Five Steps to Better Health
How Integrative Medicine Can Help
Suffering from headaches and depression? Don’t let a doctor put you on drugs; instead, look for the underlying causes. High cholesterol? Try the Mediterranean diet, with a glass of organic red wine a day. The best way to win the war on cancer? Eat healthy, exercise and develop an active social life. An increasing number of physicians are realizing that this type of approach, geared to prevention and a conservative use of medications and technology, not only increases patients’ vitality, but saves lots of money.
In the words of Dr. Dean Ornish, founder and chairman of the Preventive Medicine Research Institute, in Sausalito, California, “It is time to change not only who is covered, but also what is covered.” There is an overemphasis, he says, on treating symptoms and on the idea that caring for our health is primarily the responsibility of medical experts, rather than of individuals themselves.
Zhaoming Chen, a neurologist and chairman of the American Association of Integrative Medicine, describes the way things currently work. “We only treat the disease after it occurs.” With figures showing that 95 cents out of every dollar spent on health care goes toward treating illness, he notes that “The best way to reduce the costs is prevention.” Integrative medicine puts the patient, not the doctor or the insurance company, at the center of attention, and it puts the focus on the sources of illness and not the symptoms.
Health care costs are continually rising but people are not getting any healthier. Here is a five-point prescription for the future of health care that applies the tenets of integrative medicine to make today’s health care simpler, more effective and more affordable.
1. Emphasize Illness Prevention
About half of all American adults have a chronic illness, according to the Partnership for Solutions, a John Hopkins University-led initiative to improve care for Americans with chronic health conditions. Ornish claims that three-quarters of the more than $2 trillion recently spent on health care in a single year went to treat these kinds of conditions, including obesity. “All of these can be not only prevented, but even reversed through diet and lifestyle intervention,” he says. “It just seems so obvious to me that this is where we should be putting our focus.”
There is a long way to go before prevention is on the agenda. While prevention is indeed better than cure, we tend to reward those who find solutions for existing problems rather than those who ensure that those problems don’t occur. “Prevention is boring,” says Ornish. Rather, “We need to focus on living better.”
2. Promote Healthy Foods
Roberta Lee, a pioneer of integrative health care and primary care physician at the Beth Israel Medical Center Department of Integrative Medicine, in New York City, believes the first prescription any doctor should write should be about diet and lifestyle. “You can never lose by maximizing lifestyle management,” says Lee, pointing out that many conditions not easily diagnosed or cured in a conventional framework can be improved by dietary and lifestyle changes. “There are specific diets that promote wellness,” she says. “They reduce inflammation, [and] increase fiber, vitamins and minerals that come in the form of a lot of fruits and vegetables and whole grains.”
3. Focus on Lifestyle Changes
The majority of health problems and risk factors for illnesses stem from the choices we make: how much time we invest working, exercising and relaxing; time spent with friends and outdoors; and whether we consistently take the stairs or the elevator.
The Sanoviv Medical Institute, in Rosarito, Mexico, is located on a beautiful stretch of the Pacific coast, an hour south of San Diego. The recommended stay for most patients is two weeks. While there, they learn about and experience a lifestyle based around stress reduction, emotional well-being, healthy eating and exercise. Many patients come in with cancer or multiple sclerosis; others come just to detoxify and clear out the accumulated effects of stress. The program includes dietary changes, supplements, daily exercise and a stress management plan supported by psychological counseling and daily meditation.
A 2004 study in The Lancet showed that lifestyle changes—quitting smoking, healthier eating habits, moderate alcohol consumption and regular exercise—can prevent 90 percent of today’s cases of heart disease, which currently accounts for more premature deaths and higher health care costs than any other illness, according to Ornish.
“When lifestyle is offered as a treatment, it’s as effective and often more effective than what we’re now doing, at a fraction of the cost,” says Ornish. “We pay for all these interventions that are dangerous, invasive, expensive and largely ineffective, and yet interventions, that have been scientifically proven to reverse disease, are a simple change of lifestyle.”
4. Use Alternative Therapies
Another way to reduce costs is to use alternative and complementary therapies such as homeopathy, naturopathy, yoga and herbal medicine that can supplement and even replace conventional methods. Such complementary treatments work to nourish, nurture and augment the body’s own defenses. One alternative healing method that’s now beginning to find its way into hospitals is acupuncture, which has been shown, among other benefits, to help relieve pain, stress and nausea during pre- and post-operative care.
