Wellness and Integrative Medicine

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Interest in a holistic approach to medicine has grown over the past several decades. Integrative medicine seeks to embrace a more comprehensive view of healing and care for individuals focusing on mind, body, spirit and community. It especially emphasizes the combination of the best in conventional and alternative medicine to help patients achieve optimal health and healing. Integrative medicine focuses on taking the best of western medicine in addition to practices from other cultural systems.

The goal of integrative medicine is to not just treat symptoms but to also work in a preventive and non-invasive mode. Treatments are usually given by an internist who is very well trained in internal medicine, complementary medicine and alternative medicine practices. The internist will then help the patient to create a lifestyle plan that best accommodates their needs.

Exploring all avenues of treatment is most beneficial to pinpointing what works best for the patient. Other modalities in integrative medicine include biologic therapies, cultural therapies, manual therapies, massage therapy, and energy medicine.

Dr. Melinda Ring M.D., Medical Director at the Center for Integrative Medicine at Northwestern Memorial Hospital, an internal and integrative medicine physician, joins Andrew to discuss the holistic philosophy and healing traditions often included in an integrative medicine approach. Andrew and Dr. Ring also discuss the questions surrounding evidence-based medicines and how the FDA regulates for quality control. Also, learn more about how acupuncture is helping infertility, rheumatoid arthritis and chronic pain.

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Andrew Schorr:

Hello. This is Andrew Schorr. Welcome once again to one of our Patient Power programs on healthnet.nmh.org, the Northwestern Memorial Hospital website where every two weeks we cover an important topic.

So we've talked about surgeries, and transplantation and all sorts of chronic conditions. And typically our guests almost always are MDs but always people with extensive medical backgrounds. And then you think about, well, how you approach your health. And you wonder about beyond surgical procedures, prescriptions medicines what can you do to make a difference in your health. And then you start to hear these terms like alternative medicine or complementary medicine or integrative medicine. Well, Northwestern Memorial is very aware of that, and for ten years or so they've had a center for integrative medicine at Northwestern, and the medical director is with us today, Dr. Melinda Ring. Now, she's an M.D. She's very devoted to this topic.

Dr. Ring, thanks for being with us.

Dr. Ring:

Thanks so much for having me!

Andrew Schorr:

So what does integrative medicine mean? Tell us about your center. What's its focus and how does it come together with all the other medical resources that Northwestern has?

Dr. Ring:

Well, integrative medicine in general refers to taking the best of Western medicine and combining it with practices that come from other cultural systems. So for us what that means is that people come here, they will see an internist who has training in internal medicine and in addition is very open or specifically trained in complementary and alternative medicine practices. Some patients are self referred; some of them come on a physician's recommendation. We will help them develop a plan, a real lifestyle plan that puts together what they're already doing with their Western medicine and look at what else they can be doing to round out their wellness.

Andrew Schorr:

Let's look at one example of that. There are literally millions of people for example with chronic pain. And we have done programs certainly with experts in chronic pain, so certainly the anesthesiologists and I know there are pain clinics, you may have this procedure, that procedure, this nerve block, or that block. But also you could have acupuncture, for example. So that might be an approach. Would a specialist like you say let's see how all this can come together to help someone where maybe their pain has not been resolved in other ways?

Dr. Ring:

Absolutely. With integrative medicine the goal is to not just treat symptoms, but also work in a preventive fashion and do things as noninvasively as possible. So maybe down the line surgery might be necessary, but let's see what else we can do beforehand. And for somebody who's coming in with pain there can be a wide range of things that might help them. Like you mentioned, acupuncture, energy medicine, specific massage therapeutic techniques, even dietary sorts of things where somebody takes on an anti-inflammatory type diet can help reduce pain. So we would look at the whole range. There are so many things people can do to help themselves.

Andrew Schorr:

Now, one of the problems in this whole area has been so we have prescription medicines that go through rigorous testing and FDA review and have to be defended before the FDA will approve them, but the problem in supplements, let's say, and some of these things that you can get at the health food stores, a lot of them have not been tested that way or it's sort of a mixed bag and purity is questioned. Sometimes there may be good substances but then it's made available by a bunch of companies. Not everybody that exacting standard and I personally think that's sort of shot that industry in the foot.

How do you help people get other products that may not be prescription medicines that are helpful and are brought together for their benefit? How do you sort through all that in evidence based medicine, I guess you'd call it.

Dr. Ring:

Right. We try to use what evidence there is out there. And in my mind there are many different types of evidence. Of course, there is the beloved double blind, placebo controlled trial. If we can have those to look at supplements, that's great. But I think we also need to look at the more experiential or cultural type of evidence. So cultures who have used certain supplements for a thousand years, you know, there's a reason that they're using that sort of supplement. So evidence is one area in choosing supplements.

And then, like you mentioned, the other one is getting a quality supplement. Since dietary supplements are not FDA regulated, making sure that you get a supplement that has what the label says it has in it, and that does not have contaminants is very important. So when somebody comes in we'll first determine what supplements are appropriate for their particular condition but then also help define what makes a good quality supplement.

Currently there are four different approval ratings. There's the Good Housekeeping rating, the Consumerlab.com rating and the USP and NSF ratings. These rating systems do not mean: okay, this supplement will definitely work, but it does say this is a supplement which contains what it's supposed to contain. So to me that's a good starting point for at least making sure people are taking what they think they are taking.

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