SPECIAL REPORT 2020
THE REGION’S BUSINESS MAGAZINE
THE UNIVERSITY OF ARIZONA
ANDREW WEIL CENTER FOR INTEGRATIVE MEDICINE
25th Anniversary
82 BizTucson
<<<
Spring 2020
www.BizTucson.com
BizHEALTH
Dr. Andrew Weil Integrative Medicine’s Visionary Force
The front-row seat to the future of medicine belongs to Dr. Andrew Weil – founder and director of the Andrew Weil Center for Integrative Medicine at the University of Arizona. His boundary-pushing efforts are the force behind healthcare’s increasing focus on a whole-person approach to healing. The model he has created is stirring new buzz as it reaches across multiple disciplines in ways that are reducing costs, improving patient outcomes and re-designing the education of health practitioners. “The term ‘integrative medicine’ is now totally accepted in academic discourse – and poised to influence changes in healthcare,” Weil said. “The majority of the nation’s medical schools now have Integrative Health initiatives either in clinical care, research or education – and there are waiting lists for our fellowships and other programs. We’re opening a model integrative clinic with Banner Health that will be replicable and sustainable.” Weil’s relentless advocacy for integrative healthcare took a significant step forward last year, with his $15 million gift to name the integrative medicine center at UArizona and establish two endowed chairs and an endowed fund for the internationally recognized program. Construction of the center’s new home on campus is slated to begin in the fall, ensuring the school’s status as the pioneer in integrative medicine education, research and innovation. Propelling a whole-person approach to health is Weil’s lifetime passion, rooted in his Philadelphia upbringing. Weil’s grandmother and mother – enthusiastic gardeners who planted bulbs in their rowhouse window boxes – encouraged his love of plants. Attending Philadelphia’s Central High www.BizTucson.com
School reinforced these botanical interests, and in his senior year, a bulletinboard notice led Weil to enter a national essay contest. He placed as a semi-finalist and won a full scholarship to an experimental school that enabled him to travel internationally for an academic year and experience other cultures. On his return, Weil entered Harvard University, where he majored in biology with a concentration in botany under Professor Richard Schultes, known as the godfather of modern ethnobotany. His career interest in medicinal plants began here. Weil continued to study the properties of medicinal and hallucinogenic plants through his training at Harvard Medical School, and received his medical degree in 1968. For nearly a decade, Weil pursued journalism more than medicine as a career – traveling and writing about indigenous healing systems. It was on one of these trips – he planned to drive to Oaxaca, Mexico to deliver a baby for a friend – that Weil’s car broke down in Tucson. His first experience in the Sonoran Desert was transformative. “I had always loved cactus, and grew them in my dorm room,” Weil recalled. “I remembered seeing Walt Disney’s ‘The Living Desert’ as a kid, and that film – shot in and around Tucson – made a strong impression on me. So, I decided to stay, and rented an old stone house at the mouth of Esperero Canyon.” From his desert hideaway, Weil continued writing for various magazines – until the UArizona asked him to do a lecture on cannabis. “The lecture, for first- and second-year students, was well received and the organizers of the course – in Human Behavior and Development – asked continued on page 84 >>> Spring 2020
>>>
BizTucson 83
PHOTO: BRENT G. MATHIS
By Monica Surfaro Spigelman
BizHEALTH continued from page 83 convinced me to back up a step and create a me to stay on as an adjunct professor,” he said. fellowship for physicians who had completed “I had been rootless, making my living as a their residency training.” journalist, and it was nice to have ties to an inIn 1994, from a room in a trailer in the stitution. Cannabis was the subject of my early College of Medicine’s parking lot, Weil estabwork. I diversified by giving lectures on my new lished the world’s first program in integrative interests in alternative medicine (no one knew medicine. what that was), healing and mind-body interac“We began by inviting leaders from 12 diftions.” ferent fields to a weekend retreat, where we The lectures at the UArizona College of hammered out the basics of a curriculum in Medicine became the basis of Weil’s first book, integrative medicine. Then, we advertised for “Health and Healing,” which laid out the phiphysicians to come to Tuclosophy of what would son for a two-year fellowlater become integraship. Four came.” tive medicine. That “For the first few years, popularized Weil as we trained just four docthe guru of alternative tors at a time,” Weil said. medicine and elevat“Since then, we have ed his leadership in a trained thousands more fringe movement that through an online fellowevolved into a mainship (with residential weeks stream phenomenon. in Tucson). Our graduWeil never intended ates are in all specialties, to see patients, but not only from the U.S. when they started but from many countries showing up at his Tucaround the world.” son doorstep after the Weil’s work at AWCIM book and the lectures, has brought healthcare to he reluctantly got into an inflection point. From it. “At first, I said I was the original four residenpracticing natural and tial fellows, the center’s preventative medicine. portfolio now includes a Sometime later, I came trail-blazing in-residency to use the term ‘integraprogram, as well as leadtive.’ ” – Dr. Andrew Weil ing-edge research that inRobert Fulford, an Founder forms education, technolold-fashioned Tucson Andrew Weil Center ogy and practice. osteopath, became for Integrative Medicine Weil has also extended Weil’s mentor. “I had his teachings to the comjust chased around the munity at large – creatworld looking for healing online learning platforms, authoring new ers, and here in Tucson was the person who books and founding a group of True Food had the most to teach me, especially about the Kitchen restaurants (one of which may soon healing power of nature,” said Weil, who procome to Tucson). Weil lectures and continues duced a video on Fulford in 1986. his outreach through podcasts and appearancUntil this time, Weil had a marginal relaes on national television, including “Dr. Oz” tionship with UArizona. But all that changed and “Oprah.” He’s thinking about a new matwhen James Dalen became dean of the Colcha bar for downtown and writing a soon-to-be lege of Medicine. Dalen brought Joseph Alppublished cookbook with his daughter, Diana. ert, a good friend of Weil’s from Harvard, from Fulfillment for Weil also involves keeping the University of Massachusetts to be chief of centered at home in his routines, surrounded medicine. by three adoring Rhodesian ridgebacks, tend“Joe and I had dinner shortly after he aring his lush vegetable garden or cooking a meal rived, and he asked me what I wanted to do, for friends. “For a lot of my life, I’ve felt that I now that I ‘had friends in high places,’” Weil was ahead of the times,” Weil said. “I feel very recalled. “I said I wanted to change all of medfortunate that I’ve lived to see the mainstream icine by creating a residency in a field called catch up with all this.” integrative medicine. We met with the dean, but since the field didn’t exist yet, Jim Dalen Biz
“
The term ‘integrative medicine’ is now totally accepted in academic discourse – and poised to influence changes in healthcare.
