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Exploring the role of integrative medicine in treating chronic health conditions

Ten years ago, Sangeeta Agarawal was a busy software engineer in Silicon Valley. Her lifestyle led to professional success, but eventually work-related stress began to take a toll on her health and she was diagnosed with a series of chronic health problems. She was able to maintain a facade of "being okay" on the outside, but Agarawal said she was "in pieces" on the inside. When her physician brought up the possibility of spinal surgery, she knew that something had to change -- and a referral for physical therapy from her physician led her to yoga, ayurveda and eventually her life's path. “Within a few years, I was a nurse. I was an ayurveda practitioner. I was a yoga teacher. I started to collect these credentials… and that was when I realized it was all about treating the whole person,” she said. 

The founder of health startup Helpsy, Agawaral spoke as part of Sunday's panel at Medicine X on integrative medicine's role in treating chronic health conditions.

The 45-minute panel featured a lively and wide-ranging discussion, with all panelists acknowledging integrative medicine's potential to help those struggling with chronic health conditions. But what exactly does integrative medicine mean?  Victoria Maizes, MD, executive director of the Arizona Center for Integrative Medicine, clarified that it isn't alternative medicine -- but rather an approach that integrates complementary modalities with mainstream medicine. "We really respect Western conventional medicine," she explained. 

Maizes also stressed that integrative medicine is about more than just tapping into ancient traditions like acupuncture, ayurveda and yoga -- that it's also very much about moving into the future. "Which means we think a lot about genomics. We think a lot about the microbiome... It’s really integrating cutting edge science as well."

Stanford psychiatrist David Spiegel, MD, medical director of the Center for Integrative Medicine, brought up the fact that the desire for more integrative medicine is being driven by patients: "This isn’t a profession-driven movement. It’s a person-driven movement." He told the audience that patients "don't go to an acupuncturist for a heart attack. They go for chronic pain, stress and other things we have not dealt with well in mainstream medicine." He also spoke about the importance of integrative medicine in treating the mental-health issues that often come along with chronic health conditions; it can provide "help with coping with the disease, not just help with the symptoms." In fact, he explained, for this reason “integrative medicine becomes the default referral from oncology.”

Jeffrey D. White, MD, addressed the importance of research for evidence on many of these modalities: “Ideally integrative medicine ought to be based on as high level of evidence as mainstream medicine." Gabriel Lopez, MD, medical director at the MD Anderson Cancer Center's Integrative Medicine Program, agreed and pointed out that research can not only prove efficacy but also help integrative medicine gain further acceptance. “Research is one key way of getting sufficient info to support some of these unique practices to then allow them to enter into the mainstream," he said. 

What of the potential risks associated with the different modalities of integrative medicine? Geri Lynn Baumblatt, executive director of patient engagement at Emmi, told panel attendees, “One of the risks? Emptying your pocketbook. Many of these things are not covered." Maizes echoed this sentiment, telling the audience, “we could advocate to have this kind of care covered, considering how many Americans really want it." 

Spiegel referred to an earlier panel at Medicine X on the opioid crisis and noted that "in an era when we're realizing that some of our mainstream treatments are causing as many problems as they're solving... it's time to look into new options." 

Previously: The opioid crisis: Medicine X panelists explore the complexity of managing chronic pain and Medicine X, the academic conference where "everyone is included," returns
Photo of Sangeeta Agarawal (left) and fellow panelists courtesy of Stanford Medicine X

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