1. PCM1: Introduction to Integrative Medicine
Eugene Lee, MD, RYT
Assistant Professor
Loyola Department of Family Medicine

2. Objectives
Define and differentiate Integrative Medicine from Complementary and/or Alternative
Recognize the approach of Integrative Medicine
Discuss the impact of Integrative Medicine on society and in medicine
Learn some skills for yourself
Derive Enjoyment at least once in the next hour

3. Outline Define Integrative Medicine
Application of Integrative Medicine
Fundamentals of recommending a technique or product
Effects of Integrative Medicine in Medicine
Social Implications and Challenges

4. Definitions: Old terminology
Alternative Medicine: “instead of”
Complementary Medicine: “in addition to”

5. Defining Terms: Current terminology
“Integrative Medicine and Health reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic and lifestyle approaches, healthcare professionals and disciplines to achieve optimal health and healing.”
Academic Consortium for Integrative Medicine & Health

6. What does Integrative Medicine Include?
National Center for Complementary and Integrative Health (NCCIH):
Whole Medicine Systems
Mind-Body Medicine
Biologically Based Practices
Manipulative and Body Therapies
Energy Therapies

7. 1: Whole Medical Systems
Homeopathy
Naturopathy
Traditional Chinese medicine
Ayurveda
Shamanism
More

8. 2: Mind-Body Medicine Meditation Prayer Art/dance/music therapy
Hypnosis / Guided imagery
Biofeedback
Yoga
Cognitive-behavioral therapy
Journaling
More

9. 3: Biologically Based Practices
Dietary supplements (vitamin and minerals)
Herbal/animal supplements
Probiotics

10. 4: Manipulative and Body-Based Practices
Spinal manipulation (both chiropractic and osteopathic)
Craniosacral therapy
Massage
Rolfing
Zero Balancing
Trauma Releasing Exercises
More

11. 5: Energy Therapies Qigong Reiki Therapeutic touch Healing Touch
Quantum Touch
Electromagnetic therapy
More

12. Recent NCCIH Taxonomy 2 subgroups
Natural Products – biological based practices
Mind and Body Practices – mind body medicine + manipulative therapies
Recognizes “Other Health Approaches” – Whole Medical Systems + Energy therapies

13. POP QUIZ!
Everyone take out a piece of paper and number it 1-10.

14. Mind Body Exploration - Breathwork
Diaphragmatic Breathing

15. Breath work
4-7-8 breathing

16. Outline Define Integrative Medicine
Application of Integrative Medicine
Fundamentals of recommending a technique or product
Effects of Integrative Medicine in Medicine
Social Implications and Challenges

17. Options available in Integrative Care

18. What is an integrative approach?
The VA example - Whole Health

19. Whole Health/Integrative Medicine addresses 70%
Health Care alone = 10%
Whole Health/Integrative Medicine addresses 70%
Sandra Braunstein, and Risa Lavizzo-Mourey 2011

20. Maximizing the Mind-Body Connection

21. The Good (Placebo), the Bad (Nocebo), the Ugly (Lying?)
Ted Kaptchuk – Harvard Researcher who does open label placebo research
Kam-Hansen S, Jakubowski M, et.al. “Altered placebo and drug labeling changes the outcome of episodic migraine attacks.” Science Translational Medicine Jan 8;6(218):218ra5

22. The Power of You
Rakel DP, Hoeft TJ, et.al. Practitioner empathy and the duration of the common cold. Family Medicine Jul-Aug;41(7):
A empathetic clinician correlated with 1 day shorter cold duration and less severe symptoms.

23. Outline Define Integrative Medicine
Application of Integrative Medicine
Fundamentals of recommending a technique or product
Effects of Integrative Medicine in Medicine
Social Implications and Challenges

24. ECHO
Efficacy Cost Harm Opinion

25. Experiential: Body awareness

26. Why care about integrative medicine?
Define Integrative Medicine
Application of Integrative Medicine
Fundamentals of recommending a technique or product
Effects of Integrative Medicine in Medicine
Social Implications and Challenges

27. Use of Health Care
<-
Petterson, et.al Jan 2018

28. Most recent Blood Pressure Treatment Guidelines ->
Integrative Medicine Becomes Standard of Care Medicine
Most recent Blood Pressure Treatment Guidelines ->
When did the American Heart Association add “lifestyle habits” and “nonpharmacological therapies” to the Guidelines?

29. In 2017, about 1 out of every 8 people you meet do yoga and meditation

31. Difficult to treat conditions via traditional medical models seem to respond well.
2012

32. Resources to learn about Integrative Medicine
Integrated Medicine for the Underserved (IM4US)
Academic Consortium for Integrative Medicine and Health
VA: Whole Health
University of Wisconsin Integrative Health Program
University of Arizona: Center for Integrative Medicine
National Center for Complementary and Integrative Health

33. Outline Define Integrative Medicine
Application of Integrative Medicine
Fundamentals of recommending a technique or product
Effects of Integrative Medicine in Medicine
Social Implications and Challenges

34. Good Research Barriers

35. Is there anything wrong with these photos?

36. Experiential

37. Resources www.fammed.wisc.edu/integrative
tinyurl.com/uwmindfulpodcast
VA website
Natural Standards Database
Consumerlab.com
tinyurl.com/KPHealthJourneys

38. References
Petterson S, McNellis R, Klink K, Meyers D, Bazemore A. The State of Primary Care in the United States: A Chartbook of Facts and Statistics. January 2018.