In the following audio interview link with Frank Stacio, host of “The State of Things” at public radio WUNC in Charlotte, Duke Integrative Medicine director Adam Perlman explains the current state, underlying principles and clinical application of integrative medicine in one of the most lucid explanations of the subject that I have come across.
Follow this link to the audio (45 minutes, and well worth it)
Although many independent practitioners of what have been called holistic or alternative medical practices (those you find in neighborhood retail settings and even in shopping malls) are traditionally skeptical of the role played by academic health institutions like Duke Medicine, it is becoming clear that the inroads integrative medicine have made in conventional care are establishing a clinical and business model that holds promise for sustained growth.
Perlman’s description of how Duke Medicine has integrated integrative medical approaches into practical care and healing reflects in part the coming changes to the traditional care-payment system that Accountable Care Organizations and Patient Centered Medical Homes hope to achieve as the fee-for-service model recedes as an option, particularly for primary care. At the moment, sustainability at Duke Integrative begins with a concierge payment structure ($1500/year) that Perlman maintains is how stability will be established as other payment structures come on line.
The ACO and PCMH models require keeping people healthy. As Perlman explains, an essential if little understood value of integrative practice is oriented around primary care that emphasizes wellness and then helps people carry on themselves. Duke is moving rapidly to apply these wellness approaches internally for its own employees (Perlman also directs that program for Duke).
Unlike many other corporate wellness programs that may or may not include the likes of yoga, meditation or herbal therapies, the Duke program, next door to its own Integrative Medicine program can establish a fully integrative model for wellness that is now not in evidence elsewhere along the exploding front of employee wellness programs.
Perlman is a long time leader and innovator in the historically arduous process of combining integrative and conventional approaches that are patient and outcome-focused. His comments and Stacio’s good questions provide and excellent portrait of contemporary integrative medicine, even as it continues to move into and around the broader health landscape.
The audio recording is here.