Integrative medicine is not alternative or complementary medicine: it grew inside conventional practice, and the BMJ once suggested it might restore 'the soul' to medicine. Bernard sets out the SASIM definition and argues that the middle ground it occupies — dysfunction before pathology, and bio-energy alongside biochemistry — belongs to the family practitioner more than to anyone else.
Is general practice wholistic enough?
Brom B, MBChB, CEDH (Homeopathy, France) Dip Acup (Singapore)
Integrative medicine is not alternative medicine or complementary medicine. It has developed within the ranks of conventional doctors and has been hailed as a paradigm shift in medicine. I will explore this paradigm shift and why it is important, especially in the general practice setting¹.
An editorial in the BMJ suggested that Integrative medicine may restore ‘the soul’ back into medicine, its focus being on health and healing rather than on disease and treatment².
The South African Society of Integrative Medicine (SASIM) has defined Integrative Medicine in the following way:
“Integrative medicine encompasses a viewpoint which recognizes the complex holistic nature of the physical-energetic-informational system of each individual and the uniqueness of that system. In this approach the practitioner and the sick individual form a team working towards an integrated protocol of management best suited for that person. Supporting health is a priority, using least invasive and more natural approaches. Treating disease symptomatically may be indicated but always with the full knowledge of the sick individual.”
There is a great deal in this definition that points to a departure from the present approach of general practice, which has tended to follow the more narrow and radical approach of the medical specialist who is clearly intent on making a diagnosis and treating the disease as an entity separate from the whole body or person³·⁴.
The bio-psychosocial perspective has certainly helped to enlarge this narrow viewpoint in the general practice setting, but it has not gone far enough. There is a large middle ground which has been left out, and it is this middle ground that has been filled in by Integrative medicine. There is every reason to believe that it is general practice which can most enrich itself by recognizing what this approach has to offer.
