Envisioning the Future of Healthcare
Jan 19, 2010 07:30PM
As a tie-dye-clad, free-spirited medical student of the ’60s with a fascination for botanical remedies, Chinese medicine and mind-body healing, young Andrew Weil quickly developed a distaste for traditional medicine as practiced in the West. “I was dismayed at the lack of connection with the natural world, the complete ignorance about botanicals and the utter absence of interest in any mind-body connection,” recalls Dr. Weil, who graduated from Harvard Medical School in 1968 as a medical doctor, with no intention to ever practice medicine. “I left there completely unprepared to help people stay well. I got very discouraged.”
Now, 40 years later, this bestselling author, internationally renowned physician and founder of the Arizona Center for Integrative Medicine has channeled his discontent into action. Weil is among those pioneering a burgeoning new kind of medicine that many insist holds the answer to our nation’s healthcare woes.
Integrative medicine, a thoughtful blend of conventional medicine, common sense prevention and modalities once dubbed alternative, such as acupuncture, meditation, breath work and dietary supplements, has caught on widely from coast to coast in the past decade, both among consumers and once-skeptical healthcare practitioners. The Association of American Medical Colleges reports that 113 of the nation’s 126 medical schools now include discussion of complementary and alternative therapies in conventional medical courses. Seventy-seven offer standalone electives in such approaches as traditional Chinese medicine and mindfulness-based stress reduction. As of this year, eight major medical schools require that students take part in a 250-hour integrative medicine curriculum as part of their residency.
According to the American Hospital Association, 16 percent of hospitals, including medical facilities at Harvard and Duke universities, now feature integrative medicine centers. Of those that don’t, 24 percent plan to offer them in the future.
In February 2009, the Institute of Medicine, once leery of all things alternative, held a momentous two-day summit, Integrative Medicine and the Health of the Public, inviting 600 policymakers and practitioners to explore where this new form of medicine is taking us. Days later, a congressional health committee was calling on Weil—once a dark horse among his medical colleagues—for testimony about how to fix the nation’s crumbling healthcare system.
His answer: Stop focusing so much on making our current system more accessible via insurance reform, and instead, create a new system.
“What we have is not a healthcare system at all; it is a disease management system,” advises Weil. “Making the current system cheaper and more accessible will just spread the dysfunction more widely. What we need is a new kind of medicine.”
Integrative, Not Alternative
Mary Guerrera, a medical doctor and director of integrative medicine at the University of Connecticut School of Medicine, stresses that integrative is not just another word for alternative.
“Alternative medicine indicates something to be used in place of. Integrative is a term that has emerged in the past decade to reflect a bringing together of the best that conventional and alternative medicine have to offer,” says Guerrera, who went on to study acupuncture and holistic medicine after completing her conventional medical training in the ‘80s.
She explains that because one person can’t be an expert in everything, integrative medicine hinges on the idea of team care. For instance, a cancer patient might see her specialists for chemotherapy and surgery, and then be referred to an acupuncturist for treatments to help with nausea or pain management, as well as a nutritionist to help her restore lost weight. A patient going into surgery might practice mindfulness-based meditation beforehand, which has been shown to hasten healing times, decrease hospital stays and thus, save money.
“Integrative medicine is team-based, collaborative care,” Guerrera explains.
Cardiologist Mimi Guarneri is medical director and founder of the Scripps Center for Integrative Medicine, a multi-disciplinary center that offers care for people with heart disease, pain, weight management needs, cancer, diabetes, stress and women’s health issues. She notes that the center receives 3,500 patients a month, many of whom arrive seeking relief from costly drugs or surgeries.
“One patient came to me who had just had a bypass. He was 330 pounds, suffered from sleep apnea and was diabetic. He had all the risk factors for heart disease,” says Guarneri. She enrolled him in a $2,800, three-month weight loss and exercise program (covered only in part by insurance). “He lost 168 pounds and he went from taking 16 drugs to three. Just with that single individual, the system saved enormous amounts of money.”
In 1997, after years of quietly teaching and practicing integrative medicine in Arizona, Weil was propelled from relative obscurity to the cover of Time magazine. He has since become a go-to resource for both lawmakers and other doctors seeking healthcare advice.
Weil believes that money, or lack thereof, made it happen.
“No amount of ideological argument ever changed anything,” he reflects. In this case, “It was when pocketbooks started getting squeezed that people started paying attention. Things are going to get a lot worse, and when they do, the wisdom of what we are doing will become even more apparent.”
During congressional testimony before the Senate committee on health, education, labor and pensions last February, Weil joined heart physician and health guru Dr. Dean Ornish and others in rattling off a stunning list of statistics: The United States currently spends 16 percent of its gross domestic product on health care, more than any other country in the world, yet its health outcomes are ranked 37th in the world by the World Health Organization. In 2006, insurance companies covered 1.3 million coronary angioplasty procedures, at roughly $48,000 each, and 448,000 coronary bypass operations at a cost of $99,000. Yet, things like nutrition counseling, exercise programs and stress-reduction classes, which studies show could prevent as much as 90 percent of all heart disease, are typically not covered by insurance.
That, remarks Weil, needs to change, and he’s optimistic that it will.
“We need to transform medicine so we are not so dependent on these high-tech expensive solutions for everything,” concludes Weil, who outlines his plan in his new book, Why our Health Matters: A Vision of Medicine That Can Transform the Future. “We need doctors who know when and when not to use them and who are trained to use other kinds of interventions. That’s the great promise of integrative medicine: It can bring effective, lower-cost treatments into the mainstream.”
Lisa Marshall is a freelance writer in Colorado; connect at LisaAnnMarshall.com.