The surprising news last August that Tracy Gaudet, MD was leaving the Veterans Administration where she birthed the transformational Whole Health program was leavened on learning that Gaudet would partner with the world’s wealthiest woman, Alice Walton. Together they would form the Whole Health Institute with a goal of nothing less than to translate and build off the VA model in civilian health and medicine and spread it globally. Other than a brief announcement at kick-off, plans have not been public. Last week word arrived that the professional with the most significant experience in developing integrative strategies in civilian medical institutions, Lori Knutson, RN, BSN, HNB-BC, is joining Gaudet. Knutson will serve as the Institute’s senior director for health system redesign. I communicated with Gaudet and Knutson on this development. Gaudet shared additional insight into evolving plans that, like the rest of life, have been shifted by COVID-19.
The idea that “the first is the last and the last the first” was a value in my liberal Protestant upbringing. It likely had some noblesse oblige in it too. The concept can be challenged as an entrapping promise that good will come of waiting. Regardless, in some the call to work with the least-cared-for becomes a guiding mission. Self-preservation of the integrative field may be another motivator of such a mission. A past head of the NIH agency that researches integrative practices has challenged the main body of clinical research as un-generalizable due to the research being on upper income, well-educated, white, female patients. For a multitude of reasons, Integrative Medicine for the Underserved (IM4US) has emerged as the leading edge of the movement for integrative health.
Cast a net for papers on “innovations in group-delivered services” and what do you get? Guest editor Maria Chao, DrPh, MPA summed up the nearly 40 submissions this way: “Our editorial team was struck by the heterogeneity of integrative group visits for a range of health conditions, serving diverse patients across the life course and implemented in varied healthcare settings. A unifying theme is the potential for integrative group visits to address unmet needs of underserved and vulnerable patients. In many ways, group visits serve as a critical model towards integrative health equity.” The commentaries and research articles in the JACM Special Focus Issue on Innovation in Group Delivered Services make a potent case for an expanded role for groups not just for those who can pay cash but for all populations in a transformed healthcare system. All the articles are in open access until August 25, 2019.
From 30,000 feet – where I sit – it’s easy to proclaim all the reasons why group visits are a terrific fit for the values and practice of integrative health and medicine. Docere. What better format than groups? Adults learn better interactively. Groups are mediums for taking power in oneself and changing lifestyle. Now a presentation through the Academic Consortium for Integrative Medicine and Health (“the Consortium”) offers data on how group visits both expanded access and increased revenues in integrative health services. Meantime, peer-reviewed journal JACM has announced that it is developing an entire Special Focused Issue on Innovation in Group-Delivered Services.