11.1 Principles of integrative medicine

Integrative medicine combines conventional and complementary approaches to optimize patient care. It views patients holistically, considering all factors influencing health and wellness. This approach emphasizes the therapeutic relationship and engages individuals as active participants in their healing process.

Unlike conventional medicine's focus on treating specific symptoms, integrative medicine supports overall health. It incorporates evidence-based practices from both mainstream and alternative approaches, aiming to provide optimal treatment while empowering patients to take an active role in improving their health.

Core principles of integrative medicine

Combining conventional and complementary approaches

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• Integrates conventional and complementary approaches in a coordinated way to optimize patient care
• Emphasizes the therapeutic relationship between provider and patient
• Selects appropriate therapies based on the best available evidence
• Utilizes natural, less invasive interventions when possible before more invasive or riskier treatments

Holistic philosophy of health and healing

• Views patients as whole people with interconnected minds, spirits, and bodies
• Considers all factors influencing health, wellness and disease, including mind, spirit, community and body
• Engages the individual as an active participant in their health and healing process
• Aims to enhance the body's innate healing response by supporting the person's own healing capacities
• Neither rejects conventional medicine nor accepts alternative approaches uncritically

Integrative medicine vs conventional and alternative approaches

Selective incorporation of conventional and alternative methods

• Conventional medicine primarily uses drugs, surgery, and other interventions to treat symptoms and diseases
• Alternative medicine uses approaches considered outside of mainstream medicine, often based on historical or cultural traditions (traditional Chinese medicine, Ayurveda)
• Integrative medicine selectively incorporates elements of both conventional and alternative approaches
• Uses best available evidence to determine safety and effectiveness of all therapies, aiming to provide optimal treatment
• Does not aim to replace conventional medicine but to work collaboratively with it

Broader focus on whole-person health

• Conventional medicine generally focuses on treating a specific symptom or disease
• Integrative medicine has a broader focus on supporting the health of the whole person - mind, body and spirit
• Addresses interconnected physical, mental, social, spiritual and environmental influences on health
• Aims to support patients in fostering overall health and wellness, not just absence of disease

Emphasis on partnership and patient empowerment

• Integrative medicine places strong emphasis on the patient-provider relationship as a partnership
• Providers aim to empower patients with education and skills to take an active role in improving their health
• Engages patients in shared decision making about their treatment plan based on their preferences and values
• Conventional medicine has traditionally been more provider-directed with less focus on patient empowerment

Treating the whole person

Supporting multi-dimensional health and well-being

• Recognizes health as a state of physical, mental, and social well-being, not merely the absence of disease
• Aims to support health in all these interconnected domains using a variety of approaches
• Physical health includes having energy, restful sleep, healthy diet, strong immunity, not just lack of disease symptoms
• Mental health includes self-esteem, managing stress, clear thinking, and healthy relationships
• Social health relates to healthy family, work and community connections and fulfilling social roles

Attending to spiritual health and meaning

• Spiritual health relates to inner peace, connection to others, meaning and purpose in life
• Integrative providers may explore patient's spiritual beliefs, sources of meaning, and practices that support their health
• May offer therapies that enhance spiritual well-being (meditation, prayer, ritual, time in nature)
• Attends to existential distress and aims to help patients find comfort and meaning, especially during illness

Harnessing the healing power of the mind-body connection

• Recognizes the powerful ways mental and emotional factors can influence physical health and healing
• Offers mind-body therapies to harness this connection (relaxation techniques, hypnosis, biofeedback, guided imagery)
• Aims to reduce the harmful effects of stress and to promote states of relaxation and inner balance
• Helps patients shift mental patterns and develop coping skills to support their healing and well-being
• By addressing the interconnections of mind, body and spirit, aims to support the person's innate healing capacities

Evidence-based practices in integrative medicine

Shared commitment to evidence-based medicine

• Evidence-based medicine uses the best available scientific evidence to guide care decisions for individual patients
• Integrative medicine shares this commitment to an evidence-based approach in evaluating all therapies
• High-quality evidence from research studies (randomized trials, systematic reviews) used when available
• Providers stay up-to-date with the evolving scientific literature to inform their integrative treatment recommendations

Incorporating multiple forms of evidence

• Many complementary and integrative approaches currently lack a robust evidence base from clinical trials
• In these cases, integrative providers incorporate other forms of evidence in their clinical decision making
• Consider evidence from traditional use, expert opinion, patient preferences and their own clinical experience
• Aim to provide responsible, safe and effective patient-centered care incorporating multiple lines of evidence
• As research advances, practices and recommendations are continually updated based on the latest evidence

Engaging patients in informed, shared decision making

• Integrative providers engage patients in informed and shared decision making about their treatment options
• Discuss the strength of evidence for different approaches so patients can make informed choices
• Incorporate patient's preferences, values and cultural beliefs in developing a personalized treatment plan
• Enable patients to evaluate if an approach is working well for them and adjust the treatment plan as needed
• Empower patients with knowledge and skills for ongoing lifestyle practices that support their health