Casey Health Institute Announces an Integrative Health Care PCMH as an Evolving Model of Practice

Summary:  The elements are these: a philanthropist in the nation's Beltway with an interest in integrative medicine, her faith in an integrative-minded physician, and an opportunity to occupy a large building site near a medical corridor. Such was the opportunity offered by Betty Casey to David Fogel, MD in 2010. In this article by long-time integrative health leader Alan Dumoff, JD, MSW, a consultant to the project, readers have a chance to see the decisions 2010-2012 via an array of consultations in a cross-country exploration of best practices. Their decision was to develop the new Casey Health Institute as a model patient centered medical home (PCMH) that could influence developments across the country as the PCMH model expands. There is a position open, by the way, for a top-notch medical director. See the job description at the bottom of Dumoff's article.

I developed elaborate plans for two homes, one with a basketball court, reflecting my actual ruling passion of the time. The pleasure of dreaming big onto a blank slate, incorporating one's favored elements, is among life's best offerings.

Fogel and Bar-Levay: opportunity and responsibility

Such an opportunity, and responsibility, was handed to integrative physician David Fogel, MD and his spouse,

The Casey Health Institute Integrative Health Care Announces
Patient-Centered Medical Home as an Evolving Model of Practice

Integrative Medicine Director Sought
Coming to Suburban Washington, D.C. in the Spring of 2013

- Alan Dumoff, JD, MSW ( )

Alan Dumoff, JD, MSW

"Integrative care" has carried many meanings; functional medicine delivered by MD's, the varied work of complementary and alternative medical (CAM) practitioners, or to the elusive ideal of team-based, collaborative care central to many of these visions. Truly collaborative care has been quite elusive in practice, however, because business models have difficulty sustaining it. Meanwhile, mainstream medical practices, in partnerships with insurance companies, have been developing Patient Centered Medical Homes (PCMH) as a model for delivery with better payment that emphasizes coordination of services and preventive care.

Integrative care and PCMH models share a common core value of patient-centered care, and while they arise from different worlds, may be a natural fit. Will delivering integrative, team-based care in a PCMH model bring a workable business model to collaborative care? The Casey Health Institute (CHI), scheduled to begin offering services in the Spring of 2013, intends to demonstrate that this is the case.

The Development of CHI

In 2010, Mrs. Betty Casey, a philanthropist and long time supporter of Integrative Medicine, approached Maryland physician, David Fogel, MD, to help realize her vision of creating an Integrative Health Center in Gaithersburg, Maryland. Prerequisite to leading the project, Dr. Fogel, together with his wife, Ilana Bar-Levav, MD, organized a team of health care professionals to travel the country researching a broad range of sustainable Integrative Health Care models. I was privileged to participate, and we were able to visit a number of successful integrative centers as well as leading lights in the field, including John Weeks.

This effort led to a plan that, through the generosity of Mrs. Casey and the Eugene B. Casey Foundation, led to establishing The Casey Health Institute (CHI), a public 501(c)(3) not-for-profit. In addition to funding for the project, the Foundation gifted a 65,000 sq. ft. office building that will be a home for other integrative practices, and related services and products, cooking classes and an healthy foods eatery.

The Patient Centered Medical Home

Developed over four decades by the American Academy of Pediatrics and the American Academy of Family Practitioners (AAFP), the PCMH is an approach to comprehensive primary care that emphasizes partnerships between individual patients, families as appropriate, and their personal physicians. The team collectively takes responsibility for each patient and coordinates care among the often complex system of subspecialists, hospitals, home health agencies, nursing homes and the array of community-based services. Health coaches and navigators are integral to the team. Cutting edge technology facilitates information exchange and communication between patient and practitioner and simplifies and assures better follow-up on immediate needs, health goals, and preventive care.

Philanthropist Betty Casey

A New Kind of Doctor/New Kind of Team

This model lends itself to a whole systems approach to care; the next step is to populate it with practitioners that can offer the best available therapies.

Integrative medical physicians have become identified with either taking on CAM methods themselves or developing esoteric therapies that may have gotten ahead of the evidence. CAM practitioners most often practice in isolation. CHI believes that the professions should bring evidence-based expertise to the same table and that best care emerges from the competency and involvement of the team.

CHI will bring well-trained physicians cross-trained in a range of evidence-based CAM side-by-side with skilled CAM practitioners, including acupuncture, chiropractic, nutritional medicine, massage therapy, yoga therapy, as well as allied professionals such as nurse practitioners and physical therapists.

The Integrative Medicine Team Room

Multidisciplinary weekly case conferences will provide the formal venue for collaboration, but for CHI, this is not enough. The Integrative Medicine Team Room is a carefully designed setting where all practitioners "live" and work together. The unique interactive space design will foster cross-disciplinary discussion and consultation.

The Shared Medical Appointment

The Shared Medical Appointment (SMA) is an exciting model of prompt, easy access to one's personal physician and health team for both chronic and acute illness. In a safe and confidential group setting, the SMA gives the patient prolonged face time with their doctor, less waiting, and access to the support and validation from others with health issues.

Among patients who try these voluntary meetings, there is enthusiasm and a documented high return visit rate. SMA's reduce the isolation of chronic disease and the stigma of illness through emotional support and positive modeling between patients. The model is endorsed by the AAFP and is increasingly being used at major centers like Harvard Vanguard and Kaiser.

Community Services and Research

CHI will also be community focused and offer health services for many segments of the community, and have an active research department that will explore medical and economic outcomes associated with a wide range of integrative approaches.
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An Opportunity for a Unique Physician:
CHI is looking for a Medical Director

 
CHI is actively seeking a medical director versed in IM who has PCMH experience:

CHI is seeking an innovative Medical Director and practicing primary care physician to join us on the ground floor of newly established Integrative Health Care Institute combining traditional allopathic medicine with Complementary and Alternative Medicine (CAM) in the setting of a primary care-Patient Centered Medical Home (PCMH).

Opportunity for a physician with vision to become a key leader on our core clinical team.  Experience implementing and practicing within a PCMH is important.  Position requires creativity and leadership by an adept manager who is well versed in EHR, enjoys patient interaction, and thrives in a team approach to the practice of medicine.

The first 6 to 9 months will be 100% implementation of a well structured business and medical model.  We are projected to begin seeing patients March 2013, at which time the position will become 80% clinical and 20% administrative.

Health Center Description

The Casey Health Institute (CHI) is a fully funded 501 (c) 3, public, not- for-profit, clinical Health Institute. Interested candidates should send a cover letter, curriculum vitae, and list of references to:

Barbara Gallagher

Casey Health Institute
7920 Old Georgetown Road
Bethesda, Maryland 20814
301 664-6464