Healthcare from the Dentist’s Chair?

Ninety years after the word holism was coined, integrative medicine has come a long way in representing the best of holistic philosophy, modern evidence-based science, and respect for the whole person. Today, more than half the conventional medical schools in the United States are members of the Academic Consortium for Integrative Medicine and Health (ACIMH), including Duke, Harvard, and Stanford Universities, and the Universities of Arizona, California-San Francisco, Maryland, Massachusetts, and Minnesota. 

What is integrative medicine?

Integrative medicine is predicated on the definition of health as set out by the World Health Organization (WHO): “A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

Integrative medicine, as defined by the American Board of Integrative Medicine and the Consortium of Academic Health Centers for Integrative Medicine (now the ACIMH), is the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals, and disciplines to achieve optimal health and healing.

Integrative medicine is a personalized approach to care that puts the patient at the center and addresses the whole person—physical, emotional, mental, social, spiritual, and environmental influences, and considers the unique lifestyle, conditions, needs, and circumstances that affect a patient’s health and well-being. Employing personalized care, integrative medicine goes beyond the treatment of symptoms to address the causes of an illness and uses the most appropriate interventions from an array of scientific disciplines to heal illness and disease, as well as regain and maintain optimum health.

Integrative medicine is not the same as complementary medicine, which refers to healing modalities that are used to complement conventional allopathic approaches, or alternative medicine, which refers to an approach to healing that is utilized in place of conventional therapies. If integrative medicine’s defining principles are applied, care can be integrative regardless of which modalities are utilized. These strategies also focus on prevention of disease and foster the development of lifelong healthy lifestyle behaviors and skills for effective self-care.

Integrative health, as defined by the Academy of Integrative Health & Medicine (AIHM) is a patient-centered approach that is inclusive of all medical professions, all health professions, as well as all aspects of self—body, mind, spirit, community, and planet. Simply said, the integrative health and medicine approach is a personalized therapeutic relationship between health professionals and the patient, whereby conventional and other evidenced-based health and well-being approaches, systems, and therapies are combined for the good of each individual person.

What are the patient benefits of integrative medicine?

Research on successful implementation of integrative medicine hospital programs has shown that integrative medicine likely improves patient care and outcomes while ultimately reducing hospital costs. The benefits include:

• reduced all-risk patient mortality at both three and 12 months after discharge, which may prevent the additional costs of future hospital admissions 
• more likely to have reduced patient pain that resulted in an approximately 4% decrease in hospital costs
• in the realm of cancer, where conventional treatments are often limited, patients reported substantial improvement in their symptoms during the course of disease, including: patients were less likely to be distressed by the disease and were more involved in their own aftercare; integrative medicine approach helped patients address their concerns, which helped with coping strategies; and patients were more likely to have an improvement in appetite, fatigue, cognitive and emotional functioning, pain, anxiety, sleep, and overall whole health 
• shared decision-making and an emphasis on understanding patient life stories to better put their illnesses into context during treatment, lead to increased patient satisfaction
• a reduction in symptoms, as well as improvements in disease, mental and emotional well-being.

Overall, the patient populations that are most likely to benefit immediately from integrative medicine are the chronically ill and those suffering from depression.

 What does it take to be an integrative medicine specialist?

For any medical provider to identify themselves as a specialist, they need to fulfill the rigorous educational, experience and other requirements of one of several medical boards that confer specialist certificates. The American Board of Physician Specialties (ABPS) is the official certifying body of the American Association of Physician Specialists and the only certifying board in the United States to offer integrative medicine certification. Completion of the physician board certification process indicates that the diplomate has proven mastery of the experience and knowledge required to practice integrative medicine. It also reflects the physician’s commitment to adhere to the ABPS Medical Code of Ethics.  A key component to the certification process is obtaining experience in integrative medicine, which may be accomplished by completion of an approved fellowship in integrative medicine. There are a growing number of approved integrative medicine fellowship programs across the country.

