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

The term, "focus on healing," the emphasis on the "importance of compassion," and attention to the "centrality of relationship-based care" may resonate with yoga teachers and studios as entirely consistent with the heart-centered, spiritually mindful approach that characterizes yoga philosophy. Teachers and studios also may resonate with the report's emphasis on encouraging individuals to share fully in important decisions about their health care. Also noteworthy is the recommendation that health care providers and institutions promote a comprehensive spectrum of health care choices—a spectrum that could include yoga, meditation, and other practices considered within the realm of CAM therapies.

On the other hand, the quoted language also emphasizes reliance on "best scientific evidence available regarding benefits and harm," suggesting that clinicians whose patients practice yoga will scrutinize whether yogic practices have benefits demonstrated in the medical literature. As integrative medicine takes hold in more medical schools and hospitals, yoga teachers may find that information they give in class about the benefits of a pose may be validated, augmented, or even contradicted or corrected by a health care provider.

This clinical orientation toward yoga will be supplemented by new research to test the claims and potential clinical benefits of specific yoga poses. With regard to research, the report recommends that: "the same principles and standards of evidence of treatment effectiveness apply to all treatments, whether currently labeled as conventional medicine or CAM." In other words, CAM therapies will be subjected to the same rigorous testing requirements as conventional therapies.

This approach, while even-handed, also carries the potential downside of reductionism—the possibility that a comprehensive set of theories, philosophies, and practices represented by yoga will be divided into parts and analyzed in isolation from the rest of the practice, and medical conclusions will be drawn based on such an isolated analysis. Concern about such criticism, acknowledged in the report, has been the core of objection to many current research methodologies being applied to other holistic therapies such as acupuncture and traditional oriental medicine. To address this concern, the report does specify certain innovative research designs that may be more appropriate to test some CAM therapies.

While research ultimately may reveal the presence or absence of claimed benefits from yoga, it also might illuminate new contraindications for specific practices. Knowing about existing contraindications—such as Headstand when a student has a serious neck injury—already forms an important component of ethical yoga teaching. Given the movement toward integrative medicine, checking in with students about existing health conditions and being alert to possible contraindications relating to those conditions becomes an increasingly important risk management tool, as well as part of responsible teaching and studio management (See Should Yoga Studios Ask Students to Sign a Liability Waiver).

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