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Integrative Medicine for the Poor and Underserved: A Win-Win Situation
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Integrative medicine is often thought of as a health care option primarily available to the wealthy—the thought is that only those with abundant financial resources could possibly afford the luxury of multiple medical modalities, a holistic approach to healing, and a team of professionals collaborating on their care. How is it then, that we see clinics across the country devoted to providing health care to the poor and underserved turning to integrative medicine to meet their many wide-ranging needs? Is integrative medicine a luxury afforded only to those with resources to spare, or is it a means of providing more effective health care while making efficient use of resources to the people who need it most? My own experience working in integrative medical clinics serving underserved populations suggests that integrative medicine is plausibly part of the solution for meeting the health care needs of the underserved. If integrative medicine offers viable solutions for medically underserved populations, it may be that it will help satisfy the increasing demands on our health care system.

What is Integrative Medicine?

The Consortium of Academic Health Centers for Integrative Medicine provides the following definition of integrative medicine: Integrative medicine 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, health care professionals, and disciplines to achieve optimal health and healing.4

In its best incarnation, integrative medicine is more than an expanded toolbox of medical modalities and approaches. A variety of complementary and alternative medicine (CAM) and conventional interventions certainly is a strong point of integrative medicine; the philosophy and principles of health care being developed in integrative medicine are at its core.

Some of the key principles of integrative medicine are:

  • •    A holistic approach to health care that integrates the physical, mental-emotional, and spiritual sides of the health of the individual and the community.

  • •    A patient-centered, empowerment model of care.

  • •    A focus on disease prevention, health, and well being.

  • •    Recognition and facilitation of the body’s innate healing ability.

  • •    Cautious use of medical interventions, with a preference for minimally invasive and natural treatment approaches.

  • •    Training health care practitioners to be role models for health and well being, to be open to new concepts of health, and to be aware of cultural nuances in patient communities.

  • •    Training practitioners to view the patient and the community as teachers.

  • •    Training practitioners of diverse health care systems to collaborate and communicate effectively, to develop mutual respect, and to overcome preconception and prejudice.

Some Background

As a licensed acupuncturist, I have had the opportunity to work in several integrative medicine programs. Each program serves diverse populations and takes various approaches to integrative medicine based on the availability of resources and the needs of its target population. Integrative medicine has a different flavor in each of these programs, but there is common ground. Whether I am working with undocumented immigrants, the working poor and San Diego’s homeless population at the University of California, San Diego (UCSD) student-run free clinic, or pediatric oncology patients at Rady Children’s Hospital, I am consistently working with a medically underserved population.1 Each of these programs has turned to integrative medicine in an effort to remedy the imbalance between the health care needs of their patients and available resources.

It is no secret that a significant portion of the U.S. population has limited access to medical care, often for reasons associated with geography, race, ethnicity, or socioeconomic status. In February 1998, the Dept. of Health and Human Services announced an initiative to eliminate ethnic and racial disparities in health.2 In 2002, the National Center for Complementary and Alternative Medicine (NCCAM) offered a strategic plan with the same goal, hoping to enhance access to CAM therapies for underserved populations through collaborations with the conventional health care system. This strategic plan also aimed to utilize CAM health care approaches to contribute information about cultural differences in health beliefs and behaviors.3 According to the 2007 National Healthcare Quality and Disparities Report, while progress is being made, overall disparities in health care quality and access have...

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