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Is it possible for PAs to work in a holistic or integrative capacity?


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Bottom line is, it's possible for any provider to responsibly incorporate nutrition and holistic methods in their practice. Depends on how much of a 'robot' you are, either way.

 

There's a lot more to life than just Iron Deficiency Anemia!

On the other hand, you are what you eat...and don't eat! Many HCPs are now treating the whole patient and not just seeing the disease and what tx. Getting to know your patients is the best way of treating them...

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I wanted to focus in this area of medicine but couldn't find a rotation to do so (closest I got was doing one in palliative care, that I set up myself) -- I was in a surgical program and I don't think alternative/complementary medicine was taken very seriously -- everything was pretty hard-core. the "softer" rotations I elected were heme/onc and palliative care...but I got the surgery bug anyway and ended up working in surgery!

 

I still love surgery, but I often think I would want to do something "softer" as I get older. however, the complementary med side of things is also populated by a lot more NP-trained people and I don't find working with them as satisfying as working with MD-trained people. really different educational base.

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Hmm Im a bit confused by what a holistic medicine rotation would be. I work with an NP who often consults on nutrition and other non-pharmaceutical and behavioral medications. Demonstrates the neti pot, homeopathic solutions to common ailments, herbal ways to lower lipids. My personal physician considers himself "integrative medicine" but does the same thing I do during a physical. I have seen holistic medicine practices but they rarely are MD and PAs, rather people trained in holistics (is that what an ND is?) Every so often you encounter an MD who is doing something like that .... but its usually when they lose a license or two. When you see patients you can suggest just about whatever you want ... but at the end of the day you need evidence to support the decision. That is what the judge and jury want to see especially.

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Cancer institutions tend to have evidence-based integrative medicine programs that include things like acupuncture, music/art therapy, massage, meditation, yoga, etc. although the docs and mid-levels are not directly involved IME. I don't see why this couldn't be incorporated into any practice.

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I am currently working in an integrative clinic and I can not imagine a more rewarding job. We currently have 1 MD, 1 PA, and we are looking for another mid-level. We have a nutrition program with 3 counselors, a chiropractor who does physical rehab, and a gym that teaches fitness training all under 1 roof. Patients love what we do and that we have another recommendation besides giving them a pharmaceutical. We provide insight to alternative medicine but also remain conventional in many ways. I hated my family practice rotation because it was primarily sick care, but an integrative approach allows you to offer patients other means of staying healthy. I was skeptical a first, as PAs are taught in such a mainstream way and didn't believe in alternative approaches. I spent my last rotation with an integrative MD and saw patients' quality of life improve through education and a natural means. The concepts behind functional/integrative medicine all have a very scientific background. I hope to see more PAs turn to this form of care :)

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Wow, Liltexan, I don't think you're in the Northeast, or I would definitely be applying to your mid-level opening! I transitioned to a career as a PA from a long back ground in psychology, as a clinician and as an academic, and I directed a mind-body research lab at my university at one point. I had the good fortune to arrange an elective rotation at a medical school affiliated integrative medicine center, and it was very affirming of the value of this approach. I'm quite passionate about a wellness orientation and am struggling a great deal with my family medicine position, where the guiding principle seems to be "better living through chemistry." I'm discouraged not to have been able to find a more holistically oriented job, especially in the field of women's health and obstetrics.

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It seems there are different schools of thought in this venue. There are the naturalists that go for herbs and vitamins and at the other end are the traditionalist who deal more with Rx drugs. Probably in the middle are practitioners who believe in CAM therapy or a combination of the two. I love the concept but worry about untested and false claims. I see so much BS on TV like 'Smilin Bob' going big time or whatever and wonder how many people get sucked into these products.

 

Some vitamin therapy can be dangerous, like the fat soluble ones. Hopefully, responsible practitioners use evidence based, not faith based data in their treatment. Anecdotal evidence doesn't overcome chance and the placebo effect. I suspect the lack of comprehensive studies, and poor regulation by the FDA have lead many to sour on much of holistic medicine clumping it with snake oil and granny's rumatiz medicine.

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  • 1 year later...
I am currently working in an integrative clinic and I can not imagine a more rewarding job. We currently have 1 MD, 1 PA, and we are looking for another mid-level. We have a nutrition program with 3 counselors, a chiropractor who does physical rehab, and a gym that teaches fitness training all under 1 roof. Patients love what we do and that we have another recommendation besides giving them a pharmaceutical. We provide insight to alternative medicine but also remain conventional in many ways. I hated my family practice rotation because it was primarily sick care, but an integrative approach allows you to offer patients other means of staying healthy. I was skeptical a first, as PAs are taught in such a mainstream way and didn't believe in alternative approaches. I spent my last rotation with an integrative MD and saw patients' quality of life improve through education and a natural means. The concepts behind functional/integrative medicine all have a very scientific background. I hope to see more PAs turn to this form of care :)

 

I am an interventional cardiologist in Central, NJ. I stumbled on this doing a google search. It was a fascinating read, as I just finished putting together a facility with a gym, hired 2 exercise physiologists. I am trying to hire a mid level provider who would be interested in practicing traditional medicine but with an integrative approach. Would also appreciate if I could get some ideas on how to involve counselors in running a nutritional program. I believe that this is the way medicine needs to be practiced. There is only so many angioplasties and stents we can place. The key is prevention and a change in lifestyle.

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I am an interventional cardiologist in Central, NJ. I stumbled on this doing a google search. It was a fascinating read, as I just finished putting together a facility with a gym, hired 2 exercise physiologists. I am trying to hire a mid level provider who would be interested in practicing traditional medicine but with an integrative approach. Would also appreciate if I could get some ideas on how to involve counselors in running a nutritional program. I believe that this is the way medicine needs to be practiced. There is only so many angioplasties and stents we can place. The key is prevention and a change in lifestyle.

 

Lots of respect to you doc. Very awesome philosophy. Wish your poor practice all the luck and hope it flourishes!

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  • 2 weeks later...

SSRD, give me 2 years and I'd love to be a part of your program ;). I worked in cardiac/pulmonary rehab center that was connected to the Heart Hospital in N Florida during undergrad. My Bach is exercise physiology and what you are aiming to do is spot on to something I have always dreamed of being apart of.

Good luck! If we are ever able to overcome the current financial trends of healthcare, this will most likely be the answer and "sustainer".

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  • 2 months later...
I am currently a fellow in the Arizona Center for Integrative Medicine (Dr. Weil's program at Univ. of Arizona) and it has been the best decision I've made in my medical education.

 

nycRPAC - Currently PA student graduating in August and very interested in integrative medicine. Can you give us some more insight into the program at the Arizona Center? Thank you in advance.

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Is it possible for PAs to work in a holistic or integrative capacity?

 

Or is it mostly NPs and other fields who have such an approach?

 

Even so, is it possible for PAs to pursue such an avenue?

 

Thanks !

 

G

 

Duke University's PA program has an elective rotation in integrative medicine.

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I went to a integrative medical practice for a year or so. It had an MD who did a residency in psychiatry and had no medical training (other than medical school) and a PA who had been an MD in India and went to PA school in the states. I only stopped going after they repeatedly tried to treat strep throat with homeopathy. The homeopathy did not work and I got sicker and sicker. In the end I went to a regular IM doc who Rx'ed me antibiotics and Rx'ed steroids to get the horrific throat swelling under control.

 

I didn't return to the integrative clinic, which I am sad about, but they refused to prescribe antibiotics for anything and insisted on "holistic remedies only". I know that is not par for the course with integrative clinics, however.

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