Complementary & Alternative Medicine

=Objectives=

Define Integrative Medicine
Healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all "appropriate" therapies, both conventional (evidence-based) and alternative (non-evidence based).

Describe why the term “integrative medicine” is more appropriate than “complementary and alternative medicine” (CAM)
Integrative medicine stresses the importance of integrating “CAM” therapies into our health care model (conventional care). This is in contrast to CAM which implies secondary or second class care, and contributes to the fragmentation of healthcare delivery (conventional vs. alternative). According to the reading, “The field of integrative medicine was created not to fragment the medical culture further by creating another silo of care but to encourage the incorporation of health and healing into the larger medical model.”

Describe why the term "SCAM" is more appropriate than "complementary and alternative medicine"

 * The use of many herbal therapies is not based on high quality evidence. CAM therapies have the best efficacy when measuring subjective outcomes.  As the quality of the study increases, the magnitude of the effect tends to decrease until it approaches zero.  CAM therapies are often sold by the prescribers and the prices are comparable to over the counter pharmaceuticals.  Supplements, Complementary & Alternative Medicine is known as SCAM to the followers of the Science Based Medicine.

List the types of diseases/illnesses that are most amenable to the integrative care model.

 * CAM is most effective when used to treat illnesses like back pain, colds, neck pain, joint stiffness, and depression. Conventional medicine does not have great therapies for the most common forms of these illnesses.  These disease tend to have large subjective experiences of illness and psychosocial components.
 * CAM focuses on five areas of prevention: physical activity, nutrition, screening, stress management, and spirituality. (

Describe the purpose and the process of the integrative assessment
“To gain an understanding of the human being who presents for care.” It allows the practitioner to offer recommendations that encompass the breadth of physical, emotional, intellectual, and spiritual domains.” Appointments tend to be 1 hour, to allow the provider to compile a complete social history and understanding of the patient.

Discuss the evidence that relates to the effectiveness of the integrative medicine model

 * 1) Lots of people use it: 67% of US adults have used at least one CAM therapy in their lifetime
 * 2) People vote with their wallets: $36 Billion spent on CAM, so it must work
 * 3) People who use if feel it works: 79% of patient’s using IM feel that the combination of conventional and CAM is superior to either alone
 * 4) Growing use of NIH dollars to run randomized controlled clinical trials, perform meta analyses, etc