Future doctors expect to sit medicine School courses focused on anatomy and biochemistry. But at many schools, they can also learn about unconventional treatment options like acupuncture, hypnosis, and herbal remedies in courses often categorized as integrative medicine.
It is important for future medical students To understand what integrative medicine is, why it’s controversial and how its proponents challenge the standards of the medical profession, some experts say.
Integrative medicine combines conventional treatments such as surgery and prescription medications with complementary and alternative medicines such as biofeedback, homeopathy, naturopathy and mindfulness.
“I find that most people in any given household, at least someone uses something — massage, chiropractic, naturopathic medicine, herbal medicine — at some point,” says Fraser Smith, assistant dean and associate professor of naturopathic medicine at National University of Health Sciences in Illinois. “It’s become more mainstream in some ways or at least part of our shared culture.”
In fact, millions of American adults use these methods to manage pain and improve their overall health, according to a 2024 study from the American Medical Association. report. Treatments such as acupuncture, chiropractic care, massage therapy, meditation and yoga in particular have become more prevalent over the past two decades, according to the report.
Doctors in this discipline say they use scientific evidence to decide which unconventional therapies to recommend to patients, but there is debate in this field about what types of alternative medicine should be included. Integrative medicine doctors say they sometimes disagree with their colleagues about which alternative therapies have been shown to be safe and effective.
Debate between supporters and skeptics
Proponents of integrative medicine cite the popularity of alternative therapies among American patients as a reason to study the discipline.
“Two-thirds of their patients are going to use it, so you can’t pretend it doesn’t exist,” Smith says. “You have to have a certain open-mindedness.”
The growing popularity of some of these treatments can be attributed to rising health care costssays Jagdish Khubchandani, professor of public health at New Mexico State University. More patients will continue to seek more cost-effective treatment options, which may sometimes resort to alternative methods, he says.
It’s a complex topic, he said, adding that he has been both critical and supportive of integrative medicine.
“I think medical schools should include elements of evidence-based integrative medicine,” Khubchandani wrote in an email. “It is good to expose students to evidence-based and non-effective integrative medicine strategies because they will see it in their practice.”
But some critics, particularly those in mainstream medicine, question its place in medical schools, arguing that alternative treatment methods are often unnecessary, pseudoscientific and sometimes dangerous.
“Almost everything I hear (from integrative medicine proponents) is complete nonsense, and they often use clever misconceptions that seem reasonable to people who aren’t looking for them,” Steven Salzberg, professor of biomedical engineering and medicine genetic. has Johns Hopkins University in Maryland, wrote in an email. “We have a simple term for treatments that work: medicine. If it doesn’t work, calling it ‘integrative’ won’t make it magically work.”
Salzberg says the effectiveness of medical treatments is a scientific question, “and when a claim is made, we know very well how to test it. Problems arise, however, when interested parties have something to gain (usually money ) through treatment, and they sometimes refuse to admit that the treatment isn’t working.”
He says future doctors should avoid medical schools where integrative medicine courses are required. “If you want to use your time productively, don’t take a course where you won’t learn anything that can help you improve patients,” he says.
Smith disagrees, saying there are many scientifically proven approaches outside of standard drug treatment, such as chiropractic and herbal extracts, that can benefit people and help relieve pain.
“It doesn’t mean they avoid taking an antibiotic or a vaccine, but it serves a huge purpose,” he says. “I suppose you could dismiss it all by saying, ‘This is all just a bunch of sleight of hand,’ but I think that’s a little arrogant.
Advocates say integrative medicine identifies the most promising treatments in ancient healing traditions and that medical schools should provide more information to students about these findings.
Salzberg admits that some alternative therapies endorsed by integrative medicine teachers—yoga, meditation, and massage—could be effective stress-relieving techniques.
“These things are fine,” he says, “but then they pretend that if one of them is OK, they’re all fine, because they’ve given them all the same label, and that’s not OK. not correct and I strongly object to this.”
Dr. Judson Brewer, professor and director of research and innovation at the Brown University Mindfulness Center in Rhode Island, says it’s important for people to recognize that the health care landscape is changing. Practices such as mindfulness, nutrition and exercise “can be powerful tools for changing unhealthy habits that contribute to disease,” he wrote in an email.
“Part of this evolution involves recognizing the role of holistic approaches to health and wellbeing,” he says. “From a scientific perspective, there is growing evidence supporting the effectiveness of various integrative medicine approaches.”
Principles of Integrative Medicine
Dr. Robert Heffron, clinical assistant professor of family medicine at Brown University Warren Alpert School of Medicineargues that future doctors should not assume that a therapy is ineffective because it originated in alternative medicine.
Heffron, former director of the Integrative Medicine concentration at Brown Medical School, says medical students can benefit from learning one of the central tenets of alternative medicine: the overall well-being of a person. person cannot be measured simply by examining the health of various organs.
“The big lesson I try to impart to students is to try to step back and realize that patients are more than the sum of their parts,” he says.
Another lesson that integrative medicine teaches, its proponents say, is the importance of preventing disease and maintain optimal health, instead of reacting to the symptoms of the disease. They say an important benefit of integrative medicine is that it places more emphasis on nutrition and mental health than modern medicine.
For example, Brewer says mindfulness has been shown to reduce symptoms of stress and anxiety, while nutrition and exercise have been shown to be effective in managing conditions such as heart disease, diabetes and obesity.
“When it comes to medical education, exposing students to integrative medicine can expand their toolbox, giving them a more complete understanding of health and healing,” he says. “They learn to look beyond the symptoms and understand the patient as a whole: their lifestyle, their stress level, their mental health, etc.”
The focus on prevention and wellness is not unique to integrative medicine, Salzberg says. “Every doctor cares about the well-being, improving the patient as a whole and treating the root causes of diseases.”
The discussion doesn’t have to be one between alternative medicine and conventional medicine, Brewer says, “but rather about how we can integrate the best of all worlds to optimize health.”
“The goal of medicine is to alleviate suffering, and if integrative approaches can contribute to that goal, they deserve our attention and rigorous study,” he says. “It’s about being ‘scientists’ in the truest sense of the word: open to observation, to evidence, and to the possibility of incorporating new, beneficial methods. patient care“.
Medical schools with integrative medicine programs
Some schools, such as University of Bastyr in Washington and California, focus primarily on alternative medicine. Many medical schools, including highly ranked programs, also offer integrative medicine programs as well as allopathic programs. Here are 25 U.S. medical schools that offer integrative medicine programs:
