|ONE NATION, ONE HEALTH SYSTEM - SPECIAL ISSUE
|Year : 2023 | Volume
| Issue : 1 | Page : 21-25
Integrative medicine: A unified approach for the future medicine
Centre for Ayurveda Education, Innovation and Technology (CAYEIT), Indian Institute of Technology, Jodhpur, Rajasthan, Dr Sarvepalli Radhakrishnan Rajasthan Ayurved University, Jodhpur, Rajasthan, Uttarakhand Ayurved University, Dehradun, Uttarakhand, India
|Date of Submission||05-Oct-2022|
|Date of Acceptance||02-Nov-2022|
|Date of Web Publication||08-Dec-2022|
Prof. Abhimanyu Kumar
Centre for Ayurveda Education, Innovation and Technology (CAYEIT)
Source of Support: None, Conflict of Interest: None
In India, various healthcare systems are practiced, and every system is well-received by its citizens. Recently, the Government of India has planned to develop a “One Nation, One Health System” to offer a unified Health Care System with all the possible advantages of every system of medicine. Regarding such a plan, a well-designed Integrative Medicine Protocol for various diseases is the need of the hour. This approach to health care should be implemented after a thorough review of the situation, which may come across as a hurdle. A single healthcare system will allow for better outcomes and potentially improve the country’s quality of health care.
Keywords: Ayurveda, Integrative medicine, One Nation, One Health System
|How to cite this article:|
Kumar A. Integrative medicine: A unified approach for the future medicine. J Res Ayurvedic Sci 2023;7:21-5
| Introduction|| |
The Government of India has planned to come out with a “One Nation, One Health System” policy by the year 2030 to integrate modern and Indian systems of medicine into medical systems of conventional medicine for the benefit of the people. The government’s focus is to shift attention from the “pathy” approach to medicine. The main focus will be the patient’s benefit from the treatment, irrespective of giving undue advantage to any specific system of medicine. The proposed policy focuses on framing an Integrative Health System (IHS) so that the patients can receive treatment from any desired medicinal system after consideration of the disease and their health condition.
Niti Ayog considered that allopathic medicine and Ayush systems are already mainstream through Ayushman Bharat; therefore, there is a requirement for their integration. They proposed the framework for an integrative healthcare system for achieving “inclusive, affordable, evidence-based, person-centric healthcare.” There is a need to develop an action plan to prevent diseases and promote health in various national programs. “One Nation, One Health System” has been incorporated into the National Health Policy (NHP) (2017) and the National Education Policy (2020).
The National Education Policy mentions that “Given that people exercise pluralistic choices in healthcare, our healthcare education system must be integrative, meaning that all students of allopathic medical education must have a basic understanding of Ayush and vice versa.” It also talks about getting Ayush systems to contribute to “meeting the national health goals and objectives through integrative practices.”
| Why Unified Health System Approach|| |
A unified health system in India would bring much-needed improvements to the country’s current healthcare landscape. Presently, there is a lack of coordination and communication between different levels of the healthcare system, which leads to inefficiencies and poor quality of care. A unified system would help streamline processes and improve communication, ultimately leading to better patient health outcomes. In addition, a unified system would also give rise to economies of scale, which would help to make health care more affordable for everyone in India.
The WHO believes that the fragmented nature of India’s health system is one reason the quality of care and access to services vary significantly across the country. In addition to the challenges posed by a fragmented healthcare system, the WHO says that India’s rising population and increasing life expectancy pose significant challenges to its healthcare system. The Government of India has been working continually to improve the healthcare system. In 2003, it established the National Rural Health Mission, which increased access to health care in rural areas by training thousands of new community health workers and improving the quality of training for primary healthcare workers. The Indian government also introduced new initiatives to prevent and manage non-communicable diseases. The National Urban Health Mission launched (2013) to offer universal availability of affordable, quality care health in urban areas.
Since the early 1990s, India has been experimenting with a new healthcare delivery system known as the IHS. The IHS is a unique blend of traditional Indian medicine (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy) and modern allopathic medicine. The IHS has its roots in the NHP of 1983, which emphasized the need for developing indigenous systems of medicine. The IHS was officially launched in 2004 by the Ministry of Health and Family Welfare to provide holistic care to the people.
