Integrative Medicine Reports
Volume 1.1, 2022
DOI: 10.1089/imr.2022.0054
Accepted April 14, 2022
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GUEST EDITORIAL
Open Access
Integrative Medicine as ‘‘Medicine’’:
A Perspective
Sanchari Mukhopadhyay, MD,1 Bharath Holla, MD, PhD,1 Hemant Bhargav, MD, PhD,1,*
Kishore Kumar Ramakrishna, MD, PhD,1 Umesh Chikkanna, MD,1
Shivarama Varambally, MD, DSc,1 and Bangalore N. Gangadhar, MD, DSc2
Abstract
With the advent and acceptance of biological medicine, now called as modern biomedicine (or allopathy), the
older regional medical systems were categorized as complementary and alternative medicine (CAM). Recently,
the term CAM has been replaced with ‘‘integrative medicine.’’ This viewpoint manuscript focuses on the essential
connotation of such terms and clarifies the debates on the several confusing terminologies hampering its actual
conceptualization and leading to the ‘‘othering’’ phenomenon in health care approaches. Integrative medicine, in
its essence, is a form of holistic and evidence-based health care approach that includes but is not limited to medical treatment. A closer look at the current management protocols of most noncommunicable diseases, such as
diabetes mellitus, hypertension, obesity, pain syndromes, and psychiatric illnesses reveals that it incorporates relevant evidence-based management of all health care domains, along with mainstream pharmacologic and surgical treatment options. These management approaches point toward an already existing integration in the
mainstream medical practice. Simultaneous management of all the dimensions of health and illness by expanding the current sphere of integration will ultimately result in comprehensive patient care. Therefore, we conclude
that integrative medicine is essentially an application of different ‘‘culturally sensitive’’ health care approaches,
optimally tailored to a given patient’s needs and difficulties. Efforts are needed at the clinical, research, and administrative levels to reduce the ‘‘othering’’ phenomenon seen in health care approaches that are often detrimental to efficient patient care. There is a need to promote collaboration between different disciplines and
generate evidence base to optimize integrative medical practice further. Establishing interdisciplinary departments of integrative medicine at mainstream medical institutions may be the first step in this direction.
Keywords: integrative medicine; complementary medicine; alternative medicine; mainstream medicine
1
Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Medical Assessment and Rating Board, National Medical Commission (NMC), India.
2
*Address correspondence to: Hemant Bhargav, MBBS, MD, PhD, Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Hosur Main
Road, Bengaluru, Karnataka 560029, India, Email: drbhargav.nimhans@gmail.com
ª Sanchari Mukhopadhyay et al., 2022; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative
Commons License [CC-BY] (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium,
provided the original work is properly cited.
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http://online.liebertpub.com/doi/10.1089/imr.2022.0054
Preamble
History of medical care can be traced back to ancient
times all over the world.1 Historically, there was an era
when diseases were considered to be caused by evil spirits entering the body. Witchcraft, black magic, trepanation, mummy powder therapy, and so on were tried as
treatments for the same.2 Later, medical systems based
on concepts of health and illnesses evolved. Ancient
medical practices considered human bodily structure
and functions and their abnormalities in a holistic
way. Ancient India, Greece, Egypt, Rome, Arabia, Persia
(now Iran), China, Africa, Australia, and South America all practiced their own forms of traditional medicines as evidenced from several inscriptions.3
Gradually modifications and sophistication were introduced in the previously chronicled methods of
medical management; surgical treatment being an
example. With improvement in the knowledge of
human anatomy, germ theory of infectious diseases,
trauma management and the like, medical practice was
constantly updated and improved. The 19th and 20th
centuries saw the advent of specific biologic treatments,
radiologic imaging techniques, development of chemical,
molecular, and genetic laboratory investigation techniques, and further novel areas for scientific research,
including both technology and medicine.1
The current mainstream medical practice (allopathy) is
often denoted as biomedicine, and the other existing medical practices as complementary and alternative medicine
(CAM).4 The use of CAM has been on the rise in the past
few decades all over the world, with hospitals and care facilities often incorporating it into their management
plans.4 The National Center for Complementary and
Alternative Medicine (NCCAM) was established in
1998 under the National Institute of Health, United
States in view of the wide use of CAM, which was unregulated until then.5 Recently its name has been changed to
the National Center for Complementary and Integrative
Health (NCCIH).6 This denotes a change in the conceptualization of CAM as a comprehensive integrative
health care practice.
