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Integrative Family Medicine Program

Goals and Objectives

Goals

Residents will:

  • Broaden their knowledge of complementary medical principles and practices, and their use when safe and effective.
  • Be able to effectively communicate with patients and their families about complementary and integrative medicine.
  • Increase awareness of complementary therapeutic options that they may provide in the family medicine setting.
  • Reflect on the rich variety of approaches to health enhancement and disease treatment available in the community, and be able to appropriately refer to and work collaboratively with licensed CAM providers.
  • Understand the integrative approach to family medicine re-emphasizing relationship-centered care, shared decision making and the use of appropriate conventional and/or complementary approaches while attending to patient and physician wellness.
  • Explore and reflect on their own health enhancement practices and model this for patients.

Objectives

Upon completion of residency training, residents will attain competency in the following knowledge, skills and attitudes:

Knowledge:

  • Understand prevalence and patterns of use of complementary medicine including
    Regional variation particularly within this community
  • Conditions for which patients most commonly seek out complementary approaches

Consider patterns of pathology amenable to each modality

Understand legal issues regarding referral, collaboration with complementary medicine practitioners, and appropriate documentation

Be aware of the current status of insurance reimbursement for complementary therapies in the Portland area

Consider how the principles of evidence-based medicine apply to the study of CAM

Understand training, licensing, and credentialing standards for practitioners of chiropractic, acupuncture, massage therapy and naturopathy

Understand the importance to patient care of modeling health enhancement practices and maintaining personal well-being.

Be able to describe, for each of the modalities listed below,

  • Basic theory and philosophy
  • Tools and equipment related to each modality
  • Common clinical applications
  • Potential for adverse effects
  • Research evidence for efficacy
  • One reputable reference source for more information
  1. Mind/body medicine, e.g. hypnotherapy, biofeedback, meditation, yoga, use of imagery and visualization, spirituality in healing including use of ceremony and ritual
  2. Alternative systems/culturally-based healing traditions, e.g. Chinese traditional medicine, including acupuncture and herbology, homeopathy, and Ayurvedic medicine.
  3. Manual therapy, manipulation, and energetic systems
  4. Diet, nutrition, and lifestyle therapies
  5. Dietary supplements including the use of vitamins, minerals, and herbal/botanical medicine

Skills:

Inquire into patients' use of complementary therapies in a non-threatening, non-judgmental manner

Gather and evaluates relevant information regarding safety, efficacy, and cost of each intervention and communicates the information clearly to patients

Collaborate with and assists patients in their desire to integrate complementary and conventional medicine for maximum benefit

Interact with CAM practitioners in a collegial manner to facilitate quality patient care

Evaluate strengths, weaknesses, and appropriate applications of a range of research methodologies to the area of complementary and integrative medicine

May choose to develop skill in one or more of the following areas for application in clinical practice:

  • Herbal medicine
  • Nutritional medicine
  • Mind/body medicine
  • Manipulation
  • Homeopathy (5-10 common remedies for acute situations)
  • Acupuncture (through additional course work)

Attitudes:

Appreciate the complex means of homeostasis and healing that human beings possess and understands that one reasonable approach to addressing illness is at times the use of gentle, inexpensive, non-pharmaceutical or non-surgical options

Understand and respect cultural/ethnic influences on health beliefs and health care choices, to include patients desiring "traditional" cultural and ethnic approaches to therapy and healing

Discuss patients' use of complementary therapies as a necessary part of finding a common ground when practicing patient-centered medicine

Respect the potential of certain complementary therapies to be equally or perhaps more effective than conventional approaches for the treatment of certain conditions

Demonstrate willingness to seek out and collaborate with CAM practitioners to ensure patients' access to quality health care

Understand that physicians' attitudes toward their own self-care, self-awareness, and personal growth play a critical role in promoting the process of change in patients' lives

Understand the role that physicians' own core beliefs and cultural, ethnic, or religious background may play in their choice of recommendations regarding their treatments

Many of the objectives above were inspired by:

Kligler B, Gordon A, Stuart M, Sierpina V. Suggested Curriculum Guidelines on Complementary and Alternative Medicine: Recommendations of the Society of Teachers of Family Medicine Group on Alternative Medicine. Fam Med. 1999;31(10):31-33.

 

 


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