The polarization between reductive biomedical science and a whole person integrative model obscures deeper differences relative to human nature. The top-down, fix-it mode of the former is grounded in a fundamental belief that people (a.k.a. “patients”) either do not want to change or simply can’t. Meantime, the time-consuming, get-in-there-and-partner focus of lifestyle-oriented integrative practitioners assumes that the presenting human being arrives with seeds of change seeking ground for germination and growth. A recent Harris poll on perceptions of self-care among conventional medical doctors and their patients that was funded by the Samueli Foundation and led by its integrative health director Wayne Jonas, MD describes the chasm that has opened between the two parties. The patient is seeking an integrative model for self care amidst the present predication of medical delivery on the skeptical view of human nature.
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.
Spoiler alert. The title of a recent column marking the 10th anniversary of Triple Aim efforts to move medical payment and delivery from volume toward value makes no bones about the effort’s shortcomings. This report card from the Triple Aim’s top cheer-leader is meaningful to the high touch, human-intensive movement for integrative health and medicine for one important reason: the field’s potential uptake is pegged to advance of the values orientation. Success is more broadly meaningful because the values-based war against the forces in the industry that causally associate it with 250,000 medical deaths each year – effectively medicine’s white walkers in Game of Thrones terms – is the bullseye point of reference on what is at stake.
It was astonishing two decades ago when word emerged that medical device industry giant Medtronic – famed for its pacemakers – had made $1-million grants for cardiologists at heart centers across the country to explore complementary therapies. One seeded the creation of a center at Scripps led by interventional cardiologist Mimi Guarneri, MD. Guarneri would go on to be awarded the Bravewell Award, become the founding president of the Academy of Integrative Health and Medicine (AIHM) and most recently be presenting her Live Better Now program for PBS. I checked in with her early this “heart month” of February to get a sense of the state of integrative cardiology.