Although prevention is the ideal strategy for health promotion, programs must be designed to address the needs of individuals who are already ill. For those who are ill or at risk, preventive and curative healthcare services must be available. Universal access to primary health care has been considered one of the critical targets of the NHP. As per the Indian Constitution, health is a state subject. The responsibility for providing universal access to health services at all levels, from primary to tertiary level care, lies primarily with the states and union territories (UTs). The Constitution has also delegated the responsibility of implementing public health programs to the states and UTs. The NHP envisions that all government healthcare facilities, including those in the private sector, will be accessible to all citizens with equitable access and without financial barriers.
A unified health system in India would have many potential benefits. These benefits include improved quality of care, increased efficiency, and better coordination between different health system levels. A unified system would also lead to better patient outcomes and help control healthcare costs. In addition, a unified system would allow for easier access to care and improve equity in the health system.
| Defining an Integrative Health System Approach|| |
There is no one-size-fits-all definition for an IHS, but there are some common characteristics. These systems typically have a patient-centred focus, emphasizing whole-person care. They also often incorporate complementary and alternative therapies alongside conventional medicine. In India, Ayurveda and Yoga are two ancient sciences to be fit as the most vital partner with conventional medicine (Allopathy) in the format of Integrative Medicine.
The approach of Integrative Medicine aims to integrate the health care that keeps the patient on the main focus and considers the mental, physical, emotional, social, environmental, and spiritual aspects affecting a person’s health. Integrative Medicine prepares a personal strategy that adheres to the patient’s uniqueness, needs, and circumstances. It uses the most appropriate intervention from various available healthcare systems to cure the disease and get people optimal health.
The National Institutes of Health explains Integrative Medicine as a healing-oriented medicine that considers the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship and uses all appropriate conventional and alternative therapies. In other words, integrative health care is a comprehensive approach that considers the patient’s mind, body, and spirit.
In the treatment process through Integrative Medicine, the patient and physician are equal participants. All factors affecting health, welfare, and disease during the treatment process are kept in mind, including body, mind, soul, and community. Health providers use all healing systems to facilitate the spontaneous treatment response of the body. Integrative medicine allows natural, less invasive, effective interventions to be used whenever possible. Integrative medicine, on the one hand, follows the concept of treatment, but the focus is on promoting health and preventing diseases. This perfectly fits with the objective of Ayurveda, which first considers prevention and promotion of health followed by treatment.
Ayurveda’s uniqueness is a personalized approach for any person and is well established with Prakriti’s concept. Every person has a unique Ayurveda body and mind constitution (Prakriti), which is considered for a better lifestyle and disease management.
| Advantages of Integrative Medicine|| |
The integrative treatment approach promotes the body, mind, and spirit to regain the body’s natural equilibrium, which will help achieve the best health. Its common advantages are:
- 1. Integrative medicine is healing-oriented: Integrating medicine with Ayurveda focuses on well-being, strength, and disease treatment rather than concentrating on the disease itself. It starts with the consideration that a physical equilibrium is obstructed, leading to the expression of a disease condition. This balance could be restored by achieving natural balance, and health can be promoted.
It focusses more on the body, mind, and soul/spirit. Usually patients who present with multiple are often referred to various doctors. It may create confusion in the patient’s mind, resulting in inappropriate treatment and financial burdens. Integrative medicine focusses on how different symptoms can be linked to treating an individual’s symptoms and how to find root causes. The focus is more on how the balance is being restored.
- 2. Integrative medicine lays more emphasis on the therapeutic relationship of doctor and patient: There is a new focus on the partnership between doctor–patient. The doctor who is opting integrative approach should at first explain the equal preference of the patient in the decision-making process. Then both can work on the best-suited option. For managing chronic diseases, much attention is given to having good interaction with the patient, to have a clear disease status and treatment to know the status at that time. While addressing difficulties in lifestyle change and treatment, there are greater chances of success with the advised Ayurveda approach.
- 3. Personalized treatment approach: In integrated treatment schemes, recommendations can vary according to each person’s unique situation. Ayurveda very clearly identifies the uniqueness of every individual. Therefore, preparing treatment plans based on the assessment of individuals through Ayurveda guidelines can help decide the treatment and increase the treatment’s effectiveness.