In this article, we shall delve deeper into the concept
of integrative medicine and try to answer a pertinent
but yet-unanswered question, ‘‘What is, and what is
not, integrated medical care?’’
Nomenclature: Clarification of Concept
and debates
Integrative medicine has been known by several
names, including CAM, holistic medicine, traditional
87
medicine, and region-specific names such as oriental
medicine or Indian systems of medicine, mind–body
medicine, functional medicine, to name a few. The definition of CAM as given by the former NCCAM is that
it refers to ‘‘a group of diverse medical and health care
systems, practices, and products that are not presently
considered to be part of conventional medicine.’’4,7
Ernst et al. defined CAM as ‘‘diagnosis, treatment
and/or prevention which complements mainstream
medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy or by diversifying the conceptual frameworks of medicine.’’8
These descriptive definitions have been criticized due to
their inability to clearly explain the concept and attributes
of CAM. Rees and Weil suggested that integrative medicine is not just a synonym for CAM, and that the connotation it has is much more extensive; integrative medicine
focusses on overall health and healing rather than just disease and treatment.9 NCCIH also emphasizes on the concept of integrative health as a holistic approach to health
and well-being, achieved by coordinated conjoint use of
conventional and complementary medicines.10 It brings
natural products (e.g., herbs, vitamins, minerals, and probiotics), mind and body practices (e.g., yoga including
meditation, chiropractic manipulation, Tai Chi, qigong,
and massage), and other health approaches (Ayurveda,
Traditional Chinese Medicine [TCM], homeopathy,
and naturopathy) under the rubric of complementary
health approaches.10
The debate regarding the terminology is discussed in a
qualitative study by Holmberg et al. from four
perspectives, namely medical practice, research, public relations, and health care delivery. This study found integrative medicine to be a term well agreed-upon,
conveying its role in medicine and health care.11 While
an appropriate term plays an important role in elucidating the underlying concept, excessive focus on it may actually be counterproductive by narrowing the repertoire.
Thus, it is important that we discard the technicalities of
naming and stick to the core concept of integrative medicine as it stands now, as per the NCCIH.
It is pertinent to mention in this study the salient
points of the continued debate and conflict regarding integration of different medical systems and health
approaches. They include safety concerns, lack of welldesigned efficacy studies, insufficient knowledge about
drug–product interactions, lack of stringency in regulatory control over products leading to misuse, statistically significant bias in mainstream medicine journals
against CAM, and conflict between research- and
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clinical-based practice.12 In contrast, research in complementary health care approaches has increased and
significant data exist on the benefit of certain practices
in some illnesses.13–15 In the next section, we discuss
the current evidence-based management protocols in
some common physical and psychiatric illnesses.
Evidence of Integration in Mainstream Medical
Practice Across Categories and Dimensions
Dimensions of health and wellness include physical, intellectual, emotional, social, vocational, financial, and
environmental ones.16 A holistic health care management comprises management of all the dimensions,
medical being one of them. An effective interdisciplinary
collaboration is required for comprehensive health care
provision.17 We argue that the current approach followed by mainstream medicine is also integrative in its
essence. This can be illustrated in the current evidencebased management protocols of some important noncommunicable diseases discussed hereunder:
1. Diabetes mellitus (DM): The World Health
Organization (WHO) report on management of
DM states that proper diet and regular exercise are
the backbones that need to be tailor-made for the
patients. It has subdivided the management into
nutritional, exercise, and pharmacologic domains.
