Feature

Meeting patients where they are at is at the heart of this growing area, which offers a whole-of-person approach to health and wellbeing.

With more Australians turning to complementary medicines and therapies to support their health, there is a growing role for GPs in guiding patients with evidence-based advice.

Around 75% of Australian households use some form of complementary medicine, according to a 2024 snapshot published by the Complementary Medicines Association (CMA).

This can include natural therapies, like acupuncture and naturopathy; vitamin and mineral supplements; and herbal remedies bought over the counter or dispensed from a health practitioner.

But in reaching for these health options, patients are not always able to access objective, evidence-based advice tailored to their specific health needs that a GP can provide.

Rather than viewing integrative medicine as a challenge to traditional general practice, many doctors are embracing the health-seeking behaviours of their patients and learning more.

What is it?

Integrative medicine makes use of all appropriate therapeutic and lifestyle approaches, healthcare professionals and disciplines to achieve optimal health and healing.

And it involves integrating complementary medicine into conventional healthcare using an evidence-based approach.

Chair of RACGP Specific Interests Integrative Medicine, Dr Tamara Nation, says the integrative medicine umbrella covers a broad area.

‘When we say complementary medicine, we mean things like mind body medicine – that’s meditation, relaxation, hypnosis, diet therapies – the Mediterranean diet, the FODMAP diet, low-carb diets, the DASH diet and the full range of diets that can be used for health benefits and nutritional medicine,’ she explains.

‘It also includes nutritional supplementation, so the traditional vitamins, and the herbal and spice medicine, and plant-based medicine, which can also include medical cannabis.

‘It includes physical therapies, like kinesiology, chiropractor, exercise physiology and massage therapy, along with lifestyle medicine, which are those pillars of good health, so sleep, diet, stress management and exercise.

‘We would also include cultural medicine under the umbrella – traditional Chinese medicine, Ayurvedic medicine, Aboriginal medicine. You can say all of that is outside of a traditional Western approach, but important in caring for that holistic patient journey.

‘And then there is environmental medicine, so that includes air pollution, toxin exposure, mould-related illnesses.’

Fellows of the RACGP who have clinical expertise in this space, and depth of applied knowledge and practice, can apply for recognition of extended skills in integrative medicine via the college.

Career pathways

For Dr Nation, personal experience and professional interest drew her towards integrative medicine.

‘From a personal level, when I became a mum, I found the traditional medical model didn’t serve all of my family’s healthcare needs,’ she says.

‘I found myself needing to learn more about nutritional dietary approaches, meditation and mindfulness, music therapy, stress management, exercise and the role of exercise in better health, both for myself and my growing children.

‘I also wanted to ensure that my kids had a robust microbiome. My eldest son had issues with eczema, so you really want to make sure that their immune system is as robust as it can be, and that you are using all medicine – antihistamines or topical steroids, moisturisers, but also a really good diet, healthy gut microbiome, good exercise, good sleep.’

Professionally, Dr Nation wanted to be responsive to patients who came in with questions about integrative medicine.

‘When I started, I didn’t know all the answers, but I had patients who would ask me about integrative approaches, such as plant-based medicine or nutritional supplements, and I would always be curious and say, I’ll look it up for you – I’ll check and when you come back and see me, I will talk about it with you.

‘So, from a professional point of view I didn’t plan on taking this approach in my practice, but with patient demand, it led me to learn more, to be curious, and to upskill.’

Being part of this broader professional approach also allows integrative medicine to become part of the GP consultation, rather than something that is sought out on the side, and at times, not mentioned to the GP.

‘Meeting patients where they’re at is what I consider part of the role of incorporating integrative medicine into my clinical practice, because we know over 60% of the Australian population is using complementary medicine in some way or form, so that’s more than half of the patients that we serve,’ Dr Nation said.

College collaboration

There are a broad range of skills across the RACGP Specific Interests Integrative Medicine group, which attracts a strong membership of over 2000 GPs.

Some have deep interest in integrative medicine that becomes part of their profile as a GP, while others might practise conventional medicine while being mindful of the integrative approach, Dr Nation observes.

While the depth of practice will vary, the specific interest group brings together all these areas of expertise.

‘At the college, we’re all part of the big, specific interest umbrella where we can collaborate, it’s fabulous to collaborate, and where we work together on specific projects to represent members of the group,’ Dr Nation said.

‘My goal is to support members, to really give them evidence-based resources that they can easily find, that they can use in their day-to-day clinical practice, to also give them the opportunity to connect with like-minded GPs and discuss the pain points that they may feel in their clinical work.

‘For example, we recently did a survey and among the issues that came up was ensuring the electronic prescribing software we use includes supplements that are approved by the Therapeutic Goods Administration, because that would facilitate better patient safety and it means we’ll be able to easily put that in the treatment list and have visibility on everything our patient is on.

‘The college is also very keen on ensuring that there are registrar training pathways so that more doctors in GP training have the opportunity to learn about integrative medicine and incorporate that into their practice to serve the communities.’

Along with these areas of work are regular meetings with case-based discussions, peer reviews, invited speakers and webinars to keep members informed and well supported.

Improving care

For Dr Nation, integrative medicine helps her deliver whole-person care and build on the trusted relationship she has with patients.

‘With the burden of chronic complex illness and the complexity of management decisions that a GP needs to make, to support a patient, who often will have multiple conditions, using all medicine, both traditional Western and evidence-based complementary medicine, will improve those health outcomes,’ she said.

‘And there’s also a benefit for the doctor’s health. Being able to role model and demonstrate lifestyle medicine for an individual health provider, things like diet, exercise, sleep, stress management (walking the talk) also leads to better health outcomes for patients.’

And there is definitely increasing support behind this approach to medicine, Dr Nation adds, flagging the recent Natural Therapies Review 2024 undertaken for the Federal Government chaired by Australia’s Chief Medical Officer, Professor Michael Kidd.

It recommended the re-inclusion of seven complementary therapies – Alexander Technique, naturopathy, Pilates, shiatsu, tai chi, western herbal medicine and yoga – as being ‘eligible for private health insurance benefits’.

‘I think this really says something in terms of supporting evidence-based complementary medicine for Australian healthcare for better patient outcomes,’ Dr Nation said.

For GPs who are interested in complementary therapies, Dr Nation suggests joining RACGP Specific Interests Integrative Medicine.

‘From a college perspective, I would recommend joining the specific interest group. It’s a fantastic way to start the journey and to meet like-minded GPs who can mentor and support you if you need it.’

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