When people picture their annual primary care visit, many conjure up images of feeling rushed, unheard, or left with unanswered questions and little to no guidance on achieving and maintaining health and wellness.

A systematic review showed that 93% of patients reported feeling vulnerable with their primary care provider (PCP). This vulnerability comprised four different factors: feelings of disrespect, time constraints, the dominance of biomedical culture, and helplessness. The feeling of disrespect led patients to withhold certain medical information, such as the use of alternative medicine. Time constraints left the patients feeling rushed and not listened to. The dominance of biomedical culture oriented conversations strictly to physical aspects of health and denied psychosocial elements. Helplessness occurred when patients felt their visits were one-sided and their providers did not answer their questions.

Primary care is supposed to be the initial stop for patients whether they seek healthcare for specific illnesses or attend an annual check-up to ensure wellness. However, the conventional primary care model lacks time, openness, whole-body perspective, and individualization. This is precisely the gap that integrative medicine can bridge.

Integrative medicine treats the whole person, and integrative practitioners spend the time needed to gather information holistically to create a treatment plan that encompasses each patient's mind, body, and spirit. Conventional and alternative medicines have a lot to offer, so integrating them with integrative medicine might be the primary care solution that patients are hoping for.

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What is Integrative Primary Care?

Primary care is healthcare for preventing and treating common illnesses and general wellness. Integrative medicine takes on a whole person or "holistic" viewpoint and seeks to understand the root cause of present symptoms or diseases. Therefore integrative primary care is a holistic form of healthcare that aims to understand the physical, mental, emotional, and spiritual needs to prevent and treat common illnesses and improve health and wellness.

In an integrative primary care model, aspects from conventional healthcare, such as medication, are blended with complementary and alternative medicine, such as herbs, acupuncture, and yoga, to achieve well-rounded care.

Another distinguishing feature between an integrative primary care visit and a conventional visit is the established relationship between patient and provider and, more specifically, the time dedicated to a visit. In conventional care, the average length of the total visit was 17.4 minutes, with only 5.3 minutes on average being the amount of time for a patient to ask questions and talk about health concerns. On the contrary, visits with an integrative practitioner last between 30-60 minutes, leaving much more time for relationship building, trust development, and diving deep into the entire health history.

What are the Top Lab Tests for Integrative Primary Care Visits?

Labs can help us get a clear picture of what is happening in the body, often before we can detect symptoms. In integrative primary care, analyzing various lab markers can elicit a holistic view of the body. While the following list may seem overwhelming, it can give you a well-rounded idea of your body's function and health status that you wouldn't otherwise know. Here are the top recommendations for routine integrative primary care lab work:

• A Complete Blood Count (CBC) analyzes red and white blood cells. It can detect underlying anemia, infections, and allergic reactions.
• Certain other vitamin deficiencies are also common such as Vitamin B12 and Folate. In fact, B12 and Folate deficiencies can also cause a type of anemia and should be assessed.
• Approximately 50% of the global population is deficient in Vitamin D, so testing your status should be a part of a routine integrative primary care evaluation.
• A Comprehensive Metabolic Panel (CMP) analyzes electrolytes, metabolism, kidney and liver health, and blood glucose.
• Along with the fasting glucose levels assessed in a CMP, a fasting insulin level and an HbA1c are beneficial for evaluating signs of insulin resistance, a precursor to diabetes.
• Lipid panels are essential for assessing cholesterol and cardiovascular risk. A Comprehensive Lipid Panel is necessary if you have a high risk for heart disease. A Basic Lipid Panel is likely sufficient if you are at a lower risk.
• Healthy thyroid function is a vital part of total health since every cell in the body has receptors for thyroid hormones. A complete thyroid evaluation goes beyond an initial screening to evaluate all relevant markers so that no information about thyroid function is missed.
• The most significant cause of death in the world is chronic inflammation. A simple C-Reactive Protein (CRP) marker can help assess the status of inflammation in the body.
• Lastly, testing basic hormone levels is essential for a comprehensive view of total wellness. The Hormone Trio by ZRT Laboratory can be ordered as either a saliva test or blood spot test and is appropriate for both men and women.

Based on these results, practitioners will be able to follow up with more comprehensive testing and proper referrals to other integrative medicine practitioners to help give the patient a more root-cause approach to their healing.

What are The Top Lifestyle Interventions for Optimal Wellness?

To achieve optimal wellness, we must give our bodies what they need and avoid what would be harmful. We require adequate healthy nutrition, moderate exercise and movement, quality sleep, and mental, emotional, and spiritual well-being. Most Integrative Medicine primary care practitioners will focus on the following modalities:

Nutrition

A healthy diet is varied, nutrient-dense, and low in processed foods, artificial chemicals, fast food, sugar, refined grains, and partially hydrogenated oils. A general view of how a healthy plate should look would consist of ½ of the plate filled with vegetables and fruit, ¼ of the plate with whole grains, and ¼ of the plate with lean proteins such as beans, lentils, fish, poultry, and nuts. Healthy oils such as olive oil in moderation should be consumed for the healthy fat content, and drinking plenty of water is also vital. A well-researched diet that ticks all of these boxes is the Mediterranean Diet.

Maintaining Healthy BMI

Eating healthy is an important step to take toward maintaining a healthy weight. However, if your BMI indicates that you are overweight or obese, you should consider healthy weight loss options since obesity is a risk factor for many medical conditions. Balancing blood sugar, being mindful of food quality and quantity, and healthy moderate exercise will get you closer to a healthier BMI.

Movement

The CDC recommends weekly exercise consisting of 150 minutes of moderate-intensity physical activity plus two days of muscle strengthening.

If the same old exercise routine seems boring, maybe it's time to change it up. Along with strength training and walking, healthy exercises can also include tai chi, swimming, or even kegel exercises to strengthen the pelvic floor (recommended for both men and women).

Sleep

The recommendation for adults is to get at least 7 hours of sleep per night for optimal health. Less than 7 hours of sleep regularly is linked to health concerns such as weight gain and obesity, diabetes, hypertension, heart disease and stroke, depression, and increased risk of death.

Integrative sleep assistance includes sleep hygiene (consistent bedtime routine, decreased electronics, blackout curtains, etc.), healthy nutrient status, and certain herbs that can all be helpful if sleep quality is poor.

How to Find an Integrative Medicine Primary Care Provider Near You

There are many ways to find an integrative primary care practitioner near you. First, you can start with a quick google search. Many practitioners will work with SEO (search engine optimization) to ensure that Integrative medicine pops up on their site when googled. 

Other options include membership sites for advanced training in integrative and functional medicine. These directories are limited to only those who pay for the membership, meaning a practitioner could still be specialized in integrative or functional medicine but not show up on that specific site. Still, these are excellent places to start. A few well-known directories to search are: 

• Academy of Integrative Health and Medicine (AIHM)
• The Institute for Functional Medicine (IFM)
• Andrew Weil Center for Integrative Medicine Directory‍
• Academy of Integrative Health & Medicine (AIHM) Directory‍
• Integrative Health and Wellbeing Fellowship Directory‍
• The American Board of Physician Specialties® (ABPS) Directory
  

Summary

Integrative primary care is a patient-centered practice of medicine that views the patient holistically and considers the patient's mind, body, and spirit as equal features of health. In an integrative model, practitioners can spend adequate time knowing their patients' struggles and health goals and create relationships.

Patients want more from their PCPs. They want to feel understood, respected, and seen as an individual. This is where an integrative primary care model can take the lead and shine.