Integrative Medicine: Moving beyond a disease-based model of care

By John Allen, Ph.D., Health Psychologist
In conventional Western medicine, physicians administer medications and perform surgeries to treat diseases and injuries. Western medicine can be spectacularly effective at dealing with emergent issues, such as heart attack and trauma. It has made remarkable advances in sustaining lives through surgeries, immunizations, and antibiotics. But it’s primarily a disease-based model, which emphasizes treating symptoms rather than promoting health and preventing disease, and it’s less successful in dealing with the epidemic of chronic disabling diseases, such as obesity and diabetes. In our world of high-tech, fast-paced medical interventions, many patients and physicians are deeply disappointed in Western medicine’s limitations when faced with chronic illness and major disability. And in an era of increasing regulation and time pressures, they’re also concerned with a growing disconnect in the doctor-patient relationship.
Perhaps this is one reason there’s such an enormous appetite for alternative and complementary approaches to health and healing. In my work as a health psychologist, I’m struck by this yearning from patients and healthcare practitioners both.
Where do we turn if our focus is on strengthening health during our most active years, safeguarding or improving health as we age, and being as independent as possible in the last decades of our lives?
The growing movement of Integrative Medicine is one promising option. At its core, IM recognizes that the purpose of any intervention is to facilitate our natural, innate healing systems. In this model, the patient is an active partner with trusted healthcare providers, working together to promote optimal quality of life. IM blends the best of evidence-based conventional and complementary approaches. It doesn’t seek to replace Western medicine but offers methods that enhance overall health and wellbeing.
IM emphasizes the importance of health promotion and disease prevention and embraces the central roles of healthy nutrition, regular exercise and stress reduction in creating health. IM encompasses a range of mind/body approaches, including meditation, tai chi, and yoga, to name a few. IM can be especially relevant for aging and chronic conditions.
Research into IM approaches is in its infancy. Many more careful, controlled studies are needed. But already we have mounting evidence to support IM’s value in preventing and in reducing the impact of some common disabling diseases. Here’s how the evidence is stacking up for three common IM practices:
Meditation: We have decades of reliable studies into the multiple health benefits of meditation. At the physiological level, it has been demonstrated to lower blood pressure, improve heart rate, lower respirations, and reduce production of stress hormones. More broadly, it improves focus, reduces stress and anxiety, engenders a sense of well-being, and can lessen pain. One 2015 study evaluated whether mind/body interventions, such as relaxation response, can reduce stress, which is implicated in many illnesses that lead to visits to the doctor, lab tests, x-rays, etc. The study compared more than 4,400 patients at the renowned Benson Henry Institute at Massachusetts General Hospital with a control group of more than 13,000. The group that learned specific mind-body techniques reduced their use of medical services by 43 percent.
Tai Chi: This ancient Chinese martial art discipline emphasizes slow, flowing movements and mindful awareness of the body’s energy or chi. A 2010 study that summarized findings from 77 peer-reviewed articles on 6,400 participants found a large body of evidence that tai chi improves balance, strength, and flexibility, all factors related to fall risk. It also has positive effects on bone health in post-menopausal women. Preliminary findings suggest positive effects on the immune system, inflammation, anxiety, and depression. One recent meta-analysis of nine research studies showed that persons with Parkinson’s who practiced tai chi saw improvements in balance, agility, posture, and strength, plus reductions in stress and tension.
Yoga: Like tai chi, yoga is a special form of exercise that integrates body focus, breath focus, and mind focus. Yoga’s recognized benefits include improving balance, strength and posture; decreasing heart rate and stress; relieving insomnia; and promoting physical confidence, calm, and centeredness. With its emphasis on breathing techniques, yoga can strengthen the diaphragm and muscles around the ribs, improving breathing for people with COPD and other lung dysfunctions. Yoga can improve coordination, balance, and mood, which can be very beneficial after a stroke. Yoga poses that have been specifically adapted for back pain have been shown to reduce pain and disability and increase function. Those with high blood pressure, glaucoma, sciatica, and pregnant women should check with their physician before starting yoga, and they should learn from an experienced yoga practitioner how to modify poses specific to their condition. The restorative yoga practiced at Spaulding Cape Cod is adapted to the needs of participants. Those in a recent session ranged in age from the 60s to the 80s, and had concerns related to weakness, dizziness, stroke, and joint pain. The goal is to find just the right level of challenge for each person.
You can check the efficacy of IM methods in the National Center for Complementary and Integrative Health website at nccih.nih.gov. Look up any disease and you will find a summary of complementary approaches and the evidence to support, or not support, their use.
Our current healthcare system is in crisis as costs and chronic diseases continue to rise. So many of these illnesses are linked to lifestyle – what we eat, how much we move, how we manage stress. With its principles of health promotion, disease prevention, patient-centered, empowered care, and blending of evidence-based conventional and complementary medical approaches, IM offers tangible and readily available methods to improve our own health and enrich our lives.
John Allen, Ph.D. is a Health Psychologist at Spaulding Rehabilitation Hospital Cape Cod and advisor to the hospital’s Integrative Medicine Team. For information about wellness programs, go to spaudlingrehab.org/capecod.
This article was published in the Spring 2017 issue of Health & Wealth.