CHAPTER 44
Integrative Medicine
Marty Martin
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INTEGRATIVE MEDICINE (IM), THE evolutionary movement of complementary and alternative medicine (CAM), is growing in popularity in all types of health-care settings. This chapter is one of the first explorations—if not the first—of how CAM services might be integrated into the urgent care setting. The Affordable Care Act has served as a catalyst for a focus not only on wellness and preventive health but also on alternative delivery models like accountable care organizations. This chapter outlines the view that CAM and IM should have their own place within all urgent care centers, and it highlights 10 urgent care centers across the United States that have made CAM part of their business models. Allow these illustrations to serve as inspiration, a basis for a best practice, or simply a demonstration of today’s reality that CAM can be successfully incorporated into urgent care if we are willing to travel the more innovative route.
Before describing how such an integration can be undertaken, we must first define CAM. According to the National Center on Complementary and Alternative Medicine of the National Institutes of Health, CAM includes “…those medical systems, professions, practices, interventions, modalities, therapies, applications, theories, or claims that are currently not part of the dominant or conventional medical system.”1
Specific CAM practices include natural products (most of which are regulated as dietary supplements); mind–body practices like yoga, tai chi, and meditation; manipulation and body-based medicine, including chiropractic and massage therapy; energy medicine (e.g., Reiki); and whole systems of healing like naturopathy, homeopathy, traditional Chinese medicine, and Ayurveda. But even if you do not provide any of these CAM modalities, your urgent care center can still embrace an IM perspective.
Providing specific modalities such as acupuncture or homeopathy in your center is one approach to employing CAM practices. There is another approach, however, one which dates back to George Engel’s biopsychosocial model (1913–1999) of illness and disease and embraces tools such as assessment, treatment, and health promotion, the underlying core characteristics of CAM.
Views expressed about CAM often end up as ideological debates rather than attempts to see CAM from a business perspective. In the field of urgent care, as in any area of business, a good plan must address four basic questions:
Is there a growing market for this service?
Is there a way to make sustainable revenue from this service?
Is there a way to differentiate your business from others in the same industry?
Are there any risks to providing or not providing this service?
You may be surprised to learn that the answer is yes to all four questions, as illustrated in the following examples from actual urgent care centers. Use these questions as a guide, and allow your responses to help you make a strategic decision about whether including CAM in your center is the right thing to do.
There is definitively a market for CAM services. Table 12