84 BizTucson
<<<
Spring 2020
PHOTO: BRENT G. MATHIS
”
www.BizTucson.com www.BizTucson.com
www.BizTucson.com
Spring 2020
>>>
BizTucson 85
BizHEALTH
Integrative Medicine Comes of Age
A History of the Andrew Weil Center for Integrative Medicine By Monica Surfaro Spigelman
The landscape in modern medicine is shifting, and the Andrew Weil Center for Integrative Medicine at the University of Arizona is at the core of this disruption as it reaches 25 years. When Dr. Andrew Weil arrived on the scene in the 1970s, Tucson was already well known for the health benefits of a dry, sunny climate. The Desert Sanatorium on Grant Road was a popular gateway to personal rejuvenation and treatment of chronic illness. Although a depression and a world war spurred the sanitorium’s demise, Tucson reshaped itself as a health mecca, with dude ranches, nature trails, retreat houses, therapy centers and health resorts all capitalizing on the desert surroundings. In 1975, UArizona invited Weil to lecture medical students on marijuana and alternative modalities. By the 1980s, those lectures on mind-body interaction and healing became part of the UArizona’s College of Medicine curriculum. His theories were compiled in his bestseller, “Health and Healing,” a book that clarified the changes needed in medicine and opened the door to discussions of an integrative scope in the field. “Cannabis was my old work – my new interest was in alternative therapies,” Weil said. “I had no illusions at the time of changing things in medical school, but I 86 BizTucson
<<<
Spring 2020
wanted to teach students about a natural, preventative and more integrative practice of medicine.” Weil proposed the creation of a new residency in integrative medicine to the College of Medicine in 1993. Dean Jim Dalen, who took a significant risk among his peers to support Weil’s vision, recommended beginning the program as a fellowship. A panel of experts convened to develop a curriculum and, in 1994, UArizona established the world’s first Program in Integrative Medicine, with Weil focusing the mission on education, clinical care and research. The two-year residential fellowship, the cornerstone of the AWCIM’s educational programs, ultimately was established in 1997, funded completely by private donors. That same year, UArizona’s first Integrative Medicine Consultative Clinic opened, providing broad-reaching consultations and recommendations for preventive care for the community. For the next decade, Weil and the school focused on longterm needs of this emerging field. Scalability was key for his program. Together with seven other medical schools, UArizona founded the Consortium of Academic Health Centers for Integrative Medicine (recently renamed the Academic Consortium for Integrative Medicine and Health) to help www.BizTucson.com
shape standards and curriculum. Weil’s two-year residential fellowship for primary care physicians was adapted as an online program with three weeklong residential intensives. In addition to training midcareer physicians from a full range of medical specialties, the fellowship also attracted nurse practitioners and pharmacists. Emerging Leadership
In 2000, one graduating residential fellow was tapped by Weil to become executive director of the growing program. Dr. Victoria Maizes, who was already internationally recognized as a public-health leader, helped steward the program and engage new collaborators. Multiple innovations followed her appointment. “How you help people lead healthy lives had been a central thread throughout my career,” Maizes said. “Dr. Weil is a brilliant visionary and I knew our collaboration could take the program further.” With support from the U.S. Department of Education, an integrated Family Medicine Residency was developed with six partner institutions selected from urban and rural settings. In 2008, an IM in Residency training model was developed and merged into the residency curriculum at eight family medicine programs, which piloted the initiative. That same year, the program was designated as a Center of Excellence and officially named the Arizona Center for Integrative Medicine. The National Institutes of Health awarded the center a National Research Service Award Institutional Research Training Grant in 2001. Bravewell, a collaborative of leading philanthropists, launched a Bravewell Fellows Program at the center in 2005. In 2007, Weil was among six integrative medicine leaders whose pioneer work was honored by the Bravewell Collaborative. By 2010, the center had entered negotiations with the prominent North American certifying entity, American Board of Physician Specialties, to develop board certification in integrative medicine. The center also hosted the first national conference on integrawww.BizTucson.com
MILESTONES
tive mental health. With demand growing, the fellowship began accepting two classes per year in 2011. The IM philosophy, education and practice were enthusiastically embraced by UArizona medical students, who created an IM club with center faculty serving as advisors. Student interest inspired an expansion of the medical student elective and the development of the IM distinction track led by Dr. Randy Horwitz in 2011.
1994
Program in Integrative Medicine established.
1997
Residential Fellowship program began enrolling four physicians per year.
Evidence and Environment
1999
Integrative Medicine Consultative Clinic developed at the University Medical Center.
