By Lisa M. Belisle, MD, MPH
Medical Advisor, MaineHealth Learning Resource Centers
Originally published in MaineHealth newsletter, Fall 2004
From the beginning, the MaineHealth Learning Resource Centers have offered their clients the best possible health care information, from expert sources both local and national. While we have always covered traditional and complementary topics in our classes, last year we began to change our approach. With generous support from the Osteopathic Healthcare Foundation, we have been able to work with the Maine Medical Center (MMC) Family Practice Department and local complementary medical providers on a special Integrative Medicine project.
Integrative medicine brings together the best of traditional and complementary healing therapies. We believe that the future of medicine lies in this approach. The MMC Family Practice Department obviously agrees, making services such as acupuncture, osteopathic manipulation and massage available to its patients in Portland and Falmouth. Capitalizing on the experiences of the MMC Family Practice Department, the MaineHealth Learning Resource Centers have helped create educational experiences for patients and medical providers. Examples of this include the Healthy Beings lecture and television series.
Dr. Craig Schneider has been a key collaborator on the Healthy Beings series. Dr. Schneider is a family practice physician who trained with Dr. Andrew Weil at the nation?s first integrative medicine fellowship at the University of Arizona. He is a graduate of Harvard College, Columbia College of Physicians and Surgeons and the MMC Family Practice residency program. Dr. Schneider is currently the Director of Integrative Medicine at the MMC Family Practice Residency Program, a Clinical Assistant Professor for the University of Vermont College of Medicine and an Adjunct Assistant Professor of Community and Family Medicine at Dartmouth Medical School. We recently spoke with Dr. Schneider about his experiences in Integrative Medicine.
How did you become interested in integrative medicine?
Dr. Craig Schneider (CS): College coursework in medical anthropology and Tibetan studies led to an experience working closely with a Traditional Tibetan Medicine Doctor in the Himalayas. In addition to the beauty of the culture, I found it fascinating that local people would skillfully choose when to utilize Tibetan medicine, Indian Ayurvedic medicine or Western medicine. For instance, their experience led them to favor Western medicine for many acute problems, Tibetan medicine for things like osteoarthritis, and Ayurvedic remedies for certain forms of hepatitis.
What type of training does a doctor who practices integrative medicine have?
(CS): Because this field is still emerging there is no nationally recognized certifying body. These physicians should be licensed and well-trained in their area of conventional medicine and have dedicated substantial time and energy to acquiring knowledge and skills in complementary medicine. My training included a 2-year fellowship at the Program in Integrative Medicine at the University of Arizona under the direction of Dr. Andrew Weil and the Department of Internal Medicine.
Do you work with other types of health care providers when treating patients?
(CS): Yes. As a primary care provider I work with the breadth of both conventional and alternative medicine providers. As a consultant in integrative medicine, people are referred to me by their primary care physicians for further work in this area.
Is there insurance coverage for complementary medicine?
(CS): As a board-certified Family Physician trained in integrative medicine, my services are covered. Insurance reimbursement for complementary medicine varies greatly by insurance plan. I suggest people call their carriers to find out what is covered and let them know what they desire.
What type of research is there to support the use of complementary medicine?
(CS): There are thousands of peer-reviewed studies available, but unfortunately the quality of much of the early work is not adequate to make firm conclusions. More recently designed studies are better, but there are challenges beyond those faced in designing drug studies. For example, what is an adequate control [comparison group] for acupuncture? For prayer? Often multiple therapies and approaches are utilized concurrently when taking an integrative approach and it is extremely complicated and expensive to study such interventions. This does not mean that it cannot be done, and the field of integrative medicine is busy doing this, largely supported by the NIH. My hope is that there will be more of a focus on patient oriented evidence that matters (POEMS).
Are there patients or conditions that complementary medicine is not suited to?
(CS): The field is so broad that certainly some people would want to avoid some therapies. Working with a practitioner who is knowledgeable of both conventional and complementary medicine is an appropriate way to determine which therapies are most likely to be safe and helpful in any individual situation.
Can you give me a little background on integrative medicine at MMC?
(CS): For years nurses at MMC have provided access to a number of complementary medical services such as therapeutic touch and stress reduction. In 2001, the Department of Family Medicine was awarded a grant from the National Institutes of Health (NIH) to develop a curriculum in complementary and integrative medicine for resident physicians. In addition to enhancing resident, attending and staff knowledge in this area, several services have been added, including acupuncture, osteopathic manipulation, mindfulness-based stress reduction and more.
Describe the work you have done with the MaineHealth Learning Resource Centers.
(CS): Collaborating with the Learning Resource Centers has been incredibly rewarding. Together we have focused on educating the public and healthcare students about integrative medicine. We have expanded the Healthy Beings lectures, developed TV programming and educational resources in our waiting rooms, and brought together students of medicine, osteopathic medicine, nursing and physician assistants to explore integrative medicine. We are also working together to develop a brochure that will make it easier for people to recognize and access the diverse integrative medicine services available throughout MMC. [Copies of this brochure are available by calling 207-781-1730.]
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