[MUSIC] Within the integrity of medicine setting, guidance on the use of herbal medicinal product is provided by integrated physicians, who are conventional doctors, dually trained in complimentary medicine and supportive cancer care. Integrative physicians are for the most part considered part of the oncology team, directing a multidisciplinary staff of integrative practitioners. Who have been trained in a wide range of complementary medicine practices, which include herbal medicine, nutrition and dietary supplements, acupuncture, mind-body medicine, touch and movement therapies, among others. Professor Moshe Frenkel is a Clinical Associate Professor at the University of Texas Medical Branch. He's a board certified in family medicine and has extensive experience in the field of integrative oncology. Since 2011, Professor Frenkel has been the Medical Director of an Integrative Oncology Service at the Institute of Oncology, Meir Medical Center in Israel. >> In the old times we used to look at the alternative as something that was coming instead of. As we progressed, we said, let's talk about complementary, anything that can complement the deficiencies that we have in conventional medicine. And now we're talking about, let's look at the best of both worlds and try to integrate both of them together. The best from conventional medicine, the best from complementary or whatever, natural medicine, that was described in the past, and try to combine them together so patients will benefit from it. >> So where does the traditional medicine stands in between the alternative, complementary, integrative and maybe specifically traditional herbal medicine? >> Well, it's really goes according to the culture that people are coming from. People are coming from different cultures. And they bring their background of what their grandmother was utilizing, what was accepted in the community in the old times, and bringing to the new tradition. So nowadays it's changing because what was traditional medicine in the past is slowly, slowly is disappearing. More and more people are using conventional medicine. And what we are trying to see is how we can utilize the old times, and maybe we can integrate it into the new times. >> The following table summarizes the four models of non-conventional medical care. Which can all apply at least in theory to the case of the 52 year old patient with breast cancer, who is a taking ginger root remedy during her chemotherapy regime. Let us compare the four paradigms by viewing the source of recommendation. In traditional medicine, it's the family and friends. In alternative medicine, it's the friends and media. In complimentary medicine, it's usually the patient self-referral. And in integrative medicine, it's the oncologist referral. Viewing the source of information in traditional, they are textbooks on herbal medicine, in alternative, the health-food shops. In complementary, the popular media, and then the integrative medicine, well, it's scientific research. Expectations from the treatment, like the ginger root, in traditional, it's patient empowerment. In alternative, curing cancer, strengthening immune system, in complimentary, it's boosting the immune system. And in integrated medicine, it's to improve quality of life. Source of professional guidance, in traditional, it's self use or traditional healer. In alternative, it's self use, complementary, it's complementary medicine practitioner. And in integrated, it's the integrated physician consultation. Disclosure of herbal use to the oncologist, in traditional medicine, rarely. Alternative, mostly not, complimentary, sometimes, and integrative, in most cases. Safety related issues in traditional and alternative, they are not considered relevant. In complimentary medicine, it may bother the patient. And in the integrative setting, it's frequently discussed and explored. In the following interview, where we meet Doctor Elad Schiff, the Director of an Internal Medicine Department at the Bnai-Zion Medical Center in Haifa, Israel. Dr. Schiff has established an extensive integrative medicine service throughout the hospital, which as of today includes 12 surgical and internal medicine wards, as well as other related services. I asked Dr. Schiff to summarize the differences between the four models of non-conventional medical care, traditional, alternative, complimentary, and integrative medicine. >> I think in the past 50 years, we've seen an evolution, a tremendous evolution, from alternative through complimentary into the integrative definitions. Where the alternative denotes the opposition, the barriers, the wars between the sides. And when there's a war, there's no discussion, there's no understanding. And the patient is in between the practitioner and the physicians, who never speak and oppose each other. So I don't think there's an alternative to conventional medicine, and I don't think there's an alternative to complementary medicine. And that won't help anymore if there will be such an opposition. And that, I think, is the cause where we saw a natural transition into complementary medicine, because no one likes battle for a long time. And complementary medicine, however, wasn't also a good model. Although there was some acknowledgement of the parties, and people were tolerant to each other, they never really talked. Nobody really understood what happens in the practitioner's room. And the practitioner didn't truly understand what happens in the physician's room. >> So it was side by side. >> It was side by side. It was kind of in the best way you can say multi-disciplinary, but without any reference to one another. And so there was some acknowledgement, however, there was still no open discussion, no real understanding, and no learning between the sides. And during the time, in the complimentary medicine module, still the patient was alone. You would go to the complementary medicine practitioner, to the physician, and they would not discuss between themselves what is actually happening with the patient. And that again isn't a safe environment and isn't health promoting for the patient. And therefore, in the past 10, 15 years we've seen the evolution towards what we believe is the true and right medicine, which is the integration of both worlds. And I think there's also something that is synergistic between complimentary medicine and conventional and the integrated medicine paradigm. Where one plus one is actually not two, but is three. Because the cross-cultural talk between both systems of healthcare creates a better medicine for every one of us. And that is the future of integrative medicine, which is better for patients and promotes good health. >> So when you look at the continuum between alternative to complementary to integrative, where do you place the concept of traditional medicine? >> Traditional medicine was more in the realm of complementary medicine, where there was no opposition, okay, to traditional medicine. It was always there, but there wasn't an understanding of what is happening in the traditional practitioner clinic. And within complimentary medicine, as you see the NCCAM distribution of different systems of care, then one of the five systems of complementary medicine is traditional medicine, which can be Ayurvedic medicine or traditional Chinese medicine or Islamic medicine. But it is still under the complementary medicine paradigm. >> In the next interview, we'll meet with Dr. Elio Rossi, a member of the Tuscan Network for Integrative Oncology in Italy. The interview will focus on Dr Rossi's view on the alternative versus the interrative medical model of care. >> This integration is not against commercial oncology, but with conventional oncology. It means that we can optimize the effects of the conventional treatments. So they can reach the maximum level without not so many adverse effect. Of course, it's not for every patient. But, the majority of the patients, a significant number of the patients has benefited from this. [MUSIC]
