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Integrative Clinics/Academic Medicine: The Theme is Expansion, in Integration and Clinical Services PDF Print E-mail
Written by John Weeks   

Integrative Clinics & Academic Medicine:  The Theme is Expansion - in Clinics, Integration and Clinical Services

Summary: U Connecticut becomes the 8th school in the Integrative Medicine in Residency program at the University of Arizona ... Tai Sophia Institute adds an MD to its AOM teaching clinic ... Mary Ann Wallace, MD, MA shares significant expansion in integration activity through Samaritan Health System in Corvallis, Oregon ... Oregon Health & Sciences University adds AOM and naturopathic medicine to create an integrative neurology clinic  ... Michigan acupuncture clinic exemplifies old-style growth of community based complementary healthcare services ... Bridget Duffy, MD, takes role as "chief experience officer" at Cleveland Clinic ... Lisa Rohleder, LAc, reports growth of the Community Acupuncture Network model of community room acupuncture services.
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integrative medicine, holistic medicine, academic medicine, residency
Victoria Maizes, MD, MPH, heads up the U Arizona Program in Integrative Medicine
1.   U Arizona brings in U Connecticut as 8th Partner in an expanding Integrative Medicine in Residency program


The University of Arizona Program in Integrative Medicine (PIM) announced on October 2, 2007 that it as added the University of Connecticut/Saint Francis Hospital and Medical Center to it's Integrative Medicine in Residency (IMR) program.
Mary P. Guerrera, MD, FAAFP, an associate professor in the Department of Family Medicine at UConn/SFHMC will head up the IMR at U Conn.

The U Conn program becomes the 8th residency that is part of IMR. The University of Arizona describes IMR as a "competency-based curriculum in integrative medicine that is designed to be incorporated into the typical three-year residency program, with a common web-based
curriculum, as well as program-specific experiential and group process-oriented activities." Victoria Maizes, MD, MPH, executive director of the Program in Integrative Medicine,
says that the IMR goal over the next five years "is to develop into a national, self-sustaining educational program." The following are among the areas in which the IMR is attempting to develop competencies in the residents:

  • learn how to incorporate IM concepts into their practices. 
  • learn patient-centered care techniques
  • facilitating lifestyle changes
  • refer appropriately to complementary and alternative (CAM) practitioners
  • assess scientific and historical evidence for allopathic and CAM approaches to specific diseases and syndromes, and
  • appropriately integrate mind-body, botanical,nutrition/supplements and physical activity recommendations into their practices.

The program also includes education in self-care strategies for the residents. The UConn/SFHMC residency program joins seven other residency programs nationwide. The others are family medicine residencies at the University of Arizona, Tucson; Beth Israel, New York; Carolina’s Medical Center, Charlotte, North Carolina; Maine Medical Center, Portland Maine; Maine-Dartmouth, Augusta, Maine; Hennepin County Medical Center, Minneapolis, Minnesota; and the University of Texas Medical Branch, Galveston, Texas. Patricia Lebensohn, MD, is the director of IMR.

Comment
The University of Arizona release included a description of the mission of the Program in Integrative Medicine: "To lead the transformation of healthcare by creating, educating, and actively supporting a community of professionals who embody the philosophy and practice of Integrative Medicine." Under Maizes, the program that was founded by Andrew Weil, MD and originally directed by Tracy Gaudet, MD, is truly making a run at fulfilling on its mission. Congratulations, Dr. Maizes!

integrative medicine, acupuncture, education, academic medicine, integrative medicine clinics, integrated health care
Bringing an MD into their teaching clinic
2.   Tai Sophia Institute Brings Family Practice MD into Training Clinic


Tai Sophia Institute
has announced that, beginning in October 2007, its clinic services will include the practice of integrative medicine by a medical doctor. Jennifer Rabenhorst, MD, who is filling this role is a board certified family doctor with diverse integrative and functional medicine interests.
According to a release from Tai Sophia, Rabenhorst is "excited to be part of a national movement to improve the practice of medicine through Ideal Micro Practices."  Rabenhorst's focus will be on "patient-centered collaborative care by restoring the old-fashioned doctor-patient relationship while using the latest in medical practice technology." Information on Dr. Rabenhorst is available on her website. Tai Sophia, which was founded as an acupuncture school, views itself as an academic wellness institute.

4.    Corvallis' Good Samaritan Program Expands Integrative Offerings

I received a note from Mary Ann Wallace, MD, MA the integrative medicine leader with Samaritan Health System in Corvallis, Oregon. She writes: "Good news. Am so flippin' busy because we're expanding like gangbusters. Will be expanding by triple in the Corvallis Heartspring Wellness Center, adding several new practitioners and several new programs.  Adding a second full service clinic - the Albany Heartspring Wellness Center.  Met earlier with the architect for the new Corvallis Cancer Center where we will have a very prominent presence with some services integrated as well as a section of the center devoted to Integrative Medicine. I continue hiring Integrative Medicine staff for the Lebanon Cancer Center.  Just met with a research developer. We're looking at getting some grants to support research for some of our best and most longstanding services. Cool stuff. I'm busy."
(See prior Integrator article here.)

