Integrative Medicine in America—How Integrative Medicine Is Being Practiced in Clinical Centers Across the United States

The impetus for developing and implementing integrative medicine strategies is rooted in the desire to improve patient care. The Bravewell Collaborative, a philanthropic organization that works to improve healthcare, defines integrative medicine as “an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual, and environmental influences that affect a person’s health. Employing a personalized strategy that considers the patient’s unique conditions, needs, and circumstances, it uses the most appropriate interventions from an array of scientific disciplines to heal illness and disease and help people regain and maintain optimum health.” Over the past 2 decades, there has been documented growth in the number of clinical centers providing integrative medicine, the number of medical schools teaching integrative strategies, the number of researchers studying integrative interventions, and the number of patients seeking integrative care. But whether integrative medicine was being offered in the same, similar, or disparate ways was unknown. In addition, while previous studies focused on the prevalence and use of complementary or alternative medicine (CAM) by patients1,2 or by practitioners in hospital settings3 by enumerating the use of single CAM therapies, very little information had been collected regarding the actual practice of integrative medicine, which by definition treats the whole person. In 2011, The Bravewell Collaborative commissioned a survey to determine how integrative medicine was currently being practiced across the United States by (1) describing the patient populations and health conditions most commonly treated, (2) defining the core practices and models of care, (3) ascertaining how services are reimbursed, (4) identifying the values and principles underlying the care, and (5) determining the biggest factors driving successful implementation. Twenty-nine integrative medicine centers and programs across the nation were chosen to participate in the study. This group included the nine centers in The Bravewell Clinical Network plus 20 others that, directed by either a physician, other doctoral level healthcare practitioner, or nurse, were chosen on the basis of length of time in operation (a minimum of 3 years), patient volume, and/or prior clinical contributions to the field.