New paradigm in healthcare needed

March 4, 2009 (Washington, DC) — The term integrative medicine "is a little like showing someone a Rorschach blot and asking, what do you see," said Harvey V. Fineberg, MD. The president of the Institute of Medicine (IOM) was speaking here at the opening of the 3-day IOM Summit on Integrative Medicine and the Health of the Public last week.

He focused on 5 primary dimensions of integrative medicine. "It is in a way the fulfillment of the old [World Health Organization] definition of health, which was clearly more than the absence of disease...the extension and comprehension of heath embodying its physical, mental, emotional, and spiritual dimensions altogether."

Integrative medicine extends across the whole spectrum of interventions, Dr. Fineberg said, keeping health and restoring health. It thinks about the coordination of care across the spectrum of services. At its most basic, integrative medicine "is the embodiment of patient-centered care."

"Finally, it conveys an openness to multiple modalities of care," both traditional and nontraditional, said Dr. Fineberg. The standard for evidence should be consistent, demanding no more or no less, "open to a variety of modalities, so long as they work."

Conference chairman Ralph Snyderman, MD, from Duke University in Durham, North Carolina, compared the $2.4 trillion US medical "industry" to the airline industry in that both hold the consumer in low regard; "both are built on technology and systems that assume that people will be there because they have no choice, but [they] pay little attention to the specific needs of the individual."

He said germ theory transformed American medicine in the early 1900s with "an incredible focus on the pathophysiology of disease." It resulted in "a find it and fix it" focus on the treatment of a single causal factor.

Genomics is ushering in a second transformation of medicine "where we can anticipate things before they occur...and transform it into personalized, predictive, preventative healthcare," Dr. Snyderman said.

"If you buy into the idea that health is your most precious possession," then these and other quickly evolving tools will give patients a roadmap of their health risks over the course of a lifetime. Dr. Snyderman pointed out that people could then invest in lifestyle changes that will optimize their long-term health.