In academic medical centers promoting transformation toward integrative medicine and health, nurse leadership is rare. So is branding them with “spiritual” and “healing”. The usual chess game of change-making focuses on moving RCTs and systematic reviews like pawns to gain an advantage. Honoring the full professional value of licensed acupuncturists, chiropractors, naturopathic doctors and others is also rare. Most find it easier to gain the support of a dean by reducing such professionals to tools to deploy instead of as interprofessional partners. This year marks the 25th anniversary of an institution that modeled a road less traveled that included these and other distinctive, inclusive traits. The founder-director is nurse and health services researcher Mary Jo Kreitzer, RN, PhD, FAAN. I reached her for a long-overdue profile of a center that a close observer of the field has called “one of the most important centers globally for advancing integrative health.”
Tracking the inclusion of integrative strategies inside the Veteran’s Administration (VA) is an exception to the saying that a watched pot never boils. Integrative health research inside the VA funded in 2016 was the basis by which VA leaders chose 3 years later to more than triple the implementation of the “whole health” model to 55 medical centers. It was cause to exult. Now a special issue of the American Public Health Association journal Medical Care documents a further percolating of the inclusion process. With The Implementation of Complementary and Integrative Health Therapies in the Veterans Health Administration, one witnesses the powerful potential for change when a will is linked to a plan and a budget. The success at the VA casts cold light on the relative failure of reduction-oriented and production-minded public and private agencies to guide optimal implementation of integrative practices and practitioners into the delivery institutions on which the vast majority of U.S. citizens rely for their care.
If you ask Deepak Chopra about the purpose of the Chopra Library, he will turn quickly speak to the challenges at Wikipedia for topics like integrative medicine and well-being. “Our original intention,” Chopra recalls, “was to counter the agenda at Wikipedia that all this is not scientific.” The mission to provide quality, reliable evidence on integrative and consciousness science was supercharged this past year when word came out that Chopra’s library would become a department at the new Whole Health Institute (WHI). WHI and the library are each backed by philanthropist Alice Walton whose father Sam, the Walmart founder, recalls Chopra, “first came to see me 30 years ago.” I got in touch with Chopra, and the library’s executive director Ryan Castle – a former Wikipedia editor – to learn more about what the field might expect from this other part of the WHI entity.
That there should be a huge transformational drama underway in the US medical industry is a desire and dream that powers the integrative health movement and the work of many others. Those who might enjoy a sort of reality TV examination of not the fantasy but the multi-dimensional actuality of what such change looks like have a treat coming. The scene of action is 18 huge medical centers distributed across the entire United States. The script writers are 25 scientists on an evaluation team. The drama cuts across 4 deeply inter-related story lines: the impact of the transformational change on patients, on employees, on utilization, and on the extent of implementation and cost. We the people literally own this story. The investment and outcomes – from which any delivery organization can learn – are revealed in plain English in the public domain. If the launch of the transformational journey was Episode 1 of the series, then this 39-page report after two years is Episode 2. It’s deep insight into a dream coming true in the Whole Health System of Care at the US Veterans Administration (VA). It’s long awaited. And it is exciting.