Most of the world’s developed countries are facing an immediate crisis in delivering health care services to their citizens. Health care costs are skyrocketing due to the increased incidence of chronic diseases, aging populations and the reliance on expensive technologies and pharmaceuticals. Many nations are facing challenges delivering timely, necessary medical care to large percentages of their populations.

Countries are making valiant attempts to reform their health care systems in response to their health care crises.  In the United States health care reform was front and center in President Barack Obama’s campaign for change, leading to the historic signing of the new health care reform bill (dubbed “Obamacare”) in March 2010. This same bill, which essentially tackles health care accessibility for the American public, has become a topic of heated debate in the 2012 election campaign. In Canada and the twenty-nine other Organization for Economic Co-operation and Development (OECD) nations, health care reform has taken the shape of disease screening and early detection, primary care reform, interdisciplinary medical teams, electronic medical records, and shifting the balance of private versus public funding and delivery of health care.

Unsustainable Health Care Spending

To better appreciate the enormity of the problem, let’s use Canada as an example. In 2005, chronic diseases, such heart disease, stroke, adult onset diabetes (Type II Diabetes), and cancer, accounted for approximately 89 % of all deaths. At least 80% of premature heart disease, stroke, Type II Diabetes and 40% of cancer could be prevented through healthy diet, regular physical activity, and avoidance of tobacco products. (WHO; Facing the Facts: The Impact of Chronic Disease in Canada, 2005).

According to the report, Economic Cost of Chronic Disease in Canada 1995- 2003, cardiovascular disease cost Canada $20 billion in 1998; cancer $17.5 billion in 2002; diabetes $9.7 billion in 1999. These costs were expected to rise at a faster rate than inflation. (The report was prepared by J Patra, 2007 for the Ontario Chronic Disease Prevention Alliance and the Ontario Public Health Association).  The cost of Canada’s health care system has been rising relative to Canada’s gross domestic product. In 1984 Canada’s health care expenditure was 7% and rose to an estimated 11.6% in 2011 (The Canadian Institute for Health Information). These statistics are proportionally mirrored in developed countries worldwide.

Health care reform in its present state is doomed to failure, much like rearranging the deck chairs on the Titanic. As long as reform measures are delivered within the present model of conventional medicine, the goals of cost containment and high quality health care to all citizens will not be achieved. True health care reform requires an outside-of-the-box solution where the tenets of conventional medicine are reassessed and restructured to create a system of health promotion and illness prevention and effective alternatives to expensive, invasive therapies where appropriate. Indeed a system of medicine that embodies these characteristics and more already exists in the form of Integrative Medicine.

Integrative Medicine is defined as “healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative.” (Arizona Center for Integrative Medicine)

Integrative Medicine physicians and practitioners are skilled in empowering patients to adopt healthy lifestyle practices, the cornerstone of health promotion and illness prevention. The practice of Integrative Medicine incorporates more natural, less invasive and expensive approaches to health and healing from a wide array of healing modalities and is informed by scientific evidence. Consumers and patients in widespread and diverse countries are accessing the products and services of Complementary and Integrative Health care providers in record numbers. Trillions of out of pocket dollars are being spent world-wide and studies have demonstrated a continued and growing trend.

Numerous barriers within conventional medicine have prevented Integrative Medicine from being integrated into mainstream health care systems. For instance, evidence based medicine and funding sources for research tend to favor disease oriented health care delivery. Furthermore, reimbursement models support high tech over high touch; i.e., quality time spent with physicians.

For patients, the paradox is that accessing Integrative Medicine may lead to more fragmented personal health care. To health systems, it means that the full potential of Integrative Medicine has not been realized and is difficult to quantify.

My Personal Journey with Integrative Medicine

I have had the opportunity to practice both conventional and integrative medicine. My journey began in 1980 when I entered McMaster Medical School as a young idealistic student. There was no mention of health; our learning was focused on disease. How ironic it was that we were being trained as health care providers, yet the word health never really entered into the curriculum!

The concept of physician as role model of healthy lifestyle behaviours for their patients was unheard of.  Our physician teachers, my mentors, modeled the behaviour of self-sacrifice as being the hallmark of a good doctor. We were expected to work long sleepless hours, sacrificing time spent with family and friends. Meals of questionable nutritious value were eaten quickly in the cafeteria in order to maximize our availability. A dedicated medical student was rewarded for neglecting his/her own self-care and embracing the values of self-deprivation.

