The written summary of the IOM's Summit on Integrative Medicine and the Health of the Public can be downloaded from the IOM web site at www.iom.edu/Activities/ Quality/IntegrativeMed. aspx.
The Summit on Integrative Medicine and the Health of the Public
SUMMIT PROVIDES MODELS FOR HEALTH CARE REFORM
Before one of the largest and most diverse audiences ever assembled at the Institute of Medicine (IOM), the Summit on Integrative Medicine and the Health of the Public held February 25-27, 2009 brought forth emerging strategies for addressing some of the major problems inherent in our current health care system.
As Congress and the Obama Administration tackle issues related to escalating health care costs and the rising incidence of chronic disease, distinguished scientists, leading clinicians, top policy experts and industry leaders articulated principles and practices from integrative medicine that could form the basis for effective health care reform. According to William D. Novelli, CEO of AARP, who spoke at the Summit, health reform done correctly with a focus on prevention will provide "the biggest return on investment this nation could ever have."
Integrative medicine is an approach to health care that places the patient at the center of care, focuses on prevention and wellness, and attends to the physical, mental and spiritual needs of the person. "What we have now is a 'sick care' system that is reactive to problems," said Ralph Snyderman, MD, Chancellor Emeritus, Duke University School of Medicine and Summit Chair. "The integrative approach flips the system on its head and puts the patient at the center, addressing not just symptoms, but the real causes of illness. It is care that is preventive, predictive and personalized."
The Summit, which was sponsored by the Bravewell Collaborative, also highlighted recent research results and success from clinical practices settings across the country. The 600 plus participants at the Summit discussed how advancing technology is finally allowing health professionals to identify and understand the pathways by which many integrative medicine interventions, such as mind-body medicine and nutrition, actually work. "Genomics and advanced imaging technologies such as MRI are validating the mechanisms for integrative health care approaches that were difficult to prove before," said Mimi Guarneri, MD, Founder and Medical Director of Scripps Center for Integrative Medicine. Consequently, the new evidence is compelling.
The Summit articulated the following important factors to be considered in upcoming health care reform:
• The progression of many chronic diseases can be reversed and sometimes even completely healed through lifestyle modifications. Lifestyle modifications programs have been proven to not only improve people's overall health and wellbeing but to also mitigate cardiac disease and prostate cancer, among other chronic conditions.
• Genetics is not destiny. Recent research by Dean Ornish, MD, and others has shown that gene expression can be turned on or off by nutritional choices, levels of social support, stress reduction activities such as meditation, and exercise.
• Our environment influences our health. Mounting evidence suggests that the environment outside one's body rapidly becomes the environment inside the body.
• Improving our primary care and chronic disease care systems is paramount. Participants widely agreed that our primary care system is in danger of collapse and that we must retool how both primary and chronic disease care are delivered. The new system must focus on prevention and wellness, and put the patient at the center of care.
• The reimbursement system must be changed. The Summit grappled with the current reimbursement system that rewards procedures rather than outcomes and urged changes that would incentivize physicians to focus on the health outcomes of their patients.
• Changes in education will fuel changes in practice. Implementation of an integrated approach to health care requires changes in provider education. All health care practitioners should be educated in the importance of compassionate care that addresses the biopsychosocial dimensions of health.
• Evidence-based medicine is the only acceptable standard. Researchers and practitioners alike concurred that health care should be supported by evidence and urged further research and testing to expand the evidence base for integrative models of care.
• A large demonstration project is needed. Because funding for research on the effectiveness of specific models of care is difficult to obtain from standard grant channels, participants voiced support for pursuing a demonstration project funded by the government that would fully demonstrate the effectiveness of the integrative approach to care.
"If we fail to seize this unique opportunity to adopt a pragmatic, integrative approach to health care it will constitute a failure and we must not fail," said Senator Tom Harkin, D-IA when he addressed the assembly. "It is my intention to change our health system and to place integrative health care at the heart of the reform legislation we will pass this year."
Calling attention to the fact that the health care issues facing the United States are actually global issues facing the world, representatives from the Prince's Foundation for Integrated Health in the United Kingdom added their voice to the call for reform. A letter from HRH The Prince of Wales to Summit participants, which was read by Ralph Snyderman, MD, on the first day, urged both nations to support the creation of a health care system that places a greater emphasis on treating humans as whole beings — mind, body and spirit — and on prevention, as well as the cure, of illness and disease.
The Summit's leadership believes that the integrated approach to health care could provide the basis for our nation's health reform. "We intend to broadly share ideas expressed at this Summit for transforming health care; our key audiences are the Obama Administration and the Department of Health and Human Services," said Judy Salerno, MD, MS, Executive Director of the IOM.
"The Bravewell Collaborative looks forward to receiving the formal summary report of the IOM Summit and the Health of the Public on November 4, 2009," said Bravewell Executive Director, Diane Neimann. "There will be a major event in Washington DC to mark the release of the report."
"Immediately following the Summit, we will begin work with our Summit Coalition partners in consultation with the IOM on two major points of merging consensus," said Christy Mack, Bravewell's President. "We endorse Bill Novelli/AARP's call for a national campaign for health and wellness and will explore the potential for a public/private partnership to make it happen. We will also encourage demonstration models that will test the efficacy of the philosophy and approach to health care addressed through this historic Summit."
Complete video recordings of all Summit presentations are available at www.imsummitwebcast.org.
Click here to listen to a radio interview with Summit Chair Ralph Snyderman, MD
Click here to watch the Charlie Rose Show interview featuring Christy Mack (President, The Bravewell Collaborative), Harvey Fineberg, MD (President, Institute of Medicine at the National Academies) and Ralph Synderman, MD (Chancellor Emeritus, Duke University).
About the IOM
Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.