Integrative Medicine Usage

Components of Integrative Health

The National Center for Complementary and Alternative Medicine (NCCAM) categorizes the different modalities of integrative medicine in the following categories:

• Domains – whole medical systems (homeopathy, naturopathy, traditional chinese medicine, ayurveda)
• Mind-body medicine (meditation, yoga, acupuncture, deep-breathing exercises, hypnosis, guided imagery, progressive relaxation, qi gong, tai chi)
• Biologically-based practices (dietary supplements, herbal supplements)
• Manipulative and body-based practices (chiropractic, osteopathy, massage)
• Energy medicine (qi gong, reiki, therapeutic touch, electromagnetic therapy)

An emerging practice in integrative medicine is the Healing Circle. Some patients, typically with chronic diseases, have consulted with multiple conventional and CAM practitioners over the years with unsatisfactory results. The Healing Circle brings this patient in with three to eight practitioners from a variety of disciplines. The patient writes a statement of why they are requesting a healing circle and their physical, emotional, and spiritual autobiography. The patient also meets with a health guide or navigator in advance to determine which medical and health disciplines should be invited and each panelist reviews the patient's statements in advance.

The Healing Circle meets in person with the patient, health guide, and invited practitioners for approximately two hours in a private setting. After introductions, the patient describes why she has requested a circle and what her goals are. The practitioners address the patient directly about her health concerns, offering ideas about treatment strategies from his expertise. The health guide facilitates the discussion. The responsibility to help the patient is shared with all members of the panel and no one practitioner is responsible for finding a solution.

After the circle is completed, the health guide writes a summary of the practitioner's recommendations. No action is also an option. The health guide meets with the patient within two weeks of the healing circle to discuss next steps in her treatment plan.

Benefits from healing circles include

• Patients receive immediate practical information on resolving their condition from a variety of disciplines.
• Patients may feel more empowered to explore their psychospiritual problems and the meaning and root of their illness.
• Profound healing can occur in the circle from group interconnectedness. The relationship between the patient and practitioner, and between the practitioners, can deepen and be healing in itself.

Few integrative clinics offer healing circles. Typically the practitioners are not compensated for their time.

There are several models of integrative clinics. Larger scale clinics associated through a university, such as Duke Integrative Medicine and UCSF Osher Center for Integrative Medicine typically have a research wing. Other centers are associated with hospitals, such as Scripps Center for Integrative Medicine in San Diego, CA. Some are independently-operated, such as The Alliance Institute for Integrative Medicine in Cincinnati, OH. These larger scale clinics have medical directors who are M.D.s and typically offer a wide range of services such as acupuncture, massage, energy work, biofeedback, nutritional counseling, and stress reduction. Many schools that teach each modality (such as an acupuncture school or massage school) have low-cost clinics.

Smaller integrative clinics may have independent practitioners working in the same office and referring clients to each other.

Individual practitioners of specific modalities may be working independently.