The drug treatment options include insulin, insulin
secretagogues, insulin sensitizers, and a-glucosidase
inhibitors. The goal of treatment is to control the
plasma glucose and serum glycosylated hemoglobin
levels and any associated morbidity. The report emphasizes that comprehensive diabetes care, however,
is more than just plasma glucose management. It
needs multidisciplinary collaboration to identify and
manage the risk factors and complications also.18
Nutritional recommendations and exercise are
well evidenced in the literature as effective primordial and primary prevention as well as management
modalities for borderline to mild clinical illness. The
American Diabetes Association (ADA) has given
evidence-based recommendations for lifestyle management, including nutrition and physical activity.19 Broadly, they focus on timely evidence-based
patient-centered management, both pharmacologic
and nonpharmacologic. The 2021 revision of the
ADA guidelines on standards of medical care in
diabetes includes social and cost domains, with a
focus of care improvement and health promotion
in DM rather than only clinical management.
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Comorbidity (e.g., obesity, cardiovascular illnesses,
and dyslipidemia) management has been emphasized. Behavior change and well-being have also been
recognized as important predictors of outcome.20
2. Hypertension: The mainstay of hypertension
management includes antihypertensive medication
and lifestyle modification. Standard treatment
guidelines for hypertension by the Ministry of
Health and Family Welfare, the Government of
India have recommended either of or combination
of the different classes of antihypertensive medication (calcium channel blockers, diuretics, angiotensin receptor blockers, angiotensin-converting
enzyme inhibitors, beta-adrenergic blockers, and
spironolactone) as required along with lifestyle
modification.21 The 2020 International Society of
Hypertension global practice guidelines also state
that lifestyle modifications can prevent or delay
hypertension onset.
Lifestyle modification is considered as first-line treatment along with antihypertensives, whose effects
are often enhanced with lifestyle modification. They
include in the assessment the psychosocial history,
history of depression, physical activity, diet, tobacco
and alcohol consumption, in addition to the clinical
history, examination, and laboratory investigations
of hypertension and associated cardiovascular and
other medical morbidities.22
Thus, careful examination of existing clinical recommnedations for management of most of the
non-communicable diseases reveal that management is essentially integrative and holistic (includes
all the dimensions of the healthcare).23
3. Obesity and metabolic syndrome: Obesity is on
the rise globally, due to factors such as sedentary lifestyle and unhealthy diet. Obesity is determined by body mass index (BMI) as per the WHO
guideline. A BMI of 25–29.9 kg/m2 is suggestive of
overweight status and that above 30 of obesity.
Obesity is a known risk factor for proinflammatory,
prothrombotic states, and cardiometabolic diseases.
A multidisciplinary combination of lifestyle-related,
medical, and surgical management approaches as
necessary is strongly advised.24
Metabolic syndrome consists of the clinical parameters of insulin resistance (impaired glucose tolerance, increased fasting plasma glucose, type 2
DM, and lowered insulin sensitivity), increased
body weight (waist-to-hip ratio >0.90 in men
and 0.85 in women), dyslipidemia (triglycerides
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>150 mg/dL and/or high-density lipoprotein <35
mg/dL in men or <39 mg/dL in women), and deranged blood pressure (>140/90 mmHg).
Although the etiopathology can be multiple (genetic
factors, immune-metabolic dysregulations, lifestyle factors, psychiatric illness and care, and
medical illness and care), metabolic syndrome is
indicative of increased risk of cardiovascular
morbidities and DM.22,25 The American Heart
Association treatment goals encompass management of lifestyle risk factors, elevated blood
pressure and plasma glucose, and prothrombotic
state. In lifestyle modification, weight reduction,
physical activities, and dietary management are
considered beneficial in prevention in high-risk individuals, for example, those on second-generation
antipsychotics.25,26
4. Migraine and low back pain (LBP): Migraine is a
primary headache, contributing to almost 88% of
headache-related disability in the world.27 The
management comprises acute treatment and
prophylaxis. The first-line treatments for acute
migraine are mostly pharmacologic, including
triptans, nonsteroidal anti-inflammatory drugs
(NSAIDs), paracetamol, and caffeine-containing
analgesics. Antiemetics such as metoclopramide
and parenteral dexamethasone are considered
useful adjunct with good evidence. In about 38%
of patients with episodic migraine, prophylactic
management is found useful.28 Antiepileptics
(divalproex and topiramate), beta-blocker (propranolol and esmolol) are the usual first-line
treatments. Atenolol, nadolol, amitriptyline, and
venlafaxine are second line.
