I believe our health care system needs to be more patient- centered and engage patients in their own care. American medicine excels at crisis intervention with innovative drugs and surgical procedures. Yet chronic illness comprises the majority of problems that most physicians see in their office. Chronic health problems are adversely affected by poor diet, lack of exercise, obesity, smoking and excess alcohol. Another factor affecting chronic disease management is that insurance companies typically do not reimburse for measures to prevent disease. They instead wait until a serious disease has occurred that generally is much more costly to treat.
In a commentary published in the Journal of the American Medical Association 2004, Dr. Halsted Holman from Stanford Medical School addressed the fact that medical schools have not adequately prepared new physicians for managing chronic illness and acknowledged that changes need to be made in the curriculum to deal with this important health issue. Patients with chronic illness who lack understanding of their disease are less likely to comply with the lifestyle changes necessary to enhance the physician’s therapy.
Integrative medicine is a more inclusive approach to managing chronic illness. Several exemplary medical schools like UCLA, Harvard, Stanford and UC San Francisco (UCSF) have established centers for integrative medicine. There are currently 40 integrative medicine fellowship programs at medical schools in the United States.
UCSF was the first integrative medicine center established in 1996 and defines integrative medicine in the following way:
“Integrative medicine is a new term that emphasizes the combination of both conventional and alternative approaches to address the biological, psychological, social and spiritual aspects of health and illness. It emphasizes respect for the human capacity for healing, the importance of the relationship between the physician and the patient, a collaborative approach to patient care among practitioners, and the practice of convention- al, complementary and alternative health care that is evidence- based.”
Functional medicine is the next evolution of integrative medicine that incorporates all the conventional and alternative evidence-based options within an informational framework that enables you to detect the intrinsic mechanisms that may be driving the problem. The model is based on a systems biology perspective in which the interconnectedness of all the body systems is taken into consideration. All of our body organs and systems talk to each other and dysfunction in one system can result in disease in other parts of the body. It’s not exclusive or inclusive of any particular treatment modality or test, so surgery could be functional medicine. Recognizing and treating the underlying cause of symptoms enables the physician to engage the body’s capacity for self-healing.
Excerpt from “Outliving Your Ovaries” © 2012 by Marina Johnson MD.
Dr. Johnson has no financial conflicts of interest or ties to any pharmaceutical company.
Her only objective is determining the most effective, safest therapy for patients.