So, What’s Integrative Medicine?

Jeffrey P Schaefer MSc MD FRCPC

March 28, 2008

Objectives

Introduce Integrative Medicine, Describe CHR directions, Encourage you to think broadly about health

and illness.

What’s in a label?

Complementary & Alternative Medicine

A broad domain of healing resources that encompass all health systems, modalities, and practices, and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historic period.

Complementary modalities used with, but different from, mainstream

medicine

Alternative modalities not generally recognized by the medical

community and used instead of standard treatments not taught in schools of western medicine

Frequency of Use - CAM

n = 1,584 adults in South Carolina

CAM Therapy Life < 1 yr

Any use complementary alternative medicine

52% 44%

Personal therapies (home remedies, herbal medicine, homeopathy, or vitamin therapy) 28% 25%

Relaxation techniques (including massage therapy, imagery, or visualization) 26% 23%

Chiropractors 21% 9%

Healing (including healers, spiritual healing, Native American healers, energy healing) 5% 4%

Commercial weight loss programs 5% 3%

Life-style diets 4% 4%

Self-help groups 3% 2%

Hypnosis or biofeedback 2% 1%

Reasons for CAM

No. CAM Users n=1548

To StayHealty

Why CAM Therapy Was Used To Treat a Specific Health Problem

MSK or Neuro

Psychosocial

Cardio-vascular

&Endo

Uro-genital

 GI

Allergy&

Resp 

Other

Personal therapies 622 48% 11% 1% 4% 6% 3% 18% 10%

Relaxation 478 56% 22% 13% 1% 1% 1% 1% 5%

Chiropractors 332 12% 83% 1% 0% 0% 1% 2% 0%

Healing 87 60% 8% 6% 3% 3% 3% 2% 14%

Weight loss programs 82 76% 1% 1% 21% 0% 0% 0% 1%

Life-style diet 67 85% 3% 0% 10% 0% 2% 0% 0%

Self-help 44 41% 9% 2% 2% 0% 0% 2% 34%

Hypnosis or biofeedback 41 42% 5% 12% 12% 0% 5% 0% 15%

All other therapies CAM 78 23% 27% 1% 9% 10% 14% 9% 6%

Stay Healthy, MSK & Neuro, CV & Endo, Urogenital, GI, Allergy & Resp

Demographic Characteristics Lifetime

Education  

   Less than high school 49%

   High school diploma 47%

   Some college 59%

   College graduate 55%

Family income  

   Less than $15,000 52%

   $15,000-$29,999 53%

   $30,000-$49,999 51%

   $50,000 and over 60%

Age, Marital Status, Race, Gender (F>M – slight)

Satisfaction with CAM% Reporting CAM as Extremely or Very Effective

% Having "Bad Experience" With

CAM Therapy

% Who Would Recommend

CAM to Friends/Family

Personal therapies (including home remedies, herbal medicine, homeopathy, or vitamin therapy)

62% 4% 88%

Relaxation techniques (including massage therapy, imagery, or visualization) 64% 2% 92%

Chiropractors63% 8% 86%

Healing (including healers, spiritual, healing, Native American healers, or energy healing)

79% 3% 89%

Commercial weight loss programs 45% 11% 69%Life-style diets 72% 7% 82%Self-help groups 74% 8% 88%Any CAM use 63% 5% 88%

Physicians and CAM

% Physicians

Who Recommended CAM Use

% Patients Who Told

Provider of CAM Use

% Physicians Unaware of

Patient's CAM Use

Personal therapies (including home remedies, herbal medicine, homeopathy, or vitamin therapy) 15% 26% 63%

Relaxation techniques (including massage therapy, imagery, or visualization)

31% 18% 56%

Chiropractors 25% 34% 50%

Healing (including healers, spiritual, healing, Native American healers, or energy healing)

7% 21% 73%

Commercial weight loss programs 17% 33% 56%

Life-style diets 33% 35% 43%

Self-help groups 33% 43% 38%

Hypnosis or biofeedback 39% 12% 53%

Any CAM use 24% 26% 57%

CAM - CanadaComplementary and alternative medicine use among

colorectal cancer patients in Alberta, Canada.

Tough SC, Johnston DW, Verhoef MJ, Arthur K, Bryant H. n= 871 with colorectal cancer d = Population-based questionnaire completed by 70%

(pt or family of deceased) 49% used CAM since diagnosis

psychological and spiritual therapies (65%) vitamins and minerals (46%) herbs (42%)

68% informed their medical doctors Altern Ther Health Med. 2002 Mar-Apr;8(2):54-6

So, What’s Integrative Medicine? I.M. uses the combination of both conventional

and alternative approaches to address the biological, psychological, social and spiritual aspects of health and illness.

It emphasizes respect for the human capacity for healing, the importance of the relationship between the practitioner and the patient, a collaborative approach to patient care among practitioners, and the practice of conventional, complementary, and alternative health care that is evidence-based.

UC-SF School of Medicine Osher Centre for Integrative Medicine

Integrative Medicine Holistic

• physical, mental, spiritual, social determinants of health

Evidence-based

• held to the same standard No distinction

• traditional, alternative, complementary, folk… Target

• focus on unique characteristics of the patient

Alternative Medical Systems: Complete systems of theory and practice e.g.

Homeopathy, Ayurveda and TCM

Mind-Body Interventions: Support groups (now considered conventional),

cognitive therapy, meditation, visualization, art, music, dance therapy

Biologically Based Therapies: Herbs, vitamins, foods and other dietary

products.

Manipulative and Body-Based Methods: Chiropractic, osteopathy and massage.

Energy Therapies: Qi Gong, Therapeutic Touch, Reiki

Integrative Medicine – other attributes emphasis on relationship-centered care patient is active partner prevention and maintenance of health

nutrition, exercise, stress-management, emotional wellness

provider as educator & mentor use least invasive (& cost) method remove barriers to healing compassion is always helpful collaboration with others in the health care

team cure sometimes, heal often, support always

Integrative Medicine ‘Good’ Medicine Dr. Andrew Weil

Harvard Medical School Program Director of the

Program in Integrative Medicine (PIM) at University of Arizona; started in 1994

patients do best utilizing both mainstream and alternative medicine

mainstream medicine well-suited to crisis intervention

alternative medicine is best utilized for prevention and health maintenance

IM is an intelligent combination of both

Regional History and Initiatives Programs and Initiatives

Clinic for Mind-Body Medicine Guided Imagery Program Spirituality Heart Math Exploring Health and Healing Conference Traditional Chinese Medicine

• Spirituality • quest for ultimate meaning, purpose, relationship, hope, and transcendence.

• Religion•convictions & practices of a community of faith.

• Sacred• concepts of God, the Devine, the Transcendent or Ultimate Reality.

•Health •a balance of the physical, emotional, social, spiritual, and intellectual well-being.

Dr. Chris Carruthers - Manager of Spirituality in Chronic Disease Management

Regional History and Initiatives Institutional and Community Partnerships

University of Calgary Mount Royal College Canadian Institute of Natural & Integrative

Medicine Community and CHR Providers Scripps Clinic

Elaine Danelesko

9 – 10 am Oct 19 Nov 30 Apr 4 May 9

Foothills Auditorium

Telehealth to RGH & PLC & Rural

Network or Distributed Model