Research continued to be the crucial component to quantify the advantages of IM and build a durable model. Dr. Esther Sternberg, a rheumatologist and biomedical researcher at the National Institutes of Health, whose pioneering discoveries in the science of mind-body interactions caught the attention of Weil and Maizes, was invited to speak at the center’s 2010 Integrative Mental Health Conference and ultimately joined the center as director of research in 2012. Sternberg also joined the faculty of the UArizona College of Medicine and established the Institute on Place, Wellbeing & Performance – linking the College of Architecture, Planning and Landscape Architecture with the College of Medicine and the AWCIM to fully encompass the role of the built and natural environment in health, well-being and healing. The institute’s spotlight on sensorand evidence-based design and health research linked its expertise with industry, government and other UArizona partners, including the College of Science, Department of Psychology, College of Engineering, College of Nursing and Data Science Institute, among others. Multiple studies using wearable sensors, as well as new devices of the center’s own design, measure the effects of the environment on human health. Building the Bottom Line
Given the national conversation on healthcare costs, the center sought to validate the cost effectiveness of the IM primary care model. With the opening of the University of Arizona Integrative Health Center in Phoenix in 2012, the center began a three-year continued on page 88 >>>
PIM, together with eight other medical schools, founded the Consortium of Academic Health Centers for Integrative Medicine. Renamed the Academic Consortium for Integrative Medicine and Health, it has grown to 76 North American members.
2000
New Fellowship program began enrolling 40 physicians, nurse practitioners and physician assistants. In 2010, the 1,000-hour curriculum with residential weeks expanded to two classes per year.
2002
2002–2007 PIM awarded a $1.3 million NIH T32 Research Training Program Grant for 20 fellows, as well as a $5 million Center for Pediatrics NIH grant.
2004
Integrative Family Medicine national initiative was launched at six residency sites creating a joint family medicine residency/integrative medicine fellowship. Annual Nutrition & Health Conference convened (2004–2019) Environmental Health Meeting (2004–2018) Integrative Mental Health Conference (2009, 2010, 2019)
2005
Bravewell Fellows Program awarded 88 scholarships over six years. Alumni Association founded.
Spring 2020
>>>
BizTucson 87
BizHEALTH
MILESTONES 2007
Jones-Lovell Endowed Chair in Integrative Rheumatology established – Dr. Andrew Weil recipient.
2008
Integrative Rheumatology offers fulltuition scholarships to fellowship for academic rheumatologists. Twelve Jones-Lovell Rheumatology scholarships awarded to date. PIM designated a Center of Excellence by unanimous vote of the College of Medicine deans and center heads, and confirmed by the Arizona Board of Regents, becoming the Arizona Center for Integrative Medicine. Integrative Medicine in Residency – National curriculum in integrative medicine launched in eight family medicine residencies. Currently 85 institutions have adopted the curriculum in five specialties – Family Medicine, Internal Medicine, Pediatrics, Psychiatry, and OB/GYN.
2009
Oxford University Press began publication of the Andrew Weil Integrative Medicine Library, a 17-volume textbook series to date.
2011
The Integrative Medicine Distinction Track was unanimously approved by the UA College of Medicine. To date, 10-15% of each medical class has enrolled.
2012
AWCIM opened UArizona Integrative Health Center, a three-year pilot project designed to provide world-class integrative primary care and study the model of care.
88 BizTucson
<<<
Spring 2020
continued from page 87 research project to develop that model, study outcomes and fuel the national conversation on insurance reimbursement for IM and preventive medicine. The complex discussion for board certification that had begun several years earlier came to fruition in 2013, with the founding of the American Board of Integrative Medicine. AWCIM’s Horwitz was nominated and selected as the founding chair. Competencies were determined and a validated exam was created. In 2015, the first diplomats were awarded board certification. The first national online pediatric integrative medicine curriculum also launched in 2014 at six sites in partnership with many fellowship alumni. Complementing its physician education, the center developed a shorter fellowship to train allied health professionals that same year.
Awareness of and support for the field of integrative medicine now was reaching across specialties and professions. The center established the National Center for Integrative Primary Healthcare in cooperation with the Academic Consortium for Integrative Medicine and Health and the Health Resources and Services Administration. The NCIPH has continuing impact on interprofessional healthcare team training, and was responsible for creating a 33-hour Foundations in Integrative Health online course, the first of its kind. FIH is currently in use at 79 sites around the nation, as well as by the Allina healthcare system, which offered FIH to its 25,000 employees. The VA licenses the course for 2,000 users each year. The ‘Well-Being of Place’
Sternberg’s focus on collaborations has led to new studies measuring the impact of the built environment on human health and www.BizTucson.com
gathering for design-related industry professionals. At the 2016 AIA Convention in Philadelphia, they presented their work in an interactive, immersive experience called “Rooms for Wellbeing.” The exhibit engaged visitors in simulations and used wearable sensors to show effects of environmental factors on stress responses. The exhibit won “Best in Show, Small Booth Category” and AIA plaudits. The center and the institute have continued to lead the way in research employing wearable devices to measure health and performance. Collaborating again with government, military and industry partners, the institute has developed a sweat biomarker device program, which aims to non-invasively measure molecules in sweat.
MILESTONES 2014
The Institute on Place, Wellbeing & Performance established as a collaboration between AWCIM, the College of Medicine–Tucson, and the College of Architecture, Planning and Landscape Architecture.
