Integrative healthcare patient care trends to watch in 2022

Photo Cred: Luba Ertel/Unsplash

By Liz Gold, Liz Gold, Liz Gold

It’s been a challenging and unprecedented couple of years in medicine due to the novel coronavirus (COVID-19). Practitioners have had to revisit how they manage their time and practices, and patients have experienced increased urgency managing both their physical and mental health.

While the year ahead could present many challenges, there are also many opportunities for integrative healthcare professionals. To get a glimpse of what’s coming in the New Year, we talked with members of the Integrative Practitioner Editorial Advisory Board to hear what they anticipate for trends relating to patient needs— as well as their own.

Being a trusted source

For Robert Silverman, DC, DACBN, DCBCN, MS, CCN, CNS, CSCS, CIISN, CKTP, CES, HKC, FAKTR, founder and chief executive of Westchester Integrative Health Center, he said, without question, patients want to talk with someone they trust.

“They don’t know where to go,” Silverman said. “There’s a lot of information, there’s a lot of misinformation, and I want to be their trusted source for knowing the difference. People just want to know what’s right or what’s wrong and if you can be that source, people are going to trust you.”

Patients of Laura Rokosz, PhD, RDN, owner of EGGLRock Nutrition in Union, New Jersey, want her to tell them what to do.

“Adults literally say, ‘Please tell me what to eat, I don’t know what to eat,’” said Rokosz. “They want to learn, and they need me to tell them you have to get off the couch and get going.”

Supporting mental health, deepening trauma-informed care, and better communication among providers

Silverman said the pandemic has changed people’s schedules, their sense of normalcy, and along with that came an increase in anxiety, anger, and depression. Demonstrating empathy and sympathy and keeping up with the most cutting-edge information has become even more important for patient care, he said.

Though Melissa Carr, BSc, DrTCM, owner of Active Life Health Clinic in Vancouver, British Columbia, said her treatment plans have stayed the same during the pandemic because of the nature of Traditional Chinese Medicine (TCM), she has also seen an uptick in mental health issues among her patients.

“Anxiety and depression are quite common,” Carr said. “I anticipate 2022 will still see a bit of uncertainty. People have gotten used to things on some level, but they are getting fatigued.

Carr has also seen an increase in alcohol consumption amongst her patients and works with them to manage their lifestyle rather than turning to substances.

Kellie Blake RDN, LD, IFNCP, owner of NutriSense Nutrition Consulting in in the Charleston-Huntington region of West Virginia, also pointed to understanding how trauma and mental health can impact weight is critical to treatment for her patients.

“People who have a history of trauma are at a significant increased risk of developing autoimmune disease and it can affect every aspect of their disease treatment,” Blake said. “If you don’t take care of mental health with trauma, you can really hit a wall. That is going to be important.”

This is an opportunity for providers to gain more insight about the patient’s experience, according to  Laura Calascione-Nguyen, NBC-HWC, FMCHC, founder of GlassFull Coaching in Boonton, New Jersey.

As part of her coaching practice, Calascione-Nguyen sits in on her clients’ appointments or calls with their physicians. She is a second set of ears observing how information is processed, especially for those individuals who have complex, chronic illnesses, and may have a history of trauma. 

“This pandemic has really highlighted and hopefully opened the conversation for more trauma-informed dialogue,” she said. “I could only imagine how physicians just get through their training and programs. To be in healthcare, I can appreciate the need to compartmentalize and prioritize.”

Calascione-Nguyen said she feels there is an opportunity for collaboration to optimize appointments, communication, and patient education for those new to working with integrative health professionals.

In the meantime, practitioners are anticipating more urgency around mental health needs and how that relates to holistic care with other providers.

“There was already a focus on the importance of mental health, I think that is going to grow,” said Carr. “I hope we see growth in the integration and collaboration between healthcare professionals. I hope we see a continued direction of collaboration between conventional practices and other practices.”

Improving immune health

Blake said she anticipates people are going to be much more interested in natural ways to improve their own immune health.

“The message is there is nothing you can do, and I think people are learning there are lots of things you can do,” she said. “Using natural therapies to optimize immune system function is going to be popular.”

Carolina Brooks, ND, BA, IFMCP, owner of Anthrobotanica, in London, England, said she’s anticipating more care around immune health, more reactivated infections, metabolic disruptions, and more people wanting COVID-19 immune support. She has a hyperbaric oxygen chamber in her clinic for long term COVID-19 patients.

