Integrative health: An avenue to explore within the health care system?

Below is the english version of the full article that appeared in the Fall 2022 issue of Mieux-Être magazine.

At a time when the Quebec health care system is undergoing a priority reform, considering the philosophy of the Integrative Health concept no longer seems so surprising: the consumer of health care is and will be called upon to have an active part in his or her care and healing process; moreover, Integrative Health is already widely accepted, and its therapies are already integrated within international health care systems.

Indeed, the concept of integrative health has evolved significantly from that timid name of “alternative medicine” in the 1970s. As a physician, I have witnessed this more than positive evolution over the last fifty years, both in my own practice and in the practice of my peers, as well as in certain experiences.

My first discovery of integrative health and its benefits

At the very beginning of my medical practice, I had to become aware of the essence of this paradox that places us between science and the healing process. Obviously, the medical context obliges us to practice according to so-called evidence or scientific data. However, I have observed a series of clinical situations that have improved with other interventions that did not have the scientific rigor required within my profession.

Theo’s Case

One of the first cases in my practice was that of Theo

Theo, 64 years old, had consulted several times the doctor who had preceded me in the medical clinic, for fatigue, muscular pains, insomnia, “mal de vivre”, breathlessness…

This same doctor had performed a basic investigation, a normal procedure for the time.

Theo came into my office and told me that the doctor before me had cured him of lung cancer. I see upon reviewing the file that this doctor falsely told him, without clear evidence, that he had cancer! Then, he promised him a cure by installing vitamin solutions at home! And I answer him: “Theo, you never had lung cancer… He answers: “my young man, you’d better go back to school, I’m better since this treatment”.

Without endorsing the approach of the doctor who preceded me, I see that the improvement of his health condition does not respect the evidence. I decided at that time to undertake a quest to better understand this complex healing process and to explore the concepts emerging at the time of functional medicine, that is, a patient-centered medical approach.

In search of the concept of global health

After training in Chinese medicine and acupuncture, I obtained a D.O. in osteopathy and continued with three courses in homeopathy at the Centre d’Enseignement et de Développement en Homéopathie (CEDH), founded in 1972 in France 1. At the very end of this process, always with the aim of understanding this strange quest for the healing process, I became interested in the way the First Nations traditionally heal. You will understand that my goal was not to practice all these approaches at the same time. It was rather to better understand the possible integration of this healing process in the health system and to develop its usefulness in the care protocols. All these educational courses took place within the modest background of clinical research through my medical practice. And, at the end of my training, I developed the concept of global health.

Taking care of the patient in integrative health

The principle of the concept of global health is very simple: the patient who consults me reports one or more symptoms. I then proceed with the medical examination and the relevant investigation and prescribe the required medical treatment. However, I also ask questions about the patient’s diet, stress management, physical exercise program, environment, and the meaning of life (spirituality). These last two aspects are rather unusual in classical medical investigation.

Different complementary approaches used

Depending on the case, integrative medicine approaches can be suggested: acupuncture, Chinese medicine, manual medicine, massage therapy, phytotherapy, aromatherapy, relaxation methods, etc. And, following the 2014 reflection of Beth Rosenthal, PHD – MBA, an international luminary in integrative medicine, evidence with emerging practices should be promoted and considered. This brings us right into the concept of integrative medicine. According to Rosenthal, it is important that there be a safe combination of conventional and complementary therapeutic approaches in care plans.2

Within the concept of integrative medicine, there is a respect for culture that takes hold. For example, the West Asian community has its own unique needs and different health expectations. At the 72nd WHO Congress on May 21, 2019, a communiqué was issued that called for the monitoring of integrative medicine practices in 179 participating countries.3 Integrative medicine must therefore increase its evidence base.

Interprofessional collaboration on the agenda? Yes, but…

In addition, interprofessional collaboration must be meaningful, but there is a pitfall: this collaboration must be between members of professional corporations, especially for physicians who, according to their code of ethics, must refer to therapists who are members of recognized professional orders.

