Coalition Forming to Support IOM's Summit on Integrative Medicine

The Pressing Need for Change 

There is a growing awareness in many sectors—including business, government, academia, insurance, and healthcare itself—that our nation's narrow focus on episodic care and the isolated treatment of disease events is putting extreme financial strain on our healthcare system. Studies conducted by the World Health Organization, the Milken Institute, and others show that $2.5 trillion is being spent in a system that is not improving the public health. Incidents of chronic disease are on a sharp rise and by 2023 will cost our nation $4.3 trillion. Five chronic conditions—mood disorders, diabetes, heart disease, asthma, and high blood pressure—currently account for more than half of all US health expenditures. In its role as the leading advisor to the nation on health matters, the IOM is convening the National Summit on Integrative Medicine and the Health of the Public to explore issues, opportunities, and approaches for shifting our healthcare system to a focus on efficient, evidence-based prevention, wellness, and patient-centered care.

Integrative Medicine 

Past research by the IOM has shown that traditional healthcare focuses largely on curing physical ailments without proper attention to patients' mental and emotional challenges. By addressing the personal and community environments that affect a person's health, an increasing body of research, much of which has been funded by the National Institutes of Health, points to the fact that integrative medicine can vastly improve people's ability to help themselves get well.

Chaired by Dr Ralph Snyderman, Chancellor Emeritus of Duke University, the national summit will bring together physicians and other healthcare clinicians, researchers, policy makers, patient advocates, payers, provider organizations, and major employers to address the reform of healthcare. Harvey V. Fineberg, MD, President, IOM, will make the opening remarks.

“Despite impressive technical advances in healthcare, the current system is in great need of reform and opportunities abound. Building on the tremendous progress that has been made in understanding and treating the effects of disease, we have the opportunity to focus on an integration and coordination of approaches to health and care that can produce more cost-effective outcomes and importantly, greater patient satisfaction and engagement,” said Dr Snyderman. “The Summit seeks to create the vision of a transformative and integrated healthcare system that is personalized, predictive, preventative, and participatory so as to support improved health, prevent avoidable chronic disease and enhance the understanding of the importance of health as a value. I am very pleased to be able to participate in this major national effort to improve our nation's healthcare system at this critical time. I am grateful to the Bravewell Collaborative for their support of this major undertaking.”

Six background papers have been written that detail integrative medicine's performance in prevention and wellness, patient-centered care, economics and policy, research, public education, and professional education. These papers are available on the IOM Web site at: http://www.iom.edu/?ID=52555.

In speaking of the summit's importance and the overwhelming interest it is generating in all sectors of society, Judy Salerno, executive director of the IOM, commented, “The breadth, depth, and size of this event is extraordinary—we are breaking new ground.”

The Growing Coalition 

Over the past six months, the Bravewell Collaborative—a foundation dedicated to transforming the culture and delivery of healthcare—has been building a coalition that will carry the work of the summit into the future and translate it into social change. This coalition will investigate new healthcare delivery models, press for new healthcare legislation, and educate both the public and professional sectors to shift from disease-oriented approaches to a more integrative, whole person approach to medicine.

“Transforming our healthcare system so that we reduce the incidence of disease by keeping people healthy while also improving care for those who are already ill is an enormous task that will require the efforts of leaders and organizations in all sectors of society,” said Christy Mack, president and cofounder of The Bravewell Collaborative. “Bravewell sees its role as that of catalyst and convener, bringing key people, groups and institutions together in support of this important cause.”

In October 2008, AARP signed on as the lead partner in the coalition. “Every American should have access to quality, affordable healthcare,” said Bill Novelli, CEO of AARP. “AARP is participating in the Summit because the focus of healthcare should not just be on getting you better; it should be about keeping you healthy. Especially at this time of great economic uncertainty, we can not afford to keep a broken healthcare system.”

The U.S. Chamber of Commerce and the Prince's Foundation for Integrated Health in the United Kingdom also joined the coalition during the fall of 2008. Efforts in the United Kingdom are driven by the same pressing issues. A recent report, Building the Case for Wellness, produced by PricewaterhouseCoopers, showed that chronic disease in the United Kingdom represents “the major source of health problems for adults, with an overwhelming 37% of deaths in the total population attributed to cardiovascular disease alone.” In their examination of corporate wellness programs—which include such interventions as fitness classes, massage, yoga, health counseling, smoking cessation programs, nutritional advice, and stress management—the authors of the report found that (1) 45 of 55 programs reported a reduction in days lost through sickness absence as a consequence of wellness interventions, (2) 18 programs mentioned a positive impact on reduction in staff turnover, (3) 16 programs reported reductions in accidents and injury rates as a consequence of worksite wellness initiatives, and (4) eight programs reported an improvement in the health and welfare of their employees associated with their wellness initiatives, including improved diet, exercise, and general well-being.

