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How Integrative Medicine May Affect Yoga Teaching and Business

A new Institute of Medicine report that has set guidelines for complementary and alternative medicine may change the way you teach and talk about yoga. Here's what you need to know about its implications.

By Michael H. Cohen, JD, MBA

On January 12, the Institute of Medicine (IOM) at the National Academy of Sciences released its Report on Complementary and Alternative Medicine. This report, by a highly respected organization within mainstream health care, offered a series of recommendations to influence legislation and public policy regarding complementary and alternative medical (CAM) therapies. The broad definition of CAM therapies in the report would include, in addition to modalities such as chiropractic, massage therapy, and acupuncture, practices such as yoga and meditation. In this issue, we examine how emerging models of conceptualizing and regulating CAM therapies in the IOM report may affect the future of yoga teaching and the business of yoga.

While in ancient times, yoga teachings were transmitted from master to disciple in private settings, often as part of a rigorous spiritual initiation, today yoga classes are offered in a variety of contexts: from private settings to ashrams, yoga studios, gyms, and spas. And, like many other ancient healing arts, yoga is even offered in some hospitals as a clinically-recommended practice. For example, some cardiologists may recommend the Ornish program, which includes yoga and meditation practices, to help reverse heart disease.

This means that, within the broad context of healing arts in the United States, many clinicians and researchers would consider yoga to be a "complementary and alternative medical" (CAM) therapy—a healing modality outside conventional medical care. Understanding how yoga fits within the social and legal paradigm of CAM therapies is increasingly important for yoga teachers and studios who interact with licensed health care providers, consider whether to make claims about specific yoga practices, or receive requests from students for health advice (see Legal Implications of Health Advice for Yoga Teachers, Parts 1 and 2), or consider ethical and legal issues surrounding touch (see The Ethics and Liabilities of Touch).

The IOM report marks an effort by a distinguished panel of clinicians and researchers to make recommendations concerning U.S. policy about "integrative medicine"—the effort to integrate CAM therapies within conventional medicine. According to the report, "hospitals are offering CAM therapies, health maintenance organizations (HMOs) are covering such therapies, a growing number of physicians use CAM therapies in their practices, insurance coverage for CAM therapies is increasing, and integrative medicine centers and clinics are being established, many with close ties to medical schools and teaching hospitals."

In light of these trends, the report's essential recommendation is this: "In determining what care to provide, the goal should be comprehensive care that uses the best scientific evidence available regarding benefits and harm, encourages a focus on healing, recognizes the importance of compassion and caring, emphasizes the centrality of relationship-based care, encourages patients to share in decision making about therapeutic options, and promotes choices in care that can include complementary therapies where appropriate."

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