Heroes Not Zombies

What is “integrative care”?

This is a term which is being used more widely in recent months and many times it seems to be used interchangeably with “integrated care” (or “integrated medicine”), so what is it? And are they both the same thing?

From what I can see different people use these phrases different ways, so let me just explain what it means where I work. I work in the “Centre for Integrative Care. Glasgow Homeopathic Hospital”. Those are the titles fixed to the front wall of our building, and they’ve been there since this hospital was built just over a decade ago.

What we mean by “integrative care” is an intention to support and develop greater integration in a patient. If we think of health as being a state of wellbeing and good function of the whole person, we can think of such a state having certain qualities. These include all the bits working well together! We call that “coherence”, but sometimes, I think the metaphor of “flow” is a better one – it’s where not only does everything flow well, but the person has an experience of “flow” (Csikszentmihalyi).

If we think of any organism as being a “complex adaptive system” then we can conceptualise an idea of health as a state of optimal self-organisation – that’s maximal integration.

So, “integrative care” is an intention. It doesn’t specify a treatment or procedure. The question is, does this consultation, or treatment, increase integration? Does it, in other words, promote healing? You’d be surprised how little health care is directly intended to promote healing (rather, most biomedical health care is focused on “disease management”)

“Integrated care” on the other hand, tends to refer to the bringing together of “orthodox” and “alternative” treatments. The “Royal London Hospital for Integrated Medicine” is an example of that type – they seek to blend “mainstream” and “complementary” medicine. Terms such as “alternative”, “complementary”, “mainstream” and “orthodox” however, are social constructs, determined by whoever happens to be in a place of authority in a society at a particular time. “Complementary” treatments may, or may not, promote greater integration.