I recently gave a commencement talk at Northwestern Health Sciences University, the day before Episode One of the last season of Game of Thrones. I chose to inject the sacredness of that day by referencing that other world by presenting the landscape of health and medicine that the graduates were entering as a jockeying between three Houses. In power on the Iron Throne: the House of Volume/Industry. The other two Houses are each insurgencies: the House of Integrative Health and the House of Value-Based Medicine. Can this life-and-death game play out favorably with an alliance between the two insurgencies in a field of health creation?
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.
Organizations connected to two of the most significant researchers in the movement for integrative health and healing, Brian Berman, MD and Wayne Jonas, MD, held separate events recently to announce reports that offer insight into patients’ experience of health and healing. Samueli Integrative Health Programs, which Jonas directs, examined patient views of health in the context of their relationships with their primary care doctors. Berman’s Institute for Health and Healing – in collaboration with the Institute for Functional Medicine – dove deeply into selected patients’ perceptions of what their “healing journey” to develop a model. Both examinations highlight processes not typically part of the clinical encounter. Outcomes illuminate potential characteristics of a system focused on health creation.