What Makes Integrative Medicine Different
When I tell people I practice integrative medicine, I often see confusion. Some assume I’ve rejected conventional medicine in favor of crystals and wishful thinking. Others think it’s just a fancier term for primary care with a wellness bent. Neither is accurate.
Integrative medicine means I can treat your urinary tract infection with the appropriate antibiotic, address your chronic migraines with acupuncture that has robust research support, prescribe bioidentical hormones when your labs and symptoms indicate they’re appropriate, and create a customized herbal formula to reduce the inflammation driving your joint pain. All of this happens within the same practice, guided by the same clinician who understands how these approaches work together and, critically, how they might interact with each other.
I’m a Nurse Practitioner licensed in Washington, Oregon, and Alaska. My training includes conventional medicine—I can diagnose, prescribe, order and interpret labs, manage chronic diseases—but I’ve also completed extensive training in acupuncture, East Asian medicine, botanical medicine, and ketamine-assisted therapy. I practice in Eastsound in the San Juan archipelago, and the combination of services I offer under one roof is genuinely unusual. More importantly, the way these modalities inform each other changes how I practice all of them.
This isn’t about rejecting pharmaceuticals or embracing them uncritically. It’s about having enough tools to match the intervention to the problem. Sometimes the right answer is amoxicillin. Sometimes it’s acupuncture twice weekly for six weeks. Often it’s both, calibrated to work synergistically rather than at cross purposes.
What Integrative Medicine Actually Means
The term “integrative medicine” has been diluted by overuse, so let me be specific about what it means in my practice.
I use evidence-based conventional medicine when it’s the most effective option. If you come in with bacterial pneumonia, you’re getting antibiotics, possibly chest imaging, careful monitoring. If your thyroid labs show hypothyroidism, we’re discussing levothyroxine dosing, not just adaptogens and stress reduction. I’m not interested in substituting herbs for insulin in a diabetic patient or suggesting acupuncture instead of emergency surgery for appendicitis.
At the same time, I recognize that conventional medicine has significant gaps, particularly in treating chronic complex conditions. The standard approach to fibromyalgia—try gabapentin, maybe Lyrica, perhaps an antidepressant, and if those don’t work sufficiently, you’re largely on your own—leaves far too many patients suffering. The conventional approach to treatment-resistant depression cycles through SSRI after SSRI with response rates that should trouble us more than they do. And the opioid crisis revealed catastrophically that our approach to chronic pain was fundamentally flawed.
This is where integration matters. Acupuncture for chronic pain isn’t alternative medicine anymore. A 2012 meta-analysis in the Archives of Internal Medicine analyzing nearly 18,000 patients found acupuncture superior to both sham treatment and usual care for chronic pain conditions, with effects persisting at one year. When the American College of Physicians updated their clinical practice guidelines for low back pain in 2017, they recommended acupuncture as a first-line treatment before medications. That’s not fringe medicine. That’s evidence-based care that most conventional practices simply don’t offer because physicians aren’t trained in it.
The integration works in both directions. My training in conventional medicine makes me a better acupuncturist because I understand the Western physiology underlying what I’m treating. I can recognize when someone’s back pain is actually referred pain from a kidney stone, when their fatigue might be hypothyroidism rather than what Chinese medicine would call qi deficiency, when their anxiety might have a cardiac component that needs evaluation before I treat it with acupuncture and herbs. Conversely, my training in East Asian medicine gives me diagnostic frameworks that reveal patterns conventional medicine misses—the relationship between someone’s digestive symptoms and their headaches, why their anxiety worsens premenstrually, how their insomnia relates to the pain in their ribs.
The goal isn’t to use every available modality for every patient. It’s to have enough tools that I can choose appropriately. Some patients need only conventional care. Some need primarily acupuncture and herbs with minimal pharmaceuticals. Most fall somewhere in between, and the specific combination matters tremendously.
The Scope of Practice
Let me describe concretely what I can do, because the breadth is genuinely unusual for a single provider.
