From augmenting their morning coffee with an array of natural supplements, to adding yoga and meditation to their daily routines, people are increasingly turning to alternative methods to boost their health.
Complementary and alternative health approaches are health practices that aren’t conventionally prescribed, such as acupuncture and tai-chi, and are often rooted in non-Western medical disciplines, such as Traditional Chinese Medicine, Indian Ayurveda, Latin American Curanderismo and more.
A 2024 report from the National Center for Complementary and Integrative Health (NCCIH) found that more than one-third of U.S. adults regularly practice yoga, meditation, and acupuncture. According to the CDC, more than half of Americans regularly take supplements.
These practices fall under the umbrella of integrative medicine, part of a growing movement to pursue “whole health,” a patient-centered approach that promotes mental, physical, and emotional well-being, according to the National Academies of Sciences, Engineering and Medicine.
These forms of treatment are far from new, and have been explored and developed in practice over centuries in non-Western healing traditions. Institutions such as the UCLA Center for East-West Medicine, celebrating its 30th anniversary this year, have sought to explore the integration of these practices in traditional medical treatments, and pursue research that supports their efficacy.
For many, natural supplements offer a promise of limited side effects, health benefits and accessibility. However, with the barrage of conflicting health information online, misleading claims by supplement providers, and the continuing research into the efficacy of these practices, patients are often left with several questions.
Current medical education curricula fail to expose physicians to the full background of these approaches, leaving many doctors ill-prepared to answer patient questions, often leaving them dismissed.
Patients whose integrative health practices are grounded in their cultural identity, or those seeking to promote their health holistically, are also left behind.
The David Geffen School of Medicine at UCLA, however, is taking a new approach. Guiding a new curriculum is Rashmi Mullur, MD, a nationally recognized leader in the integration of whole-health approaches in clinical practice, and board-certified endocrinologist and integrative medicine physician at UCLA Health.
She also serves as the chief of telehealth at the VA Greater Los Angeles Health system, where she has pioneered digital, clinical, research, and educational programs that address the holistic needs of veterans, including the first tele-yoga program of its kind.
An integrated curriculum for an integrative approach
Previously, medical students interested in exploring integrative health practices, such as yoga, meditation, and acupuncture, were limited to single elective courses.
“The opportunity here was to create a thread focused on Integrative Medicine and Whole Health,” said Dr. Mullur, “where the concepts are embedded in each of their main courses.”
As students learn the scientific foundations of human biological systems and treating illnesses, they also learn evidence-based approaches to treating patients with integrative approaches in and out of the classroom.
To best prepare students for patient questions about supplements, for example, they first learn about the supplement industry, its regulatory practices, and the scientific basis behind the mechanisms of these compounds. They then immediately apply this knowledge in mock patient encounters, where they learn to ask a patient about their supplements and counsel them on their safety.
“The difference is that our approach is longitudinal,” explained Dr. Mullur, allowing for a deeper engagement with integrative healing practices. Students also gain experience with integrative medicine practitioners, supporting their understanding and increasing their likelihood of referring patients to these treatments in practice, according to a 2018 study she led at the VA Greater Los Angeles Health System.
A comprehensive understanding of integrative approaches to medicine allows student doctors to broaden their toolkit, better serve a diverse patient population, and meet their needs nonjudgmentally.
Promoting equity through culturally sensitive and patient-centered care
To Dr. Mullur, providing a safe and nonjudgmental patient experience is central to her mission as a physician. “I do most of my work inspired by my son who had multiple medical issues and a chronic disability,” she shared. Integrative approaches made a difference for him.
“Your patients are always going to try to do whatever they can, and I’d rather have our students trained in how to respectfully answer their questions rather than dismiss them.”
Dr. Mullur employs integrative approaches in her practice as an endocrinologist at the UCLA Health Gonda Diabetes Center, where she treats patients with chronic illnesses.
“Many of my patients have been through the revolving door of multiple natural paths, functional medicine doctors, and supplements,” she explained. Dismissing a patient’s experience with these paths has never stopped them from trying them, but rather increases the chance of them relying on “Dr. Google,” or ending up with practitioners without their best interest in mind.
“Almost every one of my patients is struggling with an endocrine disorder, plus something else. It’s usually not just one thing, and for many of them it’s pain,” she explained. Being able to guide patients through stretches may be more helpful for their metabolic health than simply offering them a referral.
Dr. Mullur, a registered yoga therapist, hosts integrative group visits for patients, in which she guides them through information on healthy nutrition and sleep practices and a mindfulness meditation session. A 2016 clinical study she led showed the significant benefits of regular meditation practices in improving health outcomes for patients with diabetes.
The “whole health” approach is also inextricable from its interactions with the social and structural determinants of health.
We can’t recommend healthy sleep, nutrition, and lifestyles without also recognizing that these are inaccessible to many populations, Dr. Mullur explained. A strength of the DGSOM curriculum is its prioritization of health equity, including practicing cultural humility in these practices, and ensuring their accessibility.
The inclusion of integrative medicine in the medical school curriculum is a significant step in promoting the diversity of physicians, making space for students who seek to explore practices that resonate with their own cultural healing traditions.
This curriculum was made possible in the first place by students who sought to broaden their understanding of alternative and complementary medicine, Dr. Mullur emphasized.
However, this is only the first step. “What I want students to take away,” Dr. Mullur said, “is that we need to be respectful of these traditions and their place in clinical care.” This doesn’t end in medical school, she said, but extends to the way integrative medicine is represented in licensing and certification exams, and in interactions with patients.
