Clinical and Health Affairs
Integrative Holistic Medicine in Minnesota
By Carolyn J. Torkelson, M.D., and Bill Manahan, M.D.
Minnesota has played a leading role in the integrative holistic medicine movement in the United States for more than 2 decades. This article defines integrative holistic medicine and describes how it is practiced. It also discusses the reasons why institutions and providers here and elsewhere in the country have embraced this approach to patient care.
For more than 25 years, Minnesota has been at the forefront of integrative holistic medicine. The state began earning its reputation as a leader in 1982, the year Mankato became home to the Wellness Center of Minnesota, one of the first integrative medicine clinics in the United States. In 1993, Hennepin County Medical Center became the first conventional medical facility in the country to open an alternative medicine clinic. Two years later, the University of Minnesota established the Center for Spirituality and Healing; this was followed by the establishment of integrative medicine programs at the Woodwinds Health Campus in Woodbury, Children’s Hospitals and Clinics of Minnesota in Minneapolis and St. Paul, and Abbott Northwestern Hospital in Minneapolis. In addition, Minnesota’s Complementary and Alternative Health Care Act (MN Statue 146A) was signed into law in 2000, protecting natural healers’ legal right to work with clients.
Principles of Integrated Holistic Medical Practice
Holistic health care practitioners
- Believe optimal health is the primary goal. The idea is to create a condition of well-being regardless of the presence or absence of disease.
- Strive to meet the patient with grace, kindness, acceptance, and spirit unconditionally emanating from the awareness that love is life’s most powerful healer.
- Consider the body, mind, and spirit.
- Promote health, prevent illness, and help raise awareness of disease rather than merely manage symptoms. A holistic approach to care involves relieving symptoms, modifying contributing factors, and optimizing future well-being.
- Help patients evoke and utilize these powers to affect the healing process.
- Embrace all safe and effective options for diagnosis and treatment. These options, which may include lifestyle modification and complementary approaches as well as conventional drugs and surgery, are selected in order to best meet the unique needs of the patient.
- Believe the ideal practitioner-patient relationship is a partnership that encourages patient autonomy and values the needs and insights of both parties. A good relationship between the patient and practitioner is essential to the healing process.
- Focus care on the unique needs of the patient rather than the illness.
- Continually work to incorporate the principles of holistic health in their own lives.
- Believe all life experiences including birth, joy, suffering, and death are profound learning opportunities for both their patients and themselves.
The public responded enthusiastically to these early efforts to expand the concept of medical care and to make complementary therapies more accessible. In turn, more and more physicians, including some who were initially skeptical about complementary therapies, have become interested in learning more about how to integrate them into their practice. Consequently, more than a hundred physicians throughout the state are now practicing integrative holistic medicine to varying degrees—and that number is growing.
The Integrative Holistic Medicine Movement in Minnesota
A small group of physicians with an interest in holistic medicine have played a quiet but important role in this story. During the 1970s and 1980s, physicians who were beginning to look beyond the Western biomedical model for treating patients were doing so in isolation, and they often felt they were viewed skeptically by their peers. A sense of isolation is what led one of the authors of this article, Bill Manahan, M.D., to seek out other health care providers who had an interest in holistic medicine. In the fall of 1989, he convened a meeting of holistic health care providers in St. Paul. Included in that group of 28 were 4 physicians, 12 nurses, 3 physical therapists, and 3 medical students. Each of the physicians agreed to bring a colleague to the next meeting. Four months later, 8 physicians showed up for the second meeting, along with 20 other providers. By 1992, the group had grown to about 120 members, 30 of whom were physicians. The membership became so large by 1999 that nurses and physicians decided to meet separately. Today, the holistic medical group is composed of 160 physicians and 40 other providers. (Information about some of these providers and the group’s activities is available at the www.holisticphysicians.info.) In addition, 40 Minnesota physicians are now board-certified in integrative holistic medicine.
Although the size of the gatherings has grown, their purpose has remained the same: to provide support for practitioners wishing to embrace a holistic philosophy of practice, an opportunity to network with like-minded colleagues, and an opportunity for learning. As part of each meeting, individuals describe their professional journey and share their dreams for the future. They also offer information about complementary therapies and about how various diseases and conditions can be approached from a holistic perspective. Topics have included taking a holistic approach to chronic fatigue syndrome and Lyme disease, the controversies about amalgam fillings and immunizations, chiropractic and osteopathic manipulation, and techniques for reducing stress.
What is Integrative Holistic Medicine?
Integrative holistic medicine is a healing-oriented approach to medicine that looks at the whole person—body, mind, and spirit—and uses appropriate therapies, both conventional and alternative, to improve the health of an individual. It addresses the fundamentals of lifestyle and self-care and emphasizes a therapeutic relationship between patient and practitioner.
