The 8 Principles of Integrative Medicine

  1. Patient and practitioner are partners in the healing process.
  2. All factors that influence health, wellness, and disease are taken into consideration, including mind, spirit, and community, as well as the body.
  3. Appropriate use of both conventional and alternative methods facilitates the body’s innate healing response.
  4. Effective interventions that are natural and less invasive should be used whenever possible.
  5. Integrative medicine neither rejects conventional medicine nor accepts alternative therapies uncritically.
  6. Good medicine is based in good science. It is inquiry-driven and open to new paradigms.
  7. Alongside the concept of treatment, the broader concepts of health promotion and the prevention of illness are paramount.
  8. Practitioners of integrative medicine should exemplify its principles and commit themselves to self-exploration and self-development.*

*These principles were developed by the Arizona Center for Integrative Medicine. I discuss them further in this interview with Dr Andrew Weil.

1. The patient and practitioner are partners in the healing process, and that we recognize and honor the expertise of each. Individuals’ goals can vary widely. One person may come to me and say, “I really want to work on weight loss”; for another, weight is off-limits, but managing stress is open to discussion. I honor my patients’ decisions and preferences about their lives and bodies.

2. All factors that influence health, wellness, and disease are taken into consideration. By taking an extensive history, and listening to my patient’s full story, a healing path often emerges. For instance, I have been struck by the frequency with which a careful dietary history has detected food intolerance that were the subtle culprits causing disease. Time and again, a trial off dairy for three weeks has lead to resolution of sinus symptoms, heartburn, and bloating; other common food triggers are wheat, eggs, soy, and citrus. Inadequate sleep can be the root cause for symptoms as broad as irritability, joint pain, body aches, weight gain, and depression. A freshly painted office may explain the new onset of headaches, nausea, and fatigue.

3. Use conventional and alternative methods appropriately to facilitate the body’s innate healing response. Many strategies can be used to enhance health and well-being. In addition to lifestyle measures such as nutrition, supplements, and mind-body interactions, acupuncture, Ayurveda, energy practices, and ritual might be used. Discerning which to use, in what combination, and in what order is at the heart of the art of integrative medicine; it is influenced by the available scientific evidence; the desires, beliefs, and intuitions of the patient; and the doctor’s clinical experience.

4. Use natural and less invasive interventions whenever possible. Modern medicine can be miraculous.  Still, there are risks and benefits to all interventions and so whenever possible, I recommend that we begin with lifestyle changes and the lowest doses of medication necessary.

Also, keep emotional well-being in mind.  We can suffer greatly from loneliness, a sense of failure, and other emotional struggles.  Guy Winch PhD has a thought provoking TED talk on the topic.

5. Integrative medicine neither rejects conventional medicine nor accepts alternative medicine uncritically. We must be discerning; there are practices in alternative medicine that I never recommend. Just as we don’t always jump to conventional medicine, we don’t leap to alternative, either. Working with an integrative doctor can be helpful here, so that you don’t have to sort it out all on your own.

6. Good medicine is based in good science; it is inquiry-driven and open to new paradigms. Unfortunately, many physicians still say, “There is no evidence for integrative medicine,” without actually examining the scientific literature. Or they say, “Alternative medicine is dangerous,” when many of the practices bear significantly lower risk than Western medicine.

I believe that physicians need to be open-minded skeptics. We bear an obligation to our patients to explore the existing evidence before rejecting a practice. And sometimes a lack of evidence doesn’t mean that a practice or remedy doesn’t work; it could be that adequate studies haven’t been done yet. There’s a difference between something that has been proven not to work and something that hasn’t been adequately studied.

7. The seventh principle of integrative medicine places health promotion and prevention alongside treatment. Do all that you can to be as healthy as possible.  Clean up your diet, get regular exercise, develop a regular centering practice and get a good night’s sleep.

Prevention has garnered a tremendous amount of attention during this era of health care reform.  It is important to consider what prevention means – is it lifestyle change? immunizations? screening tests for cancer?  Also, we sometimes believe that chemoprevention (using medications to prevent disease) is more effective than it is.  The Number Needed to Treat (when available) can be very useful in clarifying how effective a prevention recommendation or treatment actually is.

8. Practitioners of integrative medicine should exemplify its principles and commit themselves to self-exploration and self-development. This means that we need to “walk our talk” and commit to living the same lifestyle we advise to others.