FROM: Huffington post

Who Is a Healer
by Alison Rose Levy

Posted May 28, 2007 | 09:10 PM (EST)

Read More: Michael J. Fox, James Gordon, Donna Karan, Dalai Lama2, Robert Thurman
Over the last two weeks, Donna Karan welcomed a diverse group of integrative physicians and practitioners into the Well-Being Forum at her late husband's studio. Her goal was to promote dialogue. And dialogue she got when the conventional and integrative faced off, and looked for commonalities in today's lively discussion, sparked by the presence of actor Michael J. Fox, a real trouper.


Speaking to the group, Michael J. Fox shares his health journey, "I was diagnosed in 1991 with Parkinson's Disease. You sit in a doctor's office and hear these words, and you put it into a package that you deal with later.
I was trained to think when you get a diagnosis, you go to a doctor -- like you go to a mechanic -- and get fixed. But you have to incorporate the losses into your life. As I sat with them I began to realize that there are no vacuums. My serenity grows in proportion to my acceptance, and in inverse to my expectations."

Seated alongside her famous patient is Fox' doctor, Dr. Susan B. Bressman, the Chairman of the Department of Neurology at Beth Israel Medical Center. She tells the gathering, "I'm here because I love what I do. Being a physician is both a privilege and a serious responsibility."
"Sue and I look at my illness as a part of life." Fox confides, "The question is: how are we going to make that journey better?"

Moderator, Daniel J. Stone of America Speaks poses a question to the panelists, "How does a doctor transition from being a mechanic to being a whole person, treating whole people?"

"In my medical training, I was never prepared to treat the chronic diseases from which most of my patients suffer," says Dr. Frank Lipman, an internist who directs the Eleven Eleven Wellness Center. "Studying Chinese medicine taught me that a symptom isn't something to eradicate, but a message about where we need more balance. Everything in nature, from bad foods to environmental toxins to global warming, affects us -- as do our beliefs, feelings, and thoughts."


Dr. James Gordon, director of Washington, D.C.'s Center for Mind-Body Medicine, targets medical education. "Currently, it's about mastering huge quantities of data. But in ancient healing traditions, you balanced mental knowledge with practices to create wisdom and personal authenticity."
"In music, most traditions don't put notes on paper. It's passed along," says Dr. Larry Norton, Deputy Physician-in-Chief at Memorial Sloan-Kettering Cancer Center. "We value what we learn through published evidence-based medicine. But that's not the only source of knowledge we should take into account."

"The problem is really managed care," Bressman offers. "That makes it impossible for doctors to see patients and provide good care."
"The average doctor visit is seven minutes," agrees Dr. Woodson Merrell, Director of Integrative Medicine at New York's Beth Israel Medical Center. "That's why primary care physicians don't recommend that their kids become doctors."

"Back in medical school, there was icy contempt for the local doctor," Gordon recalls. "Now everyone wants the old GP (general practitioner) at the center of health care. If family care docs made as much as neurosurgeons, more people would go into it."

"Patients need to have one captain of the ship," says Bressman, "And they look to us to provide that central support."

"How can conventional practitioners be captains of the ship when they don't know and value integrative therapies?" Lipman wonders.

Bressman offers. "Your methods are great, but no drug company will fund research on them. You'll need to look to foundations and lobby the NIH (National Institute of Health.)"

"The NIH has a thirty billion dollar budget," Gordon agrees.
"We need a fundamental shift in how that's allocated -- towards preventative approaches."

"Still we don't want to throw evidence-based medicine into the toilet," Bressman says. "Physicians should look at other approaches, but first we need clinical trials. And no one is going to pay for a yoga study."

"I think we need to redefine evidence-based research," suggests Merrell. "I personally consider two thousand years of using Chinese medicine as a reasonable clinical trial, plus now there are tens of thousands of studies."
"There's a difference between a doctor and a healer," says Gordon. "A healer is open to whatever is useful, not wedded to a particular methodology. A healer is present with the patient and the process."
Bressman agrees but she, along with most conventional physicians, defines presence, compassion, caring and the non-material interventions that promote them, as examples of the placebo effect, ie. healing responses based on patient belief. Studies have shown that placebos sometimes are more impactful than the medications or treatments being studied. "As physicians, we know that medicine is an art," acknowledges Bressman. "You can also heal through hope and belief."

"I view the placebo effect as stimulating the natural healing capacity," offers Lipman. "As the Dalai Lama said, it's all about the belief of the patient and the belief of the practitioner. And I'm satisfied so long as people get better."

"Medical students and doctors have to learn to become vulnerable if we want patient and healer to have a different kind of relationship and be there for each other," says Gordon.

"Remember your original intention as healers," urges Professor Robert Thurman of Columbia University. "Realize that you're there to help people. Love and compassion are your motivation."

"I read about a lady caught in a flood who gave birth to a baby up in a tree," recalls Michael J. Fox. "That shows that you must do whatever it takes to solve your problem. If there's flooding and you're about to give birth, you have an obligation to climb that tree."

