At Scripps Center for Integrative Medicine,
Dr. Liz Fraser performs healing hands therapy
on patient Nancy McLaughlin. — Sean M. Haffey / UT photos
How integrative therapies can help
Evidence-based research shows these integrative treatments may help reduce or prevent certain health problems.
Acupuncture (and therefore Shiatsu/Acupressure): Chemotherapy nausea, heart failure, back and joint pain, fertility problems, migraine headaches
Biofeedback: Incontinence, headaches, chronic pain
Chiropractic manipulation: Back and neck pain, headaches
Guided imagery: Depression, high blood pressure, insomnia, anxiety
Herbal therapy: Arthritis, asthma, headaches
Meditation: Stress, anxiety, high blood pressure, depression
Nutritional counseling: Diabetes, heart disease
Therapeutic massage: Back and muscle pain, high blood pressure, headaches
Stanley Westreich wasn’t always a believer in integrative medicine. In fact, he admits he thought it was “a little hocus-pocus.” But that was before integrative medicine helped turn his health and life around.
Integrative medicine combines conventional Western medical treatments with alternative or complementary therapies such as acupuncture, massage, biofeedback and stress reduction techniques. The emphasis is on prevention and the goal is to treat the whole person — body, mind and spirit.
Following the noninvasive Healing Hearts program at Scripps Center for Integrative Medicine, Westreich lost 35 pounds, gained energy and feels “better than I have in 20 years,” said the 75-year-old Rancho Santa Fe resident, who had suffered from atrial fibrillation problems that landed him in the hospital on more than one occasion.
“The integrative medicine model puts me at the center of my health care and makes me responsible for it,” said Westreich, whose integrative program included exercise, nutrition counseling and stress management.
“Most doctors are good at treating disease, but it’s very expensive,” he said. “Integrative medicine will prevent the disease from happening. I believe it’s the wave of the future.”
Hospitals seem to agree, judging by the number of medical centers now offering integrative services.
According to a recent survey by the American Hospital Association and the Samueli Institute, a nonprofit research group focusing on complementary medicine, 42 percent of the 714 hospitals that responded offered at least one such therapy in 2010, a significant jump from just five years earlier, when 27 percent of hospitals offered such treatments.
All hospitals in San Diego County offer some type of integrative therapy. Health systems such as the University of California San Diego Medical Center and Palomar Pomerado Health only recently coordinated their integrative medical specialists into a more focused system treating patients on a referral and appointment basis.
At Scripps Center for Integrative Medicine, founded in 1997 and the oldest integrative medicine center in California, an entire department and separate facility is devoted to complementary therapies.
According to the survey, the top treatments offered at outpatient centers were massage therapy, acupuncture and guided imagery. The last uses mental techniques, including visualization, to achieve such goals as reducing stress.
Why are so many conventional medical centers hopping on the integrative bandwagon? Medical experts offer several reasons.
As the American health care system grows progressively stressed and truly patient-centered care becomes increasingly difficult to find, more people are looking for alternatives to the traditional health care model. There’s a growing recognition, along with more evidence-based research, that some integrative therapies are very effective in many instances. Acupuncture has been shown to ease the nausea associated with chemotherapy. Stress management techniques, including meditation, successfully lower blood pressure. And, therapeutic massage can ease back pain and stress.
Initially, some physicians were skeptical about working integrative medicine into the mainstream. However, those therapies with evidence-based research behind them have gained acceptance and are the ones most often incorporated into hospitals.
“For heart attacks, Western medicine excels. But, Western medicine has nothing to offer in the way of prevention, except, ‘here’s a pill,’ ” said Dr. Mimi Guarneri, medical director and founder of Scripps Center for Integrative Medicine. “In integrative medicine, we get to the underlying cause of the heart attack. So, we say let’s deal with the stress, let’s start exercising and get some weight off. We don’t just throw a pill at it.”
Doctors are hearing more patients say they want to be an active participant in their health care, not always an option in conventional medicine.
“Patients don’t want to be sitting in the backseat of their medical delivery system. They want to be in the driver’s seat and physicians want that, too,” said Dr. Alan Larson, medical director of the Center for Integrative Medicine at Palomar Pomerado Health. “In integrative medicine, the patient is in control most of the time.”
Integrative medicine is also seen by many experts as a key to successful health care reform. The complementary therapies that keep people healthy may be the new strategy as providers increasingly become part of accountable care organizations, in which they’re paid to take responsibility for a patient’s overall health rather than provide services a la carte.
“Integrative medicine is the only plan in town for the prevention of disease. Prevention is the key to better health care so integrative medicine is the key,” Guarneri said. “We’re not just treating diseases when they occur, but we’re looking at how we can change a patient’s risk or reverse the disease.”
There’s also the money factor. Since most integrative therapies are not covered by insurance, some people might speculate that hospitals offering these services have the opportunity to attract patients and make more money. According to the most recent report from the National Center for Health Statistics, Americans spent $33.9 billion on integrative therapies in 2007 — money that came out of their own pockets.
However, integrative specialists say integrative medicine is more about saving money than making money.
“The cash aspect is just a drop in the bucket. But, when complementary treatments hasten the recovery of patients and they’re able to leave the hospital sooner and not return with recurrences, now that’s big ticket savings for us,” Larson said.
Guarneri calls our current health care system “the perfect storm.”
“Chronic disease management is costing the country $2.5 trillion a year for diseases that are preventable,” she said. “We spend more money on drugs than ever before. Of all the pills produced in the world, 47 percent of them are consumed in America. We can’t keep this up. We need to turn the ship around and focus on prevention first.”
What does the future hold for integrative medicine?
Besides the likelihood of it being offered in more hospitals and medical centers, some integrative experts foresee increasing insurance coverage for complementary therapies. For the first time, Medicare is now paying for the noninvasive Ornish Program for Reversing Heart Disease, the first scientifically proven program combining aerobic exercise, stress management techniques and a nutrition plan to prevent and reverse heart disease.
Most integrative treatments are offered on an outpatient basis, however integrative physicians are hopeful that the therapies soon will be available to inpatients and in the emergency room.
“We want to get integrative medicine into more (hospital) departments and show them the difference it can make in patients’ lives,” Larson said. “Although it takes a while to adopt new philosophies, in 10 or 20 years, I think what we (currently) know as integrative medicine will be conventional medicine.”