It is a common observation that the Western medical system has some serious flaws, if not completely broken. The fact that we keep increasing “health” spending (actually disease management) while actual health suffers is more than ironic. It is depriving many of quantity and quality of life while also bankrupting countries paying for the care. In my 8,000 hours of medical training after undergraduate studies, I learned how to treat disease, not promote wellness. The emphasis on prescription drugs and high volume clinic schedules are unfortunate realities. There is rarely time or training to consider root causes of disease and offer therapies that prevent and reverse the major chronic disease. A popular analogy is that the current medical system cares for people after they have fallen off a cliff, meeting them below all bruised and fractured. Root-cause medicine, as practiced under various titles, aims to put up a fence around the cliff’s edge to prevent the original injury. That fence consists of therapies focusing on nutrition, sleep, stress, fitness, hormonal imbalance, toxicity, infections, and other correctable sources. A consumer looking for this approach might easily be confused by a variety of terms used to describe the “fence-builders”. A look at these terms reveals more commonalities than differences.
1. Integrative Medicine (IM)
The Academy of Integrative Health and Medicine explains that the field of integrative care reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and professions to achieve optimal health and healing. Simply put, IM offer best practices for optimal health and healing. The organization offers education, annual meetings and a fellowship that has been recognized and approved by the American Board of Integrative Medicine.
A further explanation is offered that clarifies this approach. It is explained that alternative medicine was a term used to express approaches outside of conventional medicine Then complementary and alternative medicine (CAM) became the preferred term. Integrative medicine is a newer term that emphasizes the integration of CAM and conventional medicine and is now preferred. One example is the department at Duke University of Integrative Medicine. They express that IM is grounded in the definition of health as a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. The goal is to understand the patient’s unique set of circumstances and address the full range of physical, emotional, mental, social, spiritual, and environmental influences that affect health. All causes of illness are addressed. They list the defining principles of IM as:
1) The patient and practitioner are partners in the healing process.
2) All factors that influence health, wellness and disease are taken into consideration, including body, mind, spirit and community.
3) Providers use all healing sciences to facilitate the body’s innate healing response.
4) Effective interventions that are natural and less invasive are used whenever possible.
5) Good medicine is based in good science. It is inquiry driven and open to new paradigms.
6) Alongside the concept of treatment, the broader concepts of health promotion
2) Anti-Aging Medicine (AAM)
According to a large, international organization, AAM is the pinnacle of biotechnology joined with advanced clinical preventive medicine. The specialty is founded on the application of advanced scientific and medical technologies for the early detection, prevention, treatment, and reversal of age-related dysfunction, disorders, and diseases. It is a healthcare model promoting innovative science and research to prolong the healthy lifespan in humans. As such, anti-aging medicine is based on principles of sound and responsible medical care that are consistent with those applied in other preventive health specialties. The anti-aging medical model aims to both extend lifespan as well as prolong “healthspan” — the length of time that we are able to live productively and independently.
Anti-aging medicine includes the following pillars:
1) It is scientific. Anti-aging diagnostic and treatment practices are supported by scientific evidence and therefore cannot be branded as anecdotal.
2) It is evidence-based. Anti-aging medicine is based on an orderly process for acquiring data in order to formulate a scientific and objective assessment upon which effective treatment is assigned.
3) It is well-documented by peer-reviewed journals. As of this writing, the National Library of Medicine hosts more than 3,000 peer-reviewed articles on the subject of anti-aging medicine.
The Metabolic Medicine Institute (MMI) provides a comprehensive educational framework of online courses and live conferences that teaches the knowledge and skills required to become a successful practitioner of Metabolic, Preventive and Integrative Medicine. Over 250,000 professionals have participated in live or online courses. The goal of the MMI trained professional is to become the standard for the wellness-oriented provider — one deeply grounded in systems biology and advanced methods of care — yet connected to the individuality and uniqueness of the patient. have international training programs for health professional that have continuing medical education hours (CME) approved and offer certifications of competence. With affiliations with the University of South Florida Morsani School of Medicine and Georgetown University School of Medicine, advanced degrees at the level of Masters and Ph.D. can be awarded with appropriate training. A database of health care providers practicing AAM is maintained on their website.
Another resource for education and practitioners is the American College for Advancement in Medicine. This group offers conferences throughout the year and has a database of healers to search. This group is known for its efforts to promote the health benefits of chelation therapy and certifies health care professionals in this therapy enjoying increasing research support and attention.
