As I sat with colleagues at a celebratory dinner this week, we had a good laugh as we reminisced about the early days of our careers and the road still ahead.
Twenty years ago, who would have thought that 1,000 people from around the world would convene in Portland, Ore., to present and critically evaluate research in integrative medicine? The Consortium of Academic Health Centers for Integrative Medicine, or CAHCIM, organized the recent 2012 Research Congress on Integrative Medicine and Health.
CAHCIM members comprise approximately 50, or nearly one-half, of the nation’s medical schools. Members must maintain responsible programs in research, education and clinical care. The University of Hawaii John A. Burns School of Medicine joined CAHCIM approximately 10 years ago after a new department was created to advance understanding of this rapidly emerging field of health care.
Hawaii has remained an active participant in national and international developments throughout the years. A separate but related entity, the Hawaii Consortium for Integrative Healthcare, now in its 14th year, was formed to involve not only academia, but also stakeholder organizations from throughout the health care industry, including the insurance, hospital, government and professional sectors.
Also in Hawaii, Tripler Army Medical Center, in collaboration with the Veterans Administration, has plans to expand its Integrative Pain Management Center to support our men and woman who have returned from wars in Afghanistan and Iraq. This is part of a countrywide initiative established by the Department of Defense.
Integrative medicine strives to bring together the best of modern medicine and traditional healing arts with cultural sensitivity. It was born with the idea that pharmaceuticals and surgical procedures, while essential at times, are alone unable to address the full spectrum of care necessary to prevent illness, optimize wellness and manage cost.
Today’s changes in health care are perhaps greater than at any other time in our nation’s history. As health care reform continues to advance and more people have access to care, cost pressures mount. Large payers such as Medicare and Hawaii Medical Service Association have begun to change reimbursement models with a stronger emphasis on provider compliance with set parameters. Compliance is now readily monitored through electronic health records.
Much of the current change centers on the patient-centered medical home that requires providers to offer standard health maintenance screening.
The truth is that payers may be able to create conditions that help build a patient-centered medical house, but by themselves cannot transform the house into a home. The house might have floors, walls and a roof, but it must be inhabited by an ohana comprising a health care team and its family of patients. The house is simply a structure. The home is about the relationships that go on inside the house. This is the kuleana of integrative medicine, which emphasizes a whole-patient approach with attention to physical, psychological, social and spiritual health. Integrative medicine focuses on the therapeutic relationship, team-based, multidisciplinary collaboration and skillful coordination of care. Clear communication and patient education are central to this approach.
During the past 20 years, integrative medicine has researched and critically evaluated patient-centered strategies for care, and is now well prepared to adapt to new payer models and leverage technological developments made possible by electronic health records. As our nation strives to provide increased access to quality care at a reasonable cost, the field of integrative medicine is prepared to inhabit the vision of a patient-centered medical home.
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Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.
