Treating patients as individuals through integrative medicine

Collaborative care must be built around the needs of individual patients and groups of patients.

The World Health Organisation (WHO) defines health as 'a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity'. This is the basis of integrative medicine – the concept of a patient-centred, holistic approach to care that addresses all aspects of the patient's needs.

The traditional, uniform approach

The traditional medical role has always been a paternalistic one, with the knowledgeable doctor prescribing treatment for the patient and minimal opportunity for patient input. Historically, treatment has centred on disease diagnosis, investigation and treatment modalities of medication or surgical intervention, or both, with hardly any patient participation.

Integrative medicine revolves around the patient

Integrative medicine considers each patient's unique needs and circumstances and allows for a practitioner-patient health partnership. It also allows for appropriate intervention from different scientific disciplines to aid in the management of illness and disease together with the healing process, thereby assisting the patient to regain and maintain optimum health.

Integrative medicine is not the same as alternative medicine where a patient chooses between conventional medical treatment and alternative care pathways. Rather, it is an approach to patient-centred care that may include conventional therapies and complementary medicine (modalities that are used to complement allopathic treatment).

A crucial aspect of integrative medicine is that in addition to addressing and managing the immediate health problems, an assessment of the causes of the disease or illness is handled concurrently. Physicians are encouraged not to offer prescriptive or recipe medicine, but to regard each patient as a unique person with dynamic and varying circumstances that affect their health presentation. Therefore, each interaction requires all physical, emotional, mental, social, spiritual and environmental influences that impact the patient's health to be addressed.

This personalised care extends beyond the simple treatment of symptoms; it also involves evaluating all possible causes of illness, including diet and lifestyle. This means focusing on the patient's immediate health needs as well as the long-term complexities and modification of behavioural, psychosocial and environmental influences that contribute to the biological presentation of disease.

The fundamental concepts of integrative medicine include:

• Multidisciplinary care across disciplines including allied health practitioners
• A health partnership that allows the patient to participate in the healing process
• A history assessment of health influences, which includes consideration of the role body, mind, spirit and community play in disease and wellness
• An awareness by healthcare practitioners of methods that may promote healing that involve 'natural body responses', for example, the role of Vitamin D in wound healing
• A personalised approach to every patient as an individual with unique health conditions and circumstances
• A stepwise approach to healthcare interventions that may prevent invasive procedures, for example, managing diet and modifying lifestyle in progressive back pain
• Patient buy-in to health awareness, which is paramount in the prevention of illness

Integrative medicine doesn't just deal with a diagnosis, nor does it start at the time of diagnosis. Rather, it encourages health maintenance and wellness throughout a person's life. Integrative medicine focuses on disease prevention by encouraging the development of healthy behaviours and teaching skills. These enable patients to achieve health goals by decreasing lifestyle diseases and improving mental, physical and emotional wellbeing throughout their lives.

- Professor Carol Ann Benn.