Advocating for integrative medicine: providers' stories of resonance, negotiation, and community


Submitted: 4 September 2017
Accepted: 10 April 2018
Published: 30 May 2018
Abstract Views: 1205
PDF: 452
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Authors

  • Courtney Hook Scripps College of Communication, School of Communication Studies, Ohio University, Athens, OH, United States.
  • Brielle Plump Department of Language Arts/Communication, Skyline College, San Bruno, CA, United States.
  • Patricia Geist-Martin School of Communication, San Diego State University, San Diego, CA, United States.

Integrative medicine (IM) is a holistic health care option that blends complementary, alternative medicine with biomedical models of care. Many medical care facilities do not offer IM treatment for patients, yet the demand for IM is growing. Therefore, IM providers are in the position of educating and promoting IM to patients and other medical practitioners. There is limited research literature focusing on how IM providers communicate advocacy for IM. Therefore, this research is designed to explore the perspectives of providers about the ways that they communicate advocacy for IM in their lives and their medical practice. Interview data we collected at The Center reveals the ways that IM providers continuously advocate for IM through their resonance with IM philosophy, by negotiating systemic tensions that revolve around IM, and by forming communities of practice with patients and other providers. Results of this investigation offer insight about IM, communication, and advocacy.


Abrams, D. I. (2013). Communication issues in integrative oncology. In New challenges in communication with cancer patients (pp. 81-90). New York, NY: Springer.

Annandale, E. (1998). The sociology of health and medicine: A critical introduction. Cambridge, England: Polity Press.

Arrow, K., Auerbach, A., Bertko, J., Brownlee, S., Casalino, L. P., Cooper, J., van de Ven, W. P. (2009). Toward a 21st-century health care system: Recommendations for health care reform. Annals of Internal Medicine, 150, 493-495. DOI: https://doi.org/10.7326/0003-4819-150-7-200904070-00115

Ballard-Reisch, D. S. (1990). A model of participative decision making for physician patient interaction. Health Communication, 2, 91-104. DOI: https://doi.org/10.1207/s15327027hc0202_3

Barnes, P., Powell-Griner, E., McFann, K., Nahin, R. (2004). Complementary and alternative medicine use among adults: United States, 2002. Advanced Data, 343, 1–19. DOI: https://doi.org/10.1016/j.sigm.2004.07.003

Barrett, B. (2003). Alternative, complementary, and conventional medicine: Is integration upon us? The Journal of Alternative and Complementary Medicine, 9, 417-427. DOI: https://doi.org/10.1089/107555303765551642

Barrett, B., Marchand, L., Scheder, J., Plane, M. B., Maberry, R., Appelbaum, D., … Rabago, D. (2003). Themes of holism, empowerment, access, and legitimacy define complementary, alternative, and integrative medicine in relation to conventional biomedicine. The Journal of Alternative & Complementary Medicine, 9, 937-947. DOI: https://doi.org/10.1089/107555303771952271

Bell, I. R., Caspi, O., Schwartz, G. E., Grant, K. L., Gaudet, T. W., Rychener, D., … Weil, A. (2002). Integrative medicine and systemic outcomes research: Issues in the emergence of a new model for primary health care. Archives of Internal Medicine, 162, 133. DOI: https://doi.org/10.1001/archinte.162.2.133

Brill, S. (2013). Bitter pill: Why medical bills are killing us. Time, 181(8), 22-45.

Brownlee, S. (2010). Overtreated: Why too much medicine is making us sicker and poorer. New York, NY: Bloomsbury USA.

Collins, J. (2012). General format. Retrieved from http://www.Scripps.org

Corrias, D., Tagliabue, L., & Strepparava, M. G. (2010). The influence of personality dimensions on communication style: A study on medical students. Paper presented at the European Association for communication in health care: International conference on communication in health care, Verona, Italy.

