Banner by Alisa Zhang
Back to the Future with Integrative Medicine
By Natalie Convertino
Integrative medicine, with roots extending into the prehistoric era, has growing potential to redefine the medical model. Dr. Ronald Glick clues us in to the discipline’s “mind, body, and spirit” mantra that has been sustained and nurtured for over a millennium.
Composed some time between 400 BCE and 200 CE, Huangdi Neijing, also known as The Yellow Emperor's Classic of Internal Medicine, is considered a foundational Chinese medical text. Not only is it an exceptionally comprehensive account of many progressive medical and scientific theories, long serving as a resource for diagnostic methods, but it’s also considered the first official documentation of acupuncture as a viable medical treatment. It is from the creation of this significant doctrine that acupuncture, previously an idea unknown to recorded history, was born as an organized system.
Acupuncture rapidly spread worldwide, eventually undergoing a vigorous transformation as the West disentangled the practice from much of its traditional spiritual associations and experimented strictly with its use as a clinical practice. Despite periods of skepticism from the West at times, facing dismissal by medical practitioners and the general public, the proven effectiveness of the therapy has stood the test of such denial and grown into a widely accepted technique. Due to its comprehensive and supplementary nature, acupuncture is considered a prime illustration of integrative medicine.
Integrative medicine refers to the use of both complementary and conventional therapies to bring about a more holistic approach to healing. Acupuncture is only one example of services under the broad umbrella of integrative medicine, with many sharing prehistoric origins. In modernity, integrative medicine has become an appealing tool to collectively address concerns in the body, mind, and spirit, and has seen a significant advancement in the medical field.
To investigate how Integrative Medicine looks in recent years, I spoke with Dr. Ronald Glick, the Medical Director for The UPMC Center for Integrative Medicine (CIM), about the center’s composition, patient population, available services, and most pressing concerns. Dr. Glick, who has a background in both psychiatry and physical medicine & rehabilitation, has been with the center since 2002, joining just five years after its establishment in 1997.
While integrative medicine can benefit a variety of patients, certain groups tend to gravitate towards its unique services. “The biggest reason people seek integrative health treatments is because of pain. Services like chiropractic, massage therapy, and acupuncture, those are all primarily directed towards pain,” explains Glick, pointing out both the motivations of the patient population and hinting at services common to the integrative approach. Dr. Glick himself is primarily interested in integrative means of pain management, particularly in chronic conditions which don’t respond well to more “functional” medical treatments. “The patients coming to us looking into services for pain management are about two thirds of people. And then stress related conditions and general health problems equally make up the rest.”
The center itself has grown in many ways in order to broaden their scope of care. Starting with approximately six practitioners, CIM now has 16 and is still growing. Its expert make-up has also evolved over the course of its development: “When I started, one of the original members was a naturopathic physician and we eventually added two others because we feel that a key part of our mission is helping people with holistic health, especially nutrition. It’s not a matter of ‘How do I lose 30 pounds?’, although we do get those questions. Rather, it’s more ‘I have multiple sclerosis or irritable bowel syndrome or migraines, and besides the usual medications I want to do whatever I can to enhance my quality of life.” Additionally, the center’s unique emphasis on psychiatric care has benefited its range of expertise.
Just as some have shown reluctance to therapies like acupuncture in the past, many physicians are only just beginning to shed their hesitation towards integrative medicine. As Glick explains it, “When I got started [in acupuncture] there was a little bit of skepticism by the physicians… In the last pretty much decade, certainly the last five years, we are much more likely to see referrals from physicians to our services, so there is a lot more acceptance that these approaches have an evidence basis and can help patients with things that mainstream medicine doesn’t help quite as well with.” At a summit hosted by UPMC, 30 professionals from various medical specialties, public health, and medical economics were invited to discuss changes in the hospital model on account of the ongoing opioid crisis. According to Glick, many physicians spoke out about not being provided the proper “tools” to move away from the use of narcotics. Acupuncture is one such solution to these concerns. In terms of patient response, even one of the most fickle groups has shown great participation in integrative therapies: “When we’ve done outreach programs offering these kinds of services to older adults, they buy in and they participate and they benefit and there’s not really any skepticism,” Dr. Glick explains. “One of my colleagues has done a number of studies looking at acupuncture for older adults with various arthritic conditions and they were very open and accepting of it.”
The future of integrative medicine lies in changing the way we approach medicine altogether. “Our vision is that the things that we do at the center will just become a part of common medical practice,” says Glick. “For your generation, it won’t necessarily be that they go to one place for their blood pressure medicine and then another place for other services, but that it would all be truly integrated. That’s what we’re hoping.” The model of care will move away from treating various parts of the body individually and towards a more comprehensive look at health. Dr. Glick describes an educational program for patients which encompasses aspects of diet, physical exercise, psychology, and stress management, that informs the patient of ways to improve overall wellness. “There’s actually models of these kinds of programs that show very dramatic outcomes in heart diseases or cancer to the point where if you had a pill that had the same results it would be malpractice not to give everybody with these afflictions that pill,” Glick says. However, lifestyle programs are less accepted by medical professionals and patients alike, making it difficult to get such ideas solidified.
As for those looking to improve their own holistic well-being, Dr. Glick recommends looking into mental health resources and taking advantage of the programs offered in and around Pittsburgh. “We have a mindfulness meditation program at our center based on the Mindfulness Space Stress Reduction Program developed at the UMass Memorial Center for Mindfulness.” The director of CIM’s Mindfulness Program, Dr. Carol Greco, as well as the Pitt Center for Mindfulness and Consciousness Studies have worked in tandem to make these programs both successful and accessible. Student populations especially would benefit from either guided meditation or stress reduction programs to address their mind, body, and spirit simultaneously.
The beauty of integrative medicine is that despite its extraordinary growth and acceptance within the past 20 years, its origins are so ancient that scholars still struggle to confidently pinpoint the date of its primary documentation. Tracing the progression of this holistic approach from the Yellow Emperor all the way to CIM’s most recent advancements, what is perhaps even more incredible is the future potential of complementary therapies to redefine the medical model altogether.