Internists are physicians specializing in internal medicine, a discipline focused on the care of adults emphasizing use of the best medical science available in caring for patients in the context of thoughtful, meaningful doctor-patient relationships as exemplified by the life and work
ntegrated medicine (or integrative medicine as it is referred to in the United States) is practising medicine in a way that selectively incorporates elements of complementary and alternative medicine into comprehensive treatment plans alongside solidly orthodox methods of diagnosis and treatment. The concept is better recognised in the US than in the United Kingdom, but a conference in London next week, organised by the Royal College of Physicians and the US National Center for Complementary and Alternative Medicine, may help to raise its profile in the UK.
Integrated medicine is not simply a synonym for complementary medicine. Complementary medicine refers to treatments that may be used as adjuncts to conventional treatment and are not usually taught in medical schools. Integrated medicine has a larger meaning and mission, its focus being on health and healing rather than disease and treatment. It views patients as whole people with minds and spirits as well as bodies and includes these dimensions into diagnosis and treatment. It also involves patients and doctors working to maintain health by paying attention to lifestyle factors such as diet, exercise, quality of rest and sleep, and the nature of relationships.
Conventional medicine has become dependent on expensive technological solutions to health problems, even when they are not particularly effective. In its enthusiasm for technology, it has turned its back on holism and simple methods of intervention, such as dietary adjustment and relaxation training, which are prominent in many alternative systems of medicine and are often effective.1 Patients want guides to help them navigate the confusing maze of therapeutic options, particularly when conventional approaches are relatively ineffective and harmful.
Most patients turn to complementary medicine out of frustration. Research shows that the consultation process and holistic approach adopted by practitioners of complementary medicine make patients feel in more control of their illness. Unfortunately, this option is not often available because physicians with the desired attitudes, knowledge, and training are few and far between. Yet the multiple options of complementary therapies range from the sensible and worth while to the ridiculous and even dangerous, and patients need physicians with the biomedical knowledge to distinguish between them.
Conventional medicine can no longer ignore complementary medicine. US expenditure on complementary medicine rose in 1990-7 from $13bn to $38bn a year, and twice as many consultations were with complementary medicine practitioners as with mainstream family doctors.This trend is also apparent in Australia,while in the UK a recent survey in Southampton (population 200 000) showed that around £4m