2015
well-being. After coming to UArizona, Sternberg continued her now 20-year collaboration with the U.S. General Services Administration, in a project called “Wellbuilt for Wellbeing.” The project uses wearable devices to measure the impact of the built environment on health, wellbeing and performance. “The GSA is the government agency that builds and operates all non-military federal buildings with more than 370 million square feet for over one million employees,” she said. “Our collaborations are tracking the environmental factors that affect workers’ happiness, health and productivity. We’re also studying the effectiveness of IM interventions on performance.” Sternberg and her GSA colleagues have presented their findings globally, including at the National Institutes of Health, the American Institute of Architects and the Greenbuild International Conference and Expo – the world’s largest www.BizTucson.com
The Integrative Health Coaching program launched and in 2017 became one of the inaugural groups to receive certification by the new National Board for Health & Wellness Coaching. AWCIM awarded a HRSA grant to establish the National Center for Integrative Primary Healthcare.
Tools for Digital Natives
The center has fully embraced technology as a creative partner in IM online programming. An Integrative Health and Lifestyle program (known as IHeLp) is open to a variety of allied professionals, and the center will soon release its My Wellness Coach, the center’s first interactive self-care app for the public. More specialized courses for techsavvy, next-generation medical professionals are in development. The center has launched a free online integrative cancer-care tool kit to help as a public resource. Eight episodes of the center’s first public podcast will air this spring. In 2020, the horizons of IM appear unlimited, impelled by Weil’s recent $15 million gift to establish the new name of the Andrew Weil Center for Integrative Medicine. His investment, added to his previous $5 million gift, also established the Andrew Weil Endowed Chair in Integrative Medicine, the Andrew Weil Endowed Chair for Research in Integrative Medicine and the Andrew Weil Endowed Program Fund for Integrative Medicine. In 25 years, AWCIM has grown from a buzzword to a collective enterprise of education, practice and research, positioning IM in the forefront of medicine.
The Integrative & Healthstyle program (known as IHeLp) launched to train licensed health professionals including nurses, dietitians and therapists.
2017
My Wellness Coach debuted, an online tool designed to result in wellness for underserved patient communities.
2019
CanHEAL: Cancer Health Empowerment, Advocacy and Learning pilot project launched AWCIM’s first free, in-depth, online patient-centered toolkit for integrative cancer care. $15 million gift from Dr. Weil, renaming the center as Andrew Weil Center for Integrative Medicine. In development: Specialist-specific IMR programming will provide a short curriculum to residency programs in Emergency Medicine, Anesthesia, Surgery and OB/GYN.
Biz
Spring 2020
>>>
BizTucson 89
90 BizTucson
<<<
Spring 2020
www.BizTucson.com
BizHEALTH
Dr. Victoria Maizes Guiding a Global Integrative Medicine Movement
If Dr. Weil is the soul of the Andrew Weil Center for Integrative Medicine, then Dr. Victoria Maizes is its gravitational pull – the powerhouse mix of vision, pragmatism and knack for gathering like-minded talent to wake the world up to the notion that health is interrelated. Maizes took the helm as the center’s executive director in 2001, helping grow a small program to what is now the most significant integrative medicine program in the world. Maizes senses that the time is right to continue this innovative repositioning of a broader, more collaborative approach in medicine. “As a society we thought conventional medicine would have the answers for everything,” she said, pointing to exciting developments around antibiotics, treatment of high blood pressure and joint replacements. “Medicine has done an amazing job and we continue to have advances that are truly remarkable. At the same time, we have a society with chronic diseases related to our lifestyle. And sadly, conventional medicine has not made healthy lifestyle a significant focus.” That’s a big part of integrative medicine – paying tremendous attention to people’s lifestyle – and training practitioners so they’re more comfortable discussing lifestyle and behavior changes. “Integrative medicine education is challenging the system to take on nutrition and physical activity, sleep, people’s www.BizTucson.com
relationships, environmental exposures and spirituality. We’re looking broadly at the root of what it is that makes us healthy or, sadly, more ill,” Maizes said. She was born and raised in New York City’s borough of Queens. Maizes’ parents were educators who stimulated her interest in public health. “I came into the world wired a certain way – and was always interested in what it meant to help people to stay healthy,” she said. At Barnard College, she fashioned her own major focused on health and society. Maizes then received her medical degree from the University of California, San Francisco. She completed her residency in family medicine at the University of Missouri, Columbia. With public health a central thread in her career, Maizes joined the Santa Rosa, Calif. Kaiser Permanente health maintenance organization, and led a re-engineering effort. She became the chief of its strategic education. “As I became more passionate about patient-centered healthcare, I heard that Dr. Weil had started a fellowship program in Tucson,” she recalled. “I wasn’t feeling good about how the experience of practicing medicine had become an ever faster treadmill. It was going too fast and not looking closely at the root causes of illness. So, I came to interview with Dr. Weil. When I felt the mission of the program and my own continued on page 92 >>> Spring 2020
>>>
BizTucson 91
PHOTO: BRENT G. MATHIS
By Monica Surfaro Spigelman
