Book Review  |   October 2009
Educational Opportunities in Integrative Medicine: The A-to-Z Healing Arts Guide and Professional Resource Directory
Author Affiliations
  • Marna Rayl Greenberg, DO
    Department of Emergency Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania♦
    Director of Emergency Medicine Research
Article Information
Book Review   |   October 2009
Educational Opportunities in Integrative Medicine: The A-to-Z Healing Arts Guide and Professional Resource Directory
The Journal of the American Osteopathic Association, October 2009, Vol. 109, 528-530. doi:10.7556/jaoa.2009.109.10.528
The Journal of the American Osteopathic Association, October 2009, Vol. 109, 528-530. doi:10.7556/jaoa.2009.109.10.528
Perusing Educational Opportunities in Integrative Medicine: The A-to-Z Healing Arts Guide and Professional Resource Directory may provide readers with an experience similar to flipping through career books in a high school guidance counselor's office. Douglas “Las” Wengell, MBA, the book's primary author, and Nathen Gabriel, ND, offer a directory encompassing 12 licensed health professions—including osteopathic medicine—and 50 “holistic disciplines.” Mr Wengell and Mr Gabriel attempt to illustrate the full spectrum of healing modalities and to describe each profession's historical roots, philosophical grounding, required training, academic degrees, and accreditation standards. The authors also cite related organizations, peer-reviewed periodicals, educational institutions, and examples of relevant research. 
One of my favorite parts of the book is the introduction, where the authors present a rather complex, yet potentially enlightening, diagram of interrelationships among the various healing modalities. The three overlapping sets (or circles) of “mind,” “body,” and “spirit” are portrayed. Each portion of the resulting diagram lists the applicable methods of healing. The mind set is labeled with “psychotherapy & counseling,” “psychologist,” and “theology”; the body set includes “allopathic doctor,” “chiropractor,” and “osteopath”; and the spirit set has “spiritual bypass (imbalanced focus on spiritual practice alone).” Healing arts belonging to more than one set are placed in the overlapping regions. 
For example, the shared area of mind and spirit is represented by such modalities as “holotropic breathwork,” “Jungian psychology,” and “pastoral counseling.” Similarly, the overlap in mind and body is theoretically addressed through such professions as “hypnotherapy,” “midwifery,” and “psychiatrist.” Finally, the “trinity” section at the center of the diagram represents the overlap of all three areas of mind, body, and spirit with eight professions and modalities, including “ayurveda (traditional),” “Chinese medicine,” “holistic nurse,” and “hospice worker.” 
This Venn diagram is an admirable, yet imperfect, representation of the healing modalities. I am not sure that the authors have a clear understanding of each of the professions they attempt to summarize. For example, “osteopath” is listed only in the body set. I found this placement surprising. Traditionally, the osteopathic physician is perceived as being at least as holistic as the other health professionals listed in the overlapping category of mind and body. The authors explain the methodology behind this categorization later in the text: 

Approximately 6% of osteopaths today use traditional [osteopathic manipulative treatment] techniques with a majority of their patients.... This means that most osteopaths are no longer truly holistic doctors.

The authors also note the following: 

As a prospective student, you must decide whether the high status and income likely to result from a DO degree is worth the osteopathic training that has been diluted from a holistic, preventive, hands-on approach toward one that is often indistinguishable from an MD's materialistic allopathic training.

The authors attempt to clarify the unique aspects of each of the healing arts that they describe. However, they appear to have limited personal experience with many of the professions and programs that they address. According to the “About the Authors” section, Mr Wengell studied rhetoric and philosophy at Rutgers University in New Brunswick, New Jersey, somatic and health psychology at San Francisco State University in California, and entrepreneurship and finance at Emory University in Atlanta, Georgia, where he received his MBA. He authored a “similar” book when he was studying health psychology at San Francisco State. In addition, Mr Wengell is the founder and chief executive officer of Know Your Source, a distributor of supplies to healthcare providers, and the founder of the publishing house that produced this book, The Hunter Press. Mr Gabriel was trained as a naturopathic doctor at Bastyr University in Seattle, Washington, and has a degree in holistic health education from John F. Kennedy University in Campbell, California. He consults on “lifestyle and addiction” in southern California. 
As I looked for the names of individuals or organizations that the authors used to help them develop the chapters outside their own training, I noticed a credit in the Acknowledgments section to a Middlebury College senior who is credited as being the “backstop” of the book. This student received accolades for “singlehandedly [sic]” researching and authoring the resource sections of the text, which generally include lists of support organizations, relevant professional publications, and helpful Web sites. Stated bluntly, it would appear as if the authors could have used some additional assistance from societal and professional experts to ensure the accuracy of content areas outside their realms of expertise. 
Educational Opportunities in Integrative Medicine is organized into three major sections. Section I, “Licensed Professions,” features—in consecutive order—chiropractic care, osteopathic medicine, acupuncture and traditional Chinese medicine, allopathic medicine, mental health, social work, massage therapy, naturopathic medicine, and holistic nursing. Each of these nine chapters, which range in length from 6 to 34 pages, includes descriptions of therapeutic modalities used; types of institutions where practiced; and training, licensure, and accreditation information. 
Some of the areas addressed in the 40 chapters of section II, “Nondegree Programs,” are aromatherapy, ayurvedic medicine, biofeedback, craniosacral therapy, herbal medicine, homeopathy, hypnotherapy, midwifery, music therapy, Pilates, somatic movement therapy, and yoga therapy. Each of these chapters consists of a description of the program, which averages about 2 pages in length, and lists of resources. 
Section III, “Practitioner Resources,” is devoted to basic information on continuing education options, retreat and conference centers, and general and international holistic resources. Convenient geographical (ie, listed by state and city) and alphabetical indexes are included at the end of this section. 
In the chapter on osteopathic medicine, the authors feature a table in which they adequately compare osteopathic and allopathic medicine in terms of education, licensure, and other career trajectory. Also in this chapter, the authors list the main, traditional organizations of the osteopathic medical profession, such as the American Osteopathic Association and the National Board of Osteopathic Medical Examiners. For an unknown reason, the authors also chose to include the American Osteopathic College of Dermatology—but to exclude the American College of Osteopathic Emergency Physicians and many, often larger, osteopathic specialty organizations. These choices are not explained and may lead readers to presume that osteopathic medicine offers a limited scope of medical practice, with many specialties wholly unrepresented. Recruiting practice-specific advisors during text development might have led the authors to include more representative lists of professional organizations in this and other chapters. 
My major criticism of the chapter on osteopathic medicine, however, is the placement of undue emphasis on certain aspects of our profession while minimizing other aspects. For example, the chapter understates the priority that the osteopathic medical profession places on evaluating the patient as a whole and the attention to preventive medicine that our profession promotes. The following excerpt provides another example of the authors' inaccurate depiction of the osteopathic medical profession: 

