Health care has become all too much disease management. The confines of this two dimensional care-space has become intolerable for patients. More than 80% of patients surveyed are generally dissatisfied with care. As a result many turn to complementary and alternative medicine (CAM) – accunpuncture, massage, ayurveda, nutrition, supplements and herbals among others, to try to find what they feel they are missing in conventional “disease management”. As a result Americans now spend more money out-of-pocket for CAM than they spend out-of-pocket for conventional disease management.
At the same time many providers – physicians, nurses, therapists and ancillary workers in “disease management” are feeling crushed, burned out and depressed with the constraints of increasingly stressful and unfulfilling work. Many have long lost the fire that lead them into their chosen field in the first place.
A movement has sprung up to combine, or integrate, the best of both conventional medicine and complementary/alternative therapies. Integrative medicine has its roots deep within cardiovascular medicine as well as the behavioral sciences. It seeks to re-establish the patient in the broadest perspective as the focus of efforts to cure when possible and heal whether cure is possible or not. I have been extremely blessed to have discover the Fellowship in Integrative at the University of Arizona Center for Integrative Medicine, where I am now a fellow. This has resulted in a shift from two dimensional reality to orthogonal reality in my role in caring for my patients and has dramatically benefited my feelings about my day-to-day job.
I am so inspired by the examples of physicians that have experienced their orthogonal shifts and changed not only their lives and their patient’s lives and have laid the foundation for a better way to care.
Another way that science can help is to drag the skeptics in through the back door. I spent a lot of time with Meyer Friedman, the cardiologist who in the 1950’s discovered the link between a certain hostile personality style known as type A and the threat of heart disease. He was a father figure to me, always talking about his recent patients, and if someone was doing well, he would say, “I’m so happy this person has become so much nicer.” He didn’t say, “I’m so happy this person has a much healthier heart.” One day I finally asked him, “Okay, what’s the deal here? Are you in the business of preventing heart attacks of saving the world?” Instantly, he responded, “Saving he world. If it takes getting people to worry about their heart valves to be nicer to each other, I’m perfectly happy to do that.” This, by the way, was a man who had his first heart attack at age 50 and saw his last patient a week before he died at age ninety-one. So he actually practiced what he preached.
Robert Sapolsky in The Mind’s Own Physician: A Scientific Dialogue with the Dalai Lama on the Healing Power of Meditation J. Kabat-Zinn and R Davidson eds. New Harbinger 2011 pp 94-95
Thanks for reading,