Recent years have witnessed a sea of change in the way we think about health. Whereas in the past health was measured by the absence of disease, many people now understand "good health" to mean enhancing wellness, staying fit, looking their best and building vitality. They want the edge that comes with mental sharpness, so more people are focused on maintaining all their senses and faculties as they age. The good news is that medicine is responding, as doctors are increasingly open to the use of "alternative" treatment methods and hospitals are opening integrated medicine departments.
The problem is that while it's getting easier to find doctors and medical facilities promising to deliver "integrative care that treats the whole patient," it's far more difficult to find doctors who have the proper training and background. An authority on integrated medicine is Leo Galland, MD, an internist in private practice in New York City and author of Power Healing: Use the New Integrated Medicine to Cure Yourself. Dr. Galland is the director of the Foundation for Integrated Medicine. He and I have spoken often about the challenges of this evolving medical environment. Given the growth in integrated offerings, we felt it was time to review what's real and what's not when considering these types of practitioners/treatment centers.
Dr. Galland said that one of the biggest problems is that integrated health care has different meanings for different people -- including to physicians and patients. Hence it's not easy to find truly skilled practitioners, but there are ways to screen doctors to improve the odds you will find one you can work with successfully. Here's what we discussed...
The Best of Both Integrated (also known as integrative) medicine reflects an approach to health that blends conventional medicine with complementary approaches to health care, including nutrition, naturopathic and herbal medicine, homeopathy, acupuncture and mind-body therapies such as meditation and yoga. The idea is to take the best of all worlds -- embracing complementary concepts such as wellness and prevention while also availing ourselves of the cutting-edge, sometimes life-saving technologies offered by modern medicine.
As Dr. Galland sees it, modern medicine is built around the theory of diseases. A physician determines what disease seems to be causing symptoms for an individual, notes the diagnostic code in the patient's chart and insurance form, and then proceeds to give the standard symptom-suppressing drugs and procedures for that diagnosis. Often the result is that symptoms that don't fit neatly are ignored or deemed irrelevant. In contrast, complementary medicine views the "whole" person, looking at all aspects of poor health, physical and otherwise.
These medical professionals explore the physical and emotional disharmonies or imbalances that led the person to get ill. Both of these approaches are combined in integrated medicine, says Dr. Galland, which leads to enhanced wellness and improved outcomes.
According to Dr. Galland, integrated medicine views each patient in terms of "the four pillars of healing"...
- Relationship: A person's support network of family, friends and community.
- Diet and lifestyle: Nutrition habits and the daily pattern of rest and exercise.
- A healthy environment: Protection from exposure to chemical and biological toxins.
- Detoxification: The body's innate ability to self-purify and protect itself from internal toxicity.
WHAT TO LOOK FOR IN AN INTEGRATED PRACTITIONER As more doctors seek to capitalize on health trends by hanging shingles calling themselves integrated practitioners, it's important for consumers to know how to locate a medical professional with adequate training and experience in this field. This is not so easy, it turns out. While there are thousands of integrated physicians around the country, no standardized training, credentials or accreditation exists for integrated medicine.
There's no reliable Web site to consult where you can find qualified practitioners. All too often, MDs who take a class or weekend seminar on a specific subject position themselves as "qualified" to practice in that area -- they may not be, for two reasons.
- First, according to Dr. Galland, they likely haven't taken a course that teaches the full topic adequately... and
- second, much like the problem with Western medicine in general, such a singular view as is taught in a class leads the practitioner to focus on an isolated process (the symptom, the treatment) which is more accurately understood as functioning as part of a whole system.
- Since he believes advertising can't be trusted, Dr. Galland says the best way to find a good integrated physician is by referral from friends or other health care professionals you trust. Once you've identified a candidate, request his/her CV to see what schooling they've had -- both conventional and complementary -- and schedule a meeting to talk before you go for a complete medical exam.
You should expect that an integrative practice will dedicate more time for this initial visit -- and indeed, subsequent ones as well -- than you are used to spending with a medical doctor. This is your chance to get to know this physician and to determine whether he/she is the right expert to help navigate your path to wellness. Ask lots of questions. Dr. Galland suggests these, for a start:
What medical education has the doctor received? This is important, says Dr. Galland, since conventional training is often more quantifiable than its complementary counterparts. You'll want to know what medical school he/she attended... whether the doctor is currently board-certified... and in what specialties.
Ask the doctor to describe the ways in which the medical practice is "integrated." What complementary training did this physician undergo? Which complementary systems is the practice based upon? How long has he/she been practicing the complementary modalities? Where did he/she study the complementary practices and for how long?
How much experience has the doctor had with your particular medical problem? What kinds of treatment are generally recommended for it? Nutritional? Environmental? Acupuncture? Homeopathy? Herbal therapies? Conventional treatment? You should seek out a doctor who has treated at least a few patients with problems similar to yours and is willing to be clear and open about the outcomes. Each of those questions is important -- but in the end there's one more, and it's to be asked of yourself.
"Am I confident in this doctor's skills and do I feel listened to, cared for and comfortable in his/her presence?" Because, as I have said before -- and will say again and again, no doubt -- even with the best doctors, you are the person who must ultimately take responsibility for your own health and wellness.