“The promise held by integrative medicine for a rational approach to building a healthy force work and healthy society has emerged internationally as an important economic and social agenda,” said Diane Neimann, executive director, The Bravewell Collaborative. “Bravewell has embraced a powerful coalition dedicated to this social change.”

How to Attend 

There are still seats available for those wishing to attend. Please go online to http://www.iom.edu/?ID=52555 to reserve your seat. For more information about the Summit, please visit http://www.iom.edu or http://www.bravewell.org.

IHH Honors Penny George with Name Change 

The Institute for Health and Healing (IHH) at Abbott Northwestern Hospital in Minneapolis has commemorated its fifth anniversary by changing its name to the Penny George Institute for Health and Healing to honor national integrative medicine advocate and philanthropist, Penny George. Dick Pettingill, chief executive officer of Allina Hospitals & Clinics in Minneapolis made the announcement in September 2008. The Institute was founded in 2003 by the George Family Foundation and the Ted and Roberta Mann Foundation.

Widely known as one of the nation's leaders in the philanthropic movement to advance integrative medicine, the George Family Foundation's philanthropic support of the institute has totaled more than $4.25 million over five years.

“My journey of recovery from breast cancer illuminated for me the vast potential for healing that can accompany a life-threatening illness,” said Penny George, “as well as the ways in which current medical practices are shortchanging Americans.” She points to integrative medicine, a patient-centered approach to healthcare that integrates conventional medicine with the wisdom of other healing traditions, as the foundation for her recovery. “Integrative medicine has the potential to fundamentally change the face of healthcare today. The Institute is a philosophical and clinical manifestation of that promise,” she added.

In addition to its research and educational programs, the Penny George Institute for Health and Healing provides a range of integrative medicine services in both the inpatient and outpatient environments, including such therapies as acupuncture, biofeedback, music therapy, nutrition consultations and massage therapy. In 2007, more than 8,000 patient visits were made to the George Institute's Outpatient Clinic. That same year, more than 14,300 inpatient visits were made by the George Institute's team of healthcare professionals, making the George Institute the nation's largest hospital-based integrative medicine program. “The Penny George Institute for Health and Healing is a tremendous resource for our patients, physicians, nurses, other healthcare professionals and the community we serve,” said Penny Wheeler, MD, chief clinical officer, Allina Hospitals & Clinics.

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Penny Pilgram George

For more information on the Penny George Institute for Health and Healing, call 612- 863-3333 or visit http://www.abbottnorthwestern.com.

Comprehensive Lifestyle Changes Shown to Improve Telomerase Levels 

A new pilot study recently completed by Dean Ornish, MD, and colleagues has revealed that comprehensive lifestyle changes increase the levels of telomerase, an enzyme vital for maintenance of the telomeres in cells that control cell aging. The findings were published in the November 2008 edition of The Lancet Oncology.

Telomeres are DNA-protein complexes at the end of chromosomes that directly affect how quickly cells age—they protect the ends of chromosomes and help them remain stable. As telomeres become shorter and their structural integrity weakens, cells age and die more quickly. In simple terms, as a person's telomeres get shorter, his or her life gets shorter.

Telomerase is an enzyme that repairs and lengthens telomeres, which are also vital for maintenance of immune-system cells. Shortening of telomeres is emerging as a marker of disease risk and premature death in many types of cancer, including breast, prostate, colorectal, and lung cancers. Poor lifestyle factors known to promote cancer and cardiovascular disease could also lower telomerase activity, but previous studies have not addressed this.

Professor Dean Ornish, Preventive Medicine Research Institute, Sausalito, California, and colleagues at the University of California, San Francisco, conducted a pilot study of 30 men diagnosed with low-risk prostate cancer, who were asked to make comprehensive lifestyle changes. These consisted of a three-day intensive residential retreat and a diet with only 10% of calories from fat, low in refined sugars, and rich in whole foods, fruits, and vegetables. Their diet was further supplemented with vitamins and fish oil. They also did moderate aerobic exercise, stress management, relaxation techniques, and breathing exercises. Telomerase activity was measured at baseline and again at three months; 24 patients had sufficient data for analysis.

The researchers found that levels of telomerase in the blood increased by 29%. Increases in telomerase activity were also associated with decreases in “bad” (LDL) cholesterol and decreases in stress. The authors conclude: “To our knowledge, we have reported here the first longitudinal study showing that comprehensive lifestyle changes—or any intervention—are significantly associated with increases in cellular telomerase activity levels and telomere maintenance capacity in immune-system cells.” They add: “The implications of this study are not limited to men with prostate cancer. Comprehensive lifestyle changes may cause improvements in telomerase and telomeres that may be beneficial to the general population as well.”*