Imagine a partnership between physician and patient, where the goal is to treat the whole person, recognizing the interrelatedness of physical, psychosocial and spiritual dimensions of the person’s life…
This treatment model would use appropriate traditional and untraditional disciplines and treatment methods that have been proven to be effective and safe, with an emphasis on wellness and disease prevention, and treatment of the person as opposed to the disease. What you would have is the basis for the integrative medicine movement.
The Evolution of Integrative Medicine
The popularity of integrative medicine has grown out of a deep dissatisfaction with the current healthcare system that often leaves doctors feeling rushed and overwhelmed and patients feeling like nothing more than a number spit out of an impersonal healthcare machine. It is no wonder healthcare has gone from being known as a lofty and honorable “practice,” to being referred to as an “industry.”
But integrative medicine is not just a nostalgic desire to return to the simple days when a kindly family doctor knew his patients personally, often from the cradle to the grave. It is an acceptance that physical illness doesn’t happen in a vacuum – and the understanding that health is affected by numerous factors, from the stress in a person’s life, the food he eats, and his activity levels, to his emotional and spiritual state of mind. It is the acknowledgement that body, mind and spirit are connected and true healing happens only when the treatment approach takes into account the whole person.
Integrative medicine utilizes state-of-the-art conventional treatments, but also embraces complementary and alternative medicine therapies (sometimes referred to as CAM) such as yoga, tai chi, meditation, acupuncture and biofeedback. While many of these methods were once considered questionable by medical professionals, advances in medical science and technology have made it possible for physicians and researchers to better understand the connection between the brain and the immune system, emotions and disease.
With the patient-centered approach of integrative medicine, healthcare becomes a team effort with close coordination between the primary care physician, specialists, nutritional counselors, exercise physiologists and other CAM providers such as massage therapists, acupuncturists, etc. At the core of the practice of integrative medicine is mindfulness, or a patient’s awareness of his physical, mental, and social states, and an alertness to any symptoms that may indicate that body, mind and spirit are not in sync.
The University of Mississippi Medical Center recently began offering a new, twice-monthly integrative medicine clinic in the Department of Allergy and Immunology to provide a cutting-edge, multi-specialty approach to therapies for patients who have not responded to traditional treatment methods alone. For example, an asthma patient may have underlying fear and anxiety about their condition that exacerbates their physical symptoms.
Well-Being spoke to Matthew T. Tull, Ph.D., Associate Professor, Division of Psychology and Department of Human Behavior at UMMC about the Medical Center’s new integrative medicine clinic and its interdisciplinary approach.
“We develop a comprehensive, coordinated treatment plan that focuses on traditional medical care, combined with other therapies that address a patient’s physical as well as psychological needs,” Tull explains. “One such therapy is mindfulness-based stress reduction, in which we teach patients to connect with the present moment, especially in times when they are flooded with worry or stressful thoughts. The goal is to help them concentrate on the things that are important to them in life, rather than being overwhelmed by fear and anxiety that makes them feel powerless.”
Dr. Tull is directing the Medical Center’s ongoing effort to open a new Center for Integrative Health that will treat patients coping with anything from digestive disorders to chronic pain and hypertension.
According to Tull, a mental health assessment should be a part of any regular check up with a patient’s primary care provider. “Without looking at the emotional state of the patient, it is difficult to appropriately address his or her physical condition. The mind and body are intimately connected and the best treatment approaches are those that focus on the whole person,” Tull adds.
An Integrative Approach to Family Medicine
Takita Murriel, M.D., is a Family Medicine physician with Merit Health Medical Group. Dr. Murriel talked with Well-Being about how family medicine can take an integrative approach to patient care by getting to know their patients as individuals.
“I remember in med school hearing a phrase coined by Sir William Osler, ‘If you listen to the patient, they will tell you what’s wrong with them,’” Murriel recalls. “It is not only important for me to get to know the human side of my patients, but also to let them know that I am human, too and therefore can empathize with them in times of joy and sorrow. This opens the door for discussion in a non-judgmental, neutral and caring environment that is lacking when physicians try to squeeze a patient into a 15 minute window of ‘what is bothering you the most today’ and treating them with a pill instead of knowing when something may be out of character.”
Part of getting to the root of a patient’s complaint, can be understanding his or her social history, which might include smoking, diet, and exercise.
“I often uncover poor sleep and nutritional habits because a lot of my patients come in complaining of fatigue,” Murriel notes. “Most of them don’t realize how poor diet and the lack of regular exercise can affect sleep, as well as mood and general health.”
Effectively addressing lifestyle and environmental factors that affect a patient’s health status can also mean taking a look at how these factors may be affecting the entire family.
“Just think, the lifestyles that negatively affect obesity, diabetes, high blood pressure, etc., can have a negative impact on everyone in a household,” adds Murriel. “Changing and improving that lifestyle can benefit the family as a whole.”
While integrative medicine has much to do with how primary care providers relate to their patients and coordinate with other professionals to offer a comprehensive and balanced approach to the plan of care, self-care and self-awareness are equally important for a patient to see optimal outcomes. Important components of self-care are the physical environment, nutrition, exercise and sleep (as Dr Murriel noted), as well as relationships, mindfulness of the mind-body connection, personal growth and spirituality. Knowing yourself – body, mind and spirit and recognizing symptoms or signs of problems early can be key to the proper diagnosis of health problems when they are most treatable. Taking an active role in your own wellbeing is key to building a healthy and fulfilling life.
Matthew Tull, Ph.D., Associate Professor, Director of Anxiety Disorder Research and the Anxiety Disorders Treatment Clinic, and the Program in Integrative Health at UMMC, received a Masters of Science degree in Experimental Psychology from Southern Methodist University, Dallas, a Ph.D. in Clinical Psychology at the University of Massachusetts in Boston and completed his internship at the Boston VA Health Care System. Dr. Tull also has training in mindfulness- and acceptance-based behavioral therapies for the anxiety disorders.
Takita Murriel, M.D., Family Medicine Physician received her Doctor of Medicine degree from Meharry Medical College in Nashville, and completed her residency at Family Medicine Residency Center in Tupelo, Miss. She is a member of the American Academy of Family Physicians, Mississippi Academy of Family Physicians, and Mississippi State Medical Association. Dr. Murriel’s Merit Health Medical Group practice is located in Madison.