"As someone who's dealt with serious illness, what's important is what you find within yourself, and from that you can learn to make the right health care choices," says Lynn Kohlman, a close friend of Donna Karan, who is a constant presence at the forum.

"In the South African bush, you see that animals always know what plants to eat when they're sick." Lipman recalls. "We're animals too, we've just forgotten what we need."

"Yes," agrees Michael J. Fox. "An animal knows and an animal can't be talked out of it."

Through May 29th, readers interested in commenting on the FDA's new guidelines on integrative care can go to wwww.citizens.org for a link to comment.

Just read this today. Big problem all over North America


Victoria spends big to attract family MDs
$442 million allocated to make field more appealing
Pamela Fayerman, Vancouver Sun
Published: Tuesday, May 29, 2007
The provincial government will spend $422 million over the next four years on financial incentives to make family medicine more rewarding and appealing for doctors.
The initiative is being undertaken to make a dent in the more than 400,000 patients in B.C. who don't have a primary doctor, to improve care of patients with chronic diseases, and to reduce hospital admissions.
B.C. Medical Association president Dr. Margaret MacDiarmid called the agreement a "watershed" milestone in primary care reform and praised its numerous features, including one that will reward young doctors who agree to move to remote areas that need their services. They will qualify for bonuses of up to $100,000 over three years, which includes $40,000 in help to pay off medical school student loans.
Details of the family medicine transformation plan are contained in a 36-page report to be released today. It sets out the goals for the medical system overhaul, and is partially based on the stunning statistic that a third of the province's population -- 1.3 million people -- have chronic conditions such as diabetes, heart or lung disease and they consume 80 per cent of the combined budgets of hospitals, the Medical Services Plan and PharmaCare.
For example, chronic obstructive pulmonary disease, a lung disease often caused by smoking, is the leading reason for hospital admissions via the emergency department. Last year, there were more than 7,000 such admissions.
"By concentrating on individuals who use the system most often, we can improve their quality of care, their overall health and well-being and reduce pressures and costs across the health system," said Health Minister George Abbott.
"We've got two waves coming at us -- aging baby boomers and the increase in chronic diseases. It will be impossible to manage the demand for care without these changes," he said in an interview.
Abbott added that those with chronic diseases are generally middle aged and older so demographic projections for the province -- which anticipate a 120-per-cent growth in the numbers of people over the age of 60 in the next two decades -- are daunting. It is projected that the prevalence rate of those with chronic conditions (now 34 per cent) could increase by 58 per cent in the next 25 years, driving up medical costs by at least 80 per cent, according to a new health ministry analysis.
Included in the changes to primary health care are these provisions:
- Family doctors will be given a "prevention-incentive payment" of $100 per patient (up to a maximum of $3,000 a year) to conduct cardiac risk assessments of patients who are unaware of their risk profile for cardiovascular disease.
- Numerous practice redesign components will be put in place to improve patient outcomes and result in better career satisfaction for family doctors who want to more closely follow patients but feel too rushed and pressured by office overhead costs to do so. A recent international survey found that Canadians were most likely to end up going to emergency departments because they couldn't get a same-day appointment with a family doctor. Doctors are now being instructed to change their appointment booking systems so they can fit in urgent patients. MacDiarmid said business case model studies have found that earnings can actually increase up to 20 per cent because with fewer appointments, there are fewer patient no-shows and urgent care patients also tend not to be long appointments
Since only about half of diabetes patients get the full realm of medical care that is recommended, doctors who treat such complex cases will receive an annual payment of $125 for each such patient, as long as the doctor can document they are following clinical practice guidelines which specify how to treat and monitor such patients. The $125 bonus is also extended to patients with congestive heart failure and hypertension. One of the ways doctors will improve care of diabetes patients is by ensuring they order a blood test at least twice a year called the A1C, which indicates how well blood glucose levels have been managed in the previous months.
- Doctors will receive a fee of $40 for every 15 minutes they talk with frail elderly, palliative and institutionalized (hospital, long-term care) patients and their families. The fee is being introduced to encourage doctors to take a more active role in such cases. About two-thirds of B.C. residents die in hospital even though surveys show that the majority say they would prefer to die at home. Doctors have traditionally stayed away from such meetings because it wasn't worth their while to spend the time required or because they couldn't leave their offices.
- In the area of maternity care, doctors will receive a $1,500 quarterly payment if they continue delivering a certain number of babies.
There are about 4,600 family doctors -- also known as general practitioners -- in B.C.
The document was developed in partnership among the health ministry, health authorities across the province, the B.C. Medical Association and other organizations with a vested interest in health care.
Abbott said he is convinced the changes will improve care of patients with chronic diseases and will improve job satisfaction for family doctors, which will help with recruitment and retention.
According to a survey by Statistics Canada, 7.7 per cent of B.C. residents (316,000) said they didn't have a family doctor because they hadn't bothered to look for one and another 2.9 per cent (101,700) had not been able to find one.
MacDiarmid concedes it is shocking that so many B.C. residents haven't bothered to find a family doctor.
"Fear and denial are powerful coping skills. However, they're not good skills when you are talking about health," she said.