Integrative Medicine Program Marks 10th Anniversary
When Rakel came to Madison from Arizona in 2001, he started the integrative medicine program with just a few like-minded colleagues. It has since grown to include about 50 health professionals representing a variety of disciplines, including physicians, acupuncturists, massage therapists and mindfulness practitioners.
They all are passionate about shifting the nature of health care from disease management to a healing-oriented approach that incorporates the body, mind and spirit.
Though Rakel is the program's founder, he said everyone involved has played a role in integrative medicine's growth.
"This takes a community, and it's the community of very passionate, talented people who really are not asking for recognition who should be given credit," Rakel said.
Integrative Medicine Emerges
When Rakel started the integrative medicine program, he sought to have it viewed in the same manner as the traditional medical programs within UW Health.
He started by sharing information about integrative medicine at grand rounds - medical lectures where clinical cases are discussed - which, if nothing else, allowed fellow faculty to see that Rakel wasn't a doctor who practiced medicine "with a headdress and rattle," he said.
At the time, UW Health offered a mindfulness program. With that as a foundation, Rakel and his colleagues expanded the integrative medicine program to include services such as health psychology, integrative medicine and cancer care, inpatient services, naturopathic medicine and massage therapy.
Communication has been important to the program's growth, and Rakel notes that integrative medicine doesn't seek to replace traditional medicine, but, rather, to complement it.
"You have to understand how to use the data, the research and the science to communicate the importance of a therapy, and that therapy may have worth and it may have no worth," he said. "And it's our job, particularly in the academic institution, to really get good at evaluating that literature and say, hey, this nutrition is really important. Maybe we won't need as many statin drugs if we just change how we eat. Or look at the importance of the mind and body in health and say, hey, if I'm angry all the time, maybe there's a connection to why I get headaches. And maybe I should address the anger instead of just suppressing the headache with a drug that reduces pain."
A Holistic Approach to Patient Care
Rakel is trying to change the way patients, medical students and health professionals think about health and healing. Integrative medicine uses science and research to best understand what therapies will work best based on a patient's uniqueness. It's a holistic approach to care that takes into account a patient's culture and belief system.
It's an idea that is coming into its own, especially considering the rising cost of health care. According to Rakel, our health care system offers remarkable technology and drugs to combat diseases and illnesses, but they can be a crutch.
"So often we're too quick just to suppress the symptom, and often that's like putting your hand over the mouth of a screaming two-year-old," Rakel said. "It comes out in some other way. Usually they'll kick you in the shin. And that's kind of what we're doing with our technology, is we are too quick to just suppress it without taking the time that a complex human needs to understand what might be at the root of a symptom so we can understand how it can go away."
One way to better understand a patient's needs is through continuity of care so that when symptoms do arise, the physician can more easily determine the underlying cause.
For example, if a patient with no history of headaches suddenly begins experiencing them, and the physician knows the patient is experiencing stress from a job loss, then perhaps the better treatment can be found by focusing on how to reduce the stress.
"If we can create teams of health care professionals who understand what it means to be well, then we're going to provide better health care by understanding what might be at the root of a disease or symptom instead of just suppressing it with our technology," Rakel said.
Education and Research Help Program Grow
The integrative medicine program has made great strides in education and research over the last 10 years. The program offers a fellowship as well as an elective rotation for medical students and residents. Both are administered through the University of Wisconsin School of Medicine and Public Health's Department of Family Medicine.
The School of Medicine and Public Health is one of 47 members of the Consortium of Academic Medical Centers for Integrative Medicine, which provides a support network to advance the principles of integrative medicine in academic institutions. The group held a conference at UW-Madison in May.
"The younger generation really seems to be getting this, which is really exciting to me, to see these younger learners come in and say, ‘Ah, this is cool, this is what I really want to do for a career.' That energizes me to share information back and forth, and that's probably one of the more rewarding things in this job, is to explore and discuss with other learners."
Though it almost sounds contradictory, good science is an important element of integrative medicine. Recent research has led to insights into the body's ability to self-heal. A study led by Rakel and Dr. Bruce Barrett, an associate professor of family medicine, found that physician empathy can impact the duration of a cold.
The randomized controlled trial comprised 719 patients who were split into three groups:
- Patients who had no interaction with a practitioner
- Patients who had limited interaction - a history and examination but little touch or eye contact
- Patients who had an enhanced interaction that included the "PEECE" concept - positive prognosis, empathy, empowerment, connection and education
Patients who experienced "perfect" empathy recovered from their colds faster and had less severe symptoms than those whose experience was "sub-perfect" in empathy.
The results reinforce one of the hallmarks of integrative medicine: By listening to the patient, physicians will provide better care.<-->
Date Published: 08/03/2011