continued from page 91 personal mission were so well-aligned, I moved from California to the desert. When I graduated from the fellowship, Dr. Weil asked if I could step into leadership, and I did.” Now, as the AWCIM director and inaugural holder of the Andrew Weil Endowed Chair in Integrative Medicine, Maizes works with Weil to expand the fellowship program’s global reach. She helped create the IM in Residency program to give foundational training to physicians. It is scalable – currently licensed at 87 institutional programs. Under her leadership, AWCIM also developed programs ranging from certification to self-paced online training, elective rotations and stand-alone continuing education. As founding co-chair of the education committee of the Consortium of Academic Health Centers for Integrative Medicine – which represents more than half of U.S. medical schools – Maizes also led a team of educators in developing objectives for medical students in IM. “Now we have growing numbers of medical schools addressing the mind-body interaction,” she said. “We’re not just teaching nutrition as part of biochemistry, but teaching cooking. The mind-body interaction is studied. The context of medical training is changing dramatically, and we’re talking about the social determinants of health in a different way.” This transformation in medicine to a total-person approach is hitting its stride with the announcement of a new home for the Andrew Weil Center for Integrative Medicine on the UArizona campus. “It will be a campus, not just a building, housing innovative spaces themed around mind, body and spirit, all connected with spaces for people to walk in nature,” Maizes said. Among the center’s accomplishments, Maizes noted its early adoption of online interactive technology for practitioner training. Digital tools also are part of the center’s plan to encourage individuals across all socio-economic levels to take responsibility for wellbeing. Also, speaking to community needs, the center plans to open an integrative primary care clinic with Banner-University Medical Center Tucson. Maizes acknowledged a personal stake in this movement. She has a “learned appreciation” for the desert, embracing it routinely on hikes, or walking her river-rock home labyrinth. Candidly, she admitted that she was uncomfortable in this landscape when she first moved to Tucson two decades ago from California. “But I quickly learned that there is a way in which the desert makes you mindful,” she said. Maizes said the desert has taught her a new respect for ritual as a conduit for wellness. AWCIM incorporates a Native Americanstyle purification lodge as an optional activity for fellows, and even uses a talking stick within education programs. “We are respectful of where ceremonies originate and feel they are a very important part of medicine,” she said. “In facing suffering, medicine encounters more intimate experiences than other professions. Ceremony is one way we teach people how to hold this.” The desert is also the perfect center for the progressive integrative medicine movement. “It’s not surprising that Dr. Weil found an openness to his ideas here – the desert is not hierarchal, with only one point of view,” she said.
‘Body of Wonder’ Podcast Offers Health Tips to Public The “Body of Wonder” podcast is a new media program, launched by the Andrew Weil Center for Integrative Medicine, that will dive into the latest integrative health news and research findings, and offer the public tips on steps toward a healthier life. Drs. Andrew Weil and Victoria Maizes will host the podcast, with the first season set to air eight episodes recorded at Weil’s Tucson home. The show will be available for free through a link on the AWCIM website, or through a number of channels including Apple iTunes Podcast, Google Play Podcast, Spotify and YouTube. In Season One, the podcast’s first guests include Deepak Chopra on consciousness, science journalist Donna Jackson Nakazawa on the latest breakthroughs in brain immunology and hope for neurodegenerative diseases like dementia, and Bonnie Kaplan, who will discuss the critical role of nutrients in mental health and development. The show is designed for anyone interested in improving health through integrative health and wellness practices. Questions for Weil, Maizes or podcast guests may be submitted via email to AWCIM, or coming soon, through this link: azcim.org/body_of_wonder.html. There will also be opportunity for listeners to leave questions through recorded voice messages which may be used in the show’s public broadcast.
Biz
Biz
92 BizTucson
<<<
Spring 2020
www.BizTucson.com
BizHEALTH
Integrative Medicine Primary Care Clinic Planned Patients Partner with Health Team By Tara Kirkpatrick A new primary care clinic that puts into concrete practice the promising tenets of integrative medicine is planned to open in partnership with BannerUniversity Medical Center Tucson. Motivation for the adult clinic, planned for north Tucson in 2021, is fueled by the success of the University of Arizona Integrative Health Center – a pilot project in Phoenix that operated from 2012 to 2016 and received high satisfaction reports from its patients. “We believe Tucson is a pretty big market for us because of Dr. Andrew Weil’s reputation and there is demand for a model like this,” said Dr. Robert Crocker, director of strategic clinical planning and implementation for the Andrew Weil Center for Integrative Medicine. “We know this model to be effective.” The UAIHC in Phoenix offered patients evidence-based, prevention-aimed approaches that combined conventional and complementary medicine. Patients met extensively with primary care physicians but also had access to a chiropractor, acupuncturists, behavioral health clinicians, a dietician, a health coach and a nurse. Patients were also ofwww.BizTucson.com
fered courses on stress reduction, nutrition and lifestyle, and could take yoga and tai chi classes there. They paid for the services with a hybrid model, combining health insurance reimbursement and membership fees, paid individually or by patients’ employers. For example, many of the Phoenix patients were employees of Salt River Project, one of Arizona’s largest utilities that partnered with the UAIHC to allow their workers to receive the clinic’s services. “Much of our success was because we were working with an employer,” Crocker said. “The result was that a number of their employees sought care at the clinic.” A 2017 study authored by Crocker and others in “BMC Complementary and Alternative Medicine” noted that of 83 UAIHC patients who evaluated their experience, 97.6% definitely felt they received enough time with practitioners, 100% felt they were cared for as a person, 100% felt the practitioners respected what they had to say and 100% trusted the practitioners with their health. “That is powerful,” Crocker said.
