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Integrative medicine: Treating the whole person

May 03, 2018 | UCI Health
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Nayan Patel and his wife, Sheela, a cardiac care nurse at UC Irvine Medical Center.  After he experienced some health issues, Sheela suggested Nayan consult with Dr. Shaista Malik, a UCI Health cardiologist.

Nayan Patel was worried.

The 46-year-old chiropractor from Fullerton knew he was a candidate for heart disease. Patel’s uncle died of a heart attack at age 57; his father recently underwent cardiac bypass surgery and stent placement. Patel’s primary care doctor had prescribed a medication to lower his cholesterol, but the drug caused side effects. He had a sinking feeling that what he was doing simply wasn’t enough to prevent the disease.

His wife, Sheela, a cardiac care nurse at UC Irvine Medical Center, suggested he consult with Dr. Shaista Malik, a UCI Health cardiologist. Malik ran extensive tests and put Patel on a different medication to lower his cholesterol.

“I knew her research focused on the potential to prevent heart disease,” Sheela Patel says.

Diet, supplements and lifestyle changes

Malik’s advice didn’t stop at medication. At her urging, the Patels switched to a plant-based, vegan diet. She also prescribed herbal supplements that have been proven to support heart health. Within six months, Patel’s cardiac tests showed vast improvement, and he no longer needed cholesterol medication.

“I feel very different now,” Nayan says. “I feel a lot of energy  and mental clarity. I feel like I’m contributing to my health. A disease should not control you. You have to control your health. To be empowered this way is amazing.”

Patel is typical of patients who adopt a broader range of regimens and alternative treatments to successfully improve their health and well-being.

Integrating Western and Eastern approaches

Now, propelled by a $200-million gift by a generous Orange County family, the University of California, Irvine, is embarking on a major expansion of its science-based approach to integrative health research, education and patient services.

While aspects of this approach for patients like Patel may not reflect traditional Western medicine, some are more innovative and use leading-edge technologies, Malik says.

“Mr. Patel’s care is integrative health 2.0,” Malik says. 

“We did a complete medical assessment and high-tech diagnostics, which included looking at his genetics. Then we looked at everything we could do to help him. Integrative health is synergistic. It makes conventional medicine work better.”

Aiming for better health outcomes

Improving health outcomes as well as patients’ experiences is the goal of the realigned health sciences college at UCI.

The gift by Broadcom co-founder Henry Samueli and his wife, Susan, is the largest in UCI’s history and will lead to ambitious extensions of medical research, education and services. It will include construction of the new Susan and Henry Samueli College of Health Sciences building on the UCI campus and also will support the creation of 15 Samueli research chairs in integrative health.

Across the UCI Health landscape, physicians, researchers, nurses, pharmacists, therapists and students will seek to understand how scientifically validated integrative health modalities can help treat and prevent disease, as well as make patients’ lives better.

Taking the whole person into account

Weaving integrative health into conventional healthcare reflects the belief that everything about a person — genetics, lifestyle, socioeconomic status as well as cultural and religious beliefs — impacts health. This approach is sometimes referred to as “systems biology,” says Dr. Michael J. Stamos, dean of the UCI School of Medicine.

“The systems approach means that all aspects of a patient’s care are brought together and considered,” he says. “It’s a changing paradigm where we treat the whole person.”

Susan Samueli says she and her husband are motivated by a desire to improve people’s lives. “Despite our technological advances, too many people still suffer from debilitating conditions such as heart disease and diabetes,” she says. “Preventive medicine is the best way to end this spiral.”

The right time and place

UCI Health is uniquely positioned to emerge as a national leader in integrative health. UCI is already home to the Susan Samueli Center for Integrative Medicine, where many non-traditional services are offered, Malik notes.

The center will grow and become the Susan Samueli Integrative Health Institute located within the new College of Health Sciences building. But integrative health research also will be incorporated across the entire allied health sciences fields — including nursing, public health and pharmaceutical sciences. And other disciplines, such as social sciences and engineering, will be brought into the research efforts, Stamos says.

“We’ve been talking for quite a while about the importance  of interdisciplinary research and interdisciplinary clinical care,” he says. “Our transdisciplinary work will make this gift much more impactful.”

Expanding integrative approaches throughout UCI Health

Integrative health may sound like an “extra” service.

In reality, several nonconventional health modalities have long been embraced at UCI Health with impressive results. Malik and others have championed diet, exercise, stress reduction and other proven integrative therapies for certain cardiac patients for many years, often tapping into programs offered at the Susan Samueli Center.

