Integrative Medicine Conference News
I just returned from the Integrative Medicine Conference for Health Care Organizations held April 12-14, 2007, in San Diego, CA. This was a very interesting three days attended by healthcare professionals and directors of integrative medicine clinical programs, academics, economists and researchers.
There were several presentations from integrative medicine leaders who are now showing successful models of integrating natural medicine into conventional hospital and clinical settings. Especially encouraging is the emerging research showing better patient outcomes.
Most thought-provoking for me were the lectures by Jennifer James, PhD, and Martin Merry, MD. Dr. James is a cultural anthropologist from Seattle who has been studying the cultural transformation underlying the huge public movement towards natural/integrative/holistic approaches to healthcare. She made several strong points that were insightful for me:
He believes that most errors are due to "First Curve" or "physician-centered" thinking. This is manifested by our current healthcare system. Merry asserts that the old model of centering systems on the expert craftsman, which worked so well in the past, no longer works in our modern world. Increased complexity, increased amounts of information and broader patient access to information and technology that were once reserved to the specialist, all result in demands for a different way of functioning.
First curve care, even when optimally practiced, still yields what is called "4 sigma error," i.e., about 6,000 deaths due to errors for every 1 million patient interventions (and this does not include patient injury, which according to some studies may be as high as 25% of interventions1). The goal, of course, is to have no injuries or deaths due to medical errors.
Merry believes this is simply not possible in a physician-centered system. According to published research, most medical errors in hospitals are due to lack of communication amongst the professionals involved in a patient's care. As long as the system is physician-centered, these communication errors will continue to happen.
The "second curve" model is centered on the patient. All involved in providing care are fully engaged and regularly communicating. The hierarchy is flattened, and the needs of all involved are met, not just the primary doctor or the patient, and a culture of safety and excellence pervades the organization.
Merry presented a most interesting example: currently in the first curve medical system: When a woman goes to see her doctor because of the possibility of breast cancer, it takes 1 to 8 weeks before she knows the result of the biopsy. These are defined as the "sleepless nights." There is no real reason for the delay other than the long string of communications that have to occur before the patient is finally informed. In a second curve system, the patient is informed in 2 hours. Yes, the same day after a short delay, not endless days of worry later.
Merry believes that integrative medicine has already moved a long ways into the second curve model and is the future of healthcare. Nice to hear a non-IM physician recognize the importance of our movement!
Conclusion. This conference was a very positive experience, documenting the great strides this new medicine is making.
1 Gandhi TK, et al. Adverse drug events in ambulatory care. BMJ. 2003;348:1556-64
Technorati Tags: integrative medicine, healthcare, complementary medicine
There were several presentations from integrative medicine leaders who are now showing successful models of integrating natural medicine into conventional hospital and clinical settings. Especially encouraging is the emerging research showing better patient outcomes.
Most thought-provoking for me were the lectures by Jennifer James, PhD, and Martin Merry, MD. Dr. James is a cultural anthropologist from Seattle who has been studying the cultural transformation underlying the huge public movement towards natural/integrative/holistic approaches to healthcare. She made several strong points that were insightful for me:
- The current chaos in healthcare, while unpleasant for both practitioners and patients, creates the opportunity for fundamental change. But, while many may appreciate and welcome the new ideas, they do not want to let go of what they have learned and do not want to be made to feel they were "wrong" in the past.
This helped me understand why many dedicated conventional healthcare professionals seem to find it so hard to accept well-documented natural therapies when this might imply that the pharmaceuticals they have used for so long are possibly not be as good and more dangerous. - We cannot expect healthcare change to come from the federal level as there is no strong political leadership, and too many vested interests resist any real change. The solutions will come at the state level.
This was encouraging to me since this means local action by dedicated activists has the best chance to develop models that can then be evaluated and adopted more widely when they are shown to be effective. - As cultures advance, they become more kind. Healthcare is kindness-manifested. I liked this one! It resonated deeply with me, and I could see the same sense of appreciative self-understanding in others in the audience. Caring about others' health is the source and core of what I do.
- Flattening of the hierarchy gives patients greater involvement in their own health care decisions. This is consistent with my perspective that each patient is his or her own best doctor.
He believes that most errors are due to "First Curve" or "physician-centered" thinking. This is manifested by our current healthcare system. Merry asserts that the old model of centering systems on the expert craftsman, which worked so well in the past, no longer works in our modern world. Increased complexity, increased amounts of information and broader patient access to information and technology that were once reserved to the specialist, all result in demands for a different way of functioning.
First curve care, even when optimally practiced, still yields what is called "4 sigma error," i.e., about 6,000 deaths due to errors for every 1 million patient interventions (and this does not include patient injury, which according to some studies may be as high as 25% of interventions1). The goal, of course, is to have no injuries or deaths due to medical errors.
Merry believes this is simply not possible in a physician-centered system. According to published research, most medical errors in hospitals are due to lack of communication amongst the professionals involved in a patient's care. As long as the system is physician-centered, these communication errors will continue to happen.
The "second curve" model is centered on the patient. All involved in providing care are fully engaged and regularly communicating. The hierarchy is flattened, and the needs of all involved are met, not just the primary doctor or the patient, and a culture of safety and excellence pervades the organization.
Merry presented a most interesting example: currently in the first curve medical system: When a woman goes to see her doctor because of the possibility of breast cancer, it takes 1 to 8 weeks before she knows the result of the biopsy. These are defined as the "sleepless nights." There is no real reason for the delay other than the long string of communications that have to occur before the patient is finally informed. In a second curve system, the patient is informed in 2 hours. Yes, the same day after a short delay, not endless days of worry later.
Merry believes that integrative medicine has already moved a long ways into the second curve model and is the future of healthcare. Nice to hear a non-IM physician recognize the importance of our movement!
Conclusion. This conference was a very positive experience, documenting the great strides this new medicine is making.
1 Gandhi TK, et al. Adverse drug events in ambulatory care. BMJ. 2003;348:1556-64
Technorati Tags: integrative medicine, healthcare, complementary medicine
Labels: hot topics, integrative medicine
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