Traditional osteopaths believe that patient healing begins once touch has been initiated. DOs may begin an exam by gently rapping on the soft tissue over the heart and lungs, for example.... From a DO's perspective, the more touch the better during every patient visit.

Irrespective of traditional osteopathic practices, in my nearly 25 years of clinical experience, I have yet to see one of my colleagues begin a patient examination with a rap to the soft tissue over the heart! 
The target audience of Educational Opportunities in Integrative Medicine is difficult to identify. Although the book's title declares that the text is intended as an overview of the healing professions for potential students, some parts of the text—including the following excerpt from the introduction's description of deficiencies in our healthcare system—appear to address patients: 

If you require intrusive or emergency medicine in the event of a traumatic injury, there is nothing better than our world-class intensive care units. If you require the removal of a cancer or cataract, there is nothing better than a modern operating room under the steady hand of surgeons with a decade of arduous training.

The basic information on treatment methods and body systems in many of the book's chapters also suggests that the authors sought to compile a reputable resource that would help patients easily understand available treatment options in the healthcare professions. For example, when describing lymphatic techniques in the chapter on osteopathic medicine, the authors write: 

A little known circulatory system parallels the bloodstream. This is the lymphatic system, and it circulates filtered blood through lymph nodes as a major part of our immune system. If patients have reduced lymph flow, they are more susceptible to infection.

However, in that same chapter, the following passage appears to be aimed at premedical college students: 

To become [an osteopathic physician] in the United States, you must graduate from a school of osteopathic medicine.... You can expect osteopathic medical school to be just as demanding as allopathic medical school.

I found a number of other problems with Educational Opportunities in Integrative Medicine. The book contains material redundancies within chapters—such as the chapter on osteopathic medicine repeating discussions of osteopathic physician salary and continuing medical education. 
In some chapters, inflammatory comments are made that may distract readers. An example of such inflammatory content, from the description of career and trends in the chapter on allopathic medicine, is: “MDs are also often considered to be arrogant, narrow-minded, abrasive, condescending, and curt.” The authors then suggest that the “rigorous hierarchical regimen” of medical training in the United States reinforces these personality traits. 
I also noted some inconsistencies between chapters. For example, the chapter on chiropractic care includes a list of current research topics in this profession, but the chapters on osteopathic and allopathic medicine do not mention any research topics. Although the main peer-reviewed journals of the osteopathic and allopathic professions are listed in their respective chapters, the lack of research-topic lists may lead some readers to infer that clinicians are not invested in ongoing research efforts. 
I enjoyed scanning the information on many of the disciplines with which I was unfamiliar, including descriptions of the “eightfold yogic path” and the different forms of yoga that one can practice. However—considering my concerns about the accuracy of the information in the chapter on osteopathic medicine—I felt that I could not be confident in the representation of material on the other disciplines. 
In summary, I believe that the authors of Educational Opportunities in Integrative Medicine made an inadequate attempt to describe the vast array of health professions. They should have called on additional professional resources for guidance in creating a more comprehensive and accurate text. This book is not worth the investment for a prospective osteopathic medical student or physician—indeed, I would regret seeing it in a guidance counselor's office. 
Educational Opportunities in Integrative Medicine serves as a reminder that osteopathic physicians need to remain vigilant regarding new reference texts that purport to describe our profession. 
 By Douglas “Las” Wengell, MBA, with Nathen Gabriel, ND. 292 pp, $24.95. ISBN: 978-0-9776552-4-3. Atlanta, GA: The Hunter Press; 2008.