Most integrative medicine clinics and centers do a poor job communicating to their patients and prospective patients about the evidence supporting their clinical recommendations and interventions.
While it’s accurate to say that the science base for integrative medicine is a mere fraction of that for conventional interventions and pharmaceuticals, the amount of quality research and positive outcomes is growing steadily. Now is the time for integrative centers to leverage these findings.
The pharmaceutical industry has had little incentive to study natural, active agents and develop products because it’s very difficult to secure intellectual property around the commercialization of natural products.
Natural products are relatively easy to “design around”, unless turned into a synthetic form or attached to an existing patent with a strong proprietary formulation. We are starting to see products like omega 3 fatty acids (EPA, DHA) and EGCG (green tea extract) enter trials and come to market as prescription drugs, but because of the limited financial incentives there remains little viable research for many vitamins, nutrients and botanicals. With so many quality omega 3 fish oil and green tea extract products on the market, it’s hard to see what value these prescription formulations actually bring to health consumers. Though for some going through insurance might be more affordable. Randomized controlled, placebo-based trials, the gold standard for scientific exploration for single interventions or active agents, has not been the best match to study integrative medicine: the reductionistic mode of random controlled trials simply doesn’t jibe with the synergistic and personalized approach to whole systems care.
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I hope that NCCAM will begin to support non-reductionistic, behavioral change studies incorporating whole systems, synergistic approaches. I also look forward to seeing the data come in from comparative effectiveness research studies, the results of which could be a game-changer. But meanwhile, it’s imperative that you, as a clinic or center, leverage the research that exists today, and effectively communicate to your patients and prospective patients the science behind the evidence base, i.e.: exercise and fatigue; exercise and cancer remission; exercise and disease prevention; diet and inflammation; acupuncture to relieve stress and pain; mind-body medicine to lower stress hormones and anxiety; yoga and relaxation; sugar and angiogenesis … the list goes on.
Between PubMed, Medline, your online journal subscriptions and the pile of print journals sitting in the corner of your office, there is a growing body of evidence at your fingertips that supports comprehensive integrative care you deliver. And just recently NIH announced its evidence-based clinical practice guidelines, to help prepare you to discuss integrative medicine approaches with your patients. Use it!
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