Beth Israel’s Department of Integrative Medicine is bringing acupuncture into the hospital free of charge as part of a fellowship program for Chinese medicine practitioners. “The future of acupuncture is to be a part of best practices in the conventional setting,” says Arya Nielsen, a nationally board-certified acupuncture specialist who leads the program. “The research is just too good.”
The goal is to train both acupuncturists and conventional doctors in the benefits of this technique so that it can be incorporated into Beth Israel’s best practices. “Even if physicians have time to read the acupuncture studies, what really makes it gel is when they see the results on the patient they treat,” says Nielsen. “The proof is in practitioners working side-by-side and people being able to experience what this therapy can do.”
Chen points out that chemotherapy, surgery and radiation dramatically change a patient’s life, and people need strong support from family and friends to adapt to these changes. Chen believes that treating cancer should involve both conventional and alternative medicine. “Patients also need some lifestyle changes: smoking cessation, minimizing alcohol intake, adopting a low-fat, high-fiber diet. Besides that, because [conventional] treatment may cause nausea and pain, patients may benefit from acupuncture, meditation, yoga and Tai chi. This will help them cope with pain better.”
5. Treat People, Not Diseases
As nurse Béatrice Fleury pours a steaming infusion of yarrow over a piece of cotton and then wrings it out, the aroma of the medicinal herb wafts over to the hospital bed where Eliane Perrot is waiting for her body wrap. When the compress and a hot water bottle have been gingerly applied to her lower back and secured by a soft cloth sash, she leans back with a contented sigh. The compress will help her liver better metabolize the toxins that have accumulated in it after months of breast cancer therapy. The wrap’s warmth will also create a sense of temporary well-being, a precious feeling for the frail, exhausted, 65-year-old.
Alternative treatments like the yarrow wrap are the order of the day at the Paracelsus Spital, in the Swiss town of Richterswil, outside of Zurich. Founded in 1994, the clinic is one of a handful of hospitals in Europe devoted to complementary healing. In addition to orthodox treatments and drugs, the conventionally schooled doctors here also use therapies and medications based on the holistic approach to medicine inspired by the anthroposophy of Waldorf education founder Rudolf Steiner.
“If you want to understand a person’s disease and support his self-healing powers, it’s of central importance to look at the human being as a whole—body, spirit and soul,” says Paracelsus Medical Director Erich Skala. “This may require more time and effort, but it’s how you treat the causes, and not just the symptoms.”
Dr. Daniel Dunphy, of the San Francisco Preventive Medical Group, believes the Paracelsus approach is what the United States needs. “You have to take time to get to know the patients and listen to their stories,” he counsels. “I want to know their personal history, their traumas, how they do at work, what they eat and at what times of the day—and then I know what to do about their problem.”
The Bottom Line
Of course, the bottom line in the debate about health care is cost. Proponents of integrative health argue that the promotion of preventive steps such as eating healthy food and making positive lifestyle changes, as well as using complementary methods to treat the whole person and not just the disease, will result in “the biggest return on investment this nation could ever have,” in the words of William Novelli, a professor at Georgetown University’s McDonough School of Business and the former CEO of AARP.
it’s a medical delivery system.”
- Dr. Daniel Dunphy, San Francisco Preventive Medical Group
Kenneth R. Pelletier, clinical professor of medicine at the University of Arizona School of Medicine and the University of California School of Medicine, has been putting numbers behind the arguments for integrative health. Pelletier has studied the cost-effectiveness of corporate programs to promote health and manage disease among employees. The programs encompassed everything from subsidized gym memberships and smoking cessation classes to biometric screening and serving smaller portions in company cafeterias. Pelletier found that companies with such programs in place realized healthier, more productive workforces, fewer sick days and less staff turnover.
He estimates that it takes, on average, just over three years before firms see a financial return on this kind of investment. “These reviews clearly indicate that comprehensive interventions do evidence both clinical- and cost-effectiveness,” says Pelletier. “There’s a very good payback. It makes us think about health as an investment.”
More money, more pills and more technology don’t necessarily lead to better health. Advocates of integrative medicine generally take a “less is more” approach—less needless medications and medical procedures and more prevention and healthy personal lifestyle changes can add up to big financial savings and big improvements in an individual’s quality of life.
Adapted from an article that first appeared in Ode, the magazine about positive change. Marco Visscher is the managing editor of Ode, Ursula Sautter and Carmel Wroth are contributors.