Limited evidence exists for drugs such as
nebivolol, bisoprolol, carbamazepine, gabapentin,
fluoxetine, nicardipine, verapamil, nimodipine,
and nifedipine. In addition to the pharmacotherapy, there is grade-B evidence for nonpharmacologic managements such as relaxation
training, thermal biofeedback, and cognitive behavioral therapy (CBT) in prophylaxis. Acupuncture has a grade-A evidence as a useful
adjunct in migraine prophylaxis.28,29 Identification and management of environmental, behavioral, and dietary triggers of migraine are also
recommended by the American Association of
Family Physicians in preventive treatment.28
Massage, yoga, and aerobic exercises are also advocated as adjuncts to first-line treatments.30
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LBP is a common musculoskeletal condition, with an
age-standardized point prevalence of 7.5% as of
2017, causing significant disability.31 The management requires assessing for red flag signs such as
cancer, immunosuppression, intravenous drug use,
fever, incontinence, unexplained weight loss in
history, and saddle anesthesia, motor weakness in
lower extremity, reduction in anal sphincter tone,
and neurologic deficits on physical examination.32
A careful evaluation of the causes and treatments
thereof are recommended. Medical and psychiatric
assessments are to be done simultaneously.
For the various attributes of LBP, CBT, self-exercise,
patient education, physical therapies such as ultrasound, heal/cold therapy, transcutaneous electrical
nerve stimulation, spinal manipulative therapy,
bracing, acupuncture, massage, yoga, interlaminar
injections, annuloplasty, and pain-relieving medications are recommended with various degrees of
evidence.32 The American College of Physicians
also advised noninvasive options such as acupuncture, massage, superficial heat, NSAID, skeletal muscle relaxant as first line for acute or
subacute LBP.
Multidisciplinary rehabilitation, exercise, Tai Chi,
yoga, mindfulness-based stress reduction, relaxation, biofeedback (thermal and electromyography), CBT, and acupuncture are recommended
for chronic cases. Yoga is among the options that
the American College of Physicians recommends
for first-line treatment of chronic LBP.33 In patients with chronic LBP not responding to nonpharmacologic management, NSAID can be given
as first-line medicine, and tramadol or duloxetine
as second line. Opioids are advocated for use only
in very limited cases with insufficient response to
other treatments, after weighing for risk and
benefit.34 Role of appropriate psychosocial interventions is also emphasized in these guidelines.
5. Depression: Depression is a serious mental illness (SMI), characterized by persistent pervasive
sadness of mood, anhedonia, bleak or pessimistic
views about future and the world, excessive or
inappropriate guilt, recurrent thoughts of death or
suicidality, and altered sleep, appetite, and sexual
interest.35 The evidence-based first-line treatment
for depression is either pharmacotherapy or psychotherapy depending on the severity and patient
preference. The pharmacologic treatment options
include selective serotonin reuptake inhibitors,
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serotonin and noradrenaline reuptake inhibitors,
tricyclic antidepressants, and other newer agents
such as mirtazapine, bupropion, trazodone, nefazodone, and agomelatine.
Among the psychotherapies, good evidence exists
for self-help, CBT, behavioral activation, interpersonal therapy, and others such as problem-solving
therapy, psychodynamic psychotherapy, behavioral
couples therapy, marital therapy, and family therapy.
