Whole health in family medicine: 6 steps to improve patient care
Family physician Rachel Abrams, MD, MHS, ABOIM, speaks about integrative health and team-based care at FMX 2026.
A female patient came to me physically and emotionally distressed after other physicians were unable to help her.
Multiple trips to her dermatologist had failed to resolve, or find the causes of, rashes and numerous weeping wounds on her legs. An allergist had added three medications for new onset of congestion and weeping eyes, but she remained miserable.
And those weren’t her only problems.
I ordered several labs, including allergy and gut microbiome tests, to get the whole picture of her health.
We discovered what the dermatologist had missed: She was allergic to citrus, an ingredient in the lotion she used. She was also allergic to dust mites and the redwood trees she lived under. We also found that multiple rounds of steroids prescribed for her rash and antibiotics prescribed to treat an STI and resulting pelvic inflammatory disease had caused an imbalance in her intestinal (and no doubt skin) microbiome, and activated her immune system in unhelpful ways.
During successive visits were able to address and resolve multiple issues:
We restored her gut health with herbs, probiotics and a high-fiber diet.
Her skin problems resolved without medication after balancing her gut and discontinuing the offending lotion.
I also counseled her to end a relationship with the partner who had given her the STI (and taken advantage of her monetarily) because emotional trauma was affecting her mental, physical and financial health—and, of course, her immune system.
Her health issues were addressed because I had the time to look at the whole person and identify the root causes of her problems. And that’s the beauty of integrative medicine and whole health.
Defining integrative medicine and whole health
Many may be familiar with the terms integrative medicine and whole health yet wonder, what’s the difference?
Integrative medicine combines conventional western medicine with evidence-based complementary therapies, such as acupuncture, yoga and meditation, as well as in-depth attention to lifestyle and social context, to treat the whole person.
Whole health is a practical, patient-centered model of integrative medicine, (created by the Department of Veterans Affairs more than a decade ago) that looks at physical, behavioral, spiritual and socioeconomic well-being driven by an individual's personal goals.
Instead of asking, “What’s wrong with you?” in whole health we ask, “What matters to you?”
I’m dual boarded in family medicine and integrative medicine, and yes, you can use this approach in family medicine. As I discussed at the AAFP’s Whole Health Summit earlier this year, there are six steps you can take to implement whole health and integrative medicine in your practice:
6 steps to integrate whole health in family medicine
Demand time. Patient visits that are 15 minutes or shorter don’t allow us to have the real conversations we need to understand a patient’s social determinants of health. One way to give patients more time, as well as more support and accountability, is group visits, which are an extremely effective yet highly underutilized approach that harnesses the listening ability and intelligence of a group for better patient support and change.
Also consider billing for time rather than codes. Not every visit needs to be long, but sometimes—particularly that first visit—we need more time to establish trust and connection. If we don't know where a patient is coming from—not to mention where they live, how they get food, what their relationships are like—it makes it difficult to understand the illness or disease they are struggling with. We need this connection because the patient knows things that we need to help them figure out the root cause of their suffering. Their story is a precious resource from which we get to do our detective work as clinicians.Create connection, care and presence. No one is going to tell you sensitive information (like their cheating boyfriend gave them an STI) unless they feel safe and you are present. Face the patient and make eye contact. AI scribes can help you do this.
Avoid empathy burnout. Connect with your patients but set boundaries in a way that allows you to give care without getting burned out by it. We want to cultivate compassion, feeling for them, rather than always feeling with them and suffering ourselves. When you blur the line between a patient's feelings and your own, you can end up with empathetic distress, taking on their struggles in ways that lead to your own burnout.
Use systems thinking to find the root cause. We need to unwind what is truly wrong with people and address underlying causes, such as trauma. Ultimately, they need more than just a prescription that covers up symptoms. By spending more time with my patient I described above, we resolved not only her leg rash but also discovered and addressed multiple other issues, including her dysfunctional relationship that led to her physical troubles.
Hold a vision of what’s possible. This can be your clinical superpower if you are able to see with compassion what might be possible for a patient’s healing—and to share your vision of what’s possible so that they can see it, too. Tiny changes can begin to untie those knots that cause insomnia, high blood pressure and other issues.
Do your own healing. We need to listen to our own bodies, give ourselves what we need, learn from that experience and take our insights with us into the exam room.
Explore whole-person care at the AAFP Whole Health Summit
The AAFP’s Whole Health Summit, which will be April 30–May 2, 2027, in Austin, Texas, focuses on whole-person health for family physicians, and offers education and support regarding what we need to care for ourselves, our teams and our patients. Attendees can focus on a specific problem they want to address, and get hands-on learning and coaching to create an action plan.
Learn integrative medicine strategies with FMX On Demand
Where can you learn more about integrative health? The Academy of Integrative Health and Medicine recently presented a dozen sessions at the AAFP’s Family Medicine Experience in Nashville, Tennessee. All 12 sessions, including a panel discussion I participated in about implementing integrative, team-based care models, are included in FMX On Demand.
These concepts are still new to many family physicians, so another FMX panel discussion I participated in (also in the On Demand package) described the core principles of integrative medicine and whole health, explained how they align with the values and scope of family medicine, and offered practical strategies for incorporating these approaches in family medicine.
Come with a challenge.
Leave with a plan.
This conference is more than a conversation about what’s causing you stress. It helps you find a way through that stress. Explore the summit.
Advance your skills with integrative medicine fellowships
For those ready to take a deeper dive, the AAFP’s fellowship directory has details on more than a dozen integrative medicine fellowships, including one offered by the Academy of Integrative Health and Medicine.
Integrative medicine and whole health create a platform that puts our patients at the center of what we do, addresses both the social determinants of health and the unique challenges of individual patients, and allows patients and physicians to thrive.
Rachel Abrams, MD, MHS, ABOIM, is board certified in family medicine and integrative medicine. She is past chair of the board of the Academy of Integrative Health and Medicine, and a former board member of the American Holistic Medical Association.
Disclaimer
The opinions and views expressed here are those of the authors and do not necessarily represent or reflect the opinions and views of the American Academy of Family Physicians. This blog is not intended to provide medical, financial, or legal advice.