title: Integrative medicine and systemic outcomes research: issues in the emergence of a new model for primary health care.
abstract: Clinicians and researchers are increasingly using the term integrative medicine to refer to the merging of complementary and alternative medicine (CAM) with conventional biomedicine. However, combination medicine (CAM added to conventional) is not integrative. Integrative medicine represents a higher-order system of systems of care that emphasizes wellness and healing of the entire person (bio-psycho-socio-spiritual dimensions) as primary goals, drawing on both conventional and CAM approaches in the context of a supportive and effective physician-patient relationship. Using the context of integrative medicine, this article outlines the relevance of complex systems theory as an approach to health outcomes research. In this view, health is an emergent property of the person as a complex living system. Within this conceptualization, the whole may exhibit properties that its separate parts do not possess. Thus, unlike biomedical research that typically examines parts of health care and parts of the individual, one at a time, but not the complete system, integrative outcomes research advocates the study of the whole. The whole system includes the patient-provider relationship, multiple conventional and CAM treatments, and the philosophical context of care as the intervention. The systemic outcomes encompass the simultaneous, interactive changes within the whole person.
authors.affiliation: Program in Integrative Medicine, The University of Arizona Health Sciences Center, 1501 N Campbell Ave, Tucson, AZ 85724, USA. ibell@u.arizona.edu
authors.forename: Iris R
authors.initials: IR
authors.lastname: Bell
authors.forename: Opher
authors.initials: O
authors.lastname: Caspi
authors.forename: Gary E R
authors.initials: GE
authors.lastname: Schwartz
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Grant
authors.forename: Tracy W
authors.initials: TW
authors.lastname: Gaudet
authors.forename: David
authors.initials: D
authors.lastname: Rychener
authors.forename: Victoria
authors.initials: V
authors.lastname: Maizes
authors.forename: Andrew
authors.initials: A
authors.lastname: Weil
mesh_terms: D000529:Complementary Therapies; D017063:Outcome Assessment, Health Care; D010817:Physician-Patient Relations; D011320:Primary Health Care; D018511:Systems Integration