Integrative Medicine Inclusive of Ayurveda

Briding Ayurveda into integrative medicine is important for skin care and health

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The integrative medicine movement is gaining much momentum in the United States and rest of the world where many leading universities like Harvard, Johns Hopkins, University of California, Mayo Clinic and others have dedicated departments for it. It provides a platform for healthcare practitioners to expand their traditional training to include other healing modalities which enhance clinical outcomes of their patients/clients. Integrative medicine is defined in many ways.[1,2,3] all of which emphasize on principles like accounting for the whole person – mind, body, soul, personalized recommendations, evidence-based treatments, collaborative efforts, partnership with client, focus on health and prevention, amongst others. 

Consider a case of a conventional medicine practitioner who is primarily trained to investigate and prescribe pharmaceutical agents. An ability to advise her patients about nutrition, physical therapy, mindfulness, acupuncture, herbs and other modalities is certainly advantageous. She may either choose to provide these directly in her office (Core integration) or collaborate with experts (Peripheral integration) who are primarily trained in those fields. Either way, this orientation to identify strengths and weaknesses of different systems with an intention to inform patients and improve outcomes is the central ethos of Integrative medicine. 

 

Unique Needs for Integration with Traditional Health Approaches

The National Council for Complementary and Integrative Health (NCCIH) considers traditional Ayurvedic and Chinese medicine to be health approaches distinct from health practices like biofeedback or massage therapy.[4] Its practitioners use all possible means of health just like Integrative medicine does: medicinal herbs, food, behavior, lifestyle, therapeutic procedures like massage, panchakarmas, exercises, and counseling amongst others. Their recommendations are based on a systemic logic[5] which encompasses multiple spectrums: physical, mental, emotional, spiritual, from health to disease, internal and external environments. Clinical recommendations for each individual are made considering states of the energy imbalances, digestion & metabolism, age, sex, environment and geography, strength and immunity, mental and emotional resilience, body constitution.[6] 

Biological systems are complex, networked hierarchies being actively studied in a field called systems biology.[7] It uses computational data models to understand the horizontal and vertical relationships between different biochemical, metabolic, proteomic, genomic, epigenomic and other markers. These methodologies can be tapped to study effects of Ayurvedic recommendations as most affect multiple targets in the body.[8,9,10]

Currently, the use of Ayurveda in integrative medicine is limited to some medicinal plants found to be effective in the randomized controlled trials. However, there are many other beneficial principles and practices missed in this selection. In order to provide the full range of benefit of this system and effectively communicate what elements of Ayurveda will be available in the Integrative consult, we suggest a stratification into core vs peripheral integration.

 

Stratifying the Therapeutic Encounter with Ayurveda

The scope of integration of two systems of medicine is influenced by the ‘resource of time’ amongst other financial, legal and regulatory constraints, Consider a) Time available to learn about a new system of medicine, b) time is taken to learn how to practice it and c) time needed to apply the whole system assessments and recommendations for an individual in the office setting. 

Peripheral integration approach is when a healthcare practitioner has been trained over a few weeks or months to know what an Ayurvedic practitioner does and how s/he thinks, and knows thus when and when not to refer to one. Such a practitioner may also suggest evidence-based treatments from Ayurveda and common health practices which Ayurveda considers beneficial for everyone.

Core integration approach is when a healthcare professional is trained to think and practice with Ayurvedic logic. The practitioner will have many more tools for assessment and recommendations know of traditional medicine properties, formats, indications, contraindications and understand the therapeutic scope along with prognosis.  Such practitioners will also need to refer for integration with other healthcare professionals like psychologists, primary care physicians, chiropractors etc.

Classifying these therapeutic encounters will aid clients/patients to know what to expect when an integrative healthcare professional offers ‘Ayurveda’. It will enhance cross-talk amongst different systems, ensure there are fewer lapses and strengthen the offerings of our healthcare systems as a whole.

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References

1.Arizona Center for Integrative Medicine. What is Integrative medicine? Accessed at http://integrativemedicine.arizona.edu/about/definition.html. Retrieved Apr 5th 2016

2.Academic consortium of Health and Integrative Medicine. Definition of Integrative Medicine and Health. https://www.imconsortium.org/about/about-us.cfm Retrieved Apr 5th 2016

3.Academy of integrative health and medicine. Integrative medicine: A definition. Accessed from https://www.aihm.org/about/what-is-integrative-medicine/. Retrieved Apr 5th 2016

4.https://nccih.nih.gov/health/ayurvedaTypes of complementary health approaches. National Council for Complementary and Integrative Health. https://nccih.nih.gov/health/integrative-health. Retrieved Apr 5th 2016

5.Tillu G, Gangadharan G, Vaidya ABD, Patwardhan B. Systems Ayurveda: Conceptual Foundation and Logic. Published by Foundation for Revitalization of Local Health Traditions, Bangalore. 2010. Accessible: http://aimswasthya.com/goals/

6.Rupesh Wadher R and  Dwivedi R. Applicability and importance of Caraka’s concept of Aaturaparijnana Hetawah in understanding a patient. Ayu. 2012 Apr-Jun; 33(2): 188–192.

7.What is systems biology? Institute of Systems Biology. Available at https://www.systemsbiology.org/about/what-is-systems-biology/. Retrieved on Apr 10 2016.

8.Patwardhan B . Ayurveda and Systems Biology . AAM. (2014), [cited April 10, 2016]; 3(1-2): 5 Available at : http://www.scopemed.org/fulltextpdf.php?mno=170935

9.Ayyadurai, V.A.S. (2014) ‘The control systems engineering foundation of traditional Indian medicine: the Rosetta Stone for Siddha and Ayurveda’, Int. J. System of Systems Engineering, Vol. 5, No. 2, pp.125–149.

10.Rioux J. A complex, nonlinear dynamic systems perspective on Ayurveda and Ayurvedic research. J Altern Complement Med. 2012 Jul;18(7):709-18. doi: 10.1089/acm.2011.0569.