A New Paradigm on the Road Less Travelled Part 2 – Concepts Needed Along the Road

By Kim M. Watson, RN, MScN

As we travel this road less travelled, and bring in an integrative healthcare approach for the delivery of care we will draw on the best that the scientific approach can bring, which includes the conventional, or allopathic type of medical care. Integrative medicine combines conventional and complementary approaches in a coordinated way. As we move forward we will need to refocus and expand on these concepts:

1.      Caring for the whole person (holism) – focusing on mind-body-spirit of persons. This includes looking at additional aspects such as the social, emotional, spiritual, environmental and more. It is time there is recognition of the importance of the mind-body-spirit connection, and incorporate these aspects in the planning and execution of care. Emphasizing lifestyle changes and patient responsibility and ownership will also be important.

2.      The practitioner-patient relationship will be key with an importance placed on caring, compassion, health and wellness. The dynamics of the practitioner-patient relationship will evolve, and entail a variety of partnerships, similar to the Family Health Teams that have developed over the last few years in Ontario, yet they will take it even a step beyond. The importance of caring and compassion will point us in the direction of a therapeutic relationship between the caregiver and the client. The NCCIH, the National Center for Complementary and Integrative Health https://nccih.nih.gov, says this relationship is the heart and soul of integrative medicine. We need to structure a focus on optimal health and wellness, to think beyond the disease-oriented approach and shift away from a curing view, to one of healing.  

3.      The patient in the driver seat of care, at least the one to determine the route! We will need to evolve to a model with the patient being the driver; a model of self-regulation within the therapeutic partnerships. Accountability for decisions will ultimately lie with the client.

4.      A truly multi-disciplinary approach to care. Unlike the present conventional medical system, the new one will not be purely physician driven in all aspects of care, though they will play a major lead with conventional medical care. Each member in the partnership will be equally important, realizing what each brings to the table, though the client will be doing the steering. Lucia Thornton (2013) states “the patient is the focus of all care, and members of the team are unified in a common mission and purpose to promote health and healing and to deliver the highest quality of care possible” p. 184. The leading Canadian research group, IN-CAM (Canadian Network for Complementary and Alternative Medicine) is a collaborative and interdisciplinary research community generating knowledge through research on complementary, alternative, and integrative medicine/health care to enhance the health of Canadians, has a wide variety of disciplines involved in driving the research. They are affiliated with the NCCIH, the National Center for Complementary and Integrative Healthcare, who are the leaders in the USA. Both advocate a multidisciplinary approach to research, education and care, as depicted in Thornton’s (2013) concept of therapeutic partnerships. 

5.      Willingness to use various complementary therapies, which are viewed as unconventional modalities of care. When you think of an integrative approach, you must have a willingness to include complementary therapies, those seen by many as unconventional modalities. Many Canadians have experienced or integrated these therapies already. Many other healthcare professionals (not just physicians) have resisted the move to an integrative approach because of these modalities. It is time we do not exclude things because we are skeptical or do not quite know how they work. Dr Andrew Weil, MD, a leader in North America for the work he has done in the field of Integrative Healthcare, says being skeptical is okay, though it is time we give these modalities a chance, especially when they are shown to not be harmful and if we are fully informed. Ultimately we may be surprised when the evidence is in.

6.      Scientific evaluation or research – a new look on how to study this approach. Dr. Ralph Synderman, in a lecture for the NCCIC stated: “we need to understand ultimately what the alternative and complementary therapies are actually doing so that we will mainstream them. And... as long as our skepticism isn’t so great that, by reductionist design, we eliminate any possibility for truth to be seen” https://nccih.nih.gov/training/videolectures/integrative.htm. It is time to perhaps look a little closer at some of those ‘soft’ methods of research and their validity from a patient perspective and outcome measurement; after all, perhaps all the Canadians who have been using complementary therapies, and are paying for them out of pocket, know something the healthcare field has yet to learn.

These are but the first baby steps on the road to better healthcare, for practitioners and patients alike. Stay tuned, we are just in the beginning of adventure. Enjoy the ride!

Blessings, in love and in light, Namasté, Kim

References:
Thornton, L. (2013). Whole person caring. An interprofessional model for healing and wellness. Sigma Theta Tau International: Indianapolis, IN.