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Duke, Arizona Announce Joint Program on Integrative Care

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Duke Health News 919-660-1306

Have you suggested Echinacea or a special tea? Maybe both. What about herbal remedies such as ginko biloba, St. John's Wort or astragalus for other ailments?

It seems any time illness strikes, someone, somewhere recommends a botanical supplement. A walk through the local health food store will demonstrate just how readily available they are.

Botanical supplements have been a staple of eastern medicine and have been widely adopted by some western cultures, especially in Europe. So, asks second-year University of North Carolina medical student Arshad Rahim, why is American medicine practically ignoring them?

"These supplements are so popular and we, as medical students, know virtually nothing about them," Rahim said.

That is why Rahim made time in his schedule to attend the 4th annual Integrating Mind, Body and Spirit in Medical Practice conference sponsored by the Duke Medical Center Program in Integrative Medicine, held Oct. 7-9. He went in the hopes of learning not only about botanical supplements, but other non-traditional healing-oriented medical treatments such as acupuncture, homeopathy, manipulative therapies and meditation � treatments that also are gaining in popularity among Americans.

"Whether or not you believe these treatments actually work, I think anyone being trained in medicine today needs to know about them," Rahim said. "You need to know how they work if your patients are trying them, especially if they are putting supplements into their bodies."

Rahim is one of a number of medical students who attended the conference, which drew more than 300 health care providers from throughout the U.S. Three years ago, Duke sponsored what is believed to have been the first conference held by a major academic research center on the topic of integrative medicine.

Now, Duke is teaming up with the University of Arizona's Program in Integrative Medicine, which offers the only certification program in the country for physicians who want to be trained in complementary care techniques. The collaboration goes beyond the immediate scope of the conference. Together, they hope to change the face of medicine by improving medical education programs and furthering research in integrative medical techniques.

In his opening address at the conference, Dr. Ralph Snyderman, Duke chancellor for health affairs, talked about the need to refocus medicine. "Medicine today exemplifies the best of times and the worst of times," he said. Even though great advances have been made in medicine, an unfortunate side effect of the science-centered approach has been a pulling away from the nurturing aspect of health care, Snyderman said.

"Let us continue the scientific understanding of medicine -- of what works and what does not -- but let us not lose sight of the power of the human approach to health care," he said.

Integrative medicine, as defined by Dr. Marty Sullivan, cardiologist and co-director of the Duke Center for Integrative Medicine, takes the best of traditional western medicine and combines it with non-traditional complementary and alternative medical techniques to offer a patient-centered, mind-body-spirit approach to health care.

"We are dedicated to making this approach an important part of the Duke University Health System. Our growing collaboration with Arizona will help us to bring integrative medicine into community medicine and into community health projects," Sullivan said. "We are, in fact, one of several academic medical centers in the United States that have taken steps in this direction."

Duke, Arizona, Harvard, the University of Massachusetts, the University of Minnesota, Stanford and the University of California at San Francisco all have taken a major initiative in the area of integrative medicine, Sullivan said. Last summer, representatives from these medical centers formed a consortium that met at the Fetzer Institute in Kalamazoo, Mich.

Considering that complementary medicine is becoming more heavily woven into the traditional fabric of Duke's high-tech health care, it comes as no surprise that Duke is taking a leading role in exploring this field, its practitioners say.

Duke's colleagues in Arizona say they are excited by the collaboration as well. Dr. Andrew Weil, director of the Program in Integrative Medicine at the University of Arizona College of Medicine, was the keynote speaker at the conference. Weil's program has made Arizona a leader in integrative medicine not only because of its fellowship program, but also because of its clinical experience. Its clinic currently has a waiting list of 1,500 patients.

"I think there are a number of directions we can take this collaborative effort," Weil stated. "By conducting multicenter trials, our research will be much more powerful. Arizona can assist Duke in training physicians who will be involved with this program because we have that experience. We can work jointly in the area of medical education reform, which is something that both Dr. Snyderman and myself are very interested in."

Dr. Russ Greenfield, director of continuing medical education for the Arizona program, sees the partnership between the two centers as a powerful force for change.

"I would like to see a system put in place where students can come through and learn about integrative medicine," he said. "At the bare minimum, we should teach what might be dangerous."

Sullivan said the collaboration is important to Duke for two reasons. "By developing a formal center for integrative medicine, we are going to develop a sub-specialty clinic that will be able to offer these kinds of treatments to people who specifically want them, and the knowledge and expertise to answer people's questions. This will hopefully help us ... to serve patients better than we have in the past."

Work satisfaction for health care providers could be improved as well, Sullivan said. For example, the integrative medicine department last year established the mindfulness-based stress reduction program. Since then, more than 40 faculty and staff members have participated in the eight-week program that teaches people how to utilize meditative techniques to reduce stress.

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