I am writing in Health Action for the first time, in what is planned to be a regular column in each issue. So some introductions are in order.

I'm a family physician living and working in Salmon Arm. Because of a congenitally open mind (just short of the point where my brains fall out), and because of a series of the usual unpredictable circumstances, I've steadily drifted into a style of practice that is now, as American Physician Andrew Weil would describe it, an example of "integrative medicine". What Weil and others mean is an approach to therapeutics that places healing, and the encounter between practitioner and client/patient, at the centre of the therapeutic process.

Along the way, any and all therapeutic modalities are up for consideration. That means just what it says: any and all options are possible, whether physical, emotional, mental or spiritual interventions, or whether from one healing discipline or another - medical or otherwise.

The first task of any practitioner is to try to understand the problem facing his or her client. The first task of the client is to communicate that problem as clearly and completely as possible. It's a dance back and forth, questions and answers, clarifications and amplifications, discussions and reiterations.

Then the real work begins. It's a process, accompanied by an ongoing dialogue, of finding out what solutions might work for the problem - no matter how complicated and how time-consuming that process might be.

Potential solutions need to be tried - if acceptable to both practitioner and client - and either continued if effective, or altered if not. If a remedy is entirely unsuccessful, then it needs to be replaced with another approach.

Clearly in such a scenario, it is highly beneficial for both practitioner and client to have a wide range of therapeutic options up their sleeves. I say practitioner and client, because in these days of rapid social change, it's unlikely that any one practitioner knows about every option available for resolving a particular problem.

It's like the situation of a professional musician: knowing lots of pieces, in different styles, of different lengths, played with different combinations of various instruments, which means that a musician can play anywhere, anytime, with anyone who is willing to play along ( the expression "Johnny One-Note" is not a term of praise!). But someone in an  audience, or another musician, may know a tune that the first musician doesn't; in that case, a true professional will approach the new musical idea with interest and an open mind - because one never knows when a new melody might be just right for a special occasion!

The process of healing doesn't end with the first chosen intervention. In the real world, getting it right the first time, in any field of endeavour, is an elusive goal. The usual outcome is that the first attempt at a remedy or solution is partly effective, and partly not. An adjustment needs to be made. Perhaps a new therapy needs to be introduced. New aspects of a problem come to light, and need to be addressed. Sometimes a whole new problem, deeper than the first, comes to the surface when the smaller one is out of the way. Now it needs to be dealt with.

Sometimes, no solution is obvious or successful. Neither practitioner nor patient can think of a better approach than the one already tried and found to be wanting. Then the healing relationship becomes very important. A practitioner has an obligation to say that he or she has run out of ideas. But no caregiver has an obligation or right to then desert the patient or dismiss him or her forever - or worse, to say that the problem doesn't exist because he or she doesn't know of a solution! At that point, patience is a critical feature, on both sides of the engagement. Over time, a solution may present itself to one or other party, and then, if the relationship is still open and accessible, an attempt to achieve healing can begin again.

That's a very brief overview of the core of "integrative medicine". And that's all for this column. In my next, I will explain why I chose the title "Global Health".

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