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Integrated Medicine In The UK

The Background
The concept of ‘Integrated Medicine’ or ‘Integrative Medicine’ has come about as an attempt to marry the CAM industry with Conventional Medicine.
In the UK the burgeoning CAM industry between about 1985 and 1995, entirely unregulated, became a public health issue, as increasing numbers of middle class patients sought complementary therapists as an adjunct, and sometimes as an alternative, to their NHS care. GPs in particular were asked to guide their patients and attempt to answer their questions.
The Medical Establishment of the day attempted to study the matter, and doctors like Dr Lewith, Dr Pietroni and Prof Ernst mentioned in my acknowledgements page devoted their working lives to this area, and by 2005 most of the scientific evidence base had been published.
The Result:
Osteopaths and Chiropractors were given legal status within their own Registration Bodies, and allowed to practice within their own traditions. Insurance Companies recognise them for treatment of musculo-skeletal problems though the Conventional Establishment does not have direct dealings with them. GPs providing referral letters so that the patient can claim on their insurance word letters such as- ‘Dear Osteopath/Chiropractor, Thank you for seeing this person who wishes to see you about their bad back.’
Such a letter does not affirm that the GP sees this referral as appropriate.
Insurance Companies accept such a letter.
It is illegal to practice in the UK as an osteopath or chiropractor without being on the relevant register and being insured.

Herbal Remedies have been severely restricted, and cannot be licensed as medicines.
Where sold eg in Health Food Shops the labelling has been carefully crafted.
However all manner of herbs are widely available via grocery shops where they are sold as food items and via the internet.

All other therapists including Homoeopaths, Acupuncturists, Chinese Medicine Practitioners, Ayurvedic doctors, and others are unregulated but function under their own self created regulatory organisations. The same applies to most forms of Psychotherapy or psychological service
What this means in practice is that any Joe Bloggs can put a sign above their door with the title Acupuncturist, Homoeopath or Psychotherapist, Healer, etc, etc.
They are breaking no UK law. Registration with a relevant body and signing up to a code of conduct is voluntary. It follows that they do not necessarily have to have insurance. Clients of such practitioners generally approach them by word of mouth and make their own checks and enquiries.

So what exactly is Integrated Medicine?
In practice this refers to Conventional Medicine+ CAM+ self help.
It does in fact require the participation of a conventional doctor.
In the UK there were several such doctors in the 1990s and up to about 2010.
Based on my informal researches there are hardly any left.
For The General Medical Council, the body which licences doctors, continuity of registration is no longer what it used to be. In the past once doctors qualified and got onto the register they stayed registered for life unless they got into serious difficulty and had to be struck off or subject to Fitness to Practice proceedings. No longer. In keeping with the times continuity of registration is like a pilot’s licence. Nowadays annual appraisal is mandatory and a Revalidation Certificate required every five years. This has created particular problems for doctors who have been working outside conventional medicine, as their revalidation is not straightforward. Most are close to retiring age anyway. The few still in practice within the CAM sector, continue to see their clients.
However there are no younger UK doctors getting involved in this area.

So what exactly is the CAM Industry?
In practice this consists of all practitioners in the ‘Health and Wellness Industry’ that are neither Medical Doctors, Osteopaths or Chiropractors.
With relation to psychological services this refers to all therapists and counsellors whose qualifications and licence do not allow them to be employed directly by an organisation like the NHS.

Does Integrated Medicine currently exist in the UK?

Use of the word ‘Doctor’
It is worth bringing to public attention that whereas, in the UK, Dr before someone’s name usually mean that they are a conventional doctor.
Actually this may also mean that they have a PhD qualification ie a doctorate in something or other. Chiropractors also use this to signify that they are a ‘Doctor of Chiropractic’. Practitioners of Ayurvedic Medicine and Chinese medicine and some Homoeopaths also call themselves doctor.
In law there is no prohibition on the use of this term and in practice, anybody can call themselves a ‘doctor’
In practice, clients of therapists within the CAM sector, have to make their own enquiries and checks on the person they are planning to see for help with their health issues.

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