3) Holistic Medicine
According to the Academy of Integrative Health and Medicine, holistic medicine is the art and science of healing that addresses the whole person — body, mind, and spirit. The practice of holistic medicine integrates conventional and alternative therapies to prevent and treat disease, and most importantly, to promote optimal health. This condition of holistic health is defined as the unlimited and unimpeded free flow of life force energy through body, mind, and spirit.
Holistic medicine encompasses all safe and appropriate modalities of diagnosis and treatment. It includes analysis of physical, nutritional, environmental, emotional, spiritual and lifestyle elements. Holistic medicine focuses upon patient education and participation in the healing process.
4) Functional Medicine (FM)
As defined by the Institute of Functional Medicine, FM addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. It is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, FM addresses the whole person, not just an isolated set of symptoms. Functional Medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, FM supports the unique expression of health and vitality for each individual.
The Institute of Functional Medicine or IFM offers regular training courses on various topics with CME hours. Paths can be pursued to achieve certification as a FM practitioner. A database of health care professionals that practice FM is maintained on their website.
5) Lifestyle Medicine (LM)
According to the American College of Lifestyle Medicine, LM involves the therapeutic use of lifestyle, such as predominantly whole food, plant-based diet, exercise, stress management, tobacco and alcohol cessation, and other non-drug modalties, to prevent, treat, and reverse the lifestyle-related, chronic disease that’s all too prevalent. The organization goes on to indicate that LM is the evidence-based practice of helping individuals and families adopt and sustain healthy behaviors that affect health and quality of life. Examples of target patient behaviors include, but are not limited to, eliminating tobacco use, improving diet, increasing physical activity, and moderating alcohol consumption.
LM practices and health habits are among the nation’s most important health determinants. Changing unhealthy behaviors is foundational to medical care, disease prevention, and health promotion. The physician’s trusted relationship with the patient, with the support of the family, an interdisciplinary team and the community, is key to improving health behaviors and outcomes. At the present time there is no board certification in LM, there are many educational opportunities for health care providers and an annual conference. There is also a directory of LM practitioners.
6. Plant-Based Medicine (PBM)
The new kid on the block in some sense is the practice of medicine centered on a plant-based, usually whole food, vegan diet. The emphasis is on single ingredient whole foods like fruits, vegetables, legumes and whole grains. In some sense, this diet goes back biblical days pre-Noah and the Book of Daniel, but has become a focus on research and the public eye in the last 60 years with the publications of Lester Morrison, MD, Nathan Pritikin, Dean Ornish, MD, Caldwell Esselstyn, MD, Neal Barnard, MD, John McDougall, MD, Joel Fuhrman, MD, T. Colin Campbell, Ph.D., and other pioneers in the field of PBM. There is newly formed organization dedicated to this approach to medical care and wellness (www.plantricianproject.org) that hosts and annual conference that has grown rapidly in size (http://pbnhc.com). The organization also hosts a site to search for a doctor familiar with PBM. The vision statement by the organization is “a nation — and world — in which the vast majority of physicians and healthcare professionals have experienced the dietary paradigm shift, enthusiastically embracing the health-protecting power of plant-based nutrition; in turn, effectively promoting patient and client adoption of a predominantly whole food, plant-based (WFPB) lifestyle. The vision is promoting sustainability of human health and the healthcare system, while producing meaningful progress toward the big picture of global sustainability”. Powerful stuff that is becoming a reality as some medical school curriculums introduce cooking classes and education on the data for PBM.
Which of these 6 styles of advanced medical care is best for you may take some study and consideration but there are many commonalities. Lengthy history taking from pre-natal experiences on are often part of the examination. Advanced laboratory testing emphasizing nutrition, occult infection, toxicity and hormonal function. Education on diet, sleep, stress, detoxification and hormonal balance is common often combined with some nutraceutical support. A common emphasis on whole foods, high or exclusively plant-based in the PBM discipline, is found. I have participated in activities with LM and FM but have focused on AAAM and PBM. I was awarded a certification in Metabolic Cardiology by the University of South Florida and MMI, the first physician in the world to achieve that. In addition, I have chosen a whole food vegan diet for 40 years and lecture at the annual conference of the Plantrician Conference. I describe my practice as LIVe cardiology: Lifestyle, Integrative and Vegan. Rather than a pill for every ill in the traditional medical model, offering the tools of self-empowerment for healing is the most powerful therapy that exists. The knowledge that over 90% of chronic diseases derive from lifestyle choices and habits that can be modified to prevent or reverse disease is the key to open the gates of wellness and fence building