The Institute of Medicine this week will lead a series of meetings to get on "Congress' radar" the concept of whole-body wellness care, also known as integrative medicine, the AP/Boston Globe reports. According to the AP/Globe, integrative medicine is based on the three P's model -- preventive, predictive and personalized -- and is characterized as "going beyond standard disease care to involve a range of factors -- physical, lifestyle habits, mind-body interaction -- that play a role in preventing illness and helping people stick with recommended changes long enough to see a benefit." The AP/Globe reports that this type of medicine has become "a rarity today in a crisis-oriented [health] care system far better at treating disease than keeping it at bay."

Tracy Gaudent, an obstetrician-gynecologist and head of integrative medicine at Duke University Medical Center, said, "The doctor says, 'Lose weight, exercise, see you in a year.' We know that doesn't work." Ralph Snyderman, who will lead the IOM meetings, said, "Health is more than the absence of disease." However, a barrier to integrative medicine is funding. According to the AP/Globe, although preventing disease is less costly than treating it, "it is not clear" where funding for the upfront investments in integrative medicine would come. In addition, health facilities face the challenge of "straddl[ing] the line between adopting nonmainstream therapies" while steering clear of unproven alternative treatments.

Donald Berwick, president and CEO of the Institute for Healthcare Improvement and a health-quality specialist from Harvard University, plans to issue a warning to the meeting that "evidence matters" in differentiating between new alternative forms of therapies and unproven therapies. Berwick said, "We're extremely wasteful in health care in America, because we don't respect what the patient can bring to the table, the healing properties of the body itself, the use of lower-technology routes to healing."

Evidence in Study
The AP/Globe reports that "[t]here is some evidence" that integrative medicine is effective. A CMS-funded study at Duke University on integrative medicine followed 154 people with a high risk for developing heart disease, the AP/Globe reports. Some of the participants received personalized instructions on leading a healthy lifestyle that complemented their regular physician-prescribed treatments, while other participants received just the standard medical checkup. After 10 months, researchers found that those who received the instructions were exercising 3.7 days per week, two days a week more than before the study. In addition, they also had an average 10-point drop in cholesterol levels. Participants who received the instructions experienced a small but significant drop in their risk for heart disease. Participants who received only the checkup experienced no significant change in their risk level.

In addition, regular exercise, a healthy diet and stress-relieving techniques have been found to offset the effects of stress, which can compromise the immune system and prevent it from halting disease or promoting healing (Neergaard, AP/Boston Globe, 2/24).