Chronicles of Health Creation: Exit Interview with Integrative Medicine Clinic Pioneer Peter Amato
After 17 years in the integrative medicine tough-lands of coal country Scranton, Pennsylvania, Peter Amato is calling it quits with his ground-breaking Inner Harmony Wellness Center. On July 31, 2014 the clinic will provide the last of an estimated 34,000 patient visits.
 Peter Amato, on St. Martens
Amato, a
member of a pioneering auto-parts family that helped create that
industry, was also, for a critical period in the late 1990s, the chair
of a policy arm of what was then a rapidly growing industry of its own:
the multiple initiatives of integrative medicine's Time magazine 2005 cover-doc Andrew Weil, MD.
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The
final accounting was 7 years
in the red, 3 years in the black,
and 6
years of break-even.
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With Weil in tow, Amato worked with Pennsylvania's then senior U.S. Senator Arlen Spector (R-PA),
naturopathic patient and chair of the powerful US Senator
Appropriations Committee to spearhead, in tandem with US Senator Tom
Harkin (D-Iowa), a vast increase in funding of the NIH National Center for Complementary and Alternative Medicine.
Along with his core Inner Harmony project, Amato supported key causes, including work of my own on three Integrative Medicine Industry Leadership Summits. These were meant to foster what we named back then "a thriving industry of health creation."
In
an exit interview, Amato spoke to the hopes we'd shared that new
integrative health and medicine centers would take off and flourish as
correctives to the reactive disease-management empire. These would
enhance the health of communities across the nation.
 For Amato,
his home in the somnolent integrative environment of Scranton came
first. If he proved a model there, America would follow. Amato recalled
that his vision for his community was articulated by our colleague, the
consultant and author Roger Jahnke, OMD. Amato wanted nothing less than to transform Scranton into "a town called radiance."
Like
numerous venture-backed businesses in that spendy convergence of the
dot-com boom and public interest in "CAM" and "integrative" care from
1996-2001, Amato and others foresaw a rapid spread of branded
enterprises - American Whole Health Clinics, CAM Centers, or in his
case, Inner Harmony Centers - across the United States. The auto-parts
franchises in his family had the model in his blood.
But first Scranton. Amato, with his COO at the end, University of Scranton MHA program director Steve Szydlowski, MBA, MHA, DHA,
would become national resources for best practices and lessons-learned
in the struggling efforts to find the right mix of services and
practitioners. I wrote of their guidance in Inner Harmony's Winding Road toward Health and Profitability.
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The relationship with the hospital,
while never more than
"congenial,
with professional courtesy and some
engagement" under
Mercy, "got
worse in the atmosphere of
the for-profit culture shift."
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Inner
Harmony began by testing a model that steered clear of the corruptions
of insurance reimbursement. Amato had a naturopathic doctor modeling
integrative practice, even though 17 years later Pennsylvania still
lacks a license for this form of primary care. Amato thought it the kind
of care his community needed. He also included services of one or more
acupuncturists, massage therapists. chiropractors, mind-body workers,
counselors, yoga teachers, health educators and others.
Amato
sought to infuse his business model with a perspective that appreciated
that to create health, we needed a change of consciousness. One of his
pride-points, along with stimulating funding increases at NCCAM, was his
ability "to engage in community education" in his home town. Sometimes
over 1000 would turn out to hear the likes of Weil, Deepak Chopra,
Marianne Williamson and others. (Fewer turned out the year I spoke!)
Yet
at the heart of the work was the layered conundrum of bringing forward a
new business, with a generally unheard of philosophy of care, in a
turned-inward coal town, amidst incentives in medicine that promote the
spread of disease, rather than his goal, the creation of health.
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Amato
estimates that he sunk $3-million
of his own funds, unrecovered,
into
the Center and his related ventures.
I did the math: $3-million
over 34,000 visits
in 17 years is a hefty $88 per visit subsidy.
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After
7 years of losses, Inner Harmony turned the corner. Szydlowski says the
final accounting was 7 years in the red, 3 years in the black, and 6
years of break-even.
The business breakthrough for Amato was to
utterly reverse himself, like many good entrepreneurs. He moved to an
insurance-accepting, integrative medical doctor-centered business and
practice model. He found quality family doctors who worked well in the
referral networks. At one time, he employed a graduate of the Fellowship that he helped Weil start.
Eventually he and Szylowski moved the clinic to a hospital base at what
was then the Mercy system but is today a part of the for-profit Commonwealth Health.
Amato
recounts that the relationship with the hospital, while never more than
"congenial, with professional courtesy and some engagement" under
Mercy, "got worse in the atmosphere of the for-profit culture shift."
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It is ironic that Amato is
stepping back
at this moment in which the perverse
incentives against
health in the US medical
industry are promoting leaders in the
dominant school to call for what he promoted,
a "radical shift" toward health creation.
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Amato
estimates that he sunk $3-million of his own funds, unrecovered, into
the Center and his related ventures. I did the math for him: $3-million
over 34,000 visits in 17 years is a hefty $88 per visit subsidy.
In recent years, Amato's personal and business interest shifted. He's finishing up a PhD in mind-body medicine via Saybrook University.
He's excited with his present work and the potential at his seasonal
home in St. Martens. There Amato has an energy healing practice and a
thriving wellness center, serving mainly locals,with a long wait-list.
He finds it refreshing to be in a place where herbs from the land are
still in regular use by his clients for health and medicine purposes.
As
an entrepreneur, Amato can't stop himself. Maybe a string of such
centers in the eastern Caribbean? Maybe a school that teaches a
multidisciplinary approach to care?
It is ironic that Amato is
stepping back at this moment in which the perverse incentives against
health in the US medical industry are promoting leaders like a Mayo
innovations strategist, Douglas Wood, MD and former CMS administrator
Don Berwick, MD, to call for a "radical shift" toward health creation.
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"Its been a long-time,nearly 20 years.
I am sure it contributed to society at
some levels.
It's not always tangible."
- Peter Amato
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How
much health has Inner Harmony created in the Scranton population it
served? In true global cost accounting, how did this venture cost out
for his community? What was the dollar value of foregone procedures and
surgeries? What human lives had a chance to flourish because the people
of Scranton, via Inner Harmony, had other options for pursuing health?
Whose lives changed through his annual lectures?
And with all
that lifestyle work, were 30 Scrantonites, over those 17 years, helped
to prevent the need for $100,000 cascades of medical interventions?
Seems likely. There alone is Amato's $3-million.
Toward the end of
our call, I asking him for final comments on his highlights and
low-lights. "Its been a long-time," he reflected, "nearly 20 years." He
paused, reflecting: "I am sure it contributed to society at some levels.
It's not always tangible."
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I'd wager that a focused census of Scranton, PA
would find a great deal of very tangible evidence
of good health created
through Amato's
investment in his community.
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Comment: Both Amato and I refrained from referencing the Greatful Dead's what a long, strange trip it's been during our call. I am guessing each of us thought it. I did. Each of us were acutely aware that, whether we like the progress we've made, or not, this shared involvement in a would-be industry of health creation certainly came, year by year, to define our professional lives. Somehow the fact the needed "paradigm shift" toward a health focus is at least making the language of Berwick and others takes the edge off the gawd-awfully slow process toward actually creating "a thriving industry of health creation."
Amato battled as an entrepreneur repeatedly to find the right model, and the right people to staff that model, in what must be one of the most inhospitable zones for integrative health and medicine in the United States. I'd wager that a focused census of Scranton, PA would find a great deal of very tangible evidence of good health created through Amato's investment in his community. Good luck with your next ventures, Peter!
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