MD, PhD, FMedSci, FSB, FRCP, FRCPEd

There are few subjects in the area of alternative medicine which are more deceptive than the now fashionable topic of “integrated medicine” (or integrative medicine, healthcare etc.). According to its proponents, integrated medicine (IM) is based mainly on two concepts. The first is that of “whole person care”, and the second is often called “the best of both worlds”.  Attractive concepts, one might think – why then do I find IM superfluous, deeply misguided and plainly wrong?

Whole patient care or holism

Integrated healthcare practitioners, we are being told, do not just treat the physical complaints of a patient but look after the whole individual: body, mind and soul. On the surface, this approach seems most laudable. Yet a closer look reveals major problems.

The truth is that all good medicine is, was, and always will be holistic: today’s GPs, for instance, should care for their patients as whole individuals dealing the best they can with physical problems as well as social and spiritual issues. I said “should” because many doctors seem to neglect the holistic aspect of care. If that is so, they are, by definition, not good doctors. And, if the deficit is wide-spread, we should reform conventional healthcare. But delegating holism to IM-practitioners would be tantamount to abandoning an essential element of good healthcare; it would be a serious disservice to today’s patients and a detriment to the healthcare of tomorrow.

It follows that the promotion of IM under the banner of holism is utter nonsense. Either it is superfluous because it misleads patients into believing holism is an exclusive feature of IM, while, in fact, it is a hallmark of any good healthcare. Or, if holism is neglected or absent in a particular branch of conventional medicine, it detracts us from the important task to remedy this deficit. We simply must not allow a core value of medicine to be highjacked.

The best of both worlds

The second concept of IM is often described as “the best of both worlds”. Proponents of IM claim to use the “best” of the world of alternative medicine and combine it with the “best” of conventional healthcare. Again, this concept looks commendable at first glance but, at closer inspection, serious doubts emerge.

They hinge, in my view, on the use of the term “best”. We have to ask, what does “best” stand for in the context of healthcare? Surely it cannot mean the most popular or fashionable – and certainly “best” is not by decree of HRH Prince Charles. Best can only signify “the most effective” or more precisely “being associated with the most convincingly positive risk/benefit balance”.

If we understand “the best of both worlds” in this way, the concept becomes synonymous with the concept of evidence-based medicine (EBM) which represents the currently accepted thinking in healthcare. According to the principles of EBM, treatments must be shown to be safe as well as effective. When treating their patients, doctors should, according to EBM-principles, combine the best external evidence with their own experience as well as with the preferences of their patients.

If “the best of both worlds” is synonymous with EBM, we clearly don’t need this confusing duplicity of concepts in the first place; it would only distract from the auspicious efforts of EBM to continuously improve healthcare. In other words, the second axiom of IM is as nonsensical as the first.

The practice of integrated medicine

So, on the basis of these somewhat theoretical considerations, IM is a superfluous, misleading and counterproductive distraction. But the most powerful argument against IM is really an entirely practical one: namely the nonsensical, bogus and dangerous things that are happening every day in its name and under its banner.

If we look around us, go on the internet, read the relevant literature, or walk into an IM clinic in our neighbourhood, we are sure to find that behind all these politically correct slogans of holism and” best of all worlds” there is the coal face of pure quackery.Perhaps you don’t believe me, so go and look for yourself. I promise you will discover any unproven and disproven therapy that you can think of, anything from crystal healing to Reiki, and from homeopathy to urine-therapy.

What follows is depressingly simple: IM is a front of half-baked concepts behind which boundless quackery and bogus treatments are being promoted to unsuspecting consumers.

12 Responses to Integrated medicine makes no sense

  • The founder of Homeopathy Samuel Hahnemann would never have used “the best of two worlds” he found that it would be a crime to use Homeopathy AND Allopathie. According to Hahnemann both worlds could never come together.

    So according to a modern interpretation of Hanemann`s §52 we should exclusively use conventionel evidence based medicine, since there is only one medicine.

    Here is the original text- sorry its in German.

    Hahnemann: §52 Organon Es giebt nur zwei Haupt-Curarten: diejenige welche all ihr Thun nur auf genaue Beobachtung der Natur, auf sorgfältige Versuche und reine Erfahrung gründet, die (vor mir nie geflissentlich angewendete) homöopathische und eine zweite, welche dieses nicht thut, die (heteropathische, oder) allöopathische. Jede steht der andern gerade entgegen und nur wer beide nicht kennt, kann sich dem Wahne hingeben, daß sie sich je einander nähern könnten oder wohl gar sich vereinigen ließen, kann sich gar so lächerlich machen, nach Gefallen der Kranken, bald homöopathisch, bald allöopathisch in seinen Curen zu verfahren; dieß ist verbrecherischer Verrath an der göttlichen Homöopathie zu nennen!

  • Spot on. Too many therapies of doubtful efficacy parading as the answer. There is a need to make known reputable information sources for individuals wishing a balanced appraisal of a therapy package.

  • I appreciate and agree with your support of EMB and disdain for the quackery. However, I’m interested in getting your opinion on the placebo quality of alternative medicine. I have several family members who are sold, lock stock and barrell, on crap like iridology, crystals, herbal remedies, homeopathy, you name it. What I notice is that if they are forced to go to a real doctor, they gripe and complain and never “feel” better because they don’t accept the validity of the treatment. however, when they go to their alternative healer, they “feel” better (even though they’re in pain still) because they “like” and accept the basis of the treatment. it’s like their attitude about the treatment colors their perception of how well they feel. And in the end, isn’t how you “feel” an important component to quality of life?

    • 1). Could it be that there is nothing actually medically wrong with your family when the visit their doctor, and that their “need” is more psychological? If there were anything physically wrong them that actually necessitated attention the placebo effect would be of no use in the final outcome.

      2). Placebo is an effect available to all medicine and non-medicine alike. But the biggest, most positive effect is on the bank balances of purveyors of alternative-reality medicine. There is no moral or medical reason why medical fraud should be tolerated.

      3) A personal anecdote – The simple act of entering a doctor’s surgery when I am in need of medical attention can invoke an effect whereby I feel much better than I did before entering. I am also aware it is an illusion. If the illusion persists then what ails me is likely more psychological than physical.

  • Ryan: of course, this is important. If someone is truly ill, however, we want him/her not just to feel better but also to get better. and this is what a placebo cannot normally achieve.

  • As has been said, “It’s called ‘alternative medicine’ because, if it actually worked, it’d be called ‘medicine'”.

  • Is that why Quantum physics isn’t just called physics?

  • As a practicing quack, one of the biggest things in my favour is time, which varies from one to one and a half hours with each client. How can a doctor really work on the science and art of medicine in 10 minutes? This is a critique of the politics of the NHS not my respect for GPs holding the coal face together. As more and more disappointing and weak evidence is produced in my field I find I have resorted to using food, not supplements, and sympathy, and very often referrals back to a GP who is not being given the whole story by a patient who is self censoring their symptoms because of time pressures. EBM is still bedding into orthodox medicine, and much of what happens in orthodox medicine is in need of review, most certainly, and many people would be shocked by how weak the evidence is behind some common interventions. But I envy the role EBM and science has in your culture, it is yet to take proper root in mine.

  • What a crock of rubbish !

    Hippocrates himself the father of medicine used IM , if he is a quack also, then stop taking is bloody oath

    Hippo critical Oath more like it !!!’

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