What is Integrative Medicine?
Integrative Medicine combines modern medicine with established practices from around the world. By joining modern medicine with proven practices from other healing traditions, integrative practitioners are better able to relieve suffering, reduce stress, and maintain the well-being of their patients.
Although the culture of biomedicine is predominant in the U.S., it coexists with many other healing traditions. Many of these approaches have their roots in non-Western cultures. Others have developed within the West, but outside what is considered conventional medical practice.
Various terms have been used to describe the broad range of healing approaches that are not widely taught in medical schools, generally available in hospitals or routinely reimbursed by medical insurance.
Complementary and alternative medicine (CAM) is the name chosen by the National Institutes of Health. CAM is defined as the “broad range of healing philosophies, approaches, and therapies that mainstream Western (conventional) medicine does not commonly use, accept, study, understand, or make available.” CAM therapies may be used alone, as an alternative to conventional therapies, or in addition to conventional, mainstream medicine to treat conditions and promote well-being.
Integrative medicine is a new term that emphasizes 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.
CAM Use in the United States
In 1998, a national phone survey of 1,500 adults in the United States estimated that the total number of visits to complementary and alternative medicine (CAM) practitioners exceeded the total number of visits to primary care physicians in 1990. It was estimated that Americans spent $27 billion out-of-pocket for CAM services in 1997.
In 2002, a much larger, nationwide survey of 31,000 American adults was performed in which a diverse population was interviewed about their use of CAM (the CDC National Health Interview Survey, NHIS ). Thirty-eight percent of those interviewed reported using some form of CAM in the previous 12 months. When prayer (used specifically for health reasons) and megavitamins were included in the definition of CAM, this percentage increased to 62%.
Why are People Using CAM?
CAM is attractive to many people because of its emphasis on treating the whole person, its promotion of good health and well-being, its valuing of prevention, and its often more personalized approach to patient concerns.
Most people who use CAM combine it with conventional medicine, because they perceive the combination to be superior to either alone. Independent predictors of CAM use in one written survey were higher level of education, poorer health status (chronic pain, anxiety, etc.) and a “holistic” interest in health, personal growth and spirituality. Dissatisfaction with conventional medicine was not an independent predictor of greater use (Astin 1998), although more than a quarter of US adults in the NHIS survey said that they used CAM because they believed conventional medicine wouldn’t help them.
Institute of Medicine Report (January 2005):
In January 2005 the Institute of Medicine of the National Academies released a report entitled Use of Complementary and Alternative Medicine (CAM) by the American Public. They recommended “health profession schools incorporate sufficient information about complementary and alternative medicine (CAM) into the standard curriculum at all levels to enable licensed professionals to competently advise their patients about CAM.” Indeed,despite the growing numbers of patients seeking CAM, less than 40% of alternative therapies used are disclosed to physicians. A lack of communication may be potentially dangerous, as some CAM therapies can interact adversely with conventional treatments.
National Center for Complementary and Alternative Medicine (NCCAM):
Funding for biomedical research in the field of integrative medicine has increased dramatically over the past several years. In 1992, Congress established the Office of Alternative Medicine (OAM) as part of the National Institutes of Health (NIH) with an annual budget of $2 million. In 1998, it was elevated to a full NIH center and renamed the National Center for Complementary and Alternative Medicine (NCCAM). NCCAM’s budget for research in this field for fiscal year 2005 is $121 million. NCCAM’s mission is to support research and training in CAM and to disseminate evidence-based information to both the public and professional worlds. Although some CAM modalities are not easily evaluated using randomized control trial methodology, the 2005 Institute of Medicine report recommends that conventional and CAM treatments both be held to similar standards of safety and efficacy.