“I would see patients with heart disease and would talk to them about the need for them to change their lifestyles,” says Malik, who became the center’s director in 2015. “But I’d see them later, and they hadn’t changed. I felt I needed more tools to help them change their behavior and manage stress.”

Integrative health therapies are being adopted by many UCI Health clinicians. Malik has done so in her Preventive Cardiology Program.

At the Center for Pain and Wellness, patients often use biofeedback and acupuncture to avoid or reduce their reliance on highly addictive opioid pain medications.

Integrating mind, body and spirit

UCI Health neurosurgeon Dr. Sumeet Vadera also recommends pet therapy, acupuncture, Reiki and other nontraditional therapies to help reduce the pain of cranial and spinal surgery patients and decrease the length of their hospitalization stays.

“UCI has been a pioneer in integrative health with the original Samueli gift that created the Susan Samueli Center,” Malik explains.

“We were among the very first academic medical centers to embark on this mission of looking at the whole person and integrating mind, body, spirit and emotional well-being, and addressing all the determinants of health. We have a history with this, and it’s a field that’s ready to expand.”

Proven integrative health practices

Folding integrative health therapies into medical care isn’t a repudiation of traditional Western care.

In fact, UCI Health is home to some of the most advanced, technologically driven medicine in the nation. Across the campus, surgeons wield lasers and other next-generation tools to remove tumors through tiny incisions, use 3-D imaging devices to create vivid, real-time images inside a patient’s body and employ sophisticated monitoring devices to study brain function.

Adding proven integrative health practices will enhance a patient’s well-being and experience, Stamos says.

“Integrative health is not an abandonment of the well-established Western medicine treatments we utilize daily,” he says.

“But I would say that traditional Western medicine has lapsed in terms of addressing a patient’s health beyond what we can measure and quantify. That has led to a weakening of the patient experience. We’re not always talking about what really matters to patients. We also need to focus on other aspects of patients’ health that are currently not being addressed very effectively or very regularly.”

For example, as a colorectal cancer surgeon, Stamos uses leading-edge technology to remove tumors. But removing a tumor and sending a patient to chemotherapy and then home to recover is not enough, he says.

Increasing survival through lifestyle change

“We’ve known for almost a decade that what a patient does in terms of lifestyle after colon cancer surgery matters to their outcomes,” he says. “Patients who adopt a healthy lifestyle, a Mediterranean diet and who exercise regularly have an improvement in survival. But those things are not espoused by many Western physicians. We are not saying a patient shouldn’t receive chemotherapy. We’re saying that, in addition to chemotherapy, these are things you can do to increase your chances of survival. That is incredibly empowering to patients.”

While Western medicine has been slow to adopt outside-the-box methods, patients have long been hungry for information and activities to improve their health. Almost 20 years ago — in part due to patient demand — the National Institutes of Health opened the National Center for Complementary and Integrative Health to lead research on diverse medical and healthcare practices.

Indeed, many integrative therapies have been practiced for thousands of years or are considered “conventional” in other parts of the world.

Demand for alternatives driven by patients

“Integrative health has been patient-driven,” Malik notes. “There is a very high demand for these services. The reason is that patients see a huge change when they add some of these therapies, when they start eating better, adding physical activity or addressing certain nutritional deficiencies. People get results.”

A major drawback to some nontraditional medical therapies, however, is that many have not been validated by high-quality, scientific research to prove their effectiveness. Studying integrative therapies to learn which work and which don’t is a key component of the UCI Health program.

“With this gift we’ll have the opportunity to do some pilot work that could get funded for a more comprehensive look at the mechanisms that underlie some of these modalities,”  Malik says. “That will help us understand which patient and condition a particular therapy works best for.”

Conventional and integrative medicine: working together

These integrative health studies will not be conducted in isolation. A key to improving patient health is to understand the potential for synergy — how integrative and conventional medicine work together.

For instance, a person may have a gene for a certain kind of cancer. But depending on the person’s behavior, exposure to stress and environmental factors like pollution, that gene could be switched off.

The integrative medicine research efforts also will explore its potential to curb spiraling healthcare costs, Stamos says.

“We recognize the unsustainability of our current healthcare spending in this country,” he says. “But what people are starting to realize is we have abandoned the recognition that we all have some individual responsibility for healthcare. We have not put an emphasis on lifestyle, meditation and things we can do ourselves to lead to better health. We hope the emphasis we have on integrative health will raise awareness and provide data to show that these things do affect disease prevention.”

The time is right to push the boundaries of healthcare and employ new strategies, Malik says. Integrative modalities may be just the answer to what ails traditional medicine. “We’re starting to see the tipping point where conventional medicine is looking for other answers to solve the healthcare crisis we see around us.”

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