Summary: The publication by the Bravewell Collaborative of Integrative Medicine in America: How Integrative Medicine Is Being Practiced in Clinical Centers Across the United States proved successful in generating substantial media attention for the emerging field. Yet the report looked only at the services in 29 clinics sponsored by health systems. Most are associated with academic health centers. However, the vast majority of consumer experience of "integrative medicine in America" is through community-based practices of holistic and integrative medical doctors, naturopathic doctors, functional medicine practitioners, holistic nurses, board scope chiropractors and others. Does this report correctly represent the field? Does it misrepresent? What would be different if a report focused on community-based practices? All responses will be included in an Integrator forum.

Would you, as an integrative practitioner, guess that academic medical and other health system-sponsored "integrative medicine clinics" reflect the typical, community-based practice of integrative medicine?

Bravewell's landmark 2012 report: But does it report what it claims?

Consider the question differently: Do you think a consumer or policy maker would get an appropriate sense of "integrative medicine in America" by examining what mainly academic medicine-sponsored clinics provide?

A fascinating new report suggests that you and the consumer should anticipate significant equivalence. The intriguing and useful document is entitled

The centers selected to be surveyed were those that provided an integrative model in which conventional medicine plays an essential role. While these centers do, to some extent, provide care drawn from other health systems - including naturopathy, chiropractic, Traditional Chinese Medicine, Ayurveda, or homeopathy - centers whose sole orientation is to deliver healthcare from these non-conventional medical systems were excluded. The authors acknowledge that the responses may have been different if another cohort of centers was surveyed.

Naturopathic physicians (NDs) are trained to provide primary care and/or naturopathic specialty care to patients of all ages. NDs see patients with acute and chronic conditions and employ all standard conventional diagnostic tools including physical examination, laboratory tests, and imaging. NDs may utilize additional physical and laboratory procedures to assess nutritional status, metabolic function, and/or toxic load, while considerable time may also be spent assessing mental, emotional, social and spiritual status to assure any treatment plan is comprehensive.

NDs use a variety of therapies to promote health and treat disease including: dietetics, therapeutic nutrition, botanical medicine, physical medicine, naturopathic manipulative therapy, lifestyle counseling, exercise therapy, homeopathy, psychological and family counseling, and hydrotherapy. NDs can perform minor office procedures appropriate to a primary care setting, administer vaccinations, and prescribe most standard drugs when indicated. Like other primary doctors, NDs delegate to nurses and medical assistants and refer to specialists when appropriate.

The financial energy behind the movement for IM in academic health centers