Moving the Health Care Needle

Healthcare provider talking with a patient laying on a bed

From a conference room in the clinic of The University of Vermont Medical Center’s Comprehensive Pain Program, Jon Porter, MD, discusses the challenge of treating chronic pain. The condition can impact every aspect of a person’s life, Dr. Porter notes: work, family roles, social relationships and mental health.

“Our focus in designing this program was how to address that entire 360-degree experience,” says Dr. Porter, a family medicine physician and founding medical director and division chief of comprehensive pain management.

The 16-week Comprehensive Pain Program combines modern medicine and evidence-based complementary therapies to develop sustainable, non-opioid options for treatment of chronic pain; alternatives include acupuncture, massage therapy and mindfulness. The program’s integrative model has drawn national attention for both its payment model and its transdisciplinary team approach, which includes staff, clinicians, treatment providers, group session facilitators and program participants.

“We're just getting going and see statistically significant change in terms of improvements in lots of different arenas in people's lives,” says Dr. Porter, from the ability to go outside to play with the dog to attending a family event. “We’re also seeing markedly reduced use of emergency room services in the program, so I have a sense that we're on a good path.”

The Comprehensive Pain Program was able to join with the UVM Medical Center’s Integrative Health and Integrative Therapies this past summer thanks to a $5.5 million endowment from the Bernard Osher Foundation. The Osher Center for Integrative Health at UVM now joins an international network of 10 academic institutions—including Harvard University, Northwestern University, the University of Washington and UC San Francisco—to study integrative health.

“So often, when people are in a health crisis, they start to forget what's important to them,” says Cara Feldman-Hunt, associate director for the Osher Center. “I think what we do really well is help people figure that out. Whether it's a cancer patient or somebody with chronic pain, an integrative approach helps people find the best tools and ways to move forward toward wellness.”

Promoting Wellness

“Many people are curious about what integrative health really means,” says Karen Westervelt, clinical associate professor in the UVM College of Nursing and Health Sciences, who will serve as the Center’s educational program director. “I find a lot of people are already doing it on their own, because it makes them feel good.”

People who practice yoga, take a walk to get some fresh air, or find someone to talk to when they’re feeling stressed are practicing integrative health and not even realizing it, she says. Integrative health is already incorporated into nursing and physical and occupational therapy programs, and integrative therapies provide support both during and post-cancer treatment, says Kim Dittus, MD, who serves as medical director of oncology supportive services for the Osher Center.

A medical oncologist, Dr. Dittus has spent more than a decade of her career observing the effects of integrative therapies such as massage and acupuncture, mindfulness-based stress reduction and Reiki on patients receiving treatments at the UVM Cancer Center.

“We know that acupuncture and massage help with pain and nausea,” says Dr. Dittus, adding that there are also many other ways that integrative therapies help reduce patients’ discomfort, including nutrition and exercise.

Making Integrative Health Care Accessible

In addition to providing education and patient care, the Osher Center will serve as a hub for research and policy development, including the cost-reduction of this preventive care model. One major success so far has been the connection with Blue Cross Blue Shield of Vermont to cover integrative health care services not traditionally covered by insurance plans.

“Our hope is to get other insurers involved in the bundle and most importantly, Medicaid,” says Feldman-Hunt. “The long term vision is that integrative care is part of our health care system - that no matter where you work, or if you don't work, or who your insurer is, you get access to this care.”

Original story by Sara White of UVM College of Nursing and Health Sciences

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