Integrative Medicine and the Health of the Public A Summary of the February 2009 Summit (2009) / Chapter Skim
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1 Summit Overview and Background
1 Summit Overview and Background
Pages 23-36
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From page 23... ...
Genomics and proteomics are bringing personalized risk assessment, prevention, and treatment options within reach; health information technology is expediting the collection and analysis of large amounts of data that can lead to improved care; and many disciplines are contributing to a broadening understanding of the complex interplay among biology, environment, behavior, and socioeconomic factors that shape health and wellness. Although medical advances have saved and improved the lives of millions, much of medicine and health care have primarily focused on addressing immediate events of disease and injury, generally neglecting underlying socioeconomic factors, including employment, education, and income, and behavioral risk factors.
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From page 24... ...
Those with chronic diseases rarely receive the full support they need to achieve maximum benefit. A patient's course of care may require contact with clinicians and caregivers and may require many transitions, for example from hospital to home care.
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From page 25... ...
This is the background to the IOM's Summit on Integrative Medicine and the Health of the Public. Integrative medicine may be described as orienting the health care process to create a seamless engagement by patients and caregivers of the full range of physical, psychological, social, preventive, and therapeutic factors known to be effective and necessary for the achievement of optimal health throughout the life span.
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From page 26... ...
The plenary sessions covered overarching visions for integrative medicine, models of care, workforce and education needs, and economic and policy implications. The planning committee worked to ensure sufficient time for discussion and active audience engagement, believing that the success of the summit would be measured by the quality of the presentations as well as the level of participant engagement.
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From page 27... ...
A list of priority assessment group participants is in Appendix C Chapters 2 through 6 of this summary include the priority assessment group reports, which are based on the rapporteurs' presentations to the plenary sessions and the ensuing discussion of summit participants.
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From page 28... ...
Fineberg noted that he, too, is skeptical, but that he is also skeptical of claims about what works in conventional medicine. He suggested that the same standard of evidence must be applied to any proposed idea about what will and will not work in health care, including conventional care.
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From page 29... ...
Many diseases can be prevented and, if they develop, be mitigated by actions people take on their own as well as through therapeutic and wellness plans in collaboration with and aided by their health care providers. Rational transformation of the current disconnected approach to health care, said Snyderman, will require a seamless integration of resources to empower individuals to improve their health, while providing the resources needed to prevent and treat disease.
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From page 30... ...
This turmoil affects all Americans, including the 47 million who do not have health insurance; employers, who cannot afford to offer insurance or whose businesses strain from insurance costs; providers, who see their own costs rising uncontrollably; and payers, especially government payers, with Medicare and Medicaid consuming larger and larger shares of public resources. Rising unemployment rates are likely to cause the number of uninsured and underinsured to grow substantially, further distorting the health care system, noted Snyderman.
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From page 31... ...
For the health system to develop the services that will more effectively promote health and well-being, Snyderman said that it will need to take this broader range of factors into account, through a tighter integration of systems, more comprehensive therapeutic approaches, and development of a health care workforce with more diverse skills. Bringing individuals into the center of their own care will require health practitioners to work with patients to create their own strategic personal health plans based on their personal health needs.
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From page 32... ...
Development of the germ theory substantiated the role of microbial agents in the development of disease; discoveries in chemistry helped scientists go from concoctions of tree bark to specific chemical treatments; understanding of physiology and pathology increased markedly and better explained disease development and classification; and advances in physics enabled imaging and radiology. These remarkable scientific leaps, however, inadvertently fostered the reductionist idea that for every complex disease there is a single cause, and doctors should find it and fix it, said Snyderman.
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From page 33... ...
These late interventions generate the high costs and low reversibility indicative of advancing chronic disease. BOX 1-1 The Inflection Curve Case Study Snyderman further illustrated the inflection curve concept by describing the case of a hypothetical, but all too typical, 55-year-old man who walks into an emergency room with crushing chest pain.
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From page 34... ...
Central to this approach is personalized health planning and the support needed to carry out individualized plans. Snyderman said that the process could begin with a shift in the usual patient–physician encounter, from the emphasis on find it and fix it to strategic health planning that integrates an assessment of current health status, risk for various diseases, tracking, and development of wellness plans, and, when needed, therapeutic plans.
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From page 35... ...
SUMMIT OVERVIEW AND BACKGROUND 35 kind of transformation described. Nevertheless, in the current economic and political climate, health care reform seems possible, and perhaps even inevitable.
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