Jun 6, 2022 06:45AM salamandra wrote:
My treatment center has an integrative medicine department that my oncologist wants to refer me to when I mention certain side effects. I've met with a nurse practitioner there, and also spoken with other practitioners in other settings.
On the plus side, if they are actually licensed professionals, they have to be concerned about maintaining their license and at least have some credentials.
But on the other hand, there's a reason that that kind of medicine is funneled away to its own category and that's because it doesn't have enough evidence behind it to become part of regular medicine. And there are plenty of doctors who are credulous and themselves are taken in by quackery, even if they're not purposely scammy.
In my experience, it lumps a bunch of different things together. Some of it has relatively strong evidence in theory - for example, plenty of studies show that people who do yoga feel better - but little real evidence for execution - e.g.: how much yoga? what kinds of yoga? is it the yoga or is it the social experience of the exercise group or is it the physical movement itself or is it that people who are more likely to engage in organized exercise are more likely to have the financial resources or background level of health to have better outcomes. Certain supplements are like this as well - there may be some evidence that the supplements are associated with feeling better or better outcomes, but the evidence itself tends to be based on fewer or shorter term studies, and/or there are not regulated sources of the supplement to ensure that a person is actually getting what they intend to buy.
I went to a presentation by an integrative doctor who does take insurance and is affiliated with a reputable hospital. Even so, it seemed like the presentation blurred different types of 'treatments' together, from stuff that has some decent evidence, to stuff that has very little evidence at all but that probably 'won't hurt'. Unless I asked her about the level of evidence for each 'treatment' individually, she seemed content to let us assume that all of them had the same level evidence behind them.
I suspect that a lot of the apparent success of functional medicine is placebo. Patients get to feel heard and paid attention to and catered to in a way that the regular medical system does not deliver. Placebo effect is *real* and seems to actually do some good for a certain percentage of people a certain percentage of the time.
I am personally wary of practitioners who take the functional or integrative route, even if they are licensed professionals associated with reputable institutions, and much more so if they are not. I certainly would not go into any financial stress or hardship for it. But I know enough people who have felt good about going that route *in addition* to conventional treatment that I also would not discourage someone whose heart is set on it if they actually can afford it.