A common misconception about integrative medicine is that it primarily involves modalities other than pharmaceuticals and surgery. Although it is true that integrative holistic physicians believe that complementary and alternative medicine (CAM) therapies can often be helpful in treating patients, they are not opposed to the use of pharmaceuticals and surgery when they are needed.
What distinguishes integrative holistic physicians is their belief that the basic foundation of care is treating the “whole person” and addressing the full range of a patient’s needs, not just the disease. Integrative holistic doctors not only pay attention to a patient’s presenting symptoms, disease, and test results, they also focus on the patient’s sense of who they are, the way they live, and their belief about a higher power, death, and the meaning of illness. They consider spirituality an integral component of health and well-being and believe a person’s capacity to grow spiritually may be a key to healing. Consider a patient who has a blood pressure reading of 140/90 mm Hg. A physician might recommend exercise, weight loss, and eating a low-salt diet, and then prescribe medication. But a physician who takes a more holistic approach might, in addition to recommending exercise, weight loss, and changes in diet, suggest to the patient that their elevated blood pressure may be a response to increased stress. The holistic physician might recommend that the patient join a mindfulness meditation class to learn to elicit the relaxation response in order to counter the stress reaction. This type of approach affirms a patient’s ability to achieve better health and gives the patient the tools to do so.
A Return to Roots
- The American Academy of Environmental Medicine (www.aaemonline.org), founded in 1965.
- The American College for Advancement in Medicine (www.acamnet.org), founded in 1973.
- The American Holistic Medical Association (www.holisticmedicine.org), founded in 1978. It is closely aligned with the American Board of Integrative Holistic Medicine, the certifying body of holistic medicine.
- The Institute for Functional Medicine (www.functionalmedicine.org), founded in 1980.
- The International College of Integrative Medicine (www.icimed.org), founded in 1983.
- The International Society for the Study of Subtle Energies and Energy Medicine (www.issseem.org), founded in 1989.
- The American Academy of Anti-Aging Medicine (www.a4m.org), founded in 1993.
- The National Center for Complementary and Alternative Medicine (www.nccam.nih.gov/health), founded in 1998.
- The Consortium of Academic Health Centers for Integrative Medicine (www.imconsortium.org), founded in 2001.
Historically, both the public and a majority of physicians considered medicine a calling—a summons to a sacred and unique pursuit focused on the health care needs of the population. The role of a physician was considered a privilege and an honor, one that gave physicians considerable fulfillment in their day-to-day work. More emphasis was placed on patient care and less on the business aspects of the profession. By the early 1970s, that started to change. Health care costs began to increase rapidly, payer issues came to the forefront, and new health care delivery models were being tested. Medicine was becoming a business rather than a calling. In response, medical schools began to emphasize the use of technological and pharmaceutical approaches to improve health and treat disease. Because Western medicine had made huge advances with these approaches since the 1940s and 1950s, there was a sense that pharmaceuticals and surgery could conquer any problem a patient had.
Yet at the same time, physicians were beginning to see a growing number of patients with chronic diseases for which there was neither a single cause nor a simple treatment. That convinced some physicians to look at patient care in a different way—to pay closer attention to not only the physical but also to the emotional and spiritual components of health.
Meanwhile, patients were also seeking out alternative ways to maintain health and treat illness often without their doctors’ knowing about it. The 2007 National Health Interview Survey, which asked more than 32,000 adults in the United States about their health- and illness-related experiences, revealed that more than one-third of respondents said they used alternatives to conventional medicine such as acupuncture, biofeedback, botanicals, meditation, and dietary supplements. Public demand has brought the study of integrative holistic medicine into medical and resident education. It has also prompted large medical institutions such as the Mayo Clinic to create integrative medicine services and study the effectiveness of alternative therapies.
As an increasing numbers of patients consider complementary modalities and alternatives to conventional medicine as treatment options, a growing number of physicians are learning more about integrative holistic health care in order to better care for them. We believe this trend will continue and that integrative holistic medicine, with its emphasis on self-care and prevention, will emerge as the prevailing model for health care in the future. Recently, in Washington, D.C., Sen. Tom Harkin and leaders in the integrative care field testified before the Committee on Health, Education, Labor, and Pensions about the need for integrative heath care to be a central theme in health care reform.
This article has mentioned only a few of the many dedicated practitioners and organizations in Minnesota that have been pioneers in integrative holistic medicine. Because of their commitment, the state will continue to be a leader in the move toward a more holistic, integrated approach to patient care. MM
Carolyn Torkelson is an assistant professor of family medicine and community health and sees patients in the Deborah E. Powell Center for Women’s Health at the University of Minnesota. Bill Manahan practiced family and community medicine in the Mankato area for 35 years. He now does consulting for hospitals, clinics, and physicians interested in developing integrative medicine programs or practices.