Coulter, I. D., & Willis, E. M. (2004). The rise and rise of complementary and alternative medicine: A sociological perspective. The Medical Journal of Australia, 180, 587- 589. DOI: https://doi.org/10.5694/j.1326-5377.2004.tb06099.x

Delgado, R., York, A., Lee, C., Crawford, C., Buckenmaier III, C., Schoomaker, E., & Crawford, P. (2014). Assessing the quality, efficacy, and effectiveness of the current evidence base of active self-care complementary and integrative medicine therapies for the management of chronic pain: a rapid evidence assessment of the literature. Pain Medicine, 15(S1), S9-S20. DOI: https://doi.org/10.1111/pme.12412

du Pré, A. (2002). Accomplishing the impossible: Talking about body and soul and mind during a medical visit. Health Communication, 14, 1-21. DOI: https://doi.org/10.1207/S15327027HC1401_1

Dutta, M. (2008). Communicating health: A culture centered approach. Cambridge, UK: Polity.

Dutta-Bergman, M. J. (2005). The relation between health-orientation, provider-patient communication, and satisfaction: An individual-difference approach. Health Communication, 18, 291-303. DOI: https://doi.org/10.1207/s15327027hc1803_6

Ellingson, L. L. (2009). Ethnography in applied communication research. Routledge Handbook of Applied Communication Research, 129.

Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129-136. DOI: https://doi.org/10.1126/science.847460

Fayers, P. M., & Machin, D. (2013). Quality of life: The assessment, analysis and interpretation of patient-reported outcomes. New York, NY: John Wiley & Sons.

Frömke, S. (Producer), & Heineman, M. (Director). (2012). Escape fire: The fight to rescue American healthcare [Motion Picture]. United States: Aisle C, Our Time Projects.

Fuchs, V. R. (1996). Economics, values, and health care reform. American Economic Review, 86, 1-24.

Gage, H., Storey, L., McDowell, C., Maguire, G., Williams, P., Faithfull, S., Poole, K. (2009). Integrated care: Utilization of complementary and alternative medicine within a conventional cancer treatment center. Complementary Therapies in Medicine, 17, 84-91. DOI: https://doi.org/10.1016/j.ctim.2008.09.001

Geist-Martin, P., Sharf, B. F., & Jeha, N. (2008). Communicating healing holistically. In H.M. Zoller & M. J. Dutta (Eds.), Emerging perspectives in health communication: Meaning, culture, and power (pp. 85-112). New York, NY: Taylor & Francis.

Geist, P., & Gates, L. (1996). The poetics and politics of re-covering identities in health communication. Communication Studies, 47, 218-228. DOI: https://doi.org/10.1080/10510979609368477

Geist, P., & Hardesty, M. (1990). Reliable, silent, hysterical, or assured: In their medical decision making. Health Communication, 2, 69-90. DOI: https://doi.org/10.1207/s15327027hc0202_2

Goldsberg, B. (1997). The mind-body-spirit connection. Asha, 39(3), 24-30.

Grol, R., Wensing, M., Eccles, M., & Davis, D. (Eds.). (2013). Improving patient care: the implementation of change in health care. New York, NY: John Wiley & Sons. DOI: https://doi.org/10.1002/9781118525975

Guyatt, G. H., Feeny, D. H., & Patrick, D. L. (1993). Measuring health-related quality of life. DOI: https://doi.org/10.7326/0003-4819-118-8-199304150-00009

Annals of Internal Medicine, 118, 622-629.

Harter, L. M., & Krone, K. J. (2001). Exploring the emergent identities of future physicians:Toward an understanding of the ideological socialization of osteopathic medical students. Southern Communication Journal, 67, 66-83. DOI: https://doi.org/10.1080/10417940109373219

Harter, L. M., Patterson, S., & Gerbensky-Kerber, A. (2010). Narrating “new normals” in health care contexts. Management Communication Quarterly, 20, 1-9. DOI: https://doi.org/10.1177/0893318910370271

Horrigan, B., Lewis, S., Abrams, D., & Pechura, C. (2012). Integrative medicine in America: How integrative medicine is being practiced in clinical centers across the United States. Retrieved from www.bravewell.org DOI: https://doi.org/10.7453/gahmj.2012.1.3.006

