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Zunin on CAM-IM Clinical Services in Healthy Living "Age Targeted" Communities PDF Print E-mail
Written by John Weeks   

Ira Zunin on CAM-IM Clinical Services in Healthy Living "Age-Targeted" Communities

Boomers are aging. Real-estate developers are beginning to design communities which will attract these new health-oriented, soon-to-be seniors. Those involved in such projects shy away from using the "R" word -- as in "retirement communities." Boomers often simply
Ira Zunin, MD, MPH, MBA, Global Advisory Services
don't see themselves as retiring. They intend to stay active. They may keep a hand into some form of work - by choice or necessity. So these are "age-targeted communities." And frequently the development will now include a health center with a variety of educational, preventive, natural health and integrative medicine services.

Ira Zunin, MD, MPH,  MBA
, runs one of the largest integrative clinics in the country, on the island of Oahu. Through his consulting business,
Global Advisory Services, he has assisted various clients on integrative clinic strategies and healthy tourism. Over the past year, Zunin, also the founder of the multi-stakeholder Hawaii
Frequently these new
will include
a health center with a
of educational,
preventive, natural health 

and integrative medicine

Consortium for Integrative Healthcare, has been contacted by "a half-dozen" developers interested in exploring how health services offered can be best integrated into their communities. The Integrator Blog News and Reports interviewed Zunin on this new phenomenon, and the opportunities it represents for integrated health care.

IBN&R:  Mega housing developments have been a part of the US landscape for years. What is the difference here?

Zunin: The differences are vast. There are a number of trends factoring into this. Aging baby boomers are an active lot. They do not intend to spend their retirement in rockers.  They expect more, much more. They are interested in the ambience, the feng shui. They are looking for natural places to live, with walking paths and also with exercise facilities nearby. Because these environments are often outside of urban areas, there is a need to provide services, and particularly healthcare services. We seeing an entirely new phenomenon, a new set of values. Boomers - and thus the developers - want an environment within their communities that fosters these values and allows them to be active participants.

IBN&R: So the developments have a different feel.

Zunin: Yes, they are different in important ways. The developers who have contacted me have become concerned about how people live, how the soul inhabits the space being designed and built. The idea is unbelievably simple and revolutionary at the same time.
"Boomers - and thus the
developers - want
environment within
their communities
fosters these new values
and allows
them to be
active participants."

They want to be able to promote the health and wellness of the individual in the ways these communities are created. We see this in design features and in the use of sustainable energy sources for heating and cooling, and in the healthy building materials and practices. There is an aesthetic interest throughout.

But along with the health and wellness interests of boomers, there is a
Subsidiary of Maui Land and Pineapple
an economic component driving the phenomenon
. Real estate expansion in the US has been going on for awhile. Investors have made a lot of money, very quickly, over a long period of time, particularly since the NASDAQ crashed in 2000. Now many are beginning to see that they need to differentiate their concepts and projects from their competitors. They also see the inherent value in sustainability. So this internal economic push is coinciding with the aging of the boomers and the rise of the concept of sustainability
. The result is an idea whose time is ripe.

IBN&R: Talk about one of the projects.

Zunin: Here on the islands we are working with Maui Land and Pineapple, one of Hawaii's oldest companies. Their development is a combination of housing, destination tourism, condos, and healthy living not only for their clients but for the local population which provides services to these communities. Our projects range from input on design and planning medical services to developing employee benefit plans. So the healthcare services clientele
"The healthcare services
clientele can range
the transient one-week
guest to three
visitor, to people retired
there, and the
development's own

can range from the transient one-week guest to three month visitor, to people retired full-time there, and to their own employees. Developers want to send a consistent message, and model in their own practices what they are offering to their clients. We are not architects and engineers. We are, however, helping Maui Land and Pineapple to design integrative systems and an enhanced lifestyle that will appeal to their various constituencies.

IBN&R:  Okay, you are talking about Hawaii, and a particularly beautiful zone on a beautiful island. But is this only a phenomenon in typical destination places like your home state?

Zunin: Not at all. We have been contacted by developers in New York, New Mexico, Minnesota, and in Michigan, for instance. Hawaii is only one form of beauty. There are beautiful natural environments all over that can be great places to retire.

IBN&R:  What are you seeing as chief interests in the way of health care and clinical services?

Zunin:  The range is broad. That's why we always begin with a needs assessment. An important factor is how isolated they are. Basic ER services or at least "staging ER services" are often important. The type of housing will shape the offerings. Some places will include independent living units, assisted living areas and others will have skilled
"From a business
perspective, healthcare

services become part
of the profile which
the developer
to sell the entire

nursing services available. These, of course, will determine the kinds of conventional medical services that are needed. The more integrative care kinds of things begin with education and wellness programs, fitness facilities, therapeutic movement, yoga, and tai chi. Community rooms will be used for talks and educational services. Some developers are looking at bringing in big name healers from time to time, to draw attention for marketing purposes and, of course, as a service for their clientele. From a business perspective, the healthcare services become part of the profile which enables the developer to sell the entire community.

IBN&R: How large are these communities? How many people will be served by these community centers and clinics? Do they expect to be self-sustaining based upon the population they bring into their community?

ImageZunin:  Who can tell? Because this is a new form of life completion, the models vary. Some focus on the residential market while others concentrate on bringing in visitors to their place as a destination, perhaps for week-long spa or medical spa program which might be linked to some other educational content.

IBN&R:  So what does the decision process on selecting integrative healthcare services look like?

Zunin: There are universal decision nodes. Who is being targeted for the services?
Community residents? Is it for a regional, national or international constituency? Is it treatment-oriented or focused on "feel-good" and focusing on wellness? Will services be fee-for-service or will the clinic accept insurance? How much retail do you want to have? Are the internal and external environments conducive to a broader acceptance of integrative medicine? And what are all of the ways the development's natural surroundings can promote the physical and spiritual health of the clientele? Are these being utilized to the maximum? The developer's own predilections figure in prominently of course.

"The true spirit of
in health care
over the last two or three
decades is to effect
in our medicine and in our
culture ...
As our work
deepens, it can only benefit
a greater number of people

IBN&R: So what I am hearing is that maybe a part of the solution to the economic challenges some integrative clinics have had over the past decade is to first aggregate the community of users, then build the clinics?

Zunin:  The true spirit of integration
in health care over the last two or three decades is to effect changes in our medicine and in our culture. Ultimately, as our work in health care deepens and as our values are spread across our communities, it can only benefit a greater number of people. If there is any antidote to the hubris that plagues us as a result of this age of terrorism, this is it. It is a collective reaffirmation of life. I'm proud to be part of it.

Disclosure note: I have worked with Zunin in limited ways from time to time, dating back to 2001 when he took on the task of chairing the Employer-Managed Care Working Group of the former Collaboration for Healthcare

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