Casting a broad vision of health and relational medicine – an integrative practitioner

Written by Alison Proffitt

NEW YORK – In opening remarks at this week’s Integrative Health Care Symposium in New York, Dr. Tirona Le Dog, founding director of integrative and functional medicine at UC Irvine’s Susan Samuel Institute for Integrative Health, urged the audience to look beyond modern biomedicine and pursue whole-system care, integrating traditional healing practices and a drive for curiosity.

Modern biomedicine, although important, uses too narrow a framework to evaluate integrative and traditional approaches to care. Dr. Le Dog says this field needs to expand its research methods and definition of healing.

She put forward a vision of a health care system in which patients could navigate emergency medicine, primary care, acupuncture, chiropractic medicine, counseling, and nutritional guidance as complementary threads rather than competing alternatives. “No profession or system feels defensive, no profession or system must win, and no patient feels fragmented.”

On treatment versus recovery

To achieve this vision, Dr. Le Dog proposed a shift in thinking from simply eliminating disease to restoring health. “Treatment is not always a cure,” she said. “When we eliminated the disease—when we got rid of the symptoms or fixed the laboratory—vitality didn’t necessarily come back.” She described healing as “relational” and “meaning-making”: “It’s about being with someone without having to fix them.”

She illustrated this point with a personal account of dislocating her hip while traveling. During a long, painful emergency room visit, she described looking across the room at a colleague who, instead of offering anxious assistance, sat with her in silence.

“He sat with me, letting people do what they needed to do. I felt things change inside me. My body relaxed, my breathing deepened, and I began to realize that healing was already happening before I fixed my hip,” she said. She put the question directly to the audience: “What is it? How do you know it? How do you capture it? How do you study it? … We can fix what we can measure, but we cannot cure what was fundamental.”

Multidimensional evidence and research methods

Dr. Low Dog does not oppose science, she only advocates a precise understanding of what can and cannot be achieved. “I don’t want to reduce the rigor,” she said. “I want the science, and I want the evidence.” “But I want more dimensional science, I want more dimensional evidence.” What concerns her is the mismatch between the randomized clinical trial model—developed to test pharmaceutical compounds in homogeneous, controlled populations—and the complexity of integrative interventions for the entire system.

She gave a concrete example: A researcher friend of mine at Columbia University conducted a study on black cohosh, interviewing 2,000 women but only enrolling 82 women after screening for eligibility. Dr. Le Dogue highlighted that these other 1,900 women represent the real women in her clinic. “How generalizable is your study if it has to be a population so pure that they don’t represent the patients in our clinic anymore?”

She distinguished the goals of science from the goals of medicine: “Science is about control, objectivity, and repeatability… Science gets at general truths… Medicine values ​​wisdom, compassion, and empathy. I practice the art of medicine and use science as a tool.”

“I don’t think my listening is any less powerful than my medicine. I don’t think my presence is any less scientific than my procedure.”

Important results

Traditional healing systems — which have incorporated traditional Chinese medicine, Ayurveda, Arabic medicine, and indigenous traditions of North and South America — are routinely dismissed in Western medicine as mere “folk practices,” Dr. Le Dog said. She called this attitude “really arrogant and uninformed.”

“These were not random popular practices,” she said. “They were experimental, observational and community-based approaches to treating diseases that evolved from generation to generation over thousands of years.” These methods provide results that matter to the patient and society: restoring hope and achieving harmony within society.

She called for humility and curiosity when dealing with patients. She recounted an obstetric experience in which a Vietnamese patient who gave birth by caesarean section refused to shower before being discharged from the hospital. Instead of insisting, Dr. Le Dog asked about the matter through an interpreter and learned that the patient believed that water and cold after blood loss were harmful. “This makes perfect sense,” she told the patient. “Thank you for teaching me that.”

But scientific results do not always align with patient priorities. She said health care often mistakes a normal biomarker for someone who has been cured, and called for measuring outcomes that reflect the patient’s experience.

“Patients never tell me: ‘Well, my vital sign is better.’ (They say:) I feel more energy. I’ve slept better… and I’m starting to imagine my future again. I feel joy. These are not easy results. These are human results.”

She pointed to integrative oncology as a field that is starting to do this kind of work in hybrid ways, combining tumor response data with measures of fatigue, sleep, energy, and immune markers. “When you can study coherence, you begin to study true healing,” she said.

Dr. Le Dog concluded her talk – and began the rest of the conference – with a challenge to the audience: “Please never give up on science, but never give up on the spirit and healing either. Bring your knowledge, bring your training, bring your cultural memory, your intuition, and your heart. Be the doctor who can run labs, hold hands, interpret vital signs, and nurture dreams. Let us know that the practice of medicine is wise enough to measure what we can and humble enough to know what we can’t. Let us know to build a system where people say, ‘I feel seen,'” “I feel heard, I feel complete.” This is the medicine our world demands and the medicine we can create, the medicine that can heal our patients, our planet, and ourselves.