Integrative medicine (IM) is a newly emerging field of comprehensive healthcare that emphasizes wellness and healing of the whole person with a focus on mental and spiritual health. It is the integration into mainstream medicine of complementary therapies for which there is evidence of safety and effectiveness. Integrative physicians strengthen the physician–patient relationship and empower the patient. The Academic Consortium for Integrative Medicine and Health, which consists of 56 academic medical centers, defines IM as “the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing.” This concept is illustrated in Figure 13-1.
The integrative medicine wheel. (Used with permission from William Collinge, PhD).
The knowledge and use of complementary and alternative medicine (CAM) is an important aspect of IM. CAM refers to a large range of therapies outside the domain of mainstream conventional/Western medicine that are used for the purpose of medical intervention, health promotion, and disease prevention. CAM includes therapies such as alternative/whole medical systems (homeopathy, naturopathy, Ayurveda, and traditional Chinese medicine), mind-body interventions (meditation, prayer for healing, biofeedback, yoga, and art and music therapy), biologically based therapies (megavitamins, nutritional supplements, and herbs), manipulative and body-based methods (chiropractic manipulations, osteopathy, and massage), and energy therapies (Reiki and Therapeutic Touch).
With increasing interest in the integration of CAM therapies into conventional pediatrics, a more appropriate term of pediatric integrative medicine (PIM) has emerged. Interestingly, the growing trend in conventional medicine toward the patient and family–centered medical home, with a focus on prevention and health promotions of the whole child, is the core of PIM.
The pediatric medical landscape has evolved over the last 20 years primarily due to increasing prevalence of complex and chronic conditions such as diabetes, autism, attention-deficit disorder, asthma, obesity, cancer, chronic pain, and depression/anxiety. Many pediatricians are developing interest in learning new skills and embracing new therapies to better care for these complex patients. The current conventional biomedical model of treating illness is not very effective in preventing the development of disease or in altering the course of chronic physical illness. In fact, the current model does not adequately address the mental, emotional, and spiritual needs of an individual. As pediatricians are becoming more aware of the need for holistic care, a trend toward the integration of CAM therapies within the practice of conventional medicine is occurring. Children’s hospitals are commonly offering CAM therapies, health insurances are covering such therapies, and a growing number of physicians are using CAM therapies in their practices. IM centers and clinics are being established, many with close ties to medical schools and teaching hospitals.
As a result of increasing interest ...