Upper LobbyHow long does it take to heal - a doctor?
Upper LobbyHow long does it take to heal - a doctor?
As the United States wrestles with a chronic disease epidemic most experts would agree that lifestyle medicine is the most important solution. But most doctors are not effectively trained to address behavior change in their patients.
For twenty years, The University of Arizona Center for Integrative Medicine (AzCIM) has been developing innovative curriculum around lifestyle change. An early adopter of online learning, AzCIM currently trains 130 fellows per year and licenses its 200-hour online residency curriculum to 70 residencies around the world.
To determine whether training IM physicians leads to improved patient outcomes, AzCIM opened The University of Arizona Integrative Health Center (UAIHC) in 2012 to provide and measure outcomes of adult integrative primary care. UAIHC delivers a team-based approach that combines conventional primary care (by AzCIM fellowship trained physicians) with providers of nutrition, mind-body, chiropractic, acupuncture, and health coaching. To evaluate the integrative approach, a comprehensive evaluation design was implemented and includes longitudinal assessment of patient self-report wellbeing measures, clinical outcomes, patient and provider integrative practice fidelity measures, and cost effectiveness.
Preliminary results for self-report measures reveal statistically significant improvements in mental, physical, and overall health; work productivity and activity; and overall well-being (n=165). Statistically significant increases from baseline to 12-month follow-up were found on the Short-Form Health Survey (SF-12) general item scale and Physical and Mental Health scales (p = .002). A 12% improvement on the World Health Organization Well-Being Index (WHO-5) was also observed (, p < .001). Employed patients (n=101) reported a significant decrease in overall work impairment on the Work Productivity and Activity Impairment Questionnaire (p = .002). A significant decrease in overall activity impairment was reported among all patients (p = .02).
Preliminary fidelity results (n=83) indicate most patients felt practitioners understood their values/beliefs about health (91%), knew about their worries/stressors (87%), explained things clearly (99%), and carefully listened (94%). Patients reported that practitioners discussed specific interventions to improve health (96%), helped them to change habits (95%), felt practitioners attended to their emotional well-being (94%), spent enough time with them (92%), and cared about their health as much as they did (93%). On a 10-point scale, 93% of patients rated trust of their practitioner at 7-10. Ninety-seven percent would recommend UAIHC to others. Examination of practitioner fidelity, clinical outcome and cost effectiveness results are underway.
The AzCIM model of IM training is effective in teaching physicians to provide lifestyle medicine and improving outcomes of care.
Victoria Maizes is the Executive Director of the Arizona Center for Integrative
Medicine, and a Professor of Medicine, Family and Community Medicine, and
Public Health at the University of Arizona.
Maizes is internationally recognized as a leader in integrative medicine. She
stewarded the growth of the Program in Integrative Medicine from a small
program educating four residential fellows per year to a Center of Excellence
training over 500 fellows and residents annually. She was responsible for developing the
Center's curriculum in integrative medicine and pioneered multiple educational
innovations including Integrative Medicine in Residency, a national model for
educating primary care physicians that is used at 70 residencies across the US
and Canada, and the Integrative Health and Lifestyle Program for allied health
founding education co-chair of the Consortium of Academic Health Centers for
Integrative Medicine, Dr. Maizes led a team of educators to create objectives
for medical students in integrative medicine. Together with her team at the
University of Arizona Center, collaborating partners, and a cooperative agreement
with HRSA she is developing interprofessional meta-competencies and an online
curriculum in integrative health.
Dr. Maizes is passionately committed
to helping individuals live healthier lives and pioneering change efforts that
solve US health care system problems. In addition to the
national educational programs, she led a team to develop an innovative,
integrative primary care clinical model, and is carrying out research to assess
the clinical and cost effectiveness of integrative care.
Maizes graduated from Barnard College of Columbia University, received her MD
from the University of California, San Francisco, completed her residency in
Family Medicine at the University of Missouri, Columbia, and her Fellowship in
Integrative Medicine at the University of Arizona.
Dr. Maizes is the co-editor of Integrative Women’s
Health (Oxford University
Press 2010; 2nd edition to be released 2015) and the author
of Be Fruitful: The Essential Guide to Maximizing Fertility and Giving Birth
to a Healthy Child (Scribner 2013). She lectures worldwide to academic and
community audiences on integrative medical education, women's health,
nutrition, environmental issues, cancer, and healthy aging. In 2009, Dr. Maizes was named one of the world’s 25 intelligent
optimists by ODE magazine.