Integrative Medicine Education, Schools, and Career Overview
Dr. Steven Hall is a pioneer of Integral Medicine. He is a Medical Doctor residency-trained in family practice and is an adjunct professor at an acclaimed university. For over 20 years he has refined his integrative medical practice to incorporate nutrition, herbs, homeopathy, hypnosis, functional medicine, osteopathic manipulation, and Craniosacral Therapy, as well as conventional western medicine. Dr. Hall was gracious enough to speak with Allied Health World to help us gain a deeper understanding of the unique and dynamic world of integrative medicine.
What is Integrative Medicine?
Integrative medicine is the integrated melding of the scientific methods of conventional western medicine with the wisdom, human connectedness, and intuition of alternative healing methods. It was born of the highest ideal: To create and promote healing and sustained wellness by addressing the whole of the human condition and thereby isolating and treating the core issue behind physical ailments, and not just the manifested symptoms. Dr. Steven Hall explains, “Everything has an impact on your health. Even the rock in the field is leaching minerals into the soil, which feeds the plants that you eat. Because the planet is so interdependent like that, everything in your life impacts your health: belief, perspective, language- everything.” He went on to say, “There are certainly valid concepts of healing in conventional medicine. There’s a time and a place for the tools of conventional medicine. And there are a lot of good valid concepts and techniques in the various types of natural medicine. The best thing is to use what’s most appropriate.”
Integrative medicine schools present the idea that the Integral Worldview represents the ultimate in medical integrity because it seeks to define and promote physical, psychological, social, emotional, and spiritual wellness in a collaborative effort between physician and patient. Integrative medicine in practice combines the scientifically substantiated aspects of western medicine with alternative modalities that have been proven effective in bringing about healing and sustained wellness. As Dr. Hall explained, “Integral Medicine has a home in it for every valid concept that we know about healing. It’s a way to seamlessly combine the best of what we know about natural medicine, with the best of what we know about psychology, environmental medicine, and conventional medicine.”
Dr. Hall elaborated on what is at the very hart of this groundbreaking approach to medicine: “Integral Medicine is much more than just a combination of conventional and alternative medicines. It is a system of medicine based on two main observations: First, everything and anything in your life; such as diet, exercise, work, beliefs, attitudes, the environment, and your family, exerts some influence upon your health. Therefore, we need a medicine that is based on a broad science that can take all of these factors into account, as opposed to a medicine based on a narrow science of only the physical. Second, we as human beings are more than just biochemistry. We are body, mind, energy, beliefs and creative consciousness all functioning simultaneously and interdependently while being immersed in a social and environmental milieu. We need a system of therapeutics that can treat all of these aspects and interrelationships simultaneously and effectively. These are the goals of Integral Medicine. “
What is the Wellness Process versus the allopathic process?
Practitioners of conventional western medicine, and even practitioners of natural medicine who do not hold to the Integral Worldview, most often engage their patients in treatments intended to suppress symptoms enough that people can go about their normal lives. The symptom is effectively treated as if it were the actual condition. This usually means treating a symptom repeatedly rather than bringing about healing and final resolution of the core issue. This symptom-oriented treatment is known as the allopathic process.
For example, a person might visit a doctor complaining of headaches so severe that he or she is unable to focus on work. This person’s doctor would most likely prescribe a powerful pharmaceutical-grade painkiller that the patient would be instructed to take at the onset of one of these headaches. The prescribed drug effectively dulls the pain enough that the patient is able to continue working. According to the allopathic process when the symptom is abated and the patient is able to resume his or her daily routine, the problem is solved.
However, when embracing an Integral Worldview, the allopathic process as described here is very limited in its ability to bring about actual healing and sustained wellness. Conventional medical physicians and practitioners of natural medicine who adhere to the allopathic process are resigned to the fact that headaches will continue to plague the individual in our example, so they seek only to make life bearable by helping to alleviate the pain.
The Integral Worldview takes a much broader perspective and sees symptoms as clues that may indicate a deeper issue. Integrative medicine seeks to eliminate the occurrence of the symptoms indefinitely by addressing and resolving the core issue, rather than just making the symptoms easier to live with. This is what Dr. Steven Hall calls the Wellness Process.
The Wellness Process may involve looking to the symptom’s history to identify specific events or life-changes that immediately precipitated the onset of the symptom; headaches in this case. If it is discovered that the headaches began when the patient started his or her new job, which involved exposure to toxic chemicals or new levels of chronic stress, it may be concluded that the job itself is the source of the headaches.
