Aspiring physicians expect to sit in medical school courses that focus on anatomy and biochemistry. But at many schools, they can also learn about unconventional treatment options like acupuncture, hypnosis and herbal remedies in courses on what’s known as integrative medicine.
Experts say it’s important for prospective medical students to understand what integrative medicine is, why it’s controversial and how proponents of the practice are challenging norms in the medical profession.
Integrative medicine blends conventional treatments such as surgery and prescription drugs with complimentary and alternative medicine like biofeedback, homeopathy and mindfulness. Doctors in this discipline say they use scientific evidence to decide which unconventional therapies to recommend to patients but there is debate within the field about what types of alternative medicine should be included.
Integrative medicine physicians say they occasionally disagree with their colleagues about which alternative therapies have been proven to be safe and effective. Critics say alternative treatment methods are often useless and sometimes dangerous.
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Controversy Between Advocates and Skeptics
Proponents of integrative medicine say all aspiring doctors should study this topic during medical school.
“As more and more patients are turning to alternatives to conventional, pharmaceutical based medicine, it is necessary for medical doctors to at least have a working knowledge of the basics of integrative medicine in order to better guide their patients,” said Dr. Kathleen Fry, a Colorado-based obstetrician, gynecologist and homeopath, in an email.
Critics question whether it ought to be taught in medical school at all and argue it is pseudoscientific.
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“Integrative medicine techniques, what goes under that rubric, is mostly nonsense,” says Steven Salzberg, a biomedical engineering professor at Johns Hopkins School of Medicine who holds a Ph.D.
Salzberg says aspiring doctors should avoid medical schools where integrative medicine courses are required. “If you want to use your time productively, don’t take classes where you’re not going to learn anything that helps you make patients better,” he says.
Advocates say this type of medicine identifies the most promising treatments in ancient healing traditions. They say medical schools should provide more information to students about these discoveries.
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“There are some extremely valid and extremely efficacious treatments that are still considered to be complementary, alternative and integrative that are not being taught to medical students,” says Dr. Ronald Whitmont, clinical assistant professor of family and community medicine at New York Medical College.
Salzberg concedes that some alternative therapies that integrative medicine professors endorse – yoga, mediation and massage – might be effective stress relief techniques.
“Those things are fine,” he says, “but they then pretend that if one of those are okay, they’re all okay, because they gave them all the same label, and that’s not correct and I strongly object to doing that.”
Dr. Judson Brewer, a psychiatrist and chief of the division of mindfulness at the University of Massachusetts Medical School, says that meditation is a valuable tool for doctors to use to address psychological conditions such as anxiety, depression and addiction.
“I would say that it doesn’t matter what specialty you go into,” he says. “We’re all going to have our own stress and we’re also going to have patients who are stressed out and anxious, and this can serve as a tool that helps us work with our patients and connect with our patients no matter what our subspecialty is.”
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Dr. Robert Heffron, clinical assistant professor in family medicine at Brown University’s Warren Alpert Medical School, says aspiring doctors shouldn’t assume that a therapy is ineffective because it originated in alternative medicine.
Principles of Integrative Medicine
Heffron, the former director of Brown’s medical school concentration in integrative medicine, says medical students can benefit from learning one of the central tenets of alternative medicine: that a person’s overall wellness cannot be measured simply by looking at the health of various organs.
“The big lesson that I try to get across to the students is to try to take a step back and realize that patients are more than the sum of their parts,” he says.
Another lesson integrative medicine teaches, its proponents say, is the importance of preventing illness and maintaining optimum health, as opposed to reacting to the symptoms of disease. An important advantage of integrative medicine, proponents say, is that it puts more emphasis on nutrition and mental health than traditional medicine.
But Salzberg says that its focus on prevention and wellness is not unique. “Every physician is concerned with wellness and in making the whole patient better and in treating the root causes of diseases.”
Integrative medicine advocates cite the popularity of alternative therapies among U.S. patients as a reason to study this discipline.
Dr. Bindiya Gandhi, an Atlanta-based family physician, says patients often demand integrative medicine. “They want to take a more ‘natural’ approach to their health care,” she said in an email. “This is why it’s important to expose medical students early on, regardless of what specialty they go into, so they can help their patients make the right decisions about their health care.”