- 4. Use of various compatible therapies: Combining allopathic treatment options with Ayurveda, Yoga, and meditation, a treatment plan can be developed that uses non-invasive and cost-effective treatment. Getting a sense of well-being is particularly vital in cases in which treatment is not possible every time. Most integrated experts determine the appropriate treatment after ascertaining their scientific validation. Most of the time, taking allopathic medicines and adding some Ayurvedic therapies, especially Panchakarma, offers a good combination and potentiates the effects of Allopathic drugs with the added advantage of minimizing the side effects of Allopathic drugs.
| The Challenges of Implementing an Integrative Health System|| |
One of the biggest challenges is the lack of adequate communication between the healthcare systems. Conventional medicine is based on empirical knowledge, whereas traditional medicine is based on centuries of experiential evidence. Conventional medicine tends to be reductionist, whereas traditional medicine takes a more holistic approach. The two systems depict different cultural backgrounds, which render their perceptions to be diverse from one another.
The second most significant challenge is the country’s vast size and population. With over 1.2 billion people and a landmass of 3.28 million square miles, India is one of the world’s most populous and geographically diverse countries. This presents a considerable challenge for any government seeking to implement an integrative system across such a vast territory. Various challenges need to be addressed while implementing such a system in India:
Developing a common platform that all the stakeholders can use.
To get the buy-in from all the stakeholders.
Ensuring that the data collected are accurate and complete.
Need to ensure that the system is secure and confidential.
Entrenched poverty, illiteracy, and corruption.
To incorporate a health insurance scheme to cover medical expenses with integrative medicine treatment.
| Designing of Integrative Medicine Protocol|| |
In designing of integrative treatment approach for any specific disease condition, a few things are advisable to take into consideration:
- The protocol for the integrative treatment approach should be for the resolution of symptoms, not simply the suppression of symptoms.
- There should be supporting evidence of the treatment planned to adopt with the integrative treatment protocol.
- Knowing about therapy’s advantages is insufficient; awareness about any potential harm of the proposed treatment schedule is also essential and should be considered essential.
- Management of co-morbidities present in the patients must also be planned.
- Integrative treatment model must be cost-effective.
- Integrative treatment protocol should match with patient’s culture and Belief System.
| The Possible Impact of an Integrative Healthcare System|| |
Integrative medicine offers a close affiliation between the patient and the physician. There is the use of conventional (Allopathy), Ayurveda, and other Systems of Medicine to treat the patient more effectively and holistically. Integrative treatment emphasizes non-invasive treatment whenever possible. With integrative medicine, there is a commitment to ensure that diagnoses and treatments are based on scientifically sound research. With this approach, the physician considers all the factors influencing health, wellness, and disease. The most crucial aspect of Integrative Medicine is its high emphasis on health promotion and illness prevention through healthy living.
It would allow for a holistic approach to treatment. Instead of only treating the symptoms, we could treat the whole person.
This would lead to fewer relapses and better quality of life for patients.
It would promote cross-cultural understanding and communication.
Both medical systems could learn a lot from traditional medicine by working together.
We would be able to use techniques that are effective.
It would allow for more efficient use of resources.
We could save money and provide better care by using the best techniques from both systems.
| Probable Disease Conditions That Can Be Treated with Integrative Medicine|| |
Integrative medicine incorporating Ayurveda treatment has been found to be most effective in various chronic physical health problems and psychological and psychiatric disorders.
Pain is the most common health issue, and most of us have experienced it many times. Chronic pain, musculoskeletal and joint pain, and headache are common types of pain that are very effectively managed by an integrative approach to treatment. Ayurvedicpanchakarma therapies add a lot for the relief of chronic pain.
Gastrointestinal conditions such as irritable bowel syndrome, chronic constipation, hyperacidity, and so on are problematic to treat with conventional medicine alone. Still, adding some Ayurveda treatment protocols proved to be a very effective treatment method.
