Welcome to Fullscript’s integrative medicine education series. Discover how integrative medicine improves patient outcomes and why it’s being adopted by forward-thinking practitioners across North America.
In 2002, Dr. Ralph Snyderman, MD, Duke University, and Dr. Andrew Weil, MD, University of Arizona, wrote that integrative medicine is bringing medicine back to its roots. They concluded, “the integrative medicine of today will simply be the medicine of the new century.” (13)
Leading the charge to integrate the best of conventional and complementary medicine are a diverse group of integrative medicine doctors working to make integrative medicine “the medicine of the new century.” Continue reading to learn more about some of the different types of integrative medicine doctors and how they’re taking a holistic approach to treating patients.
Types of integrative medicine doctors
Integrative doctors take the best that conventional and complementary medicine has to offer to create evidence-based, individualized whole-health treatment plans that focus on body, mind, and spirit. (9) Integrative doctors can be medical doctors, chiropractors, naturopathic physicians, osteopaths, Ayurvedic practitioners, doctors of oriental medicine, and homeopaths.
Having such a diverse group of integrative doctors adds to the efficacy of integrative medicine as a whole. “Utilizing a team of providers with diverse perspectives and experiences will further enhance patient outcomes,” explained Lise Alschuler, ND, FABNO, who is the Associate Program Director of the Fellowship in Integrative Medicine at the University of Arizona Andrew Weil Center for Integrative Medicine.
“The diversity within integrative medicine is key because it allows for more patients to access this paradigm of health promotion,” said Jeff Gladd, MD, founder of GladdMD Integrative Medicine and Chief Medical Officer at Fullscript. “It’s also important for every level of provider to know their limitations and when to seek a higher level of care.” Dr. Gladd encourages all integrative providers to seek education from entities that have an evidence-based formal certification. “This helps ensure that the practice of integrative medicine maintains a consistent standard of care, and the more we all work together at this level the better,” he said.
Dr. Alschuler agrees, stating that “the more integrative health and medicine training that providers have the greater the benefits for both the patient and provider.”
Let’s take a closer look at the key types of integrative medicine healthcare providers.
Chiropractic doctors focus on the diagnosis, prevention, and treatment of neuromusculoskeletal disorders and use mostly manual techniques, known as adjustments, to positively influence health. (12) Most chiropractors provide nutrition and lifestyle advice and many of them also recommend dietary supplements to help enhance health and reduce the risk of illness. (6)
Conventional medical doctors
Conventional medical doctors (MDs) are sometimes also referred to as allopathic physicians. Integrative MDs are also referred to as holistic medical physicians as they work to expand their medical knowledge beyond the conventional medical system.
“There is a growing number of conventional medical doctors desiring additional integrative medicine fellowship training, such as our program at the University of Arizona,” said Dr. Alschuler who is also a clinical professor at the University and maintains a private oncology practice in Arizona. Dr. Alschuler recognizes that there are several quality certification programs for physicians in various aspects of holistic and integrative medicine that help advance the field as well as the skills of the provider.
As of 2020, 70 different medical and nursing schools were offering integrative medicine fellowships throughout the United States. (8)
Naturopathic doctors have unique training that emphasizes diet- and lifestyle-based self-care, supplements, homeopathy, manual therapies, and non-drug-based treatments with a philosophy codified by these seven principles:
- Doctor as teacher
- Emphasize the healing power of nature
- First do no harm
- Focus on wellness
- Promote health to prevent disease
- Treat the cause
- Treat the whole person (14)
There have been many studies conducted showing that naturopathic medicine is effective at treating a variety of health conditions including heart disease, mental health issues, type 2 diabetes, and a wide range of complex chronic diseases. (10)
Doctors of osteopathic medicine (DOs) practice alongside MDs, but they also are trained in manual manipulation and their philosophies of prevention and whole-patient care are more aligned with integrative medicine doctors. (17) Much of the research on osteopathic medicine focuses on the efficacy of manipulative treatments for musculoskeletal issues and low back pain. (2)
Derived from India, one of the oldest traditional medical systems still utilized worldwide is Ayurvedic medicine, a complex combination of elements, humors, and body constitutions that help practitioners devise whole-body treatment strategies. (5) There is scientific evidence demonstrating its efficacy to promote well-being. (11)
Doctors of oriental medicine
A practitioner who studies oriental medicine is often referred to as a doctor of oriental medicine (DOM) or a doctor of acupuncture and oriental medicine (DAOM). These practitioners focus on traditional Chinese medicine (TCM), which is a healing system that dates back to 200 BC. (15) TCM utilizes a holistic approach that looks at the Chinese philosophy of Yin-Yang and Five Elements, with the fundamental concept that Qi (vital energy) influences health along meridians mapped out on the human body. (4) The World Health Organization has included TCM diagnostic patterns into the International Classification of Diseases code, which is the global standard for diagnostic health information. (3)
Homeopathics are highly diluted, targeted remedies that trigger a therapeutic reaction in the patient to create homeostasis and correct physiologic illness imbalances. (1) Homeopathy remains controversial; however, research does show that individualized homeopathic remedies may be superior to placebo. (16)
Other integrative medicine practitioners
There are many other types of healthcare professionals who utilize an integrative approach. This includes acupuncturists (many of whom are also DOMs), massage therapists, nurses, nurse practitioners, and nutritionists.