Physical activities are also mentioned in cases of mild
to moderate depression.36,37 The American Psychiatric Association (APA) guidelines for management of major depression mention acupuncture,
folate, S-adenosyl methionine (SAMe), St. John’s
wort, and light therapy as potential treatment options.37 Both National Institute for Health and Care
Excellence (NICE) and APA guidelines incorporate
assessment and management of psychosocial factors and comorbidities along with the primary
treatment of depression.36,37
6. Schizophrenia: Schizophrenia is another SMI,
characterized by hallucinations, delusions, negative
symptoms, disorganization of speech and behavior,
catatonic symptoms, and significant decline in
socio-occupational and biologic functions.38 The
first-line management is with antipsychotics, firstgeneration (e.g., haloperidol, fluphenazine, and
chlorpromazine) or second-generation (e.g.,
olanzapine, risperidone, aripiprazole, quetiapine,
ziprasidone, and amisulpride), depending on the
patient profile, tolerability, and preference.39,40
However, the management does not stop at reduction
of the positive symptoms. Patients may often have
deficits in general and social cognition, general wellbeing, quality of life, and may have persistent negative symptoms, leading to disability.41 Comorbidities are high in schizophrenia patients. These
comorbidities may be due to the illness itself or
medications. Lifestyle modifications and drug
therapy are recommended to manage them.39,40 A
successful rehabilitation plan is needed for a comprehensive management of schizophrenia.
The Schizophrenia Patient Outcomes Research Team
found benefits of psychotherapeutic techniques such
as social skill therapy, supported employment, CBT,
assertive community treatment, token economy, family therapy, and psychosocial interventions
for substance use and weight reduction.42 The NICE
guidelines in 2014 included yoga as one of the
complementary approaches in schizophrenia due to
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its demonstrated benefit in reducing negative
symptoms and improving social cognition.43 Thus,
although the acute treatment of schizophrenia is
essentially pharmacologic, long-term management
includes psychosocial, environmental, and physical
domains.
Some of the major noncommunicable disorders
causing significant global disease burden are
mentioned in this study. The list, however, is not
exhaustive. There are other conditions, such as
Parkinson’s disease, dementias, motor neuron
disease, multiple sclerosis, and cardiovascular and
cerebrovascular illnesses that contribute to considerable morbidity and mortality. In the standard
treatment guidelines of these illnesses, the management approach recommended is patientcentered and holistic, catering to all the dimensions of health, including medical care.
Where Does Integration Lie?
From the aforementioned discussion, it is noticeable that
integration of different health care approaches is carried
out all over the world without giving it a particular
name. Lifestyle management in form of diet and physical
exercise forms an integral part of almost all the preventive and treating mainstream medicine protocols, as
mentioned earlier. Yoga, Tai Chi, qigong, acupuncture,
and other mind–body practices are often recommended
as add-on to medical treatment. In psychiatry, the role of
comprehensive management is widely seen in chronic
SMIs, wherein medical, psychiatric, psychological, occupational, social, environmental, financial domains are
included in the long-term plan.
Thus, careful examination of existing clinical
recommnedations for management of most of the
non-communicable diseases reveal that management
is essentially integrative and holistic (includes all the
dimensions of the healthcare).
Other Systems of Medicine and Integrative
Approach: Expanding the Scope
Physical exercise, dietary regulation, and to some extent yoga have already been incorporated in standard
medical practice at present. However, these are not
the only forms of treatment available across the
world. TCMs include acupuncture, cupping, moxibustion, massage, herbal medicines, and mind–body
practices such as Tai Chi and qigong. The therapeutic
goal of TCM is to correct the disease-causing
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imbalance of the opposing life forces (Yin and Yang)
and enhance vitality.44 Similarly, traditional Indian
medicines such as Ayurveda, Siddha, and Unani
focus on the treatment of a disease and promotion
of well-being in a holistic manner, taking into account the personal attributes of each patient.