“This really is whole-person, patientcentered care. You see the physician first, they spend a lot of time with you – an hour or more. You work together as partners to come up with a treatment plan.” The Tucson clinic would operate the same way. Crocker and his team are currently evaluating which practitioners would be included in the health team. All would need to have integrative medicine training. At the UAIHC, IM fellowship training was required for the primary care doctors and the staff completed a two-week online training – Introduction to Integrative Medicine – which included a thorough overview of current literature and approaches to treating common conditions such as diabetes and cardiovascular disease. “It’s important for us to find the very best people who are eager to work in this integrative medicine model and in a team environment,” said Crocker. The clinic is also looking for local employers to partner with as SRP did in Phoenix. “That from our perspective was a win-win,” he said. “We want to work with employers to create a culture of wellness.” Biz Spring 2020
>>>
BizTucson 93
BizHEALTH
Dr. Esther Sternberg Designing a Healthier Workplace
PHOTO: BRENT G. MATHIS
By Monica Surfaro Spigelman Dr. Esther Sternberg is working to bring a sense of place to wellness. As Director of Research and Inaugural Andrew Weil Chair for Research in Integrative Medicine, Sternberg’s work in the science of mind-body dynamics is helping to deliver the evidence needed to advance integrative medicine education and practice, and to develop alternative diagnostic devices that measure complex IM interventions on health and well-being. “What do stress, the brain-immune interaction and the built environment have to do with integrative health?” she said. “Everything!” Weil saw this way ahead, Sternberg said. “He knew there needed to be a movement toward a body of proof on how mindbody intervention makes you well.” Sternberg is also the founding director of UArizona Institute on Place, Wellbeing & Performance and holds joint UArizona appointments as professor of medicine and psychology. She first met Weil when she was invited to speak at the center’s 2010 Integrative Mental Health Conference in Phoenix. “I showed a clip of a PBS television special I had created, ‘The Science of Healing,’ based on my book ‘Healing Spaces,’ ” she said. Dr. Gulshan Sethi, a cardiothoracic surgeon who had taken the AWCIM fellowship, and his wife, Neelam, saw the clip and arranged for Sternberg to do a screening of the PBS special at Fox Theatre Tucson. “Dr. 94 BizTucson
<<<
Spring 2020
Maizes moderated a panel between Dr. Weil and me at the showing. It was very exciting,” said Sternberg, whom Maizes later invited to come to Tucson. Sternberg, a senior scientist and section chief at the National Institutes of Health at the time, met with the center’s team about data’s role in IM decision making. “I was a big city East Coast girl who fell in love with the desert,” she said. “I knew my evidencebased work would find a home here.” Sternberg’s vision of new frontiers in IM comes full circle in the center’s initiatives, using wearable devices to measure the impact of the built environment on health, wellbeing and performance. The research also provides foundational knowledge in the center’s core curricula, validating and converting findings to IM practice, which later can impact policy and flourish in the public domain. Her studies are fully embraced in the architectural plans for the center’s new building, which should break ground in 2021. Collaborations across UArizona and in outside networks are helping to accelerate the pace of Sternberg’s research. Teams like the Advisory Committee for the AWCIM’s new complex include architects from the UArizona College of Architecture, Planning and Landscape Architecture, as well as advisors from the U.S. General Services Administration. Other projects, with engineers and chemcontinued on page 96 >>> www.BizTucson.com
Spring 2020
>>>
BizTucson 95
BizHEALTH continued from page 94 ists aiming to develop real-time wearable that he developed. At the time, it was not sensors to measure molecules in sweat, accepted that changing brain chemistry have engaged industry and government could be related to immune disease or that partners, including the Air Force Research stress could cause illness. This was a new Labs. Still others apply these technologies beginning for me.” to measure the impacts of the AWCIM’s Sternberg had a strong upbringing in stress management protocols. science. Both her parents were born in Romania, and her father was a physician who “Partnership is the essential catalyst for was transported to science and technological innovaRussian concentration, and through tion camps in World relationships, we’re War II. Convinced pushing the forehe could find peacefront of integrative ful uses for radiation health to build deafter the war, her favices and programs ther was one of the to optimize health pioneers in nuclear and performance on medicine. an individual basis,” Sternberg worked Sternberg said. in his lab in Canada As she delves into when she was 15 working with big and was exposed to data analytics for discussions with and integrative mediabout physicians, incine – it’s surprising cluding her father’s to learn that data colleague Hans Sewasn’t always Sternlye. This all laid the berg’s main interest. groundwork for her Sternberg reinterest in the body’s ceived her medical response to stress – Dr. Esther Sternberg degree and trained and environmental Director of Research & Inaugural in rheumatology at conditions. Andrew Weil Chair for Research McGill University Sternberg continin Integrative Medicine in Montreal, Canaues to close the loop da, then served on on whole mind-body the faculty at Washhealth through her ington University research and writin St. Louis, Mo. It was a Christmas Eve ings. Her next book on working spaces will emergency consult in Montreal in 1978 be published by Harvard University Press. that changed the course of her life into a Her ongoing collaborations are measuring career of research. stress, sweat molecules and other health “I came from a hard-core biomedical responses under different environmenbackground, and in the course of training tal conditions. She has even advised her as a rheumatologist, I saw a patient with a daughter and son-in-law, trained in architecture and professors at California’s Artvery rare and fatal form of epilepsy who Center College of Design, on a project for was being treated with an experimental a children’s burn center in Chile. drug,” she recalled. She is fully devoted to the promise this “The patient had developed an autoresearch holds: “To create adaptive enimmune scarring inflammatory disease. vironments that monitor health effects It looked like he had third-degree burns across his entire body,” Sternberg said. through wearable sensors and, in turn, link “The neurosurgeons didn’t know what health outcomes automatically through caused the patient’s condition. My very the Internet of Things to the environment first article, in the New England Journal around you to optimize your own health – of Medicine, described the biochemistry this is where the future is headed. It’s not of serotonin in this patient and the disease here yet – but it’s coming.”
“
What do stress, the brain-immune interaction and the built environment have to do with integrative health? Everything!