As a Nurse Practitioner with full practice authority, I provide comprehensive primary care. I diagnose and treat acute illnesses—respiratory infections, urinary tract infections, skin infections, acute injuries. I manage chronic diseases including diabetes, hypertension, hypothyroidism, asthma, COPD. I order appropriate labs and imaging, interpret results, adjust medications accordingly. I prescribe when prescription medication is indicated, from antibiotics to antidepressants to controlled substances when appropriate. I perform procedures within my scope—wound care, abscess drainage, joint injections, IUD insertion and removal, skin biopsies.
I also provide urgent care for issues that need same-day attention but aren’t emergencies. Someone with suspected strep throat, a twisted ankle, a medication that ran out, sudden onset of hives—these are straightforward urgent care visits that I handle exactly as any urgent care would, with the advantage that I often already know the patient’s medical history.
This conventional foundation matters because without it, I couldn’t safely integrate other modalities. I need to know when symptoms represent something that requires immediate conventional intervention, when labs are necessary before trying botanical medicine, how herbs will interact with the medications someone is already taking, which patients are appropriate candidates for ketamine therapy and which have contraindications.
My acupuncture training was extensive—not a weekend course but hundreds of hours of didactic study plus supervised clinical practice, leading to licensure. I practice acupuncture primarily for pain conditions (migraines, fibromyalgia, arthritis, low back pain, neck pain), but also for anxiety, insomnia, digestive disorders, and women’s health concerns. The treatment protocol varies dramatically depending on both the Western diagnosis and the Chinese medicine pattern diagnosis. Someone with low back pain from a herniated disc gets different point selection than someone with low back pain from kidney qi deficiency, even though the Western diagnosis might be identical.
I use electroacupuncture when appropriate—attaching small electrical stimulation to the needles for enhanced effect, particularly useful for neurological conditions and stubborn pain. I sometimes incorporate cupping or gua sha for myofascial release. The goal is always to use acupuncture not in isolation but coordinated with everything else we’re doing.
My training in botanical medicine means I can create individualized herbal formulas rather than just recommending supplements off the shelf. There’s an enormous difference. Medical herbalism requires understanding pharmacokinetics, drug-herb interactions, appropriate dosing for different conditions, quality sourcing, potential adverse effects. Turmeric as a spice in your food is fine but therapeutically irrelevant. Turmeric extract standardized to 95% curcuminoids, combined with piperine for enhanced absorption and dosed at 1000-1500mg daily, has clinically meaningful anti-inflammatory effects comparable to NSAIDs for osteoarthritis, as demonstrated in multiple studies. That level of precision requires training.
I prescribe herbs most commonly for inflammation and pain (turmeric, boswellia, willow bark, devil’s claw), for mood and stress resilience (rhodiola, ashwagandha, holy basil), for sleep (valerian, passionflower, California poppy), and for hormonal support (vitex, black cohosh, dong quai). I’m cautious about interactions—St. John’s wort with oral contraceptives, ginkgo with anticoagulants, licorice root with hypertension medications. This is pharmacology, not wellness advice.
I’ve completed specialized training in ketamine-assisted therapy through the Psychedelic Research and Training Institute (PRATI). Ketamine represents one of the most significant advances in psychiatric medicine in decades, particularly for treatment-resistant depression, but it requires careful patient selection, appropriate protocols, monitoring during administration, and integration support afterward. I use ketamine for treatment-resistant depression and anxiety, for PTSD when combined with appropriate therapy, and for certain chronic pain syndromes, particularly those involving central sensitization like fibromyalgia or Complex Regional Pain Syndrome. The protocol, dosing, and session frequency differ substantially between psychiatric and pain applications. This isn’t something you learn in a weekend workshop, and it’s not something that should be offered in isolation from comprehensive care.
How Integration Changes Practice
The real power of integrative medicine isn’t just having multiple tools available. It’s how those tools inform each other and create treatment approaches that wouldn’t exist otherwise.
Consider a patient who comes in with chronic daily headaches. Conventional neurology has typically tried multiple preventive medications—propranolol, topiramate, amitriptyline, perhaps Aimovig or one of the other CGRP inhibitors. Maybe Botox injections. If migraines persist despite this, there aren’t many options left except escalating to more medications or accepting chronic suffering.