During my family medicine training, my commitment to my profession was questioned by my supervisor when he chastised me for wanting to leave at 6 p.m. to attend an exercise class. This was McMaster University, renowned for innovative medical education in the 1970’s and 1980’s. In addition to spearheading evidenced-based medicine and problem-based learning, it was an example for bringing more humanity to medical training.  Most other medical schools were known to treat their students with less compassion.

In 1985 I completed my family practice education and began practicing as a community family physician in Burlington, Ontario. I quickly became frustrated by the narrow scope of my training in treating and counselling my patients.  My knowledge of lifestyle interventions was superficial at best.  Practicing prevention was mostly limited to providing immunizations and screening tests for the early detection of diseases. I was unaware of less invasive more natural therapies to offer my patients. Consequently much of my practice was dependent on pharmaceuticals with their inherent side effects.  It became imperative for me to broaden my skills and knowledge to serve my patients more effectively and profoundly. I began searching.

In the early 1990’s I found out about Dr. Deepak Chopra, an American physician who lectures and writes eloquently about Ayurveda, an East Indian holistic form of medicine, and the effects of the mind, and spirituality on the physical body.  The information and insights in his books were a fascinating supplement to my medical training. I eventually attended his center’s training courses and became certified to teach meditation and health and wellness workshops.

I found myself better able to address the interface between the mind and the body, also known as the field of psychoneuroimmunology, as well as the spiritual concerns of my patients. Patients interested in a more holistic approach to health care began to seek me out as I became known in the community for my open mindedness to Complementary and Alternative Medicine. However, I realized that I was still not adequately trained to deliver a broader, less invasive approach to both the prevention and treatment of disease.

In 2000 the University of Arizona launched an Integrative Medicine fellowship program for practicing physicians, created by Dr. Andrew Weil. Dr. Weil is an American physician, who is an expert in botanical and complementary and alternative medicine as well as a prolific writer and advocate about the discipline of Integrative Medicine.  I was delighted to discover the two-year distance learning fellowship program and enrolled in 2001.

The course work provided me with the content, tools, references, and resources to enable me to begin practicing Integrative Medicine (IM).  Halfway through the program I realized that working in a conventional family medicine clinic was not conducive to the practice of IM. Appointment times were too short, the waiting room and offices were too busy and clinical. I was compelled to create a new healing centre which would reflect the philosophy of IM.  In October 2003, I realized a dream and opened the Family Practice Centre of Integrative Health and Healing (FPCIHH), in Burlington, Ontario.

FPCIHH was an oasis in an arid medical building. The décor was constructed from natural elements including slate and wood, complemented with natural lighting, soothing colours, calming music, lush plants and a wall water feature. Many of our patients stated that they began to feel better just by sitting in our waiting room. We offered herbal teas and frequently I shared a pot of tea with my patients during their appointment times with me. What a welcomed difference from a rushed five-minute appointment in my last practice! It was truly a healing space.

The centre consisted of myself, as medical director and Integrative Family Physician, two other Integrative Medicine Physicians, a Naturopathic Doctor, Chiropractor, Chinese Medicine Practitioner, Nutritionist, Massage Therapist, a Psychotherapist who practiced Reiki, and an Osteopath.

Our mission statement guided us: The Family Practice Centre of Integrative Health and Healing is a collaboration of health care practitioners dedicated to integrating the highest standard of conventional, complementary and alternative medicine, nurturing intrinsic healing in the whole person, body, mind and spirit. It is our mission to serve, empower and partner with our patients and our community on the path to wellness, transformation and wholeness.  We will serve as a model for the new paradigm of patient-centred health care dedicated to furthering evidenced based research and education in Integrative Medicine.

We took the time to get to know our patients and gained a deep appreciation for them as individuals with their unique personalities and experiences. Often, the simple act of listening to their stories was a powerful healing experience in itself.  We spent time educating and empowering our patients to make healthier lifestyle choices within the context of their life circumstances. Many of our patients who had come to us fatigued and unwell became renewed and re-energized by simple lifestyle modifications which included healthy eating, physical activity, and stress management.

When illness was present, we were able to offer less invasive therapies such as supplements, herbs, acupuncture, massage, chiropractic and Reiki, minimizing the use of pharmaceuticals and surgery where appropriate. We worked independently and as a team for the welfare of our patients. As health care professionals we benefited tremendously from working collaboratively and learning from each other. Our patients were delighted and grateful for the services we provided.

Renata’s Story

As an example, a patient of mine, who I will call Renata S. came to see me complaining of fatigue and frustration with her medical care. Her previous doctor had discovered that her blood pressure, cholesterol and blood sugar were in the borderline high range. He had recommended that she go on a low salt diet, lose weight and begin medications.

