Divining integrative medicine

Medicine, like scientific inquiry, is necessarily dynamic. As our understanding of health and disease continues to grow, medicine as we know it will change. Alternative therapies and perspectives that are coming to light will be illuminated by modern methods of inquiry applied to pre-modern healing systems. At the same time, patient demands and cultural concerns about health and healing influence the expansion of conventional medicine. The integrative medicine movement is a reflection of how these issues have tumbled together creating a medical field that is at once undefined and almost indescribable. Integrative medicine is growing in popularity among consumers and healthcare providers alike. An August 7, 2006 article in the Los Angeles Times (1) asserted under the heading Twice as Strong that ‘Western medicine team[ed] up with acupuncture, yoga and herbs to fight both disease and pain . . .[is] going mainstream’. Three regional clinical programs were described. Each was based in a conventional medical clinic; each identified as an integrative or multidisciplinary practice. Readers of the Twice as Strong article (Los Angles Times daily circulation is approximately 850 000 as of March 2006) (2) and viewers of The New Medicine television show broadcast March 29, 2006 (estimated audience between 4 and 9 million) (3, 4) learned that conventional biomedicine is undergoing a transformation from within. The popular message is that this movement is led by conventionally trained physicians who are opening their practices to include mind–body therapies as well as traditional techniques from other medical cultures such as acupuncture and oriental medicine (AOM). However, this is a narrow view. We hold a particular interest in the integration of AOM with conventional medicine where the breadth of this phenomenon can be readily comprehended. This emergence of integrative medicine in the public eye is full of irony, giving rise to our question: what comprises integrative medicine exactly? It is not complementary and alternative medicine (CAM). (5) It is a phenomenon that has defined itself, with requirements for membership self-determined by each practitioner who chooses to promote her practice as integrative medicine. Consider the following brief descriptions of integrative medicine providers.