Integrative, alternative, holistic—it’s easy to get lost in the lingo of modern medicine. It used to be as simple as eating an apple a day and checking in once a year with your family physician, but let’s face it: Health care has gotten complicated. (Don’t even get us started on health insurance.)
Say you have a migraine. You could choose to treat it by seeing a general practitioner, an acupuncturist, or even a Reiki master. The vast array of medical care options is impressive—and perhaps a bit overwhelming. “As a consumer, you’re now in the driver’s seat,” says Steven Eisenberg, M.D., an integrative oncologist in San Diego, CA. “There’s value in both practitioners and patients keeping an open mind about different modalities, while at the same time there are potential benefits and risks with each type of treatment.“
If your head is spinning, you're not alone. Here's a brief guide to the various approaches practiced today.
1. Conventional Medicine
Conventional or mainstream medicine is what comes to mind when you think of standard health care: med school grads in white coats, pharmaceutical drugs, and surgeries. The primary goal of conventional care is to cure patients by eliminating physical symptoms of illness and injuries. “It's the evidence-based, science-backed foundation of modern medicine,” Eisenberg says. “If you have pneumonia, for example, you’ve got to take antibiotics. If you’re in a car crash, you have to go to the emergency room.”
One downside: It can be costly (emergency room visits can cost thousands of dollars, even when no procedures are performed.) It’s also sometimes criticized for a lack of focus on the patient-doctor relationship, lack of long-term support, and rushed visits, as the pressure is on doctors to see as many patients as possible.
2. Alternative Medicine
This approach includes nontraditional treatments—think Chinese medicine, Ayurveda, homeopathy, acupuncture, yoga, herbal remedies, hypnotherapy, massage, or chiropractic therapy. While these methods aren’t new (some have been around for thousands of years), they’re gaining mainstream popularity.
According to a 2007 survey (the most recent data available), 38 percent of American adults report using alternative therapies. Dietary supplements—herbs like gingko or echinacea, vitamins, or probiotics—are the most popular alternative approach, with 18 percent of Americans using them. Deep breathing, yoga, tai chi, or qi gong, as well as chiropractic or osteopathic manupulation, are also among the most common techniques.
3. Complementary Medicine
“Alternative” and “complementary” are often used interchangeably, but they’re actually different terms, according to the National Center for Complementary and Integrative Health (NCCIH). When practices and products of non-mainstream (alternative) origin are used in conjunction with traditional medicine, it's referred to as complementary medicine—or CAM. When you turn to only non-mainstream therapies as treatment, that’s considered “alternative.”
4. Integrative Medicine
Depending on what type of specialist you see, you may be prescribed a pill, switched to an anti-inflammatory diet, or advised to reduce stress with meditation. But using all three approaches in tandem? That would be integrative health care. “It’s the intelligent combination of alternative and conventional medicine,” explains Andrew Weil, M.D., founder and director of the Arizona Center for Integrative Medicine, who’s commonly considered the pioneer of integrative medicine. For example, turning to acupuncture to manage asthma isn’t considered integrative medicine—unless it's used in coordination with, say, an inhaler.
This approach also centers on a therapeutic doctor-patient relationship, in which the doc encourages lifestyle changes and provides continuous care. Integrative medicine and patient-centered care. Maizes V, Rakel D, Niemiec C. Explore (New York, N.Y.), 2009, Dec.;5(5):1878-7541. The practitioner places an emphasis on mind, body, and community, caring for the whole person through changes in diet, lifestyle, and mind-body practices.
5. Functional Medicine
Finally, functional medicine came into play in 1991 when Jeffrey Bland, Ph.D., founded the Institute for Functional Medicine. This approach involves practitioners understanding the cause of disease, looking at the body as a whole, and figuring out how to treat the illness by delving into patients’ health histories. Think of it as an entirely new GPS navigational system in the world of health and illness, says Mark Hyman, M.D., chairman of the Cleveland Clinic Center for Functional Medicine.
Think of it as an entirely new GPS navigational system in the world of health and illness.
Functional medicine and integrative medicine are on the same page when it comes to breaking down the many segments of conventional, specialized medicine: The whole body matters, the patient experience matters, and the doctor-patient connection matters. But functional medicine goes a step farther, Hyman explains. “It uses the latest scientific understanding about how our genes, environment, and lifestyle interact as a whole system to diagnose and treat diseases based on patterns of imbalance and dysfunction—without treating the disease specifically.”
Sounds counterintuitive, but as Hyman explains, disease is often the result of the body trying to rebalance its system. The key isn’t so much about naming the disease or finding the drug to treat it; rather, it’s about listening to the patient’s story and history, and looking at factors like allergens, toxins, stress, infections, diet, and genetics to get to the root of the disease.
What the Research Says
Depending on who you ask, opinions of the various modalities are mixed. While supporters of integrative medicine call it “healing-oriented“ and functional medicine supporters say it's “the model for medicine going forward,“ some doctors are dead-set against unconventional approaches. “It's cleverly marketed, dangerous quackery,” Steven Salzberg, Ph.D., a professor at the Johns Hopkins University School of Medicine, declared of alternative medicine, while David Gorski, M.D., Ph.D., a surgical oncologist at the Barbara Ann Karmanos Cancer Institute, has called functional medicine “highly dubious medicine“ and “pure pseudoscience.“
Still, a good deal of research supports CAM and integrative approaches to healthcare. Several studies point to promising effects for managing pain and anxiety, relieving fatigue, and improving mood in cancer patients. Effects of integrative medicine on pain and anxiety among oncology inpatients. Johnson JR, Crespin DJ, Griffin KH. Journal of the National Cancer Institute. Monographs, 2015, Jun.;2014(50):1745-6614. Massage Therapy vs. Simple Touch to Improve Pain and Mood in Patients with Advanced Cancer: A Randomized Trial. Kutner, J, Smith, M, Corbin, L, et al. Annals of Internal Medcine. 2008 Sepl 149(6): 369-379. Yoga for persistent fatigue in breast cancer survivors: A randomized controlled trial. Bower, J, Garet, D, Sternlieb, B, et al. Cancer. 2012 Aug 1; 118(15): 3766–3775.
Research has also found that yoga and meditation may help smokers quit the habit and may help with weight loss. Brief meditation training induces smoking reduction. Tang, Y, Tang, R, Posner, M. Proceedings of the National Academy of Sciences, 2013 Aug 20; 110(34): 13971–13975. Other studies have pointed to the benefits of herbal supplements, like ginger for relieving indigestion or turmeric for its anti-inflammatory properties.
At the same time, many key claims aren’t backed by large, carefully controlled medical studies, or in some cases, those bigger studies refute the claims. For example, several major studies of the herbal supplement echinacea found it did not prevent or shorten the duration of the common cold. And since science-backed research is still limited, many health insurance plans consider CAM or integrative therapies too experimental and do not cover them. In other words, be prepared to pay a pretty penny to take advantage.
Still, it’s worth noting that many well-established medical centers are turning toward integrative approaches, including the Memorial Sloan-Kettering Cancer Center in New York City, M.D. Anderson Cancer Center in Houston, TX, and the Dana-Farber Cancer Institute in Boston.
The Bottom Line
Before using any of these approaches, people who’ve been diagnosed with any illness or injury should talk with their primary health care provider.
Despite their differences and the doubts of some doctors, both functional and integrative health practitioners are working to shift the focus from disease management to disease prevention—and redefining our understanding of health care in the process.
Additional research and reporting by Locke Hughes.