AIHM and its predecessors have been at the vanguard of the integrative health and medicine movement for more than half a century. In 2016, the AIHM created the Interprofessional Fellowship in Integrative Health & Medicine (Fellowship), a 1000-hour program for healthcare practitioners from a broad range of professions who want to become leaders in integrative health and medicine. The Fellowship blends online learning with clinical immersion and residential retreat experiences. Delivered by leading educators in the field, this transformative interprofessional program is designed to foster collaboration, engage professionals’ sense of purpose, and provide evidenced-based educational experiences and tools to immediately apply in practice.

How the AIHM’s Fellowship changed the life of its first dental graduate.

KnoWEwell interviewed Amy Dayries-Ling, DMD, FAIHM, AIAOMT, a graduate of the Inaugural Class of 2018 | Fellows of the Academy of Integrative Health & Medicine (FAIHM). Dr. Dayries-Ling is one of KnoWEwell’s Health and Well-Being Advisors. Here is what she had to say about her AIHM Interprofessional Fellowship in Integrative Health & Medicine:

KWW: Why did you choose to participate in the AIHM Fellowship?

AD-L: I had just completed an 18-month-long herbal medicine program and wanted to expand my journey of learning and better help my patients. The AIHM Fellowship program brings together high-quality people, diverse professionals from across the country, sharing experiences in a noncompetitive manner, and learning the best of medicine from a wide range of evidence-based therapies.

KWW: What makes the AIHM Fellowship unique?

AD-L: It truly brings together heart-centered professionals who want to work together to make the world a better place, utilizing a variety of evidence-based therapies. With the online curriculum, it is convenient to participate even with a full patient practice. With their wonderful retreats, I have not only learned, but made a lot of friends across the country and don’t feel so isolated. We don’t have a lot of progressive techniques. The FAIHM has been my light here in Atlanta. It really opened my eyes to the vast amount of evidence-based therapies that can be utilized as practical solutions to help my patients.

KWW: How has being a graduate fellow of the AIHM helped your patients?

AD-L: We generally see our patients more frequently than doctors. With our broken healthcare system and a primary physician shortage, dentists are a more affordable solution between doctor visits. 90% of dental offices are small, local practices and we have multigenerational patients and deeper connections with these families.

Over-the-counter and traditional herbal remedies, natural supplements, and homeopathic remedies can significantly impact oral-systemic health, but they are not necessarily free of risks or side effects. I am able to give my patients the space to disclose this information, help them make informed choices, and educate them regarding oral-systemic connections. Most systemic disease has signs visible in the mouth. The mouth is part of the gut, which contains the majority of the body’s immune system cells.

Overall, as a FAIHM I am now better able to identify whole-body problems and support my patient’s health journey. My patients win.

KWW: Were there any unexpected benefits and why would you recommend the fellowship to providers?

AD-L: Since becoming a FAIHM, my practice has more than doubled. I have become a Continuing Medical Education (CME) instructor and have taught my colleagues these integrative therapies. My dental hygienists now spend a full hour with our patients before they see me. Patients are self-educating and are looking for support with integrative health and medicine. They really appreciate our supportive environment, the extra time we spend with them, and the knowledge we provide.

Being a FAIHM helped me not only achieve my financial goals, it has opened so many professional opportunities, connected me with a broader community across the country, and personally inspired me. I’m thrilled to go to work again and I am able to add so much more value to the care of my patients.

Where does integrative medicine go from here?

The demand for integrative medicine by consumers and the resulting need for additional qualified and innovative integrative health and medicine professionals is on the rise. Integrative medicine has a positive effect on the health and well-being of patients and those same results improve the satisfaction and drive the passion of the practitioners delivering those benefits. But more education is needed on both sides of the equation. A survey conducted on pediatric resident physicians at Baylor University in Texas showed that although over 80% of the children's parents had asked about integrative medicine options, almost 90% of the pediatric resident doctors felt that their knowledge of integrative medicine needed expansion. Programs like the AIHM Fellowship are helping to fill the gap and attract more physicians to the specialty. The AIHM has had so much interest in its April 2020 Fellowship class that they have extended the application deadline to February 29, 2020. Likewise, while consumers have more access to information about health and medical approaches and treatment options, they will need to take greater responsibility for their healing, health, and lifestyle to optimize the effectiveness of integrative medicine treatment plans. Together, the future for integrative health and medicine is a bright one.