Women’s health issues, such as infertility, nausea, vomiting in pregnancy, and pre-/post-menopausal conditions, are treated with hormonal therapy. Still, some women avoid or discontinue it due to negative hormonal impacts. Specific Ayurveda procedures like Uttar-Basti and Ayurveda medicines and dietary considerations provide a highly added advantage to conventional treatment.
Children suffering from conditions such as cerebral palsy, muscular dystrophy, attention-deficit/hyperactivity disorder, and autism need support from Ayurveda to get good improvement.
Various behavioral disorders are best managed by an integrative approach of treatment in ailments, viz., depression, anxiety, stress-related neurological problems, fatigue, and so forth, which are best treated with integrative treatment methods by adding Ayurveda treatment, therapies, and Yoga.
Scientific studies very well support that the use of Ayurvedic drugs minimizes the side effects of chemotherapy. Palliative cancer care can be done best by adding the Ayurveda approach and meditation.
| The Best Model of Integrative Medicine: The Fusion of Allopathy, Ayurveda, and Yoga|| |
Every system of medicine has advantages with some of its limitations. The human being is the best example of nature’s creation which, despite its complexity in structure and function, works very smoothly. Therefore, all the best of Allopathy, Ayurveda, and Yoga may be taken together to serve the human being for maintaining health in its best form.
| Application of Information Technology in Integrative Medicine to Make It More User Friendly|| |
Information technology (IT) is having a tremendous impact on integrated medicine. One of integrative medicine’s fundamental approaches is making patients aware of their health problems. Though the Internet has easy and quick access to health-related information, its biggest problem is its credibility. False and confusing information can do even more harm to the patients. Therefore, the importance of online support groups, bulletin boards, chat rooms, and other social networking sites well supported by the experts of Conventional and Ayurveda and similar other systems needs to be actively functional.
Maintaining regular communications with patients can help to observe patient responses and any adverse events observed during the treatment, better compliance of the patient, and improve patient-centred outcome assessment in clinical studies. The use of artificial intelligence has the potential to contribute to the whole system research of Ayurveda. The use of IT in research of Integrative Medicine may provide many tools that have not been used adequately.
| Conclusion|| |
A single, IHS in India has the potential to provide many benefits for the country’s citizens. These benefits include improved access to care, better coordination of care, and increased efficiency. Additionally, a single health system would allow for better outcome tracking and could improve the quality of care. Implementing the principles and practices of integrative medicine will help transform health care, improve the healthcare system, reduce costs, and make a healthy nation.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Anonymous. Centre to formulate One Nation, One Health System policy by 2030: Minister. Available from: https://www.thehindubusinessline.com/news/centre-to-formulate-one-nation-one-health-system-policy-by-2030-minister/article33305905.ece
. [Last assessed on 20 Oct 2022].
Anonymous. National Health Policy, Ministry of Health and Family Welfare, Government of India. Available from: https://www.nhp.gov.in/nhpfiles/national_health_policy_2017.pdf
. [Last assessed on 20 Oct 2022].
Anonymous. National Educational Policy, Ministry of Human Resource Development, Government of India. Available from: https://www.education.gov.in/sites/upload_files/mhrd/files/NEP_Final_English_0.pdf
. [Last assessed on 20 Oct 2022].
Kasthuri A Challenges to healthcare in India—The five A’s. Indian J Commun Med 2018;43:141-3.
Srinivasan R Health Care in India—Vision 2020. Available from: https://niti.gov.in/planningcommission.gov.in/docs/reports/genrep/bkpap2020/26_bg2020.pdf
. [Last assessed on 20 Oct 2022].
Anonymous. National Rural Health Mission—Meeting People’s Health Needs in Rural Areas, Framework for Implementation, 2005–2012, Ministry of Health and Family Welfare, Government of India. Available from: https://nhm.gov.in/WriteReadData/l892s/nrhm-framework-latest.pdf
. [Last assessed on 20 Oct 2022].
Anonymous. National Health Mission. Available from: https://main.mohfw.gov.in/sites/default/files/02%20ChapterAN2018-19.pdf
. [Last assessed on 20 Oct 2022].
Fortney L, Rakel D, Rindfleisch JA, Mallory J Introduction to integrative primary care: The health-oriented clinic. Prim Care 2010;37:1-12.