Sometimes the core issue isn’t physical at all; it could be psychological or emotional, and brought on by certain circumstantial or environmental factors.
Dr. Hall explained, “Symptoms are clues that something somewhere in your system is out of balance. The part of you that detected the imbalance knows the answer, and when the balance has been achieved, the symptom goes away. The symptom goes away by virtue of treating the actual issues.”
Integrative Medicine Career
Integrative medicine is a form of medicine that involves the applied use of conventional western medical techniques while embracing the view that accepts all known natural and alternative concepts of healing. This form of medicine is sometimes referred to as the “third path” for patients with chronic and undiagnosed conditions since it offers answers that neither conventional nor natural medicine by themselves have been able to.
What types of medical issues do practitioners of integrative medicine address?
Dr. Hall and other medical practitioners who share a similar Integral Worldview, very often find themselves working with people who have had ongoing medical issues that conventional medicine has been unable to help them resolve. Dr. Hall explains, “These people don’t get help because their issues cross multi-specialty lines. People with fibromyalgia have sleep issues and immune deficiency, hormone imbalance, and digestive problems. They’ve got aches and pains so they tend to visit the rheumatologist, but he’s not going to treat their sleep problem or their adrenal fatigue, or their digestive problems.”
Dr. Hall began to apply the integral worldview in his medical practice years ago as a way to help people resolve issues that conventional medicine had no answers for. He explained, “I just had this gut feeling that something was at the root of what these people were experiencing: chronic pain, autoimmune diseases, and fibromyalgia, kids with ADD, kids with autism.” He went on to explain how the Integral Worldview applied to medicine is often able to provide answers that conventional or even natural medicine alone cannot, “That’s one of the advantages of Integral Medicine; you can literally see the person as a whole person rather than as separately functioning organ systems.”
Practitioners of integrative medicine represent the most well-rounded and universally knowledgeable segment of the medical community so their scope of practice generally isn’t limited to treating only certain physical ailments. These conventionally trained and uniquely skilled physicians are able to apply the principals of western medicine or alternative healing modalities based on what is most appropriate for their individual patients.
Some common ailments addressed through integrative medicine would include: Adrenal Fatigue, chronic fatigue (Fibromyalgia), hormone imbalance, allergies, asthma, skin conditions, menopause by use of natural hormones, chemical sensitivities, ADD and ADHD in both children and adults, headaches, back and neck pain, digestive issues, car accident injuries, general fatigue, immune system imbalances, arthritis, addictions, sleep disorders, physical and emotional traumas (PTSD), chronic pain or illness, auto-immune diseases, newborn cranial treatment, and many other unusual or undiagnosed conditions. Doctors of integrative medicine may also perform Lifestyle-Wellness evaluations to help individuals stay healthy.
How to Become a Practitioner of Integrative Medicine
Dr. Steven Hall, residency trained family practice M.D., who integrated natural medicine and alternative methods of healing into his practice over 20 years ago, spoke with Allied Health World to tell of the journey that led him to establish his Integral Medical practice:
Steps to becoming a practitioner of Integrative medicine:
- Pursue a formal medical degree, osteopathy degree, doctor of naturopathy degree, or nursing certificate by first taking related courses in physiology, biology, chemistry, anatomy, kinesiology, etc.
- Gain exposure to both ancient and newly developed alternative approaches to health and wellness to become familiar with the known concepts of healing. This would include the various forms of bodywork.
- Adopt an Integral Worldview that is accepting of all known concepts of healing, both alternative and conventional.
- Explore different forms of complimentary and alternative bodywork. Find the ones that you have a natural affinity and propensity for.
- Pursue a certificate program in massage and bodywork through massage therapy or integrative medicine schools to develop mastery of your chosen bodywork modality.
Why integrative medicine?
For Dr. Hall, embracing the idea of integrative medicine so as to ultimately establish an Integral Medical practice of his own was a journey that began early in his career. It was shortly after med school at a time when he was practicing conventional medicine exclusively in his family practice. It was both an affinity for the idea of integrating all known concepts of healing into his practice, and a frustration at the limitations of conventional medicine that inspired Dr. Hall to pursue Integral Medicine.