”
Biz
96 BizTucson
<<<
Spring 2020
www.BizTucson.com
Your Own Wellness Coach Via New App
The Andrew Weil Center for Integrative Medicine’s new wellness support app, called My Wellness Coach, will help individuals over age 18 learn about health, assess current behaviors, then create goals to improve lifestyle choices. My Wellness Coach will facilitate tracking and healthy behaviors in seven core areas – movement, nutrition, sleep, relationships, resilience, environment and spirituality. AWCIM tested the initial app over several years through focus groups and pilots, with input from representatives across the University of Arizona campus. A collaborative evaluation with El Rio Health Center included 40 participants, representing a diverse underserved population, who worked through My Wellness Coach and responded to surveys. Research findings were presented at El Rio’s Research Poster event last year, netting an award for Innovative Research. In 2019, AWCIM began a small study of UArizona athletes utilizing the app. The study will continue through 2020 to see how the app impacts resilience, health and performance in student athletes. Further collaborations, including employee wellness initiatives, are under consideration. My Wellness Coach will be available on the App Store and Google Play. The wellness app will work with any Android phone or tablet (5.1 or higher), as well as iPhone (iOS 12.2 or higher). The tool also will work on an iPad, with both English and Spanish language options. More information on the app is available at selfcare. arizona.edu.
Biz
Spring 2020
>>>
BizTucson 97
BizHEALTH
The Programs
Integrative Medicine Education at Every Level of Medicine By Tara Kirkpatrick When Wisconsin allergist Dr. Randy Horwitz applied for Dr. Andrew Weil’s signature Fellowship in Integrative Medicine in 2002, he was looking for something he had lost – his passion for practicing medicine. “I was in a practice in Madison and I was seeing patients every 20 to 25 minutes,” said Horwitz, now director of the IM Distinction Track for the Andrew Weil Center for Integrative Medicine. “It was like a conveyor belt. I was looking for something else.” So have many doctors since Horwitz. Since beginning with four fellows in 1997, AWCIM now celebrates more than 1,500 fellowship alums throughout 29 countries. Beyond the fellowship, the center has thoughtfully and methodically built a multi-faceted educational program that spans numerous medical specialties, training almost 1,000 new and continuing residents each year. Ultimately, AWCIM programs are now guiding the care of more than 8 million patients. “The initial goal of the fellowship program was to seed the country with leaders in integrative medicine,” said Horwitz. “And initially, it was a lot of doctors who were not satisfied with their medical practice. They were looking to reignite their passion for going into medicine.” Now, it’s not only seasoned doctors, nurse practitioners and physician as98 BizTucson
<<<
Spring 2020
“
We are expanding in different areas, always thinking how can we have the most impact on the practice of medicine.
”
– Dr. Randy Horwitz, Director of the Integrative Medicine Distinction Track, Andrew Weil Center for Integrative Medicine
sistants who want integrative medicine training. Students and residents want in on the growing movement. “There is a new generation coming and people are going for progressive change,” Horwitz said. “It’s a better way to practice medicine. You are taking an all-encompassing look at the patient and it’s more satisfying.” This was a vision that Weil had back in 1993, when he proposed the creation of a new residency in IM. James Dalen, dean of the UArizona College of Medicine at the time, suggested a fellowship model and a two-year, onsite program for primary care physicians was created. “Generous and visionary philanthropists supplied all funding for the program, which assuaged concerns from the dean’s critics who complained that state funds ought not be used to develop an unproven field,” wrote Dr. Victoria Maizes in a 2015 article in the Journal of Integrative Medicine. From 1997 to 2007, the residential fellowship was offered with four then eight fellows in training at any one time. “While the residential fellowship was a transformational experience for the majority of physicians who participated, it depended on philanthropy to sustain it and could only train limited numbers of physicians,” she wrote. “Scalability and financial sustainability were critical to the longterm needs of the field.” That’s when AWCIM took it online, www.BizTucson.com
with three weeklong, hands-on trainings. “Creating a mostly online fellowship was a fruitful gamble,” Maizes explained. “The online platform made it possible to partner with eager learners and gifted faculty anywhere in the world.” The program is now the largest fellowship program of its kind in the nation. “The roots are strong in the fellowship and over time, we have grown the trunk and now we are branching out,” said Horwitz. “We are expanding in different areas, always thinking how can we have the most impact on the practice of medicine.” AWCIM now offers an IM Distinction Track to give medical students access to its tenets at the earliest stages, an IM elective rotation for fourth-year medical students and residents, an IM in Residency program and an IM Pediatrics program and rotation. Combined with the fellowship, these programs comprehensively target practicing physicians, residents and medical students. They fuse conventional approaches with integrative areas such as nutrition, botanicals, mind-body interventions and traditional Chinese medicine. Each program is rigorous in its curriculum. Those are augmented by online courses in IM health and lifestyle, health and wellness coaching, physician wellbeing and, now, in the works are new digital tools for the public to take the initiative in their own health. AWCIM was also instrumental in founding the Academic Consortium of Academic Health Centers for Integrative Medicine in 1999 with eight other medical schools to support and mentor academic leaders, advance IM education, research and clinical care, and to inform healthcare policy. And a decade ago, AWCIM helped create an American Board of Integrative Medicine, with the American Board of Physician Specialties, to offer board certification. “I am most proud that the center is regarded as the world leader in integrative medicine education,” said AWCIM founder Dr. Andrew Weil. “The curriculum we have developed and refined remedies the deficiencies in conventional medical education and prepares doctors and allied health professionals to practice the medicine of the future.”
