgeries," according to the authors of a study.
Integrative medicine's use in psychiatry
The National Institute of Mental Health estimates that more than one in five adults in the U.S. (57.8 million in 2021) are living with a mental illness. Although prescribed medications paired with psychotherapy are commonly used to treat mental health conditions, other methods are often sought out by healthcare providers and patients who aren't seeing the results they'd like to see from traditional methods.
The integrative approach in psychiatry, or integrative psychiatry, uses complementary therapies such as nutritional assessments, mind-body centering, and guided imagery in personalized treatment plans.
"We have to truly not just give lip service to the idea of understanding body, mind, and spirit," said Jeffrey Becker, MD, a guest on NurseDot Podcast's Integrative Medicine episode. Becker is known for his focus on whole health integration, combining conventional medicine with research-supported nutrients and complementary treatment modalities.
He said he believes traditional methods of addressing mental illness are most useful in emergency situations. "We resolve acute conflict, acute crisis relatively well," Becker said. "If we know how to use our basic pharmacologic toolbox, we can help people feel better pretty quickly. We can get them out of danger."
However, Becker said, over time he'd like to see healthcare providers expand their toolboxes "because there are all kinds of things that we can use to help people feel well." Ultimately, integrative medicine's success depends heavily on building trust with the patient, said Lunsford. "When somebody trusts you, they open up and then you learn more about them, which then helps you to make a diagnosis and create a care plan for them," she said.
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