Renata had felt that he did not take time to deal with her concerns regarding her fatigue and medical issues. I spent an hour getting to know Renata at our initial appointment.   She was a 48 year old married mother of two young girls. Renata had given up her career to raise her children and often felt purposeless and lonely. She confessed that since becoming a mother she had let go of many of her healthy habits and had gained over 50 pounds. Her father and grandfather had passed away prematurely from heart disease, after being challenged with obesity, high blood pressure and diabetes for years. Renata was concerned about not being around for her daughters if she continued on her present path.

I acknowledged how physically and emotionally challenging it is to be an older parent. Renata shared that it was a relief to be listened to and understood. We decided to delay initiating pharmaceuticals and to work with lifestyle therapies while monitoring her blood pressure and blood work.  We worked together to incorporate healthy habits that would fit into her daily routine.

Renata began to go to a gym directly after dropping her daughters off at school. I encouraged her to work with our nutritionist, who helped her to adopt healthy eating behaviours and within 12 weeks lost 20 pounds.

I taught Renata a breathing technique and meditation which she used on a regular basis. Her sleep which had been problematic became deep and restful. In addition to some general supplements, I recommended a safe herb for her heavy periods, which worked successfully for her. With coaching, Renata began to take some time for herself each week to reconnect with her old friends and to go out on “dates” with her husband.

Within 6 months of our first meeting, and 30 pounds lighter, Renata felt vital, connected and enthusiastic, much like her “old self” again. Her blood pressure and blood work were all well within normal range. Renata was a motivated patient who just needed a health professional to take the time to get to know her and offer her practical advice and support.

Healing Health Care – and the Healer

My personal experience as a provider of Integrative Medicine has convinced me of its benefits for both patients and physicians. It wasn’t only my patients who experienced a sense of empowerment and healing. Back in 1995, when I had attended my first course in healing, the speaker, an Integrative Medicine Oncologist, asked the 500 members of the audience to put up their hands if they were a healer and many did. It was a moment of undeniable clarity for me that I could not in good conscience raise my hand.  Practicing Integrative Medicine healed my connection to my profession and transformed me from medical doctor to physician healer.  It provided me with a renewed sense of meaning and purpose for the practice of medicine and for my life.

The experience at FPCIHH is a reflection of a greater reality. Studies are demonstrating the efficacy of Integrative Medicine models of care on various outcome measures including quality of life, health outcomes, patient satisfaction, cost effectiveness and cost savings. Additionally it has the potential to decrease the incidence of adverse events frequently suffered by patients using conventional medicine.

Unfortunately, physician burnout is a common symptom of the disease oriented health care systems in the OECD countries. With the renewed sense of meaning and purpose experienced by physicians practicing Integrative Medicine, physician burnout could be significantly reduced.

Rachel Naomi Remen, M.D, Clinical Professor of Family and Community Medicine at the University of California, San Francisco School of Medicine and bestselling author echoes this in another way: “The meaning of medicine is not science, but service…Service is a human relationship. It is the most powerful antidote to cynicism, depression and burnout which is so widespread in our profession today.”

The time has come for an out-of-the-box solution to stem and reverse the tide of chronic, costly, preventable lifestyle-induced illnesses, and to save our floundering health care systems. Integrative Medicine is the natural solution.

Dr. Esther Konigsberg is the medical director of Integrative Medicine Consultants Inc. with offices in Toronto and Burlington, Ontario, where she consults with clients who are interested in preventing illness and optimizing their health and wellness. She is also a mind-body wellness educator, a transformational seminar leader for the public, academic and corporate worlds, a teacher, speaker and writer. She has studied extensively with world leaders in health, healing, spirituality and human potential, including Dr. Deepak Chopra, Dr. David Simon, Dr. John Demartini and Dr. Andrew Weil, and is a contributing author for the book Inspiring Breakthrough Secrets to Live Your Dreams. Dr. Konigsberg is an Assistant Clinical Professor at the University of Arizona in the Program in Integrative Medicine. At McMaster’s Medical School she is an Assistant Clinical Professor; McMaster’s Longitudinal Curriculum Planner for Complementary and Alternative Medicine; as well as McMaster’s representative for Canada’s Complementary and Alternative Medicine in the Undergraduate Medical Education project. She is on the steering committee for the Consortium of Academic Health Centers for Integrative Medicine. Learn more about Dr. Konigsberg at http://integrativemedicineinc.com.