Wellness seems to be the current buzzword on everyone's lips. The larger question, however, is precisely what will be needed to truly achieve wellness. On Feb. 23, 2009, concurrent with the Institute of Medicine's Summit on Integrative Medicine and the Health of the Public (see the Public Health column), two acupuncturists from the Tai Sophia Institute, in Laurel, Md., were able to testify before the Senate Committee on Heath, Education, Labor & Pensions (HELP) to share their recommendations for policy changes to help put the American health care system on the path to wellness. Robert M. Duggan, MA, MAc (UK), Dipl. Ac. (NCCA), co-founder and president of Tai Sophia, and Sister Charlotte Rose Kerr, RSM, RN, BSN, MPH, MAc (UK), Professor Emerita at Tai Sophia, took time out of their busy schedules to tell Acupuncture Today not only the message that they took to Capitol Hill, but how it was received.
Acupuncture Today: How did you come to participate in the Senate hearings?
Robert Duggan: We received a formal invitation letter from U.S. Sen. Barbara Mikulski (D-MD), who is from Tai Sophia's home state of Maryland. She has known of our work for 30 years.
AT: What do you feel are the three biggest challenges facing the current state of health care in this country?
RD: First, that 45 million Americans are uninsured. Second, that the United States is ranked 37th in the world for care outcomes, yet this is at double the cost of other countries. Third, that people don't get care unless they are actually sick. We have to turn around all three of these. The public knows that our current health care system is no longer sustainable.
AT: Health care reform is clearly one of President Obama's top priorities. What role does each of you see for wellness care/integrative medicine within a reformed health care system?
RD: Health care has gotten dramatically more expensive, less accessible and of lower quality, across the board, without a doubt. The changes we need to see are a national movement toward a wellness system in which people rediscover how to keep themselves healthy. We will see a smaller health care system and a larger wellness movement that will be part of our culture.
I believe that integrated medicine focused on treating disease will be a subset of a larger wellness movement. It is clear that 70 percent of individuals have chronic conditions that can be self-managed without access to the disease care system. A key part of the future is for all health professionals to give up their turf-dividing licenses and learn to collaborate as healers enabling individuals and families in most situations to be able to be their own primary care provider.
CK: Don't just change health insurance. Change the paradigm to focus on health and wellness based on an ecological world view. Some examples of what must come up/improve are: Health outcomes; patient satisfaction and empowerment; caregivers/providers' satisfaction; and a delivery/system that functions collaboratively. Some examples of what must come down are: The number of people with no access to health care; the cost of a broken system that rewards doing too many tests and giving too many drugs, which produce too few results; the escalation of chronic diseases to include a younger and younger population; and the stress and alienation felt by individuals and families, as well as providers, who have a pervasive feeling that no one is on their side.
AT: What sort of reception toward wellness care/integrative medicine did you sense among the senators? Did they appear favorable?
RD: They were definitely favorable toward the concept of wellness. If you listen to the hearings, the senators made it very clear that this is all about wellness rather than integrated medicine. Integrated medicine is just a subset of integrated wellness.
CK: The Senate working groups on prevention and public health (Sen. Tom Harkin, D-IA), and health care quality (Sen. Mikulski) firmly believe that a system that rewards health promotion, wellness and quality in health care delivery will not only restore the vitality of American lives but also save money.
AT: Can you summarize some of the major take-home points from the hearings?
RD: We need a White House Office devoted to wellness, demonstration projects and wellness offices within each federal department.
CK: An integrative health approach utilizing primary care/self care, complementary and alternative medicine, and assistance in addressing behavioral and lifestyle issues would be a quantum leap forward. We must invest in public health infrastructure.
AT: Anything else you would like to add?
RD: The question becomes for practitioners of acupuncture and Oriental medicine: Do they see themselves primarily as doctors fixing disease in competition with other providers, or are they healers collaborating closely with other caregivers and community educators, teaching people to live well? Most acupuncture practitioners that I know are primarily about assisting people to learn to live well; essentially they are patient educators. However, I do not believe the leaders of the profession have focused on that as the essential gift of the profession to the nation in this time of crisis.
CK: Listening to my colleagues and fellow presenters, I was and am filled with respect and admiration for their persevering and creative contributions to the domain of integrative health.