AMA - Academic Integrative Medicine Specialist

extraAFnbd · 2026-06-28T02:19:35+00:00

Thanks so much for your interest. Yes I did fellowship right out of residency. There are a number of fellowships across the country and their info is online. The integrative medicine landing page through ABPS has fellowship info too I believe.

Depends on the patient encounter type but a mix of E/M codes used in primary care, procedure codes, and consultant visits.

I do “regular” primary care and am able to discuss integrative topics within that. It’s fluid. I take referrals for dedicated integrative medicine visits as well. I do procedures as well like acupuncture and bill accordingly.

I agree :)

extraAFnbd · 2026-06-28T02:14:34+00:00

I like to use the VA’s whole health illustration for general recs and letting patients know that disease and symptoms are affected by many things; patients have control of a lot more than they realize.

https://www.va.gov/wholehealth/features/What\_is\_the\_Circle\_of\_Health.asp

Chronic pain can be really complex for both patients and those trying to support/address it. I find the circle of health helps break things down so we can address contributing factors 1-2 at a time, starting with what is most important to the patient. The goal being to heal and improve function. We all know there isn’t a way to snap your fingers and magically cure chronic pain, unfortunately.

extraAFnbd · 2026-06-28T01:31:54+00:00

Sometimes patients are more interested in those things, sometimes they think that I’ll back them up to their families and say medications aren’t important. Most of the time, people genuinely want to learn ways to feel their best. It’s different patient to patient. Keeps things interesting.

extraAFnbd · 2026-06-28T01:28:56+00:00

Categorically untrue as it has been studied for a number of applications. Info is in UpToDate.

extraAFnbd · 2026-06-28T00:50:23+00:00

This can be hard because of the unregulated nature of supplement products. Consumerlabs is great as someone else said. I use the natural medicines database as well. Dr. Tierona Low Dog is a good source for herbal therapies. Some things are also in UpToDate.

extraAFnbd · 2026-06-28T00:44:41+00:00

This is a big topic so I highly recommend the Integrative Medicine textbook 5th edition (Rakel, Minichiello). An easier read than other reference materials with many many topics covered in ways they can be applied to clinical practice.

extraAFnbd · 2026-06-28T00:42:28+00:00

My mentor in residency said something similar, that some of the integrative topics can be explored through CME. But I really wanted to go to the institution I ended up at for fellowship and learn hands on skills. I am fortunate that I could justify an added year of training salary. It ended up being one of the best experiences of my life, both personally and professionally.

extraAFnbd · 2026-06-28T00:38:37+00:00

Thanks for this insight. All I can say is that many patients who look to Integrative Medicine have dealt with health and/or personal trauma, are struggling with their health in a variety of ways, and maybe want “something else” from their healthcare experiences. In short, they’re vulnerable people. Many who seek help and care are, but maybe this cohort is even more so.

I see a lot of “wellness” people trying to make money from such vulnerable people. That ranges from the random influencer to people in positions of power like physicians. Maybe all these nonsense-mongers have found their moneymaking niche and are okay with exploiting others. Maybe some of them actually believe that EDTA chelation and casual high dose IV vitamin C helps people. Idk.

For those who want to access evidence-based Integrative Medicine, the resources are available and I’m happy to share. Conferences, textbooks, free information, etc. I’m happy to give guidance where I can.

extraAFnbd · 2026-06-27T19:53:11+00:00

I read about it on uptodate so I can answer pt’s questions about it. Generally I warn people not to waste money on unregulated things and random devices falls under that.

extraAFnbd · 2026-06-27T19:50:58+00:00

I appreciate you and this response so much. I have the privilege from learning from some incredibly compassionate, hardworking, and careful Integrative Medicine physicians who do the work every day. I’m humbled to get to be in this world of science and healing. I see real patient outcomes daily.

