Integrative Medicine: Evolution, Principles, and the Healthcare Crisis

Flashcards covering key concepts from the lecture notes on integrative medicine, CAM modalities, mind-body connections, and evidence-based evaluation.

What does Salutogenesis describe in integrative medicine?

The factors that make people healthy rather than the factors that make them sick.

What are the approximate 2016 U.S. healthcare statistics cited (per person cost and total spending)?

About $10,000+ per person and a total of around $3.4 trillion.

What is the No.1 reason Americans use CAM according to the notes?

Pain.

What percentage of Americans use CAM, as mentioned in the notes?

Approximately 40%.

Name major CAM family members listed in the notes.

Traditional/Oriental Medicine (TCM, Korean, Japanese), Other Traditional Medicine (Ayurvedic, Native American), Manipulative Therapies (Massage, Chiropractic, Osteopathy), Herbal Medicine & Dietary Supplements, Naturopathy, Homeopathy, Mind/Body Medicine, Energy Medicine, Spiritual Healing.

Who founded Osteopathy and in what era were the founders active?

Andrew Taylor Still, M.D. (1828–1917).

What are the core Osteopathy principles summarized in the notes?

Each person is a unit of mind, body & spirit; self-healing and self-regulating; structures and functions are interrelated and interdependent; neuro-musculoskeletal system is integral to most pathophysiologic processes.

How does the notes describe the philosophy of Health vs Disease in Osteopathy?

Health is a natural state of harmony with normal flow of body fluids and nerve activity; illness is often caused by mechanical impediments to that flow.

What is the somato-visceral interaction described in the notes?

An emerging area of biomedical research exploring how somatic structures (like the musculoskeletal system) interact with visceral organs.

What is the scope and some privileges of Doctors of Osteopathy (D.O.s) in California?

Licensed physicians who can prescribe drugs, perform invasive procedures/surgery, and enter MD residency programs; in CA they are recognized as doctors and can also perform acupuncture without separate licensing.

What does HVLA stand for in Chiropractic care, and what is a key study finding about it?

High Velocity Low Amplitude thrusts; a study found HVLA is not more effective than placebo for back pain.

What is the Chiropractor’s history with the concept of subluxation?

Subluxation is a central chiropractic concept describing a misaligned/dysfunctional spinal segment that may alter neurological function; its mainstream scientific support is limited.

Who started chiropractic and in what year?

Daniel David Palmer, in 1897.

What controversy involved the American Medical Association (AMA) and chiropractic?

AMA formed a Committee on Quackery in 1963 to contain/eliminate chiropractic and labeled it unscientific; resolved after an antitrust case in 1987.

What are the six core principles of Naturopathy listed in the notes?

Healing power of nature; First do no harm; Identify and treat the cause; Doctor as teacher; Prevention; Treat the whole person.

How many states license naturopathic doctors, and how is licensure described in California?

Licensed in 13 states; California recognizes NDs as doctors and has a licensing program, though not strictly required in practice as a naturopath.

What is the general naturopathic education path described?

Four-year postgraduate medical school, two-year clinical internship, pass Science and Clinical Board exams; rigorous study in basic medical sciences, diagnosis, labs, pharmacology, and natural therapeutics.

What is the naturopathic scope of practice?

Primary care doctor, diet/lifestyle advice, diagnostic services, collaboration with other providers; may prescribe vitamins/minerals, herbal medicines, and bio-identical hormones.

What is the basic principle of Homeopathy?

Like cures like: substances that induce disorders in healthy people are used to cure similar disorders in sick people; based on the law of similars.

What are key critiques of homeopathy mentioned in the notes?

Dynamization/dilution can leave no molecules of the original material (Avogadro’s number); water memory is questioned; clinical trials have not definitively shown superiority to placebo; regulatory standards differ.

How does Traditional Chinese Medicine (TCM) differ from Western medicine in delivery and visit length?

TCM is delivered by Oriental Medicine Doctors and licensed acupuncturists; Western medicine by MDs; visits are often longer (TCM ~30 minutes vs Western ~10 minutes).

What are Qi and meridians in TCM?

Qi is an immeasurable vital energy that flows through meridians to nourish the body; balance of Qi is associated with health.

Name some Qi-enhancing therapies in TCM.

Herbal medicines, acupuncture/acupressure, moxibustion, and qigong.

What is TIM/Ayurveda’s fundamental philosophy regarding healing?

Life wisdom (Ayurveda) and Yoga: union of body and mind; harmony between cosmic intelligence, ego, and self-consciousness; TIM aims to maintain this harmony.

What are the core TIM principles related to basic matter and nonmaterial qualities?

Based on the five elements (Earth, Water, Air, Fire, Ether) and the three gunas (Sattva, Rajas, Tamas); also Fire (Agni) and Soma, plus Naari channels.

What are some maintenance practices in TIM for health?

Fellowship (Saat sang), service with love (Seva), study (Saadhya), meditation (Saadhana).

What is Evidence-Based Medicine (EBM) and its Gold Standard?

EBM emphasizes funded research and peer-reviewed publication; the Gold Standard is the Randomized Controlled Trial (RCT).

What FDA-related topics and challenges are noted about clinical trials?

FDA phases of drug development (Pre-Clinical, Phase 0-4); not all Phase 3 trials succeed; politics vs science vs business; off-label use and dietary supplements issues.

What are common pitfalls in EBM highlighted in the notes?

Expert pronouncements, misleading placebo effects, trivial but statistically significant results, generalizability issues, and power concerns.

What is the difference between placebo effect and placebo response?

Placebo effect refers to the physiological changes that occur; placebo response is the overall physiological changes in subjects responding to placebo in a trial.

Approximately what fraction of a positive therapeutic response is attributed to the placebo effect, per the notes?

About one-third (roughly ~1/3) of the positive response.

What factors contribute to the placebo effect beyond the treatment itself?

Natural history, regression to the mean, bias, conditioning, patient expectations, and the consultation context.

What autonomic nervous system mechanisms are involved in mind-body connections?

Sympathetic (fight/flight) and parasympathetic (relaxation) pathways, plus the HPA axis (hypothalamus-pituitary-adrenal) and cortisol.

What sleep-related effect on inflammation is noted?

Sleep deprivation increases inflammation and impairs brain function, mood, and cognitive performance.