When Dr. Victoria Maizes started practicing medicine in northern California, it was not unusual for patients to ask her about complementary medicine — that is, combining conventional medicine with non-mainstream approaches to treatment, such as diet, exercise, pain management and meditation.
Now more patients are asking their physicians the same kinds of questions they asked Maizes 30 years ago, and thanks to that growing interest in complementary medicine, the field of integrative medicine was born.
Faculty at the University of Arizona Center for Integrative Medicine, or UACIM, and their collaborators successfully demonstrated the feasibility and effectiveness of an online approach to train more family-medicine residents in integrative medicine.
The American Board of Physician Specialties defines integrative medicine "as the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, health care professionals and disciplines to achieve optimal health and healing."
Effective online training in integrative medicine is important, given the increased demand for physicians with expertise in integrative medicine coupled with the call from medical and public health organizations for alternatives to traditional medical approaches to such matters as pain management.
With that in mind, Dr. Patricia Lebensohn, professor of family and community medicine at the UA College of Medicine – Tucson, directed the development of an Integrative Medicine in Residency Program, or IMR, a robust, online curriculum with the aim of establishing integrative medicine as a routine part of family medicine residency education throughout the country.
An in-depth evaluation of the project and its results was published in the July-August 2017 issue of the journal Family Medicine.
The study tested a 200-hour online curriculum at eight sites offering integrative medicine residencies across the United States. Study subjects included 186 family medicine residents who participated in the IMR and 53 residents in other programs without integrative medicine training who served as controls.
Of the 186 IMR residents, 77 percent completed the program and tested significantly higher in their medical knowledge of integrative medicine than the control residents.
"Despite how busy the residents were, there was a very high completion rate," said Maizes, executive director of UACIM. "The level of knowledge improves in those who complete the curriculum and doesn't change in those who don't."
"I am pleased with the results of the residents' evaluation of the high clinical utility of the curriculum and the ease of navigating the online delivery," Lebensohn said. "Most of the residents in an exit survey stated that they intend to utilize integrative medicine approaches in their future practice of family medicine.
"Family medicine is the natural place where everything is integrated: the mind, the body, the social determinants of health. They all play a role."
Said Maizes: "When we started this study in 2008, it was a novel idea to deliver common curriculum online across eight sites. This curriculum is now shared at 75 residencies and has expanded well beyond family medicine. We started with this project in family medicine. Now we're in pediatrics, internal medicine, preventive medicine and we have a pilot program in psychiatry."
Additional study authors included Audrey J. Brooks and Paula Cook at the UA; Dr. Benjamin Kligler, Icahn School of Medicine at Mount Sinai; Dr. Raymond Teets, Albert Einstein School of Medicine, New York; and Dr. Michele Birch, Carolinas Medical Center, Charlotte, North Carolina.