Integrative medicine was recently defined as “medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines (conventional and complementary) to achieve optimal health and healing” (www.imconsortium.org). Such complex approaches are especially relevant in the management and prevention of chronic health problems, which are the main cause of disability and account for 78% of health expenditure.1 A session at the recent US Institute of Medicine summit on integrative medicine in Washington, DC was devoted to the science behind the integrative medicine approach to health care,2 and the subject has been debated at a recent Prince’s Foundation for Integrated Health conference at the King’s Fund, London (www.fih.org.uk).

Since the 1990s, attempts have been made to make integrative approaches more available in mainstream care. The experience of patients and clinicians might support their wider use, yet frustration is growing …