As I have watched the evolution of integrative medicine over the last seven years, in particular its gradual adoption of uptake into conventional healthcare settings, I have been interested to observe how a community’s most important health enterprise, its hospital, embraces—or not—therapies from outside the medical world that have been so clearly preferred by a large percentage of the population in its serving area.
My first exposure to integrative medicine in a hospital took place in 2007 at Suburban Hospital in Bethesda, Maryland, (now a part of the Johns Hopkins Medical System). It had received a targeted donation from one of its most important long-time local donors, stipulating that the funds were to be used to establish an office for integrative medicine. (As has so often been the case in integrative medicine, the funder was aware of a very favorable outcome from an alternative medicine intervention and was inspired—as Sen. Tom Harkin had been when he created the Office of Alternative Medicine at NIH in the early ‘90s—to invest in making alternative treatments more available.)
Suburban hired as director of this office an RN who was experienced in mind–body medicine and was trained in healing touch. She organized mindfulness-based stress reduction (MBSR) classes, inviting Michael J. Baime, MD, MBSR pioneer and director of the University of Pennsylvania Health System’s “Penn Program for Mindfulness,” to the Suburban campus to teach the staff. Word reached the public that this was taking place, and soon Suburban was offering a class for the community.
But MBSR and integrative medicine were not part of the hospital’s DNA. Despite donor commitment and belief and oversight of a medical director, the program functioned as a kind of orphaned “store-in-a-store,” and was dropped after a couple of years.
Later I visited the Anne Arundel Medical Center in Annapolis, Maryland, where a wellness center director was organizing programs and coordinating with external alternative-care practitioners. The hospital had installed a specially landscaped healing garden on the property. Its then-CEO said that he believed “a large market exists for hospital-approved CAM [complementary and alternative medicine] therapies” (his wife is a Reiki master). But he was an operating realist, and such non-reimbursable ancillary services were not seen as essential, at least to the hospital’s financial sustainability. This was particularly true at a time when AAMC was completing a large expansion.
Since then, many hospitals across the country have put in place wellness or integrative medicine programs that offer some form of non-reimbursable complementary therapies—yoga, massage, acupuncture—and nutritional and lifestyle counseling. The American Hospital Association has surveyed its members several times in recent years on the use of CAM therapies. An AHA press release from its 2011 study noted: “According to the survey, 85 percent of responding hospitals indicated patient demand as the primary rationale in offering CAM services and 70 percent of survey respondents stated clinical effectiveness as their top reason.” 
Beyond this gradual, constrained, and careful adoption of a previously untrusted class of treatment modalities, another element was arriving in the hospital culture with them. Inevitably, the third-party yoga or massage specialists contracted to provide the service or hired as staff brought with them a full understanding of the attractions their disciplines presented to people. Accepted by hospitals initially for their treatment qualities—pain control, stress management, few side effects—integrative modalities have another appeal: simple personal health enhancement. When the National Center for Complementary and Alternative Medicine (NCCAM) surveyed the users of CAM therapies in 2007, it reported that 50% of the respondents used it for bolstering personal well-being.
And so what does that mean? It may be something of a stretch, but perhaps it means that a hospital might expand its service framework beyond serving acute problems and chronic illness and build on a slowly evolving wellness sensibility to create a comprehensive all-health resource for its community.
And what would it take to make that happen?
Apparently it takes a disease epidemic whose resolution can only take place outside the treatment system, a hotelier with an acute sensitivity to customer preferences, and a regional philanthropist making a Bet 2.0 on integrative medicine.
The disease, of course, is obesity. The hotelier-turned-hospital CEO is Gerard Van Grinsven, formerly an executive at Ritz-Carlton hotels and, until July 1, CEO at Henry Ford Hospital in West Bloomfield, Michigan. The philanthropist is the Eugene B. Casey Foundation in Montgomery County, Maryland, funder of that short-lived office of integrative medicine at Suburban Hospital.
In 2010 Van Grinsven described in a video (link below) the process of creating a new hospital for the massive Henry Ford Health System in Michigan. To say that his animating philosophy was “customer-oriented” barely begins to describe how his team created a facility that, by its physical design, “must first communicate wellness to you” when people walk through the front door. Their intention: Create a “Cirque de Soleil for healthcare” by designing the facility as “a northern Michigan lodge,” on behalf of, and with, his primary customers, women.
When his team drilled down to understand women’s “unexpressed health needs,” Van Grinvsen says that, in addition to their general unhappiness with health care delivery, “They want activities and programs that help them in physical and mental well being.”
Instead of saying “that’s the job for Gold’s Gym and Spa Envy,” Van Grinsven describes the principles on which West Bloomfield operates, principles that he believes address the obesity issue:
We have to become health coaches in the communities we operate in…we have to keep communities healthy…and create an environment that healthy people actually want to come…and partake in activities and programs that help them stay healthy.
We said that we will be a community center for well-being.
The resulting expansive array of wellness offerings developed for West Bloomfield includes its wellness brand, Vita, with “11 healing rooms, a mind-body studio, water therapy.” The facility contains a food education center where hospital chefs from around the country come to learn about food preparation (“We got rid of the fryers and the freezers,” Van Grinsven says), a theatre for presentations, and the Henry Cafe that attracts 300 dining patrons each day who have no need for treatment; that is, just folks from the community coming in for a meal.
It is too early to say whether the new leadership at Henry Ford will embrace the full measure of health services, but as an exemplar of what may be for hospitals, there is a great deal to marvel at in Van Grinsven’s 18-minute presentation, and I urge anyone interested in the nuts and bolts of on-the-ground transformation to take a look.
Back in Maryland, in Gaithersburg, Maryland, 12 miles north of Johns Hopkins’ Suburban Hospital, is a new clinic-sized variation on Van Grinsven’s theme. Like the hospital in West Bloomfield, Casey Health Institute (CHI), which opened its doors to the public in April, has deliberately created its own tightly integrated, dual health and wellness paradigm: a newly emerging model of integrative primary care (itself rare) that extends naturally to the programs of its own branded Wellness Center at Casey Health Institute.
In addition to excellent and team-coordinated primary care, patients and non-patients have access to the Wellness Center’s yoga and movement classes, workshops in nutrition, healthy living, health coaching and personalized wellness plans, sessions with massage and acupuncture specialists for simple health enhancement, and soon an educational cooking center.
Like Van Grinsven, the founders of CHI, spouses David Fogel, MD, and Ilana Bar Levav, MD, believe in creating a center of health in their community. CHI is also a nonprofit whose mission includes extending access to its unique blend of service to community groups and organizations. (Disclaimer: CHI is a client of Integrative Health and Wellness Strategies.)
Casey Health does not have a $3 billion health care enterprise like the Henry Ford Health System at its side. But it does have a new form of partnership with its patients, a patient-centered team model, and a commitment to the health of its community at large. It also shares a sentiment Gerard Van Grinsven expressed during his tenure:
It is my obligation to change the way health care is being delivered.
This is the kind of sentiment that will either end recruitment of healthcare executives from outside the industry, or it will resonate with them and inspire a comprehensive view of serving the whole person’s health needs that is embodied in these two—for now—audacious customer-centric health enterprises.
“More Hospitals Offering Complementary and Alternative Medicine Services,” press release, Sept 2011, American Hospital Association. http://bit.ly/CAM-2011
Barnes PM, Bloom B, Nahin R. “Complementary and alternative medicine use among adults and children: United States, 2007,” 2008.
Now CEO of Cancer Treatment Centers of America
Republished with permission of the Altarum Institute.