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JAMA Reviews the Journal Edited by the Wiki-Medical Founder

Majid Ali, M.D.

In July 2001, the Journal of the American Medical Association published a review of two journals devoted to integrative medicine, one of them which edited. I was humbled by the Journal’s recognition of my definition of integrative medicine, as published in The Journal of Integrative Medicine (1998): "Integrative medicine seeks to integrate all therapies that are effective and safe into the care of the sick, without subservience to any one school of thought."

The view of JAMA—undoubtedly reflecting the position of the American Medical Association—is revealing in it grudging acceptance of some of the core tenets of integrative medicine as accepted by the practitioners in the field.

********

Integrative Medicine. by Denise McKee, MD, Joan S. Zenan, MLS. JAMA. 2000;283(22): 2993-2994.

Integrative Medicine: Integrating Conventional and Alternative Medicine, edited by Andrew Weil, quarterly, $98 (institutions), $48 (individuals), New York, NY, Elsevier Science, 1998.

The Journal of Integrative Medicine, edited by Majid Ali, quarterly, $30, Denville, NJ, Aging Healthfully, Inc., 1997.

The new consumer-driven medical paradigm combines conventional and alternative medicine. "Integrative medicine" seeks to integrate all therapies that are effective and safe into the care of the sick, without subservience to any one school of thought. 1.2.

Many health care consumers are dissatisfied with the therapeutic limitations of conventional medicine, especially in the treatment of chronic diseases. Consumers also are disenchanted with the concept of drug treatment for all acute diseases and the exclusion of the spirit and psyche as part of a treatment plan. Integrative medicine places emphasis on prevention and health care maintenance without relying on expensive technology or a drug to cure every ill. Patients within the integrative medicine framework are asking physicians to "sort out sense from nonsense"1 in a valid way.

Integrative Medicine (IM) and The Journal of Integrative Medicine (TJIM) are timely journals in their distribution of desired information intended for the health care professional audience. Both are subject to peer review and editorial revision. IM seems to have the most clinical significance for the primary care physician with its diversity of types of articles and depth of focus on clinical reviews of the literature. TJIM publishes mostly original articles and book reviews; IM publishes original articles, review articles, literature reviews, case reports, book reviews and essays.

The reviewers evaluated the first three issues of both journals. All articles in IM except the editorials, were written by a diverse set of authors. In all but two TJIM articles the editor, Majid Ali, MD, was lead or sole author. The authors in both journals certainly have appropriate expertise, but IM has a high degree of synthesis and critical analysis in its review articles. Topics covered in TJIM included nutrition therapy, antioxidant therapy, integrative medical education, and fibromyalgia therapy. IM included articles on homeopathy, chiropractic, medical education, antioxidant therapy, acupuncture, and therapeutic touch.

TJIM highlights "seven care principles of integrative medicine: empiricism, integrative, integrity of cellular and tissue ecological relationships, physician-patient reciprocity, spontaneity of oxidation, spontaneous healing, and spiritual surrender." The editor believes it is shortsighted of medical editors to emphasize articles that are double-blinded crossover model studies for drug evaluations in chronic illnesses, and considers this practice to be the principal folly of 20th century medicine.

A statement in TJIM reads: "mainstream editors readily reject submissions concerning integrative models, reports of clinical outcome with integrative therapies simply do not get published."3 However, this statement conflicts with the published clinical medicine literature.4 The entire November 11, 1998, issue of JAMA was dedicated to articles on alternative medicine.5 American Family Physician has published numerous articles on alternative medicine, herbal therapy, and other therapies considered "alternative" by the National Institutes of Health's National Center for complementary and Alternative Medicine. Examples of those therapies are manual healing methods, diet and nutrition, bioelectromagnetic therapies, alternative systems, herbal therapy, pharmacologic treatments, and mind-body intervensions.6.7 The Journal of Family Praictice and the Southern Medical Journal also have published peer-reviewed articles on integrative concepts. 8.9

Both journals have qualified editorial boards consisting of an appropriate mix of MDs and PhDs. IM provides a more detailed description of each member's affiliations. Both journals are equally original in their tables of contents. IM appears to have higher scientific standards for research methods and analytical techniques. Dr. Ali makes relevant points very articulately in TJIM. Yet, IM instead publishes articles according to what JAMA readers generally would consider to be a higher standard for quality of research, technique, and practice. IM also presents a more comprehensive and well-rounded content than TJIM. In summary, IM represents the more clinically useful journal for the primary care practitioner.

Denise McKee, MD, Joan S. Zenan, MLS

University of Nevada School of Medicine, Reno

1. Weil A. Title. (editorial). Integr Med. 1998;1:1.

2. Ali M. Why should you earn a degree in integrative medicine? What should such a degree mean? J Integr Med. 1998;2:74.

3. Ali M. Seven core principles of integrative medicine. J Integr Med. 1998;2:81.

4. Barnes J, Abbot NC, Harkness EF, Ernst E. Articles on complementary medicine in the mainstream medical literature: an investigation of MEDLINE, 1966-1996. Arch Intern Med. 1999;159:1721-1725.

5. Fontanarosa PB, Lundberg, GD, eds. Alternative medicine. JAMA. 1998;280(theme issue):1549-1640.

6. Chung M. Why alternative medicine? AM Fam PHysician. 1996;54:2184-2187.

7. Gordon J. Alternative medicine and the family physician. Am Fam Physician. 1996;54:2205-2212.

8. McKee D, Chappel J. Spirituality and medical practice. J Fam Pract. 1992;35:201-208.

9. Byrd R. The positive therapeutic effects of intercessory prayer in a coronary care unit population - South Med J. 1998; 81:826-829.

List of Related Philosophy Essays

Below is a list of my other essays of the subject of the healing philosophy. These essays are based on materials included in the twelve volumes of my textbook, The Principles and Practice of Integrative Medicine:

* JAMA Reviews the Journal Edited by the Wiki-Medical Founder

*  Philosophy of Integrative Medicine

*  Of Reason, Belief, and Oxygen

*  Ideas and Ideologies Define the Human Condition

The Aristotle Principle

The Darwin Principle

*  Of Diagnosis, Detection, Ethics, and Denial

*  Freedom of Thought in Integrative Medicine

There Are No Controversies

Science and An Angry Colleague

*  History, Like Science, Is Never a Finished Story

*  Oxygen Orchestrates Human Life

*  An Air Pump Works Well When It Pumps Clean Air

*  Organized Around Metals

*  Quantum Spirituality and Uncertainty

The Father of Unthinking Medicine

When Should a Doctor Not Listen to the Patient?

A Letter to President Obama

 

 

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