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What Is Integrative Medicine?

Experts explore new ways to treat the mind, body, and spirit -- all at the same time.

The Mind-Body Connection

Sternberg, a researcher who has done groundbreaking work on interactions between the brain and the immune system, says technological breakthroughs in science during the past decade have convinced even skeptics that the mind-body connection is real.

"Physicians and academic researchers finally have the science to understand the connection between the brain and the immune system, emotions and disease," she says. "All of that we can now finally understand in terms of sophisticated biology."

That newfound knowledge may help doctors to see why an integrative approach is important, she says.

"It's no longer considered fringe," Sternberg says. "Medical students are being taught to think in an integrated way about the patient, and ultimately, that will improve the management of illness at all levels."

The Osher Center for Integrative Medicine at the University of California, San Francisco, takes a similarly broad view of health and disease. The center, which includes a patient clinic, says on its web site: "Integrative medicine seeks to incorporate treatment options from conventional and alternative approaches, taking into account not only physical symptoms, but also psychological, social and spiritual aspects of health and illness."

To promote integrative medicine at the national level, the Osher Center and Duke have joined with 42 other academic medical centers -- including those at Harvard, Columbia, Georgetown, and the University of Pennsylvania -- to form the Consortium of Academic Health Centers for Integrative Medicine.

Medical Schools and Integrative Medicine

Even medical schools have added courses on nontraditional therapies, although doing so can sometimes be a point of contention among faculty.

At the University of California, San Francisco, medical students can augment their coursework in infectious disease and immunology with electives, such as "Herbs and Dietary Supplements" or "Massage and Meditation." They can even opt to study as exchange students at the American College of Traditional Chinese Medicine. In the world of integrative medicine, it's not unusual to see a Western-trained MD who also has credentials in acupuncture or hypnosis, or a registered nurse who is also a yoga teacher and massage therapist.

Opposing Views

Not all doctors are jumping onboard, though. Some critics have charged that integrative medicine is driven largely by market forces, as well as public fascination and demand for alternative treatments.

"This is a very faddish country," says Tom Delbanco, MD, a Harvard Medical School professor and doctor at Beth Israel Deaconess Medical Center in Boston. In one national survey of hospitals that offer complementary therapies, 44% listed "physician resistance" as one of the top three hurdles in implementing programs, along with "budgetary constraints" (65%) and "lack of evidence-based research" (39%).

Delbanco says he's concerned that there's not enough scientific evidence to justify the amount of resources spent on integrative medicine and complementary therapies. "I worry that people are making claims in the context of scientific medicine that they cannot really justify. I think there have been few rigorously controlled, scientifically sound studies in the area, and when they have been done, the vast majority have shown these medicines to be no different from placebo."

"I have no trouble with offering hope," he adds. "I think people need hope and optimism. Where I have trouble is when we promise things to people that aren't real."

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