When I see this patient, I’m simultaneously thinking in multiple frameworks. From a conventional perspective, I’m considering whether we’ve adequately ruled out structural causes, whether there might be a hormonal component if the patient is female, whether medication overuse is contributing. From an East Asian medicine perspective, I’m looking at the quality of the headaches—are they one-sided or bilateral, pounding or pressure, worse with stress or with menstruation, accompanied by nausea or just pain? I’m observing their tongue and pulse. This gives me a pattern diagnosis that guides both acupuncture point selection and herbal formula creation.
The treatment plan might include continuing one preventive medication that’s providing partial benefit at the lowest effective dose, adding acupuncture weekly (which has Level A evidence for migraine prevention per multiple systematic reviews), prescribing a customized herbal formula targeting the specific pattern I’ve identified, and ensuring we’ve addressed triggers including sleep, stress, and dietary factors. This isn’t replacing neurology—it’s filling in the gaps neurology leaves.
Within six to eight weeks, most patients with this combination approach see meaningful reduction in headache frequency and severity. Some can eventually taper their preventive medication entirely as acupuncture and herbs provide sustained benefit. Others maintain a lower dose of medication indefinitely because the combination works better than either alone. The point isn’t ideological purity about “natural” approaches. It’s pragmatism about what reduces suffering most effectively.
Or consider treatment-resistant depression. The conventional approach cycles through SSRIs, SNRIs, perhaps augmentation with atypicals, maybe tricyclics if older medications are acceptable, sometimes MAOIs as a last resort, possibly ECT for severe cases. Each trial takes weeks to months, and response rates for second and third-line medications are discouraging—often 30-40% or less.
Ketamine therapy has changed this landscape. Research consistently shows 60-70% response rates for treatment-resistant depression, often within 24 hours of the first infusion. This is transformative for patients who’ve suffered for years through multiple medication trials. But ketamine isn’t a standalone solution. It creates a window of neuroplasticity—a period when the brain is more changeable, more receptive to new patterns—but that window needs to be used intentionally.
In my practice, ketamine is embedded in comprehensive treatment. I coordinate with the patient’s therapist so they’re doing intensive work during the window when it’s most effective. I use acupuncture to support nervous system regulation and reduce the anxiety that often accompanies depression. I prescribe herbs to extend and stabilize the benefits ketamine initiates. We address sleep, exercise, social connection, all the factors that influence mood. And yes, I keep patients on SSRIs or other medications if they’re providing partial benefit, tapering only when appropriate and with careful monitoring.
The integration means I can also identify when someone’s depression has components that won’t respond to ketamine alone. If their depression is significantly tied to undiagnosed hypothyroidism, or chronic inflammation from an autoimmune condition, or unaddressed trauma that requires specific therapeutic modalities, I can see this and address it rather than just adding another intervention to an already failing approach.
What Distinguishes This Practice
I chose to practice on Eastsound deliberately, and the location shapes what I can offer in ways that matter clinically.
Island medicine means I’m often the only accessible provider for miles. The nearest hospital is a ferry ride and drive away. This reality means I maintain a broader scope of practice than I might in an urban setting where every subspecialty is ten minutes away. I’m comfortable managing things that some providers would immediately refer—complex wounds, moderate psychiatric crises, uncertain diagnoses where we’re watching carefully but not panicking. This breadth benefits patients because I can coordinate care that in fragmented systems no one coordinates.
The pace of island life also shapes practice. I’m not seeing a patient every fifteen minutes trying to meet productivity targets set by administrators who’ve never provided patient care. My initial visits are 60 to 90 minutes because that’s what comprehensive assessment requires. Follow-ups are 30 to 60 minutes depending on complexity. This isn’t luxurious—it’s necessary for the kind of medicine I practice. You cannot take an adequate Chinese medicine history, perform both conventional and acupuncture examination, discuss treatment options thoroughly, and provide the first acupuncture treatment in a 20-minute slot.
