Is it possible that group visits can outperform individual visits in patient reported outcomes? The audience for an energetic panel discussion that touched on group visits at the February 2019 Integrative Healthcare Symposium heard an intriguing – though yet premature – data point. Panelist Mark Hyman MD noted that the Cleveland Clinic Center for Functional Medicine (CCCFM) has developed a functional medicine “shared medical appointments” group model at the. Hyman then noted that first indications appear to be that self-reports of participants in groups in the Center’s Functioning for Life program. A cursory look at data showed more positive change on key self-report measures via group than via the Center’s already positive individual functional medicine program outcomes. Scientifically verified outcomes have not been reported. Will the performance of group-delivered services hold up under statistical analysis?
The past 20 years witnessed the expansion of a new type of institution in academic health care – and specifically in integrative health and medicine: multidisciplinary universities with professional degrees in multiple natural health fields. Variously denominated as universities of “natural health sciences” or “health sciences” or “integrative health” or merely as “university,” these 7 institutions were each founded as single purpose colleges to educate chiropractors, naturopathic doctors or acupuncturists. They expanded to include other disciplines, degrees and certifications. Many have played important roles in the integrative health movement. All sit at the intersection of two fields in turmoil: health care and higher education. I interviewed the presidents of each to access their vantage points. This overview is a first in a two-part series.
When a global scientific community for traditional, complementary and integrative medicine emerged 20-years ago, it declared for the importance of what it called “whole systems research” (WSR). Such exploration was declared as core mission of an organization, ISCMR, formed to network the community. It was formed in contra-distinction to reductive, single agent trials that were then a relatively unchallenged “gold standard” for research. Researchers associated with chiropractic, naturopathy, acupuncture and other licensed integrative practice fields prioritized such research in a 2009-2011 campaign to influence the priorities at what is now the NIH National Center for Complementary and Integrative Health. Academic integrative medical doctor researchers called for it. Yet now a special issue of an integrative health journal – available entirely in open access to the public – is questioning whether steam is left in that thrust – and whether, ironically, such interest is dissipating at a moment of potentially broader embrace.
The news broke last week that the physician most associated with the term “integrative medicine”, Andrew Weil, MD, had donated $15-million to fuel the work of what is now known as the University of Arizona Andrew Weil Center for Integrative Medicine. The donation comes on top of $5-million Weil has already gifted the program he founded over two decades ago. In October 1996, I met him during a small symposium on the coverage issues in integration co-sponsored by the National Institutes of Health and Weil’s nascent program. (For perspective on one of the program’s influences, it was held in the first week of work of the individual Weil chose as his program’s first executive director, Tracy Gaudet, MD, now head of the VA’s Office of Patient Centered Care and Cultural Transformation.) A time of beginnings. The huge gift seemed a good excuse to connect with Weil on his generous bequest, and to ask him to muse on developments in an “integrative” field that in 1996 had just been birthed as such. This article reconstructs some of that conversation.