Integrative Medicine is the umbrella term used to describe a healthcare approach that incorporates a wide range of health modalities – including Ayurveda, manual therapies, Chinese medicine and acupuncture, anthroposophic medicine, herbal supplements, chiropractic, yoga, and holistic nutrition – into conventional biomedicine.
Integrative medicine as a field arises from the frustrations of physicians who feel they are limited in their treatment of the more-than physical dimensions of diseases and illnesses. By drawing on holistic healing modalities to treat the mind, body, and spirit of patients, integrative medicine is refocusing healthcare around the needs of patients.
This “whole patient” approach to care is attracting $35 billion in out-of-pocket healthcare spending annually in the United States alone.
Looking for ways to treat chronic conditions, injuries, and cancer, women are the leading consumers of integrative medicine. The significance of this pattern is often dismissed by explanations which rely on gendered conventions of femininity to elucidate why integrative medicine is sought after by predominantly white, middle class, educated women between the ages of 30 to 69. In this article, we address four of these assumptions to create new insight into the particular conditions and constraints that motivate women to seek out this very different approach to medical care. In so doing, we seek to invite interest around the promise of this emerging field.
Assumption One: White, wealthy, educated women access integrative medicine because they can
It won’t come as a surprise to anyone to learn that women, especially wealthy, educated, white women, are the largest consumers of integrative medicine. The question, then, is why these women are using their social and economic privilege to seek out and pay for more personalized forms of medical care? They aren’t accessing integrative medicine just because they can afford to pay for it out of pocket, or because they have the privilege of education and time to seek out alternative forms of care; they are doing so because they are dissatisfied with biomedical care.
To challenge our assumptions about integrative medicine as simply an expensive luxury for the privileged few, we must acknowledge that women’s consumer choices are also political choices that express a demand for difference. The choice to seek integrative medicine is an active decision that reveals emerging sets of values, ideas, and expectations when it comes to healthcare. For example, women with breast cancer are often motivated to find ways to improve the conditions of their care because the conventional medical approach is unable or unwilling to treat anything other than the physical symptoms of their disease. These women pursue integrative medicine because they recognize the shortfalls of conventional medicine, and want an individualized approach to their treatment that will also support their mind and body on their path to recovery.
The recent push in many healthcare institutions to become more patient-centric means that they are looking to listen and involve patients in new ways – ways that respect their decisions. It is important to recognize that women choose integrative medicine because it better meets their health concerns, and the pursuit of this practice is not merely a matter of personal preference for those women lucky enough to be able afford it.
Assumption Two: Emotional connections are especially important to women
Integrative medicine delivers whole patient care that takes account of how patients live – how their disease or illness affects and is affected by their thoughts, emotions, and relationships. One of the reasons integrative medicine is growing in popularity among affluent women is because they are seeking more meaningful interactions with their healthcare professionals. This is not because women are more emotionally needy, but because they have found conventional medicine to be too disease-focused, and therefore dismissive of the psycho-social dimensions of their disease.
The application of technological interventions and business metrics in biomedicine today has created a disconnect between doctors and patients. Both are frustrated by the constraints of the 8-minute appointment slot; it’s difficult to build relationships when doctors are always in a rush. On the other hand, integrative medical practitioners deliberately schedule more time for appointments, time that is used to learn about their patients’ lives, families, fears, and joys. By giving patients more time to share their concerns, these practitioners are refashioning the patient-practitioner relationship.
For a long time, we’ve sensed that the opportunity to build trusting relationships with healthcare professionals is important for healing. Now we also have the science to back this up. Recent studies show that good patient-doctor relationships improve health outcomes. Therefore, regardless of our gender, age, ethnicity, or class, we could all benefit from more empathetic care from our healthcare providers.
Assumption Three: Women are more in-tune with their bodies
It is sometimes argued that women are “naturally” connected to their bodies and their bodily needs by virtue of experiencing menstruation, pregnancy, and menopause. However, not all women experience these events, nor are biology or biological processes the only determinants of female identity. The relationship women have with their bodies is terse and complex, and female embodiment is shaped by cultural norms and expectations.
We might consider that women seek integrative medicine not because they are more connected to their bodily needs, but rather because biomedicine has displaced them from their bodies.
For instance, many women seek integrative care for support through adjuvant chemotherapy after undergoing a mastectomy, to help them feel whole again after having part of their body removed precisely because biomedicine has little resources to help them process that loss.
To dismiss integrative medicine as “something for women” because they are naturally more in tune with their bodies is harmful to both men and women, and the many ways in which we individually relate to our bodies. If we can look beyond social stereotypes, we might recognize that integrative medicine provides care for those of us who are working to develop a better sense of all our health needs, to discover what it takes to make ourselves feel well and whole.
Assumption Four: Women use emotion rather than reason to make healthcare decisions
The idea that women’s choices are driven by feelings and not tactics prevents us from recognizing the implications of their increased use of integrative medicine. This assumption sets up a false dichotomy between emotion and reason, as these ideas are not so diametrically opposed. We have only to consider the passion of physicians, researchers, and nurses who lead innovation in the fields of medicine and science to understand the intertwining of these polarities.
For example, rather than listen to the many people with digestive complaints who claim to feel better when they eat gluten-free products, science dismisses these testimonials and the popularity of the products as evidence of a food trend among hypochondriacs who have nothing medically wrong with them. Public health choses to ignore educated women who opt to use integrative medicine because they question the so-called “objective” data and results, and because they distrust unbiased medical regulators who claim to have only their best interests in mind. In biomedicine, where evidence-based medicine is king, there is no room for healers who apply their experience and use their intuition to treat individuals.
Women’s use of integrative medicine is calculated and informed by personal experience. Their negative experiences with conventional medicine have rerouted them to seek different kinds of doctor-patient relationships and different treatment options. This interest might be seated in an emotionally charged experience of disappointment with conventional medicine – of feeling like they were a number or a disease and not a person – but women are very much active and decisive in their choices to seek a different kind of medical care.
Implications for Health and Business
Women have very real reasons for accessing integrative medicine. They want more empathy, more choice, and more personalized care provided by healthcare practitioners that they can trust. Of course, we can chose to ignore these reasons and continue to sideline other health and healing practices, or we can choose to better understand the value of these practices for responding to and predicting the needs that motivate women’s consumer choices.
Having challenged some common assumptions about women’s uses of integrative medicine, we feel that it is now time for women to be recognized as early adopters of new forms of care. We acknowledge that it’s a classed privilege in North America to be able to select and access integrative medical care, but nevertheless, these patterns of consumption show us the value of alternative options. Therefore, from an economic perspective, it would be beneficial to increase access to integrative medicine for all of us. It improves individual health, while acting as a radical alternative to the exploding healthcare costs plaguing most industrialized countries today.
Dr. Melissa Atkinson-Graham is a ethnographer at Idea Couture.