The natural environment matters more than you might expect. There’s emerging research on the health impacts of nature exposure—reduced stress hormones, improved immune function, better cardiovascular health, decreased rates of depression and anxiety. When patients come here for treatment, particularly those traveling from urban areas for ketamine therapy or intensive treatment for chronic conditions, the island setting itself becomes part of the intervention. They’re walking on beaches between appointments, sitting in forests, watching eagles hunt. Their nervous systems are doing something different than they do in cities. This isn’t mysticism—it’s biology.
I also benefit from knowing my patients as whole people embedded in community rather than as isolated cases. I see them at the farmers market, know their families, understand the context of their lives. This deepens care in ways that are difficult to quantify but impossible to dismiss.
Who Benefits Most From This Approach
Integrative medicine serves anyone, but certain patients benefit particularly.
If you have multiple interconnected symptoms that conventional medicine treats as separate problems—chronic pain plus depression plus insomnia plus digestive issues, for example—you’re likely an ideal candidate. These symptoms are almost never truly separate. Chronic pain disrupts sleep, which worsens pain and contributes to depression. Depression increases pain sensitivity and causes gastrointestinal symptoms. Poor sleep dysregulates stress hormones, which increases inflammation, which worsens both pain and mood. Treating these as isolated problems means you end up on multiple medications, each addressing one piece while potentially worsening others, and never getting at the fundamental dysregulation driving everything.
Integrative medicine looks for the patterns. Why are all these systems dysregulated? Is this autonomic nervous system dysfunction? Chronic inflammation? HPA axis dysregulation? Unresolved trauma stored somatically? The answer guides treatment that addresses root dysfunction rather than just suppressing symptoms.
If you’ve been through multiple specialists without resolution—seen rheumatology, neurology, gastroenterology, psychiatry, each ordering their tests and finding nothing definitively wrong or offering treatments that don’t adequately help—integrative medicine may offer what you need. Often these are cases where conventional diagnosis is elusive because the problem isn’t structural or straightforward. Chinese medicine diagnosis sometimes succeeds where Western diagnosis struggles because the frameworks are different. Liver qi stagnation, spleen qi deficiency, kidney yang deficiency—these aren’t Western diagnoses, but they’re clinically useful patterns that guide effective treatment.
If you’re trying to reduce medications, either because of side effects or because you prefer fewer pharmaceuticals when alternatives exist, integrative medicine can often accomplish this. I’m not categorically opposed to medications—they’re powerful tools—but many people are overmedicated, and careful integration of other modalities can allow reducing pharmaceutical burden while maintaining or improving symptom control.
That said, integrative medicine is also perfectly appropriate for straightforward issues. If you need urgent care for strep throat, a physical for work, annual labs, prescription refills, you’re welcome here. The difference is that if your acute care visit reveals patterns suggesting deeper issues—frequent infections suggesting immune dysfunction, fatigue suggesting thyroid problems or profound stress—I can address those comprehensively rather than just treating each acute episode in isolation.
Moving Forward
Healthcare should be personalized, comprehensive, and effective. You shouldn’t have to choose between conventional medicine and complementary approaches when the evidence supports both. You shouldn’t have to see six different specialists who never communicate. You shouldn’t accept that chronic suffering is inevitable when treatments exist that might help.
Integrative medicine isn’t perfect, and I’m not arguing it’s appropriate for everyone or every condition. Acute emergencies need emergency medicine. Complex surgical conditions need surgeons. Advanced malignancies need oncology. But for the enormous middle ground—chronic complex conditions, treatment-resistant psychiatric illness, pain that conventional approaches haven’t adequately addressed, prevention and optimization of health—integrative medicine often succeeds where conventional approaches alone do not.
I serve patients throughout Washington, Oregon, and Alaska where I maintain licenses. Many patients come to Eastsound for in-person visits. Some conditions require in-person treatment—I can’t do acupuncture via telehealth—but initial consultations and follow-up for medication management, herb adjustments, and ongoing coordination can often happen remotely.
If fragmented care that treats symptoms but doesn’t make you better is no longer acceptable, if you want a provider with time to listen and tools to address your health comprehensively, integrative medicine may be exactly what you need.
Experience Comprehensive Integrative Care
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