Howard, L. A., & Geist, P. (1995). Ideological positioning in organizational change: The dialectic of control in a merging organization. Communications Monographs, 62, 110-131. DOI: https://doi.org/10.1080/03637759509376352

Hurwitz, B., & Charon, R. (2013). A narrative future for health care. The Lancet, 381(9881), 1886. DOI: https://doi.org/10.1016/S0140-6736(13)61129-0

Joseph-Williams, N., Elwyn, G., & Edwards, A. (2014). Knowledge is not power for patients: a systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision making. Patient Education and Counseling, 94, 291-309. DOI: https://doi.org/10.1016/j.pec.2013.10.031

Kelner, M. (2014). Complementary and alternative medicine: challenge and change. New York, NY: Routledge. DOI: https://doi.org/10.4324/9781315080109

Keshet, Y. (2009). The untenable boundaries of biomedical knowledge: Epistemologies and rhetoric strategies in the debate over evaluating complementary and alternative medicine. Health: An Interdisciplinary Journal for The Social Study of Health, Illness

& Medicine, 13, 131-155. doi:10.1177/1363459308099681. DOI: https://doi.org/10.1177/1363459308099681

Kessler, R. C., Davis, R. B., Foster, D. F., Van Rompey, M. I., Walters, E. E., Wilkey, S. A.,

… Eisenberg, D. M. (2001). Long-term trends in the use of complementary and alternative medical therapies in the United States. Annals of Internal Medicine, 135, 262-270. DOI: https://doi.org/10.7326/0003-4819-135-4-200108210-00011

Knutson, L., Johnson, P. J., Sidebottom, A., & Fyfe-Johnson, A. (2013). Development of a hospital-based integrative healthcare program. Journal of Nursing Administration, 43, 101-107. DOI: https://doi.org/10.1097/NNA.0b013e31827f2229

Kocher, R., Emanuel, E. J., & DeParle, N. A. M. (2010). The Affordable Care Act and the future of clinical medicine: The opportunities and challenges. Annals of Internal Medicine, 153, 536-539. DOI: https://doi.org/10.7326/0003-4819-153-8-201010190-00274

Levinson, W., Roter, D. L., Mullooly, J. P., Dull, V. T., & Frankel, R. M. (1997). Physician-

patient communication. Jama, 277, 553-559.

Liao, W. L., & Tsai, F. J. (2013). Personalized medicine: a paradigm shift in healthcare. BioMedicine, 3, 66-72. DOI: https://doi.org/10.1016/j.biomed.2012.12.005

Moore, M. (Producer), Moore, M. (Director). (2007). Sicko [Motion Picture]. United States: Lionsgate.

Mumby, D. K. (1987). The political function of narrative in organizations. Communications Monographs, 54, 113-127. DOI: https://doi.org/10.1080/03637758709390221

Mumby, D. K. (2004). Discourse, power and ideology: Unpacking the critical approach. In

D. Grant (Ed.), The SAGE handbook of organizational discourse (pp. 237-258). Thousand Oaks, CA: SAGE Publications.

Nahin, R. L., Barnes, P. M., Stussman, B. J., & Bloom, B. (2009). Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States, 2007 (National Health Statistics Report No. 18). Hyattsville, MD: National Center for Health Statistics.

Ni, H., Simile, C., & Hardy, A. M. (2002). Utilization of complementary and alternative medicine by United States adults: Results from the 1999 national health interview survey. Medical Care, 40, 353-358. DOI: https://doi.org/10.1097/00005650-200204000-00011

Nicks, P., Hirsch, W. B., Davis, L. Open'hood (Organization), Independent Television Service., Peer Review Films., Docurama (Firm). Cinedigm (Firm),.(2013). The waiting room.

Olson, K. (2011). Essentials of qualitative interviewing. Walnut Creek, CA: Left Coast Press.

