Integrative Health Class

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Integrative Health Class
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What do the following terms mean?

• Interdisciplinary
• Multidisciplinary
• Integrative
• Complimentary and Alternative
• Allied Health

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National Center for CAM Domains

• Whole Medical Systems
• Mind-Body Medicine
• Biologically-Based Practices
• Manipulative and Body-Based Practices
• Energy Medicine

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David Rakel
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Components of Integrative Medicine

• Respect for the human capacity for healing
• The importance of the relationship between the
  practitioner and patient
• The importance of self-care for chornic
  conditions
• A collaborative approach to a patient care among
  practitioners

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Clinicians and Educators Desk Reference
available at www.accahc.org
Powerpoint developed by Jan Schwartz, MA Beth
Rosenthal, MPH, MBA, PhD
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ACCAHC Vision

• a healthcare system that is multidisciplinary
  and enhances
• competence, mutual respect and collaboration
  across all complementary, alternative and
  conventional healthcare disciplines deliver
  effective care that is patient centered, focused
  on health creation and healing, and readily
  accessible to all populations.

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Five Licensed CAM Professions

• Acupuncture and Oriental medicine
• Chiropractic medicine
• Direct entry midwifery
• Massage therapy
• Naturopathic medicine

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What is acupuncture?

• Acupuncture is an ancient Chinese method that
  involves placing fine needles at specific points
  on the bodys surface to treat various health
  problems with a recognized history of almost 3000
  years.
• It is designed to correct any imbalances in the
  body which may give rise to disease or illness.
• In acupuncture, the belief is that there is a
  continuous circulation of energy in the organism.
  Illness can occur because of derangement of this
  circulation. Where energy fails to circulate as
  it should, vital organs may suffer from it. The
  Chinese call this flow of energy, or life force,
  Qi.
• By inserting needles at specific acupuncture
  points along energy channels within the body,
  called meridians (energy paths), energy channels
  can be unblocked or stimulated in order to an an
  effect on a particular parts of the body or
  symptom.
• Acupuncture, if practice properly, can redirect
  and normalize the flow of energy and bring the
  patient back to health.

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Acupunture

• In theory, there are more than 365 points along
  the 12 meridians of the body. The ear auricle
  contains a complete set of acupuncture points
  which when stimulated can produce rapid relief
  from acute pain.
• Fine gauge needles and massage can also be used
  in combination to stimulate acupuncture points in
  the low back, abdomen, feet, and hands.
• Needles are sometimes attached to an electro
  acupuncture machine to provide extra stimulation.

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Two dominant energies in chinese medicine

• Traditional Chinese medicine describes the bodys
  balance in terms of Yin and Yang.
• YIN Female energy, represents traditional
  female
• qualities of peacefulness and
  calm.
• Fluids
• Water
• Damp
• YANG Male energy, represents traditional male
  qualities of aggression and stimulation.
• Fire
• Movement

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http//www.sacredlotus.com/resources/index.cfm
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Who does this sound like?

• A system of primary health care-an art, science,
  and philosophy and practice of diagnosis,
  treatment, and prevention of illness
• Recognizes that the body to heal itself
• Seek to remove the underlying cause of disease
• A holistic health discipline that began at the
  turn of the century
• A 4 year, 4,000 hour post-baccalaureate program

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Naturopathic Medicine - Principles

1. The healing power of nature
2. Identify and treat the cause(s)
3. First Do No Harm
4. Doctor as teacher
5. Treat the whole person
6. Prevention

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Approach to Patient Care

1. Establish the conditions of health
2. Stimulate self-healing mechanisms
3. Support damaged or weakened systems or organs
4. Address structural integrity
5. Address pathology using natural substances
6. Suppress pathology

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• Holistic, comprehensive system of health care
• Integrates variety of modalities
• Encourages inherent self-healing
• 6 accredited or pre-accredited schools in North
  America
• Have a series of national board exams
• Licensed naturopathic physicians in US
• In 2000 1978
• In 2006 4010

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Regulation and Certification

