Using an integrated approach in the treatment of our patients

6 months ago

I’ve recently been going through our patient files as we are scanning notes as we move towards electronic records. It’s been a good reminder for me of the patients that I’ve seen over the years, some that come for a short time for one main issue or problem and others that have come now and then over many years, using us almost like an alternate GP. It has also been a reminder of how patients have seen several practitioners and the benefits to patients and to us as practitioners of several of us working together. While for many patients a single practitioner, who themselves might use several different tools from a therapeutic tool kit, might be enough. For other patients, particularly those with more long-standing and deep-seated issues they benefit from a blend of different treatments. For me this integrating of different approaches is a core part of what has made the practice successful in treating more complex cases and supporting patients over a lifetime of care. For my own patients, it was good to be reminded about how often patients have received and benefited from intercurrent treatment with acupuncture, nutrition, chiropractic or other body work and psychological interventions. 

Several patients I’ve seen recently with quite severe physical symptoms have wondered why I’m interested in their psychological state. Why I might alongside a prescription of natural medicines I’ve recommended they see someone who can focus on psychological support to that might include relaxation techniques, hypnosis, ‘constellation work’ or looking at previous trauma or ongoing relationship or work stresses. A reminder that the fundamentals of a holistic approach is that a disturbance in any one part of the whole can cause dysfunctional in other parts. I rarely see a patient with a physical chronic disease without a psychological component. Likewise I rarely see patients with a long-standing psychological disease without a physical component.

While the mind and body are two parts of the whole, obviously how we live our lives also influences our environment. From our relationships, what we choose to eat, indeed all aspects of how we interact with, and how we influence our surroundings. That’s why we use the term holistic medicine because it reflects the mind, the body and the environment which all are part of who we are and the health issues we are faced with. I often try and gently introduces this idea and invite patients to reflect on their symptoms as, in a way, what is your body trying to tell you. Or another way of thinking about this might be ‘how do you need to change your life style so you don’t need this illness’. Just removing the symptoms isn’t enough, as I sometimes say it’s not about recovery (returning to how you were before) but more discovery, finding a new state of health that doesn’t need the symptoms. We are very supportive of those trying to rebalance the environment but I do think there is a connection between how we treat the world around us environmentally and relationally and our fundamental well-being and health balance. Perhaps some of the work to change our environment needs to parallel the work that has to be done on ourselves. Certainly many common diseases that impact on the patients we see are a pointer to how our lives and environment are out of balance. 

One of the most satisfying aspects of my practice has been treating people over a number of years, decades and life stages. Patients who have used natural remedies for many years often have a high vitality and working to support them feels like we are supporting a natural medicine family.

Another aspect that has struck me while reviewing patients files is how patients management often seems to go in different phases. Sometimes I think of dealing with the most pressing or ‘presenting’ issues as an active phase and then there might be a maintenance phase which is about embedding an improvement. Then something happens at a particular point in time and another more active treatment phase is helpful. Possibly with a different practitioner but always moving patients to a better overall state of health. Given the way medicine is often perceived in this country it is often thought about as a short-term intervention in response to symptoms. For us there is a case to think about health and well-being more as an ongoing tool with which we navigate our choices around activities, relationships, diet and even the environment we create around us.