Integrative medicine

Integrative medicine describes a medical direction "that reaffirms the importance of the practitioner-patient relationship. It focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, health care professionals, and disciplines to achieve optimal health and healing" as articulated by the Consortium of Academic Health Centers for Integrative Medicine in 2004.

Integrative medicine makes use of approaches from conventional and complementary medicine. The concept came up in the US in the late 1940s. In the german sphere it was used from 1990.

Compared to the concepts alternative medicine and complementary medicine it focuses on integration with conventional medicine. The wording alternative medicine describes approaches used instead of conventional medicine. Complementary medicine pictures a complementarity of approaches. Integrative medicine uses scientific methods to evaluate complementary and alternative medical (CAM) therapies and is open to a dialog of different paradigms including those from non-conventional systems in a manner of medical pluralism. Central is the effort for scientificity and research with openness of the concept of science.

History of the concept

In polarity to alternative medicine, which emphasizes separation, the term integrative medicine denotes exchange and collaboration of complementary (complementary) partners. The term integrative medicine was applied in the late 1940s in Anglo-American literature and propagated since the 1990s by, among others, Andrew Weil. In the German-speaking world, the term came into use only from the 1990s. The emphases and interpretations of the still relatively young term changed over the years and are weighted partly differently by different representatives even today. Below are some descriptions and definitions.

In the 2000s, the focus was on a combination of elements of conventional medicine with scientifically evaluated elements of complementary and alternative medicine (see definition NCCAM). Through the years the concept broadened to include aspects like the relationship between patient and doctor, a network of caretaking persons and in 2020 a democratic environment and a healthy natural environment, bringing the concept close to that of One Health and impulses arising in mainstream medicine.

Criticism of the concept

There is also criticism of the term, which, apart from its salutogenetic orientation, contains no conceptual innovation over that of complementary medicine.

Aspects of integrative medicine

A definition by the Andrew Weil center for integrative medicine sums up different aspects of integrative medicine:

Andrew Weil Center definition	Perspective	Concepts
Patient and practitioner are partners in the healing process.	Relationship of patient and medical provider	Partnership
All factors that influence health, wellness, and disease are taken into consideration, including mind, spirit, and community, as well as the body.
Appropriate use of both conventional and alternative methods facilitates the body's innate healing response.	Appropriate use of conventional and CAM therapies
	Support of "body's innate healing response"	Salutogenesis, Hygiogenesis
Effective interventions that are natural and less invasive should be used whenever possible.
Integrative medicine neither rejects conventional medicine nor accepts alternative therapies uncritically.
Good medicine is based in good science. It is inquiry-driven and open to new paradigms.	Scientific basis	Science
		Plurality of paradigms
Alongside the concept of treatment, the broader concepts of health promotion and the prevention of illness are paramount.		Treatment, Health promotion, Prevention Salutogenesis, Hygiogenesis
Practitioners of integrative medicine should exemplify its principles and commit themselves to self-exploration and self-development.		Self-exploration Self-development

Concept of Human Being

Integrative medicine is sometimes perceived as a more human-centered approach to medicine, partly in response to perceived deficiencies in conventional medicine. The latter achieves high levels of technical precision, but it is argued that its focus on a reductionistic-mechanistic worldview and concept of human beings does not always adequately address essential aspects of human nature. Aspects such as the uniqueness of each individual, human interaction, and biography come into play, which are difficult to reconcile with the prevalent machine paradigm. These considerations have also led to the development of biopsychosocial medicine.

Depending on the concept of human beings, questions regarding life processes, the human soul, and spirituality may come to the fore.

Providers

A variety of healthcare providers delivers care through integrative medicine. These providers may include: Physicians, nurse practitioners, chiropractic doctors, holistic mind-body psychotherapists, acupuncturists, chinese herbal therapists, tai chi practitioners, yoga practitioners, massage therapists, nutritionists, chefs (culinary medicine).

Research

Scientific research is a central element in the field of integrative medicine.

Examples

Within the framework of the 7th Framework Programme of the EU (FP7: 7th Framework Programme), a coordination project called "CAMbrella" was conducted to investigate the supply and demand of complementary medicine. The acronym "CAMbrella" stands for "umbrella of Complementary and Alternative Medicine".