• Licensed/regulated in 15 states
• Licensing efforts underway in 12 states
• Licensed/regulated in 4 provinces in Canada

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Scope of Practice

• Varies from state-to-state
• Diagnosis including order of lab tests, imaging,
  etc.
• Management which may include prescription of some
  drugs, homeopathy, acupuncture, manipulation,
  minor surgery
• May practice as PCP or may require referral or
  co-management with medical doctors in some states

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Organizations

• Council on Naturopathic Medical Education
• North American Board of Naturopathic Examiners
• Naturopathic Physician Licensing Examination

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Peer-reviewed scientific journals

• International Journal of Naturopathic Medicine
  http//www.intjnm.org/homepage.php?id23
• Natural Medicine Journal http//www.naturalmedicin
  ejournal.com

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Key Challenges

• Having enough practitioners to meet growing
  demand
• lt1/3 states regulate profession
• Scope of practice expansion slow in some
  jurisdictions

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Key Opportunities

• NDs in greater demand
• of schools doubled in 20 years
• Diverse practice opportunities
• NDs fill void of decreasing MDs in family
  practice/primary care
• Collaboration increasing within the profession

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Research Agenda

• Naturopathic treatment of type 2 diabetes
• Naturopathic care for the preservation and
  promotion of optimal health in the geriatric
  population
• Develop methodologies for the understanding of
  the healing process

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Naturopathic Bibliography (CEDR pages 141-143)
Alschuler LN, Gazella KA. Alternative Medicine
Magazines Definitive Guide to Cancer An
Integrative Approach to Prevention, Treatment,
and Healing. Berkeley, CA Celestial Arts
2007. Bove M. An Encyclopedia of Natural Healing
for Children and Infants. New York, NY
McGraw-Hill 2001. Canadian College of
Naturopathic Medicine Press. Fifteen textbooks
based on naturopathic curriculum, written by
naturopathic physicians, faculty, and lecturers.
http//www.ccnmpress.com/. Accessed November 17,
2009. Hudson T. Womens Encyclopedia of Natural
Medicine Alternative Therapies and Integrative
Medicine. Lincolnwood, IL Keats 1999.
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Naturopathic Bibliography (CEDR pages 141-143)
Pizzorno JE, Murray MT, Joiner-Bey H. The
Clinicians Handbook of Natural Medicine.2nd ed.
Philadelphia, PA Churchill Livingston
2002. Pizzorno JE, Murray MT. The Encyclopedia of
Natural Medicine. 2nd ed, revised.Roseville, CA
Prima Publishing 1997. Pizzorno JE, Murray MT.
The Textbook of Natural Medicine. 3rd ed.
Philadelphia,PA Elsevier 2006. Pizzorno JE.
Total Wellness Improve Your Health by
Understanding the Bodys Healing Systems.
Roseville, CA Prima Publishing 1997. Standish
L, Calabrese C, Snider P. The Future and
Foundations of Naturopathic Medical Research
Science Naturopathic Medical Research Agenda.
Kenmore, WA Bastyr University Press
2005. Yarnell E. Naturopathic Gastroenterology.
East Wenatchee, WA Healing Mountain Publishing
Inc 2000.
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Homeopathy

• Based on a concept of vital energy an effect
  of substances that is the opposite of the effect
  and higher concentration
• Substances that produce certain symptoms in
  humans are put through a process of serial
  dilution into homeopathic remedies
• The more the dilution the higher the potentiation
• Consultation and matching of a list of patient
  signs/symptoms with a repertories provides the
  remedy
• The final substance may not contain any active
  molecules

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Remedies

• Found in Materia medica and repertories
• May be animal, plant, mineral, and synthetic
• Created by multiple dilutions in water of
  alocohol and then succused
• Nosodes
• Sarcodes
• Imponderables
• thunderstorms

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Effectiveness

• Systematic reviews have failed to demonstrate
  efficasy
• In 2010, inquiry into the evidence base for
  homeopathy concluded that it is no more effective
  than placebo