Why I Practice Pediatric Integrative Medicine

2/25/2008

A physician who practices integrative medicine works in partnership with his patients, using his or her scientific knowledge and clinical experience to find the best conventional and alternative therapies to treat a particular individual. It’s a method of practice that considers a person as a whole---looking not only at the mechanics of the body but also at the influences of mind, emotion, family, and physical and cultural environment. Many doctors intuitively practice this way, and I truly believe it is the way all medicine will be practiced in the future.

The foremost proponent of Integrative Medicine in this country is probably Andrew Weil M.D. When I first decided to learn more about botanical remedies, mind-body techniques, and other forms of alternative medicine, I turned to his books, and attended training and conferences with him. The principles that informed his practice soon informed my own as well.

In our book Healthy Child, Whole Child, we devoted an entire chapter to integrative medicine as it applies to pediatrics. Let me distill the basics for you:

• Support for the natural healing processes of the body.
• Focus on identifying the underlying causes of a problem rather than just treating its symptoms.
• Recognition of the constant interaction between body systems, and the influence of emotions, thoughts and attitudes, and environment on health.
• Strong emphasis on lifestyle choices to prevent or treat medical conditions.
• Customization of treatment to the individual.
• Preference for gentle and low-cost therapies over invasive, unnecessary, or expensive ones.
• Knowledge of alternative medicine and when and how to use these approaches and practitioners with conventional therapies.
• A partnership in which the doctor offers his or her knowledge, experience, and advice, and the patient offers both the facts and his instincts about the problem, and whatever ideas or research he has collected.
• Concern for the long-term effects of treatment on a child’s developing systems.

These principles shape the way I approach most issues that come up in my pediatric practice, and have made my professional life far more rewarding than I ever imagined.

An example of integrative pediatrics in action might be the challenge of recurrent ear infections. Constrained by time, many doctors just dole out antibiotics with each new attack, gradually moving to higher doses and stronger, more widely targeted drugs. An integrative approach is quite different. I may suggest using pain-relieving eardrops or an herbal extract of garlic and mullein, but except for certain specific situations, I don’t start with antibiotics. Most ear infections heal on their own, and many of them are caused by viruses, which aren’t affected by antibiotic drugs. If an infection doesn’t clear on its own in a few days, then it’s time for a simple, cheap, narrow-spectrum antibiotic like amoxicillin.

With the acute situation dealt with, I confer with parents and often the patient herself about the cause of the recurrent ear problems—could it be something in the diet, a food allergy, some environmental irritant, or an underlying condition like gastroesophageal reflux? Together we work out to identify and eliminate whatever’s triggering the infections. This parent-practitioner partnership should be one of mutual trust and openness with everyone working for the best interests of the child.

I truly believe that many pediatricians practice integrative medicine, though they may not call it that. It was pediatric oncologists, after all, who were among the earliest advocates for integrating alternative therapies such as guided imagery, biofeedback, self-hypnosis, massage, and music and art therapies into conventional cancer care.