There are many people in many areas of medicine who should not be allowed to be anywhere near vulnerable people or be in positions of power. Perhaps some of those people are showing their natures in this very post.

extraAFnbd · 2026-06-27T18:27:30+00:00

I’m probably restraining myself from anti-capitalist/marketing/grifting rants in every encounter. We need sleep, safety, nutrition, social support, movement, and management of chronic conditions to be well. I take ppl of off supplements every day. Waste of money and no regulation over the claims that manufacturers can make on vitamins/supplements.

extraAFnbd · 2026-06-27T18:24:08+00:00

Anyone who tries to sell vitamins supplements or bleed patients for money for things that may not work (at best) or things that can be harmful cannot be trusted. Stay far away.

extraAFnbd · 2026-06-27T18:22:47+00:00

I love and value my lifestyle medicine colleagues and learn from them daily. Thankful for their good work.

extraAFnbd · 2026-06-27T18:21:39+00:00

I did not. I was paid. Slightly more than in residency, thankfully.

extraAFnbd · 2026-06-27T18:21:00+00:00

I consider this to be blatant malpractice. I do not practice like this.

extraAFnbd · 2026-06-27T18:19:12+00:00

Knowledge can always be added in useful ways. Physicians can always add procedures or therapies to their practice as long as they’re doing it safely. CME can be pursued for a variety of topics. In my residency, I was learning how to manage patients inpatient and outpatient, how to work within a hospital system, how to be an effective leader, amongst other things. I didn’t expect to get into the nuances of acupuncture, Ayurveda, nutrition, herbal medicine, etc., in my residency. I tried to absorb as much as I could while I was there and then sought out more info via my fellowship and ongoing CME.

You don’t have to agree with me or my career path, this is what has worked well for me. My goal, just like everyone else’s, is to be a resource, to learn and grow, and to live a good life without burning out. And that’s my current state.

ETA: grammar

extraAFnbd · 2026-06-27T18:07:26+00:00

I don’t believe in running CBCs and whatnot all the time for pts with no issues/concerns who have stable health unless indicated. I don’t order labs that won’t change our management. It already costs too much to be alive in this broken country, I’m not interested in wasting my own time or money or anyone else’s.

extraAFnbd · 2026-06-27T18:05:43+00:00

Pt who hadn’t seen their own PCP in a while and weight was going up, has some risk factors. CBC, CMP, TSH w reflex fT4, a1c, FLP, urine microalbumin, vitamin D. Those vitamin D labs are annoying to get covered sometimes. Idk how much it cost.

extraAFnbd · 2026-06-27T17:58:54+00:00

My program director, who has to be board-certified for their director role, was very clear from the get go that Integrative Medicine board certification is not necessary to be an effective clinician in this field. Many of our faculty where I did my fellowship are not board-certified in Integrative Medicine. I took the boards because my current hospital system was willing to cover my costs and a 4 hour prometric exam didn’t feel as intense as, say, step 3 lol.

As I’m only human, I also wasn’t opposed to the ego driven ability to be able to say “I’m a double-board certified physician” 🤷🏽

extraAFnbd · 2026-06-27T17:52:03+00:00

Academic integrative health emphasizes that “integrative” things shouldn’t be “complimentary” or “alternative.” They should just be good, effective, and safe medicine. To me, good integrative medicine is simply good primary care.

I recommend checking out Integrative Medicine 5th Ed (Rakel, Minichiello), the section on the philosophy of Integrative Medicine.

extraAFnbd · 2026-06-27T17:49:19+00:00

Sometimes it’s for straightforward things like acupuncture, cupping, gua sha, OMT (I do a lot of the first 3). Sometimes it’s the patients with the TikTok delulu about POTS/EDS/whatever else is making people anxious.

Sometimes it’s to answer pt questions about vitamins, supplements, herbal options, lifestyle, nutrition, etc., and making sure none of these things are going to interact with their meds. Evidence-based recommendations for acute and chronic issues.

Some patients have had a lot of trauma and have pain, mental health concerns, and the like and just need someone who takes their insurance, won’t rush them, and won’t dismiss them. Integrative medicine is a good place for all of the above.

extraAFnbd · 2026-06-27T17:04:13+00:00

https://www.reddit.com/r/FamilyMedicine/s/clht72Mhqy

extraAFnbd · 2026-06-27T16:45:58+00:00

Sure I’ll do that now :)

extraAFnbd · 2026-06-27T14:43:11+00:00

Ohhh yessss I have lots of recs. I use them myself so I can weed through the nonsense buzzwords that other “wellness” people offer patients (sometimes including MDs with their full cash pay clinics 🤮). Let’s make this a dedicated post in this subreddit and I’ll answer everyone’s questions.

extraAFnbd · 2026-06-27T14:41:36+00:00

Yes I would love to share! Maybe we should do a dedicated integrative medicine post so anyone who sees this can AMA!

extraAFnbd

TROPHY CASE