In addition, Brooks uses Frequency Specific Microcurrent (FSM) and Icare machines for digestive issues, especially related to adhesions impacting motility, stress-related issues, trauma physical injuries, illness, and inflammation. FSM connects to mobile phones, which makes treatments more cost effective because people can do it at home.

“It’s really hard to maintain regularity when the messaging is so confusing,” Brooks said. “We’re not necessarily going to see the implication of metabolic health the last two years in most people, but I think some people will see a big deterioration.”

Silverman said he’s been learning new protocols and has added modalities to his practice, such as using low-level laser therapy to support and balance the immune system and improve mitochondrial function. He points to fatigue, brain fog, and digestive issues as the significant concerns he fields from patients. In addition, he said he now sees many patients who have long-term COVID-19 symptoms and need help with ongoing problems, such as dealing with post-exertional malaise and gut barrier compromise.

“Two years ago, many practitioners weren’t as aware of immune system issues as they are today,” he said. “[COVID-19] has made us recognize the immune system as an essential aspect of functional medicine.”

Providing more lifestyle management

Blake also predicts more patient care around mental health and immune system function using natural therapies, supplements, and foods, as well as more personalized nutrition recommendations for the upcoming year.

Among Rokosz’s pediatric patients, there has been a concerning shift since the onset of the pandemic. Whether they weigh too much or not, the children she sees all have elevated cholesterol and triglycerides, which she describes as living like a 10-year-old to living like an 80-year-old. This is due to stress, lack of exercise, and a desire to eat comfort food.

Patient care needs have remained much of the same for Kim Furtado, ND, owner of a private family practice in rural Lewes, Delaware. Her patients come to her for hormonal imbalances, thyroid issues, and immune system care. She said she expects to see more of the same this year.

While Carr can’t do acupuncture at a distance, she said she can make dietary and lifestyle recommendations, send patients ear seeds, and give them acupressure points or press needles. Carr also teaches her patients how to do cupping on themselves using silicon cups.

Carr recommends that her patients create a “frame” or routine to their day— this includes regular sleep, waketimes, mealtimes, as well as activity and movement. While some people found working from home beneficial, for others, it had a major impact on their health. Some people couldn’t get the treatment they needed, either because patients were afraid to go to the hospital or surgeries were delayed.

Brooks has seen this in her practice, too.

“It’s quite hard to understand how an oncologist can say to someone, “yeah, your tumor surgery will be in three to six months”,” Brooks said. “The mental impact on that is a long time. There’s been a lot more mental support for those patients.”

Adopting strong boundaries and adapting to change

Brooks said the lack of access to healthcare is also an issue.

“I’ve seen the way our healthcare system has been massively overburdened,” Brooks said. “Lack of ability to get appointments, appointments are being pushed back, and that is creating a situation for people.”

While Brooks’ clinic has remained busy throughout the pandemic, a cancellation policy has helped support her practice. More cancellations started to happen for a variety of reasons—patients panicked about spending money, patients wanting to move the appointment because test results were late, or their supplements weren’t available due to supply chain issues.

“The most important thing is to have good boundaries, so people are clear on what you are and aren’t able to offer,” Brooks said. “Patients can become very dependent on you and expect you to step outside your remit and provide advice for example, in urgent situations. Boundaries help to establish practitioner role and remind patients that I am not their primary care clinician.”

In addition, she said it’s been important for practitioners to be able to adapt to how people want to receive their care, whether that’s in person or online.

Carr said generally managing her practice through the pandemic has brought its own set of challenges, including navigating numerous changes, communicating with patients, and staying on top of regulatory issues. But there were also benefits, such as more online consultations and openness to virtual patient care.

Furtado experienced growth in 2021 and hired an office assistant for the first time. She transitioned to telemedicine, as her patients weren’t requiring in-person appointments. In telemedicine sessions, she finds that in-depth clinical conversations with a focus on emotional, physical, and spiritual health still occur, but clients no longer need to travel. 

“I just take what comes, I don’t steer the ship in terms of who comes to see me,” Furtado said. “Some practitioners might focus on a certain condition or a way to think about their practice, I see who needs me.”

Blake said she has also changed to virtual sessions, which works for her patients.

Whether practitioners see patients in person or online, one thing is clear – agility is needed in these uncertain times.

“We are moving forward, but we are not moving forward from 2021 we are moving forward from 2019,” Rokosz said. “People are going to adjust to doing things virtually. We can’t let living and working virtually hold our health back. We are going to have to adapt.”