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Wednesday, March 22, 2006

My Experience with Integrated Medicine

I guess I am a pioneer in Integrative Medicine. When I was a “young”
obstetrician-gynecologist, newly in practice in the late 1980s, I found allies early on in “alternative” practitioners such as lay-midwives, nurse-midwives, doulas, childbirth educators, La Leche League, chiropractors, accupuncturists, yoga instructors, massage therapists, naturopaths, herbalists, Bradley Childbirth instructors, etc., etc.

I was open to the support that these disciplines offered my patients that complemented the “allopathic” practice that I was trained to provide. I don’t know why I was more supportive of these practices and less threatened by them than my colleagues, except to say that I was open-minded to what worked for my patients, and I realzed that “Western” medicine did not have all the answers.

In the early 1990s I had the privilege of meeting Dr. Andrew Weil in Tucson. One principle that he elaborated stuck with me: that medical treatments and healing practices do not work miracles: they only support an individual to heal.

Dr. Weil’s assertion is that Western medicine might be at the end of a spectrum of choices that people have to support their healing, and that while surgeries, medications, and invasive procedures might sometimes be necessary, “alternative” or complementary therapies that are more attractive and more gentle to patients only make sense in many cases.

I’ve come to trust the intuitive wisdom that my patients have in charting their courses for healing. And, I believe it is my duty to offer my expertise and experience, but to stay out of the way of a patient’s process as she discovers her healing course. I am reassured by the cumulative success of my practice style, and by feedback from patients about what makes for an ideal doctor.

In 2003, I joined the medical staff of North Hawaii Community Hospital on the island of Hawaii. This relatively young, but ten-year-old hospital was founded from a vision of Integrative Medicine, and it remains a pioneer in state-of-the-art care for “treating the whole individual – mind, body, and spirit – through a team approach to patient-centered care…” I am proud to remain a member of the medical staff here, and I have found the process supportive of my professional approach to holistic medicine.

I have also become aware of the challenges in the evolution of the “New Medicine.” These are primarily political and financial challenges.

Until allopathic physicians embrace the potential that “alternative” medical practices have to offer, there will be a smugness and resistance from traditional hospital medical staffs to facilitate other practitioners’ integration into plans of care for patients. Medical doctors need to gain trust and experience with integrating alternative therapies into therapeutic plans to the point that they are proactive towards (and even suggestive of) their inclusion rather than simply tolerated upon a patient’s insistence.

And, the financing of healthcare services must be expanded and revamped to more fairly support the integration of all healing modalities. There are pluses and minuses to third-party vs. patient payment for medical services, but it is clear to me that the decisions around what are covered and not covered are mostly arbitrary at present. The delicate debate of healthcare expenditures must include a sensitivity to the expansion of covered services.

The good news is that the movement towards “integrated medicine” is patient-driven. I think that’s reinforcement of what I learned long ago, that patients, not doctors, know best what’s right for themselves.

RW, MD

Related Topics: Choosing and Using Alternative Medicine, Complementary Therapies

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Posted by: Robert Warnock MD at 4:17 pm