The therapeutic goals include enhancing longevity
and rejuvenating the body, besides treatment of the disease.45 Many other forms of treatment are available
worldwide, such as herbal remedies from different geographical areas, reflexology, chiropractic, spinal manipulation, massage, and relaxation techniques.46
Yoga is known to improve depression, anxiety, autonomic hyperactivity, and promote mindfulness and
acceptance, and scientific studies on yoga have been
on the rise.47 Similarly, there are Ayurvedic herbal formulations such as ashwagandha (Withania somnifera),
brahmi (Bacopa monnieri), which are shown to have
beneficial effects in cognitive impairment and dementia, depression, anxiety, schizophrenia, Parkinson’s
disease, ataxia, amyotrophic lateral sclerosis, attentiondeficit/hyperactivity disorder, and so on.48,49 The active phytoconstituents of these herbs have been analyzed. Mechanistic pathways for action have also
been proposed and that includes inflammatory, immune, oxidative, and endocrine, causing adaptogenic effects. 50,51
TCM has also been demonstrated to act at molecular,
biochemical network, tissue, and organ levels.52 Nutritional supplements such as folic acid, SAMe, curcumin,
St. John’s wort, omega-3 fatty acids, vitamin E, and vitamin B are well studied in terms of effects, side effects,
contraindications, and dosage, and are prescribed in
conventional clinical settings. Essentially, all the traditional systems of medicine follow an inclusive approach
in diagnosing and managing medical conditions.
The concept of holism is evident in the ancient texts,
including Charaka Samhita (Shareera Sthana, 1st Chapter, 86th Shloka) and Sushruta Samhita (Sutra Sthana,
4th Chapter, 7th Shloka) from India. There is evidence
of holistic practices all across the world with similar
basic principles modified by indigenous properties.53
Thus, there is a vast scope of expanding the current
medical practices to incorporate the evidence-based
traditional medicines. For example, an integrated system of health care exists in Cameroon, Central Africa,
in collaboration with WHO, and is considered to have
some role in improving health care access and treatment gap in the face of poverty and other socioenvironmental disadvantages.54
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Stumbling Blocks in Conceptualization
and Application
The conceptualization of all the current medical practices as essentially integrative practices stumbles on
the confusion regarding the nomenclature. Owing
to the varied, inconsistent, and stigmatized naming
of the other modes of treatment, the fundamental understanding is often lost. This next problem is the
lack of knowledge among professionals. Owing to
strict separation of medical and paramedical training,
a professional trained in one form of health care often
has minimal or no understanding of the other forms.
This invariably leads to disapproval of the other management approaches as well as narrowing the range of
health care delivery.
Belief systems of both the practitioners and patients
may be responsible for creating the dichotomy and
poor acceptance of an integrative medical care.
Another pertinent issue is the lack of well-designed
studies to establish the efficacy and safety of several
CAM modalities. Although there is an increase in research work in yoga, Ayurveda, and Siddha in the
past few decades, the evidence is still not robust for
all clinical conditions. Wholesome integration gets
jeopardized because of lack of methodologically
sound data on mechanisms of action, safety, and
drug–product interactions.
TCM also encounters similar problems, although
research is being carried out on toxicologic analysis,
dose–toxicity relationships, and drug interactions.
Similar large-scale research is required for the
other traditional therapies as well. Other obstacles
to realization of integration include unethical practices and unscientific propagation by untrained professionals, thereby reducing acceptance in the
scientific community and raising doubt regarding
their validity.
What Is Not Integrative Medicine?
As noted in the earlier discussion, integrative medicine is the inclusive medical practice of all modalities of evidence-based treatment. However, there
are several treatment practices that, although globally followed, do not have sufficient evidence for efficacy and safety. Reiki is one such example whose
efficacy is not established for the conditions studied
such as depression, anxiety, and pain.55 Another instance may be herbs such as Yohimbe, cinnamon,
Cat’s claw, dandelion, to name a few.46 Yohimbe is
widely used in the Central and Western Africa for
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erectile dysfunction, but it has a significant number of
adverse effects such as seizure, tachycardia, and other
cardiovascular morbidities.