Oshima Lee, E., & Emanuel, E. J. (2013). Shared decision making to improve care and reduce costs. DOI: https://doi.org/10.1056/NEJMp1209500

New England Journal of Medicine, 368, 6-8.

Pan, W., & Zhou, H. (2014). Inclusion of integrative medicine in clinical practice. Integrative Medicine International, 1, 1-4. DOI: https://doi.org/10.1159/000362628

Pellegrino, E. D. (1999). The commodification of medical and health care: The moral consequences of a paradigm shift from a professional to a market ethic. Journal of Medicine and Philosophy, 24, 243-266. DOI: https://doi.org/10.1076/jmep.24.3.243.2523

Politi, M., & Street, R. L. (2011). Patient-Centered communication during collaborative decision making. In T. L. Thompson, R. Parrott, & J. F. Nussbaum (Eds.), The Routledge handbook of health communication (pp. 399-413). New York, NY: Routledge.

Reader, T. W., Gillespie, A., & Roberts, J. (2014). Patient complaints in healthcare systems: a systematic review and coding taxonomy. BMJ Qual Saf, 23, 678-689. DOI: https://doi.org/10.1136/bmjqs-2013-002437

Sacristán, J. A. (2013). Patient-centered medicine and patient-oriented research: improving health outcomes for individual patients. BMC Medical Informatics and Decision Making, 13, 6. DOI: https://doi.org/10.1186/1472-6947-13-6

Saltzman, E., & Eibner, C. (2016). Donald Trump’s health care reform proposals: Anticipated effects on insurance coverage, out-of-pocket costs, and the federal deficit. The Commonwealth Fund, 32, 1-14.

Scholl, I., Zill, J. M., Härter, M., & Dirmaier, J. (2014). An integrative model of patientcenteredness–a systematic review and concept analysis. PloS One, 9, e107828. DOI: https://doi.org/10.1371/journal.pone.0107828

Schulz, P. J., & Nakamoto, K. (2013). Health literacy and patient empowerment in health communication: the importance of separating conjoined twins. Patient Education and Counseling, 90, 4-11. DOI: https://doi.org/10.1016/j.pec.2012.09.006

Sharf, B. F. (1990). Physician-Patient mommunication as interpersonal rhetoric: A narrative approach. Health Communication, 2, 217-231. DOI: https://doi.org/10.1207/s15327027hc0204_2

Sharf, B. F., & Street Jr., R. L. (1997). The patient as a central construct: Shifting the emphasis. Health Communication, 9, 1-11. DOI: https://doi.org/10.1207/s15327027hc0901_1

Shi, L., & Singh, D. A. (2014). Delivering health care in America. Burlington, MA: Jones & Bartlett Learning.

Snyderman, R., & Weil, A. T. (2002). Integrative medicine: Bringing medicine back to its roots. Archives of Internal Medicine, 162, 395. DOI: https://doi.org/10.1001/archinte.162.4.395

Tracy, S. J. (2012). Qualitative research methods: Collecting evidence, crafting analysis, communicating impact. Hoboken, NJ: Wiley-Blackwell.

Wang, W., Keh, H., & Bolton, L. E. (2010). Lay theories of medicine and a healthy lifestyle. Journal of Consumer Research, 37, 80-97. DOI: https://doi.org/10.1086/649772

Willard, B. E. (2005). Feminist interventions in biomedical discourse: An analysis of the rhetoric of integrative medicine. Women's Studies in Communication, 28, 115-148. DOI: https://doi.org/10.1080/07491409.2005.10162486

Wilkins, A. L. (1983). Organizational stories as symbols which control the organization. Organizational Symbolism, 81, 92.

Supporting Agencies

Dr. Joyce Gattas, Dean of Professional Studies and Fine Arts

Hook, Courtney, Brielle Plump, and Patricia Geist-Martin. 2018. “Advocating for Integrative Medicine: Providers’ Stories of Resonance, Negotiation, and Community”. Qualitative Research in Medicine and Healthcare 2 (1). https://doi.org/10.4081/qrmh.2018.7049.

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