Dr. Hall described some of the frustration that led him to adopt an Integral worldview: “In my day family practice meant you take care of the whole person and the whole family in the social network and the environmental network, and look at all those different variables. What I found in practice is that most family practice doctors weren’t doing that. What we were really trained to do in conventional medicine is treat symptoms. So you listen, find out what symptoms patients are having, give them a medication designed to suppress the symptom, then rush off to see the next patient. That was really unsatisfying to me because anybody that came in with any kind of complex issue that required you to actually stop and listen and think; that threw your whole schedule off. But those were the people that I was most interested in working with. What I needed was a way to get to the real root of the problem and not just treat the symptom.”
Dr. Hall went on to explain how he first began to explore alternative approaches to healing, “At first I thought maybe natural medicine had better answers than conventional medicine; they have a lot of good ways of treating things. What I found was the vast majority of natural practitioners are still treating symptoms. I looked into nutrition. I looked into herbs, homeopathy. I’ve read about Chinese medicine and Ayurvedic medicine. I looked at lots of different types of bodywork: chiropractic, osteopathy. I looked at a lot of different modalities that are out there and thought: How we can put them all together including conventional medicine.”
Thanks to pioneers like Dr. Hall, the next generation of natural health and healing art practitioners don’t have to take such a long road home. By helping to blaze the trail, Dr. Hall, and other like-minded MDs who have accepted an Integral Worldview, have demonstrated that conventional and alternative medicine can not only peacefully coexist, they can be complimentary to one another in providing the most well-rounded and universally wise approach to healing and wellness.
Integrative Medicine School
How do people choose a bodywork modality to integrate into their integrative medical practice?
Deciding which alternative methods of bodywork to embrace as part of an integrative medical practice is a very personal decision based on an exploration of various modalities. Many modalities are culturally derived, and can be more appealing to practitioners who either come from or relate to a certain cultural background. Integrative medicine programs may help aspiring students arrive at a decision by offering an opportunity to gain exposure to a number of different modalities.
Dr. Hall’s personal journey included the study of Ayurvedic bodywork, Chinese medicine, homeopathy, and chiropractic work. After exploring these and many other alternative methods of healing through various forms of bodywork, Dr. Hall found Craniosacral Therapy to be the modality that best suited him: “When I found cranial work I just had this strong sense that I had come home afterwandering in the desert for seven years. I had learned a lot about the different alternative modalities, but no one thing could hold it all. I’ve been able to find a nesting place within the cranial worldview for every concept of healing that I learned about from all these different things.”
What alternative methods might physicians include in their integrative medical practice?
Dr. Hall works with patients to help them recognize the emotional component of physical sensation by helping to foster a deeper awareness of the mind and body, specifically the body part or body system that is in a state of imbalance. By simply having his patients place their conscious awareness into the body part or body system that is giving them trouble they are able to tune into the sensory information that is available there. In some cases this is able to provide the doctor with information that is more relevant than an x-ray or EKG could provide. This is because placing conscious awareness into the body reveals the emotion associated with an injury or ailment and the block in the flow of energy that may have caused the ailment, rather than just providing a visual representation of an injury.
Functional medicine makes use of advanced metabolic testing to identify chemical imbalances in the body. The purpose of functional medicine is to restore balance to the chemical interactions that take place within the body so as to eliminate fatigue, allergies, hormonal imbalance, and digestive dysfunction. Restoring this balance will promote overall health and vitality, which is the body’s natural homeostasis.
Integrative Medicine Program
To practice Integrative Medicine one must make an academic journey that usually begins with a formal education in either conventional medicine or naturopathy. Students of Integrative Medicine will also engage in hands-on training in one or more of the many complimentary and alternative modalities of healing bodywork, as well as a full exploration of the various approaches to natural medicine.
What are the educational requirements for practicing integrative medicine?
Part of what makes Integral Medicine so unique is that any naturopathic doctor (ND), osteopathic doctor (DO), or doctor of conventional medicine (MD) who chooses to explore and study alternative healing modalities, and who accepts an Integral Worldview that respects all known methods of healing, can effectively practice this form of medicine. The academic path chosen by the individual is as subjective as his or her own life experience, but will always involve formal training in either conventional, osteopathic, or naturopathic medicine; as well as training in some chosen alternative approaches to healing that will often involve bodywork.
What can I expect from bodywork training programs?
Accredited bodywork training programs will include course study in anatomy, physiology, kinesiology, business ethics, and will also provide hands-on instructional practice in the chosen modalities of bodywork and the specific techniques that these involve.