In view of the possible benefit but definitive risk,
Yohimbe is not recommended as a dietary supplement. Cinnamon, although investigated for DM
and irritable bowel syndrome, has not been found
unequivocally effective. Besides these examples, it is
pertinent to mention that not all treatment modalities
among the traditional systems are thoroughly investigated for safety and efficacy. Thus, it is important to
emphasize that integrative medicine, as it should be practiced and conceived, involves the amalgamation of only
the treatment procedures whose safety and efficacy are
acceptable.
Conclusion and Future Directions
To summarize the discussion, we can say that
health care, practiced properly, is integrative medicine, integrating more than one principle of treatment.
As emphasized in this article, patient-centered health
care is the call of the hour across disciplines. A holistic
health care management includes management of all
the dimensions of health and well-being, including
but not limited to medical treatment. Integrative medicine is essentially an application of different health care
approaches, optimally tailored to a given patient’s needs
and difficulties. All the modalities may not be needed in
every patient and thus, customizing the health care to
the individual profile will make the health care delivery
truly patient centered.
From the current scenario of working in silos, there
is a need to incorporate approaches that are more
inclusive. To achieve the same, the stumbling blocks
need to be removed by strengthening scientific researchbased evidence for all forms of management, improving awareness in the population regarding benefits
and adverse effects of all medical practices. Educating
the professionals of different disciplines on the fundamentals of different systems of medicine, mind–body
practices, nutritional supplements, and advocating
collaborative treatment practice by bringing all the
professionals together and encouraging interdisciplinary dialogue will be conducive to the proper evolution
of integrative medicine.
Efforts at institutional, national, regional, and international levels in this direction will establish a comprehensive health care beyond the puzzling, inconsistent,
and meaningless trivia of nomenclature, and will
pave the way toward establishing the integrative health
92
care approach as the mainstream management offered
by the state or national health systems. Establishing
such interdisciplinary departments of integrative medicine at mainstream medical institutions may be the
first step in this direction.
Acknowledgments
Authors thank the Ministry of AYUSH, Government
of India for funding the Center of Excellence in
AYUSH Research at the National Institute of Mental
Health Neurosciences, Bengaluru, India. The Wellcome Trust/Department of Biotechnology (DBT)
India Alliance supports H.B. and S.V., respectively,
with early and intermediate career fellowships for research in integrative medicine.
Author Disclosure Statement
H.B. is on the editorial board of Integrative Medicine
Reports journal. Other authors have no competing
financial interests.
Funding Information
No funding was received for this article.
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Cite this article as: Mukhopadhyay S, Holla B, Bhargav H, Ramakrishna KK, Chikkanna U, Varambally S, Gangadhar BN (2022)
Integrative medicine as ‘‘medicine’’: a perspective, Integrative
Medicine Reports 1:1, 86–94, DOI: 10.1089/imr.2022.0054.
Mukhopadhyay, et al.; Integrative Medicine Reports 2022, 1.1
http://online.liebertpub.com/doi/10.1089/imr.2022.0054
Abbreviations Used
ADA
APA
BMI
CAM
CBT
DM
GOI
LBP
¼
¼
¼
¼
¼
¼
¼
¼
American Diabetes Association
American Psychiatric Association
body mass index
complementary and alternative medicine
cognitive behavioral therapy
diabetes mellitus
Government of India
low back pain
94
NCCAM ¼ National Center for Complementary and Alternative
Medicine
NCCIH ¼ National Center for Complementary and Integrative Health
NICE ¼ National Institute for Health and Care Excellence
NSAIDs ¼ nonsteroidal anti-inflammatory drugs
SAMe ¼ S-adenosyl methionine
SMI ¼ serious mental illness
TCM ¼ Traditional Chinese Medicine
WHO ¼ World Health Organization
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