Risks

The treatments promoted in integrative medicine are not substitutes for conventional medical care. They should be used along with standard medical treatment. Integrative medicine should be used together with regular medical treatments. Integrative medicine providers communicate their care recommendations with other medical providers. Adequate regulatory and policy frameworks need to be put in place to ensure that risks are minimised.

Definitions

Definitions of Integrative Medicine

Source	Year	Definition	Authors
National Center for Complementary and Alternative Medicine (NCCAM)	2000 (ca)	Integrative medicine combines mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness.
NCI Dictionary of Cancer Terms		A type of medical care that combines conventional (standard) medical treatment with complementary and alternative (CAM) therapies that have been shown to be safe and to work. CAM therapies treat the mind, body, and spirit.
Mayo Clinic		Complementary and alternative medicine (CAM) is the popular name for health care practices that traditionally have not been part of conventional medicine. In many cases, as evidence of efficacy and safety grows, these therapies are being combined with conventional medicine. Thus, the term alternative has been dropped and replaced with newer terms, such as complementary and integrative medicine, integrative medicine and health, or just integrative medicine.
British Medical Journal (BMJ) Editorial	2001	Integrated medicine (or integrative medicine as it is referred to in the United States) is practising medicine in a way that selectively incorporates elements of complementary and alternative medicine into comprehensive treatment plans alongside solidly orthodox methods of diagnosis and treatment.	Lesley Rees, Andrew Weil
Academic Consortium for Integrative Medicine & Health		The practice of medicine that reaffirms the importance of the practitioner-patient relationship. It focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, health care professionals, and disciplines to achieve optimal health and healing.
National Center for Complementary and Integrative Health (NCCIH)		There are many definitions of “integrative” health care, but all involve bringing conventional and complementary approaches together in a coordinated way. ... NCCIH generally uses the term “complementary health approaches” when we discuss practices and products of non-mainstream origin. We use “integrative health” when we talk about incorporating complementary approaches into mainstream health care.
World health organization (WHO)		Traditional, complementary and integrative medicine - Definitions Traditional medicine - Traditional medicine has a long history. It is the sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness. Complementary medicine - The terms “complementary medicine” or “alternative medicine” refer to a broad set of health care practices that are not part of that country’s own tradition or conventional medicine and are not fully integrated into the dominant health-care system. They are used interchangeably with traditional medicine in some countries. Herbal medicines - Herbal medicines include herbs, herbal materials, herbal preparations and finished herbal products, that contain as active ingredients parts of plants, or other plant materials, or combinations.
Brinkhaus B and Esch T, adapted Version of the US consortium IM	2020	Integrative medicine and Health reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic, preventive, health-promoting, and lifestyle approaches, healthcare professionals and disciplines to achieve optimal health and healing, emphasizing the art and science of healing. It is based on a social and democratic as well as natural and healthy environment.	Brinkhaus B, Esch T
Andrew Weil Center for Integrative Medicine		What is IM/IH? Integrative Medicine (IM) is 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. The Defining Principles of Integrative Medicine Patient and practitioner are partners in the healing process. All factors that influence health, wellness, and disease are taken into consideration, including mind, spirit, and community, as well as the body. Appropriate use of both conventional and alternative methods facilitates the body's innate healing response. Effective interventions that are natural and less invasive should be used whenever possible. Integrative medicine neither rejects conventional medicine nor accepts alternative therapies uncritically. Good medicine is based in good science. It is inquiry-driven and open to new paradigms. Alongside the concept of treatment, the broader concepts of health promotion and the prevention of illness are paramount. Practitioners of integrative medicine should exemplify its principles and commit themselves to self-exploration and self-development.

Geographical distribution

USA

In USA the integrative medical movement is represented by organizations like the Academic Consortium for Integrative Medicine & Health, the Academy of Integrative Health & Medicine (AIHM), the international college of integrative medicine (ICIM) or the Integrative Medicine Consortium (IMC). In the national institutes of health there is a department for integrative medicine called National Center for Complementary and Integrative Health (NCCIH).

Germany

The Hufeland society is the umbrella organization of complementary medical organizations in germany. In 2021 an alliance for integrative medicine and health began to form.

Weblinks

• Integrative medicine on Citizendium