Comment: I bet she is. Nice to hear of such robust development.


integrative medicine, naturopathic medicine, academic medicine, Oregon Health & Science University, integrative clinic
Lynne Shinto, ND, MPH - naturopathic services in the OHSU neurology clinic
4.    Oregon Health & Science University Establishes Integrated Neurology Clinic


In early September, Oregon Health & Science University announced that it is initiating an integrative neurology clinic
at its Center for Health & Healing. The release states that "this unique clinic will provide care that integrates both conventional and complementary medicine for patients with neurological conditions, chronic pain, and headache who are interested in incorporating acupuncture, diet, stress management, and nutritional supplementation/counseling to promote wellness." Services will be provided by Stephen Dardis, LAc, DAOM and Lynne Shinto, ND, MPHThe clinic accepts patients that are referred by other providers (MD, RN, PA, PT) as well as self-referrals. A flier from OHSU also states that patients "with neurological conditions, chronic pain and headache, who are interested in complementary medicine may call and schedule an appointment directly." The integrative clinic will operate from 9 AM-1 PM on Fridays. See related Integrator article on Anne Nedrow, MD, the medical doctor who has taken the lead in setting up this clinic.

5.    Organic Growth of an Acupuncture Clinic: Acupuncture Healthcare Associates

An article entitled "The needles have it" (
Lara Mossa for the Oakland Press, West Bloomfield, MI) provides interesting data on the growth of a historic, community-based acupuncture practice. Owner-practitioner Julie Silver, MSW, LAc, began Acupuncture Healthcare Associates of Michigan the practice 7-years ago in 700 square feet, leasing space from a medical doctor and "networking to build a client base." Last year, Silver added a second acupuncturist and this year expanded to a new, 1400 square foot space. The new space also includes a massage therapist and a naturopathic physician.  Silver is quoted as explaining the addition of the other practitioners this way: "I thought it would complement the work that we do and (allow us) to treat the whole body." The price of initial acupuncture consultations is $130 with follow-up visits at $75-$85. The article notes that "health insurance does not cover services but some patients may pay for services from their health savings accounts." Silver claims that her networking has been successful, as "many patients are referred by physicians." Thanks to the Acupreneur Community News for the link.

patient-centerd care, integrative medicine
Bridget Duffy, MD
6.   Bridget Duffy, MD, Takes Cleveland Clinic Position as "Chief Experience Officer"


Imagine it is the 1950s. Some sci-fi writer is presenting a futuristic view of US healthcare. In the vision, hospitals are committed to ensuring that patients have a positive experience. They seek to guarantee that practitioners offer compassionate care. They know that certain technological imperatives of the system tend to downplay these human elements. So they begin hiring physicians to serve as "chief experience officers." The core responsibility of these physicians: oversee delivery of compassionate healthcare throughout the system.

That future is here. Bridget Duffy, MD, was recently named to a post with this title by the Cleveland Clinic. Duffy's responsibility:
"to ensure all aspects of the patient experience at Cleveland Clinic meet the highest standards." Duffy is known to many in the integrative medicine field as a physician advisor to the Earl and Doris Bakken Foundation. She also oversaw a series of $1-million grants from medical technology giant Medtronic which added high-touch to high-tech centers, mostly in cardiology.

Comment
The announcement of Duffy's position acknowledges that the system has a ways to go to be treating patients as they would optimally be treated. Duffy's role is not to maintain or nourish an existing form of care. Rather, she is to be a leader in "creating a culture that addresses the emotional and physical experience for the patient, restores empathy as a core value and recognizes the central role that employees play in delivering an exceptional patient experience." Here's to the day when we won't need to police compassion.

7.    Community Acupuncture Network Model: Model Expands Nationally

Curious about what it might mean for a patient to receive acupuncture in a community setting? A video featuring a panel of patients is available here at the site of Working Class Acupuncture (WCA).  WCA has elevated the potential of community room acupuncture as a business model.  Lisa Rohleder, LAc, co-founder of WCA told the Integrator that the video "raises more issues than you can shake a stick at."

community medicine, group visits, group services
Community room acupuncture model grows
Rohleder also shares that the Community Acupuncture Network, based on the WCA model, now features a blog on their site. She believes that "it's going to be good for acupuncturists overall (not just community acupuncturists) to have a bunch of their peers thinking out loud about their practices in public on a regular basis."

Queried about the growth of the movement, Rohleder noted that CAN has 40 clinics listed on their site. Each does at least 3 days/week of community acupuncture.
CAN currently has 383 members -- that includes "folks who are doing community acupuncture, thinking about doing community acupuncture, and still in school. 47 acupuncturists recently participated in a CAN training for which 30 were anticipated. Rohleder guesses that the "total number of clinics using some type of 'community acupuncture' nationwide is probably close to 150."  In it's first year, CAN has trained 300 acupuncturists. CAN estimates that nationally, about 2500 patients each week are getting acupuncture in "CAN-type clinics."

Comment/personal note: The CAN model uses a sliding scale of $15-$35 for an acupuncture treatment.  One-to-one acupuncture (see #5 above) is often $75-$85, with more for the first visit. My spouse and daughter have been using one of the CAN clinics, Communi-chi
for a sudden onset asthma that hit my daughter in the middle of a basketball game last year. The 8 visits have run $280 (@ $35/each), versus what would have been $610 in the clinic in #5 ($130 initial plus 7 X $80). We like the savings, and the care has been good and helpful. I must add that one unintended consequence of the lower rate is that my spouse has sometimes chosen to place herself in one of the CAN clinic's recliners to get needled while she is waiting on my daughter. Our total cost has gone up a couple hundred bucks to pay for her treatments.  But how does one measure the positive impacts (and potential placebo value) of mother and daughter receiving acupuncture together?

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