INM President and CEO Michelle Simon, PhD, ND, and David Katz, MD, renowned physician, nutritionist, and author, delve into the future of integrative medicine and its potential to transform health care.
Why Integrative Practice Is an Essential Model for Modern Health Care
A collaborative approach that opens up the widest possible spectrum of treatment options emphasizes the kindest, gentlest forms of treatment to get the job done and seeks to [find] the root causes of pathology rather than just treating downstream effects with drugs and surgery is the best that medicine has to offer. It’s the right and most respectful way to care for people, empowering them with the widest array of options.
MDs and NDs Can Work Together to Improve Patient Care, Lower Costs, and Expand Treatment Options
Even when we look at the conventional practice of medicine in the United States, we routinely refer to colleagues. In particular, if I’m the primary care provider, I’m the quarterback—the gatekeeper. My patient may have a cardiologist, a rheumatologist, an endocrinologist … any number of ‘ologists.’ We share information because two heads are better than one. I don’t think drugs are the answer. I don’t think surgery is the answer. Are there other modalities that could help alleviate pain without the toxicity of nonsteroidal anti-inflammatory drugs or narcotics? I’m not sure how best to get at this [issue] with lifestyle; I’m not an expert at elimination diets, so I need your help. All of a sudden, we’re friends and colleagues. We’re working together for the benefit of the patient. And frankly, the cost effectiveness is predicated on two things: 1) costs are lower in general when patients see the best-qualified person because they stop doctor shopping. Patients who aren’t satisfied just keep seeking additional levels of care and 2) highly effective remedies in the realm of natural medicine tend to be much less expensive than the prevailing norm in conventional medicine.
An Integrative Approach Could Eliminate Chronic Disease
We’ve long known how to prevent 80 percent or more of all chronic diseases and premature deaths. This is codified in the peer-reviewed literature. But we need a cultural revolution to pivot from reactive post-calamity medical care to proactive preventive care, and it stands to reason that healthcare professionals should be in the vanguard of that revolution. We can coach for better nutrition and physical activity. We can coach on the importance of getting adequate sleep, managing stress, cultivating strong and healthy social interactions, and avoiding toxins, like tobacco and excess alcohol. We can extend the practice of prevention into the realm of clinical preventive services—cancer screening, risk factor detection, all the things we customarily do—and modify risk factors when we find them. But for people to eat better, we need a better food supply. For people to fit [in] more [exercise], they need daily routines that allow for physical activity, and that means modification at the workplace. We need safe places for people to walk inside and outside. We need adjustments to crazy, hectic schedules. There are debates about changing the length of the work week that [could] have significant implications for health. But none of this is going to happen unless someone issues the clarion call for change—and that’s us.
To Work Side by Side, Health Professionals Must Learn from Each Other
I’ve had the privilege of working closely with naturopathic doctors to care for patients and learned a tremendous amount. The prejudice on both sides complicates attempts to build bridges because it has people moving into bunkers. I think we need to ask each another: “What [are you doing] to produce good outcomes that I would not be able to achieve [otherwise]?” It’s reasonable and healthy for us to [set] expectations [for] one another. We should all share a devotion to evidence-based medicine. We should all share an appreciation for the importance of science. But I think we should also share a humility about the extent of that science and how [so] many things impose burdens on our patients that we don’t have the answers to address in our textbooks or with randomized controlled trials.
If we can get out of our bunkers, build bridges, and share expectations for one another, the collaboration has the potential to empower us both. I think that vision can pull systems together and create whole new models of care because not being able to fix what’s broken [is frustrating for everyone]. We all encounter that in medical care—the patient we can’t help get better. Collaborative models can relieve that frustration and enable us to do exactly what we signed up [for] … to help more of our patients get the vitality they deserve. Integrative medicine is the promise of bringing fields together and saying we have conjoined missions: to elevate the standards of care, empower our patients with the best possible options, improve the human condition, add years to lives, and add life to years.