A university program on integrative medicine? Why not?

Set against this background, I consider that the concept of integrative medicine would benefit from being taught at the University in health sciences. Then it should be seriously considered, without distorting it, so that it is recognized and integrated into the health system at its true value, being both preventive and curative. This is an excellent avenue in health care when many well-trained therapists, but still without a professional order, are on the ropes because they have made a health recommendation with the notions of prevention and care V/S the codes of ethics of the professions.

There is therefore a need for the legal integration of therapists who are not members of professional corporations into the health care system with appropriate training

Integrative health course for medical students at Laval University

For several years now, I have been giving a course on integrative medicine to medical students at Laval University (3 hours). The basic concept of all these medicines surprises them because, for example, to make a diagnosis with only the Chinese pulses does not make sense to them. Or taking a product in homeopathic dilution is a placebo.

When we take them to the world of research on approaches, they will be able to see that research on the modulation of cytokines to reduce inflammation is produced with acupuncture treatments. A meta-analysis published in 2018 considers 39 studies involving 20,827 patients who consulted for chronic pain and who received acupuncture treatments, concludes that the effect of acupuncture cannot be explained solely by the placebo effect.  And I only cite these studies as a few examples.  It includes several teams: Swiss, Italian, German, French, Brazilian and Indian. This research has further proven the biological action of homeopathic solutions on cellular, animal and plant models.4

In conclusion

There would definitely be a significant gain for the Quebec health system if integrative medicine were to be integrated and if it were to promote better cohesion among professionals by decompartmentalizing care, teaching and research, which is the trademark of any university program. Let us hope that the best is yet to come…for the health of Quebecers.

 

REFERENCES:

1    CEDH | Accueil

2    Rosenthal, Beth, PHD, MBA, MPH, directeur du groupe “Académie Collaborative for integrative Health Council Medecine integrative, Chea Y, & Al , 2007

3     WHO global report on traditional and complementary medicine 2019, section “Forword”, page 5

4   Olioso D, Marzotto M, Moratti E, Brizzi M, Bellavite P. (2014) « Effects of Gelsemium sempervirens L. on pathway-focused gene expression profiling in neuronal cells.» J Ethnopharmacol. 2014;153(2):535‐539

Marzotto M, Olioso D, Brizzi M, Tononi P, Cristofoletti M, Bellavite P. (2014) « Extreme sensitivity of gene expression in human SH-SY5Y neurocytes to ultra-low doses of Gelsemium sempervirens. » BMC Complement Altern Med. 2014;14:104.

Harrer B. Replication of an experiment on extremely diluted thyroxine and

highland amphibians. Homeopathy, 2013; 102(1):25-303

Jäger T, Scherr C, Simon M, Heusser P et al., Effects of homeopathic arsenicum album, nosode, and gibberellic acid preparations on the growth rate of arsenic-impaired duckweed (Lemna gibba L.). Scientific World Journal, 2010; 4(10):2112-29

Books by Dr. Jean Drouin, dealing with concepts in integrative medicine:

« Guérir sa vie. », Drouin Jean, Éditions  Le Dauphin Blanc, 2006, p.161

« Vieillir en jeunesse. », Drouin Jean, Éditions  Le Dauphin Blanc, 2008, p.117

 

About the author:

Jean Drouin obtained his medical degree from Laval University in 1973, where he now teaches. He is a Clinical Professor in the Department of Family Medicine and a Senior Lecturer in the Faculty of Pharmacy.

Dr. Drouin was head of the family planning clinic at the CHU de Québec from 2001 to 2021. He is the founding chef of the Clinique D’Andropause de Québec and has been in charge of the Colloque en santé de L’homme since 2005.

He has completed training in acupuncture, osteopathy and homeopathy. He acts as an advisor on alternative and complementary medicine for various groups of professionals and he also gives conferences on integrated medicine, in Quebec and abroad.

Dr. Drouin has been practicing private practice since October 2021 in the menopause and andropause sector. He is a health columnist and vulgarizer in the media and is the author of several books.