Full-time and part-time programs are available and can typically be completed in six to 18 months respectively. Many programs offered through accredited integrative medicine schools will also assist with apprenticeship placement. This allows students to complete the 600 hours of apprenticeship needed to meet the licensing requirements set by some states, and the requirements set by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) in order to earn bodywork certification on a national level.
What can I expect from formal medical training?
Earning a doctorate-level degree so as to earn the Medical Doctor (M.D.), Doctor of Naturopathy (ND), or Doctor of Osteopathy (D.O.) credential requires four years of undergraduate study followed by an additional four years of medical school. After the academic and clinical study is complete an additional three to eight years of residency is also customary.
Integrative Medicine Certification and Licensure
Since integral medicine involves complimentary and alternative modalities of bodywork as well as the practice of conventional western medicine, there may be questions about the necessary licensure required to establish an integrative medical practice.
Those interested in how to become a doctor of integrative medicine should note that since this type of medical practice is in fact the integration of conventional and natural medicine that simply incorporates one or more chosen alternative modalities of healing bodywork, there is no certification specific to the practice of integrative medicine itself. An integrative medical practice that incorporates bodywork is very accessible to those who have earned doctorate level degrees. An M.D. (Medical Doctor), N.D.(Naturopathic Doctor), or D.O. (Doctor of Osteopathy) needs no additional license or certification to perform bodywork. They are able to perform specialized forms of healing bodywork on their existing medical licenses.
A license to practice bodywork is granted upon completion of an accredited bodywork program, which includes a number of hours spent in clinical practice, and the successful completion of an exam that tests related knowledge and applied skills. Because this test and the subsequent licensure is administered and granted on a state level, it isn’t transferrable to other states. Only a few states have continuing education requirements to maintain state licensure, and these requirements are typically minimal. In most cases submitting an online application for re-licensure and paying a fee that rarely exceeds $200, are the only state-mandated requirements for renewing a bodywork license.
Is there a state transferable national certification for bodywork?
An organization called the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) provides national certification that satisfies the requirements for licensure enforced by most states. The NCBTMB administers an exam called the National Certification Examination for Therapeutic Massage and Bodywork (NCETMB). Completing a program through an accredited school and successfully completing the NCETMB exam will earn graduates the NCTMB credential, which stands for Nationally Certified in Therapeutic Massage and Bodywork. NCTMB certification must be renewed every four years, but it isn’t particularly difficult to meet the requirements for doing so. Massage therapists who wish to retain the NCTMB credential are expected to complete 200 hours of therapeutic massage or continuing education within this four-year period.
Integrative Medicine Career and Salary Outlook
Choosing to establish an integrative medical practice is a decision made largely based on a personal calling to practice medicine with the highest level of integrity and a desire to make use of all the valid natural and alternative concepts of healing that mankind has fostered through the ages.
Increased recognition of the benefits of alternative approaches to medicine has led to a dramatic increase in the demand for services provided by those who are well versed in natural medicine and the various modalities of healing bodywork. This is also evident in the fact that schools of alternative medicine and bodywork are beginning to offer more options for those interested in pursuing integrative medicine programs.
The concept of integral or integrative medicine is often applied to physical therapy, family practice (MD), naturopathic practice (ND), or osteopathic practice (DO). Doctors and other health care practitioners have always been recognized as being among the best compensated of any workers in any industry. Although there are some opportunities for retaining integrative medicine jobs within an established practice, opening an independent practice is more common. Independently operated integrative medical practice would be as lucrative as any independent MD, ND, or DO practice. Practitioners of this specialized approach to medicine have the potential to earn even more than conventional MD, ND, or DOs since an integrative medical practice would be appealing to those patients interested in alternative approaches to healing as well as those who prefer a more conventional approach to medicine.
Specialized physicians who operate independent practices are among the best compensated of any medical professionals, and can earn even more than their salaried counterparts. The BLS publication was careful to note that the number of years in practice, the location of the practice, and the number of hours spent in the office were also significant factors in an independently employed physicians yearly income. It is also important to consider that doctors who operate independent practices need to provide for their own health insurance and retirement.
According to the BLS, a physician’s demonstrated skill, professional reputation, and even personality can play a significant role in yearly income as well. This can be particularly true of practitioners of Integrative medicine who are likely to develop a following of devoted patients who provide a steady stream of referrals.
The following table represents information published by the BLS and other sources providing information specific to various specialized medical practices in which certain physicians have incorporated the practice of integrative medicine:
|Type of Practice||Average Hourly Wage||Average Yearly Income|
|Physical Therapy practice||$25.00||$50,700|