By R. W. “Chip” Watkins, MD, MPH, FAAFP
Integrative medicine is a field that combines conventional medical practices with alternative therapies to address the holistic needs of patients, as opposed to maintaining sole focus on disease management. A common public perception is that conventional medicine is fractured and splintered among many specialties, with profit prioritized over patients. As a result, patients can feel lost, isolated and unheard as they seek providers to address their physical, mental and emotional health needs. In response, the integrative approach is gaining popularity: more healthcare providers are seeking to offer more comprehensive care for their patients, incorporating preventive strategies and promotion of wellness activities.
Laboratory medicine is still critical for quality healthcare under a more holistic approach: ongoing development of advanced technologies and assays offer new and varied diagnostic tools to holistic medicine providers. Laboratory tests can be used to provide insight into nutritional deficiencies, hormonal imbalances, allergies and inflammatory markers, which can be useful in tailoring personalized treatment plans.
Other functional laboratory tests—such as those assessing gut health and genetic predispositions to chronic health issues—have become increasingly popular with patients who seek more personalized healthcare. However, as the demand for such tests grows, so does the need for standardization and thorough validation of these methods. While not all of these tests are laboratory-developed, many are; as a result, medical providers who are using these tests in their practice are rightly scrutinizing the array of alternative testing methods available to them.
As with any type of laboratory testing, providers should seek out laboratories that adhere to standards ensuring the accuracy and clinical relevance of their results. Test methods should be supported by both scientific evidence and relevant clinical guidelines, and laboratories should have robust quality assessment procedures in place to maintain high levels of accuracy and precision in their results. This can include regular and carefully-documented calibration and quality control activities, as well as extensive training and continuing education provided to their testing personnel to ensure consistent work practices. In addition, external assessment, whether through a recognized proficiency testing program or an alternative method such as split-specimen analysis, can ensure that the laboratory’s results are consistent.
Accreditation, too, can serve as a sign of quality. A laboratory that has obtained and maintained accreditation from a recognized entity such as COLA is demonstrating that they are consistently able to meet the requirements of their accreditation provider, which are often above and beyond those required by the CLIA regulations.
As integrative medicine gains a foothold and continues to evolve, laboratory medicine will have a large role to play in ensuring that providers are operating from high-quality information about their patients’ baseline health. Laboratory medicine remains central to quality healthcare, whether that care is delivered within the framework of traditional medicine and its many specialties, or the complementary field of holistic and integrative medicine.