Integrative medicine meets public health

What do you want your health for?

That was the question posed by Victoria Maizes, MD, executive director of the University of Arizona Center for Integrative Medicine and a professor of medicine, to attendees at the Integrative Healthcare Symposium in New York City earlier today.

When Maizes was a student, she thought she wanted to study public health. After designing her own major that allowed her to pursue this interest, she quickly realized that her personal definition of public health and reality were two very different things. “Public health was really focused on infectious diseases, but I viewed [public health] as helping people lead healthier lives,” said Maizes, who accepted the Leadership Award at the conference.

Through her medical school education, Maizes remained focused on helping people in the community—a challenge, she adds, as the focus was curing disease, not making people feel better. Oftentimes, the focus was on quick solutions for breaking bad habits, with little consideration on the “why” or “how,” says Maizes. “How often does that happen?” she asked. “If it was that easy, we’d all do it.”

According to a 2013 report from the Centers for Disease Control and Prevention, dietary factors are the single most significant risk factors for disability and premature death. However, little to no physician specialties require nutrition education. This led Maizes to collaborate and create an integrative medicine curriculum, offered through the University of Arizona, which trains people who can engage with patients in full way to optimize health and wellbeing.

Integrative medicine is looking to both the past and future, picking up ancient healing methods while simultaneously incorporating genomics, the microbiome, and epigenetic influences. The unique combination allows practitioners to offer the best care to patients.

The fellowship in integrative medicine is a two-year, 1000-hour program taught primarily online using faculty-mentored, interactive, evidence-based education. It also incorporates two residential weeks. So far, 60 fellows have graduated from the program.

While the bigger goal is to transform medical education, the scope, elective nature, and cost proved to be a challenge for the program, so a national model was also developed to address gaps in conventional medical education, including integrative approaches to prevention and management of chronic illness. The 200-hour core curriculum is offered in a flexible format with online evaluation and highlights physician self-care and wellbeing.

Integrative health and wellness are becoming more mainstream aspects of public health, and both providers and patients can reap the benefits of an integrative self-care program, says Maizes. The key is giving individuals the right tools to be successful in their communities. “We all know people don’t change in the [physicians] offices,” she said. “They change in the real world.”

There are seven elements of wellness that are central to integrative health and lifestyle programs:

• Physical activity and movement
• Nutrition
• Relationships
• Sleep
• Spirituality
• Environmental exposures
• Resiliency

By incorporating these seven factors, patients and practitioners can achieve better health of mind, body, and spirit.

“Integrative medicine is flourishing because it is recognized that we have to do these things to live a healthy lifestyle,” says Maizes.

Stay tuned for a detailed article of the seven elements of wellness, and how you can incorporate self-care in your own patient practices.