What does it mean to be an integrative practitioner in today’s world?

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By Scott Howe

Increased acceptance of integrative approaches has helped practitioners bring more personalized and effective care to their patients. However, a lack of provider training, short office visits, and skepticism from traditional providers and insurers can present roadblocks for integrative practitioners.

“Being an integrative practitioner in today’s world is extremely rewarding as well as challenging,” said Lora Jody, RDN, LD, a Kentucky-based registered dietitian and nutritionist.

Over the course of her career, Jody said she has seen “how western medicine alone is failing in managing chronic diseases and disease prevention.” She believes that an integrative approach—one that considers multiple physical, psychological, and socioeconomic factors and integrates alternative medicine with conventional treatments—can produce tremendous benefits for patients.

For many integrative practitioners, the benefits come from the creation of strong-provider-client relationships and a willingness to explore non-traditional approaches.

“Conventional medicine teaches physicians and other health practitioners to treat patients from a purely pharmaceutical approach; a given symptom is treated with a given pill,” explained Heather M. Skeens, MD, CFMP, founder of the West Virginia Cornea and Cataract Center of Excellence. “With integrative medicine, we are using alternative approaches to treatment that are not simply pharmaceutical in nature.”

Deanna Berman, ND, LM, a specialist in women’s health, also believes in the promise of an integrative practice. She defined integrative medicine as “looking at the whole person, looking at where are their susceptibilities, where are their weaknesses.” Unfortunately, she reported, many providers who intend to take an integrative approach with their patients are “not really pulling it together,” resulting in poor treatments and outcomes.

Berman “pulls it together” by investigating a wide range of factors that can influence an individual’s health. For example, when she works with women who have interstitial cystitis or bladder infections, she searches for the “underlying issues” that cause disease.

“I ask them if they have hormonal issues? Do they have sleep issues? Do they have anxiety? Allergies? Is their cortisol high? Are they using hormones? I ask them what’s going on in their life,” she explained. “I’m really trying to get into the details and find out what is causing their symptoms and not just saying ‘Oh, you have this diagnosis.’”

Like Berman, Jody takes many factors into account when treating her patients. “Using only prescription medication without identifying and correcting the cause of the condition appears futile and seems to offer only minimal benefit to the patient in the long run,” she asserted. “Although many of us need the help of traditional medicine for some diseases and conditions, things like type 2 diabetes, high blood pressure, irritable bowel syndrome, autoimmune diseases, heart disease, and other conditions are more effectively treated with nutrition and lifestyle changes.”

Despite the advantages of an integrative practice, Jody stated that “lack of insurance coverage for non-traditional treatment and testing options along with resistance and lack of knowledge of alternative treatments by providers and specialists” can undermine efforts to help patients find effective approaches to their issues.

Given these issues, Jody believes that practitioners who lack proper training or are not open to integrative approaches to disease management “will likely continue to practice with the disease and treatment method continuing the cycle of poorly managed healthcare for chronic diseases.”

Sarah Gray, PsyD, founder and director of Integrative Psychology, and an instructor at Harvard Medical School, also believes that integrative care offers many advantages, but she feels that strong provider-client relationships must be built to tap into its potential.

“The typical visit for a psychotherapy session is almost an hour, which is a luxury compared to my colleagues in other disciplines,” Gray stated. “My physician colleagues may only get 15 minutes. How well can you know anyone in 15 minutes? I know my patients really appreciate that they have the ability to go more in-depth, to be seen and heard by someone fully and not feel like they have to bottle their whole experience into 15 minutes.”

Berman agreed that taking the time to truly understand a patient is an essential component of integrative care. “A big, big problem in urgent care, the emergency room, and group practices is you don’t get to know your patient,” she said. “When my patients go to urgent care when they have symptoms, they’re often told, ‘Oh, here’s an antibiotic.’ Often, they are not the right antibiotics, and that just perpetuates the problem.”

Despite the challenges, integrative practitioners continue to find ways to combine traditional and non-traditional approaches to care and find the best ways to treat each individual patient.

“My patients really appreciate an approach that looks at the relationship between mind, body, and spirit, as well as the ways environments and social relationships intersect in terms of someone’s overall health,” Gray said.

Scott Howe is a writer and editor with more than 35 years of experience working in fields such as higher education, healthcare, finance, and insurance. For the past 20 years, he has focused on the healthcare industry. He has written for many companies and organizations in the northeast U.S., including Boston Children’s Hospital and McLean Hospital. A native of Massachusetts, he currently lives in Portland, Maine.