INTEGRATIVE

MEDICINE IN ER
Dr Kingsly Robert Gnanadurai V
MBBS, MD, MBA, PGDMLE
Dy. Chief of Medical Services
Bangalore Baptist Hospital
Outline
Definition
Spectrum
Worldwide scenario
Indian Scenario
ER situation
Integrative Medicine

NCCAM Definition

As defined by the National Center for Complementary

and Alternative Medicine at the National Institutes of
Health
Integrative medicine "combines mainstream medical
therapies and CAM therapies for which there is some high-
quality scientific evidence of safety and effectiveness."
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Integrative Medicine
 Forms of Integrative Medicine
The relationship between modern and traditional
medicine has taken 4 broad forms
Monopolistic system. Modern medical doctors have the soul right to practice
medicine.
 Tolerance system. One of Co-existence where traditional medical practitioners,
while not formally recognized, are permitted to practice in an unofficial capacity.
Parallel or dual health care system. as in India, where both modern and
traditional medicine are separate components of the national health systems.
 Inclusive Integrated model. Modern and traditional medicine are integrated at
the level of medical education and practice (e.g. China, Vietnam).
Gerard Bodker, A framework for cost-benefit analysis of traditional medicine and conventional medicine; Traditional Medicine in Asia ,2002 WHO pp.159
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 Resurgence- Need for Integration

◦ A resurgence of interest in Ayurveda and other

AYUSH systems has resulted from the preference of
health seekers towards
◦ holistic approach
◦ products of natural origin
◦ About 80 % of population in India utilize AYUSH and
LHTs to help meet their primary health requirements
Health Seeking attitude
Role of AYUSH/TM
◦ The most prevalent users of Traditional Medicine are
individuals who have
◦ Refractory conditions
◦ Non–life-threatening conditions that may be chronic
viz. neurological disorders, arthritis etc.
◦ The second largest group of users are those struggling
with
◦ Chronic, potentially life-threatening diseases, such as
Cancer and HIV/AIDS etc.
Synergy of AYUSH interventions with NRHM
Source: www.mohfw.nic.in/nrhm/htm

◦ Location of AYUSH dispensaries in PHCs in different States.

◦ Appointment of AYUSH doctors and paramedics (pharmacists) on contractual basis in
the primary health care system.
◦ Inclusion of AYUSH modules in training of ASHA.
◦ Inclusion of Punarnavdi Mandoor in the ASHA Kit for management of anaemia during
pregnancy.
◦ Inclusion of seven Ayurvedic and five Unani medicines in the RCH programme.
◦ Establishment of specialty clinics, specialized therapy centres, and AYUSH wings in
district hospitals supported through CSS.

 
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Traditional Medicine in an Allopathic Set-up

 Integrated health care / training at Institute of Medical

Sciences, Banaras Hindu University, Varanasi ,Uttar Pradesh
and MGIMS, Wardha ,Maharastra .
 Ayurvedic Treatment in Safdarjung Hospital, New Delhi
(A 1500-Bed Allopathic General Hospital)
 Homoeopathic Treatment in Dr. R.M.L. Hospital, New Delhi ( A
900 Bed Allopathic General Hospital)
 Ayurvedic /Unani /Yoga Treatment in Dr. R.M.L. Hospital,
New Delhi ( A 900 Bed Allopathic General Hospital)
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 R&D on Integration and mainstreaming of AYUSH
National Health system Resource centre
Study on Role of AYUSH and Local Health Traditions Under National
Rural Health Mission(NRHM)*
◦18 states across India
◦Implications of the NRHM strategy of mainstreaming AYUSH’ in terms
◦ Coverage
◦ Quality of services
◦ Demand of services
- Validation of Local Health Traditions (LHTs)
Outcome
◦ 80-90% house holds aware about utility of AYUSH/LHTs
◦ Co-located services are Well utilized in some states
◦ Utility ; 1. Chronic illness 2. acute illness 3. Health promotion
◦ 70% Allopathic doctors viewed AUYSH is not rudimentary

*Status and Role of AYUSH and Local Health Traditions Under National Rural
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Health Mission- Report of a Study;National Health Systems Resource Centre,
Ministry of Health & Family Welfare Government of India New Delhi; 2010
R&D on Integration and mainstreaming of AYUSH
ICMR Collaboration
Feasibility of introducing Indian systems of medicine (Ayurveda &
Siddha) in the National RCH at the primary health care (PHC) Level: An
Operational Study *

◦ 17 drugs developed through R&D

◦ 50 PHCs/CHCs

◦ Integration with the Reproductive & Child Health program

◦ Prevention & Management of morbidity & mortality

◦ Prevention of complications antenatal , peri-natal and post natal

◦ Extent for integration and efficacy of interventions

*CCRAS-ICMR Collaborative Project EFFECTIVENESS OF AYURVEDIC INTERVENTIONS FOR
ANTE-NATAL CARE (GARBHINI PARICHARYA) AT PRIMARY HEALTH CARE LEVEL-A MULTICENTRE OPERATIONAL
STUDYJournal          Journal of Research in Ayurveda and Siddha | Year : 2015 | Volume : 36 | Issue : 1-4 | Page : 109-
120Author(s)1. Sulochana Bhat, 2. Ena Sharma, 3. Babita Yadav, 4. Omraj Sharma, 5. N. Srikanth, 6. Adarsh Kumar, 7.
Prameela Devi, 8. Sarada Ota, 9. M. M. Padhi, 10. K.S. Dhiman 12
Challenges: Integration

• Diverse concepts
• Complex approaches
– Clinical Trial Design
– Diagnosis & Therapy
– Clinical Efficacy
– Outcome measures
• Drug interaction
• Harmonization
The way forward– Integrated Healthcare

Conventional and non-conventional approaches to

healthcare and those that practise them working together in
an integrated approach offer a wider range of options for the
greater benefit of patients.
Way forward
Thank You