Beyond combining therapies: A reflection on conceptual pluralism in integrative medicine

Integrative medicine is often understood as the incorporation of therapies from different medical traditions into patient care. While this therapeutic focus has advanced important research and expanded treatment options, it may overlook another dimension of integration: the conceptual frameworks through which clinicians understand health, illness, and healing. This reflection argues that the greatest promise of integrative medicine may lie not only in combining therapies but also in cultivating conceptual pluralism-the deliberate use of multiple explanatory frameworks to inform clinical reasoning while remaining grounded in scientific evidence, patient safety, and critical reflection. Drawing on the first author's experience practicing traditional Chinese medicine before entering medical school we compare how these traditions organize clinical information, define illness, and guide decision-making. We suggest that meaningful integration begins before treatment selection by broadening the questions clinicians ask, rather than simply expanding the interventions they offer. Although Western biomedicine and traditional Chinese medicine differ substantially in their theoretical foundations and evidentiary traditions, both contribute perspectives that may illuminate different dimensions of a patient's experience. We propose that conceptual pluralism offers a framework for understanding integrative medicine as an expansion of clinical reasoning rather than merely an accumulation of therapies, with implications for clinical practice, medical education, and future research.