Collaboration is key
All types of integrative medicine doctors aim to improve patient outcomes, and research shows that one way to do this is through interprofessional collaboration. (7)
“The premise of integrative medicine is that it is an individualized journey for each patient,” said Dr. Gladd. “That means there has to be a variety of providers from different disciplines, backgrounds, and experiences to deliver the best integrative medicine possible to the masses.”
“Openness to collaboration based on mutual respect for the expertise and training of other provider types is critical to harmony within the field and helps ensure optimal patient care,” said Dr. Alschuler.
- Bellavite, P. (2015). Homeopathy and integrative medicine: keeping an open mind. J Med Person, 13(1), 1-6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363517/
- Dal Farra, F., Risio, R. G., Vismara, L., & Bergna, A. (2021). Effectiveness of osteopathic interventions in chronic non-specific low back pain: a systematic review and meta-analysis. Complementary Therapies in Medicine, 56. https://www.sciencedirect.com/science/article/pii/S0965229920318835
- Eigenschink, M., Dearing, L., Dablander, T. E., Maier, J., & Sitte, H. H. (2020). A critical examination of the main premises of traditional Chinese medicine. Wien Klin Wochenschr, 132, 260-273. https://link.springer.com/article/10.1007/s00508-020-01625-w
- Fung, F., & Linn, Y. (2015). Developing traditional Chinese medicine in the era of evidence-based medicine: current evidences and challenges. Evid Based Complement Alternat Med, 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4407626/
- Jaiswal, Y., & Williams, L. L. (2017). A glimpse of Ayurveda—the forgotten history and principles of Indian traditional medicine. J Tradit Complement Med, 7(1), 50-53. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5198827/
- Lee, M., Amorin-Woods, L., Cascioli, V., & Adams, J. (2018). The use of nutritional guidance within chiropractic patient management: a survey of 333 chiropractors from the ACORN practice-based research network. Chiropractic & Manual Therapies, 26:7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819231/
- Lutfiyya, M., Chang, L, McGrath, C., Dana, C., & Lipsky, M. S. (2019). The state of the science of interprofessional collaborative practice: a scoping review of the patient health-related outcomes based literature published between 2010 and 2018. PLOS ONE, 14(6). https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0218578
- Marcus, D. M. (2020). Alternative therapies in academic medical centers compromise evidence-based patient care. The Journal of Clinical Investigation, 130(4), 1549-1551. https://www.jci.org/articles/view/137561
- Millstine, D. (2021, Oct). Overview of integrative, complementary, and alternative medicine. MSD Manual. https://www.msdmanuals.com/professional/special-subjects/integrative,-complementary,-and-alternative-medicine/overview-of-integrative,-complementary,-and-alternative-medicine
- Myers, S. P., & Vigar, V. (2019). The state of the evidence for whole-system, multi-modality naturopathic medicine: a systematic scoping review. J Altern Complement Med, 25(2), 141-168. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389764/
- Narayana D., & Durg, S. (2021). Ayurveda: (w)here is the evidence. Journal of Ayurveda and Integrative Medicine, 12(2), 408-411. https://www.sciencedirect.com/science/article/pii/S0975947620300590
- Salehi, A., Hashemi, N., Imanieh, M., & Saber, M. (2015). Chiropractic: is it efficient in treatment of diseases? Review of systematic reviews. Int J Community Based Nurs Midwifery, 3(4), 244-254. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4591574/
- Snyderman, R., & Weil, A. (2002). Integrative medicine bringing medicine back to its roots. Archives of Internal Medicine, 162(4), 395-397. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/211225
- Steel, A., Foley, H., Bradley, R., Van De Venter, C., Lloyd, I., Schloss, J., Wardle, J, & Reid, R. (2020). Overview of international naturopathic practice and patient characteristics: results from a cross-sectional study in 14 countries. BMC Complementary Medicine and Therapies, 20, 59. https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/s12906-020-2851-7
- Tabish, S. (2008). Complementary and alternative healthcare: is it evidence-based? Int J Health Sci, 2(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068720/?report=reader
- Ullman, D. (2021). An analysis of four government-funded reviews of homeopathic medicine. Cureus,13(6). https://www.cureus.com/articles/62105-an-analysis-of-four-government-funded-reviews-of-research-on-homeopathic-medicine#references
- Wu, P., & Siu, J. (2015). A brief guide to osteopathic medicine. American Association of Colleges of Osteopathic Medicine, April, second edition. https://www.aacom.org/docs/default-source/cib/bgom.pdf