BY THE NUMBERS Fellowship and Integrative Health & Lifestyle Program 1,500 alumni 570 students 29 countries IM Elective Rotation and IM Distinction Track 540 participants IM in Residency and Pediatric IM in Residency 1,163 graduates 1,000 current residents 87 institutional programs
Biz www.BizTucson.com
Spring 2020
>>>
BizTucson 99
CanHEAL:
A Free Online Cancer Tool Kit CanHEAL is a new online tool kit, developed by the Andrew Weil Center for Integrative Medicine, to be a resource for patients who have just been diagnosed with cancer. This tool kit is already supporting thousands of users who have been touched in some way by cancer. Supported by the Scheidel Foundation, CanHEAL is an information resource that allows individuals to explore questions about the disease or treatment options. Among current users, more than 32% are cancer survivors and more than 25% identify as healthcare providers. Initially designed as a short course for patients, CanHEAL is now a flexible tool, allowing users to click through sections or use a keyword search feature to get answers to health questions. It is easy to explore by phone, tablet or computer. Sections, for example, feature discussions on mood and emotions during cancer care, the impact of environmental exposures and a lifestyle resources unit with wellness education tools. In one section called Care of the Spirit, users can learn more about mindfulness practices, healing rituals, contemplation or gratitude exercises. CanHEAL provides sections that explain how complementary therapies support wellness in conjunction with conventional western medicine treatment. The tool kit also covers side effects, safety, how to look for student clinics and how to find a practitioner. A feedback feature allows users to dig deep or ask follow-up questions. An AWCIM account name and password are needed to access this free community resource. Sign in to gain toolkit access at: cancertoolkit.integrativemedicine.arizona.edu
100 BizTucson
<<<
Spring 2020
www.BizTucson.com
Conceptual Design Imagery Entry/Lobby
BizHEALTH
NEW ANDREW WEIL CENTER FOR INTEGRATIVE MEDICINE:
A Beacon of Integrative Health Worker Wellbeing Drives Design CONCEPTUAL DESIGN IMAGERY: LINE AND SPACE
By Tara Kirkpatrick When the new Andrew Weil Center for Integrative Medicine opens at the University of Arizona, it will offer concrete proof of what a healthy workplace can look like. The 34,000-square-foot complex of glass buildings, planned for UArizona’s north health campus, will showcase what is possible to enhance physical and emotional wellbeing at work – and serve as a flagship to the 25 years of normchallenging medical research and training forged by Dr. Andrew Weil and his devoted team. “It’s such an exciting opportunity – to expand these principles and incorporate them into a building that embodies integrative health,” said Dr. Esther Sternberg, AWCIM’s research director and head of the UArizona Institute on Place, Wellbeing & Performance. Her www.BizTucson.com
pioneering work in healthy spaces set the ambitious vision for the new design. The $20 million project, set to break ground next year, will offer a central headquarters for Weil, AWCIM faculty
and staff, which until now have been scattered across the city in different locations, including the original brick house on Mountain Avenue that served as ground zero for Weil’s transformative efforts in medicine that began in 1994. The new center will also serve as a mini-campus that will incorporate open, light-filled spaces where people can work collaboratively or privately. There will be a teaching kitchen, a “living lab” to test the impacts on health of new building technologies and products, large educational spaces, rooftop gardens and a smart system that allows the windows to open and close easily for fresh air exchange. One unique section of offices will extend like a treehouse over a greenbelt, fed by rainwater runoff. continued on page 102 >>> Spring 2020
>>>
BizTucson 101
BizHEALTH
Conceptual Design Imagery North Elevation continued from page 101 “It’s going to be very focused on being a healthy and productive work environment” said Kieran Richardson, the center’s director of operations. “Not only will it be an example of a healthy work space, we are also going to figure out the ideal positions for how people should work. It’s going to be the endless search for the perfect environment.”
102 BizTucson
<<<
Spring 2020
“We are going to spend a lot of time thinking about the lights,” said Richardson. “There will be a lot of shade structures and angles and landscaping to mitigate the sun, yet still let in that ambient light. I get happy every time I see a new drawing.” There will be a lot of shade structures and angles and landscaping to mitigate the sun, yet still let in that ambient light. I get happy every time I see a new drawing. The building’s vision also calls for nontoxic materials to be used with no “off-gas-
sing” – which happens when chemical compounds from new products such as carpeting or paint evaporate into the air and can trigger sensitivities in people. The center’s “Living Lab” will also focus on testing new “green” products and bioresponsive materials. “We believe that the built environment is an essential component of integrative health, which can help prevent disease and optimize health,” said Sternberg. “Our research has proven that the design of the office environment can affect people’s stress and activity levels, their posture, even their stress levels and sleep quality when they go home at night.
This state-of-the-art office building will embody all these data-driven, science-based principles.” A noteworthy 2018 study in Occupational & Environmental Medicine, authored by Sternberg and her team, found that people in open bench seating were more active at the office than those in private offices and cubicles. That higher activity was linked to lower physiological stress after hours. Other findings in the study, carried out with the U.S. General Services Administration, showed workers who were more active and less stressed also had better sleep. The study is just one example of Sternberg’s international recognition as a leader in mind-body continued on page 105 >>>
Conceptual Design Imagery South Elevation
CONCEPTUAL DESIGN IMAGERY: LINE AND SPACE
www.BizTucson.com
Spring 2020
>>>
BizTucson 103
BizHEALTH
Conceptual Design Imagery Demonstration Kitchen
Lower level floor plan
Upper level floor plan
Conceptual Design Imagery
Yoga/Classroom/Large Conference
104 BizTucson
<<<
Spring 2020
interaction in illness and healing and the role environment plays. Her best-selling books include “The Balance Within: The Science Connecting Health” and “Emotions and Healing Spaces: The Science of Place and Well-Being,” which was recognized by the president of the American Institute of Architects as an inspiration for the group’s Design and Health Initiative. “It’s an incredibly exciting time to work with builders and architects,” Sternberg said. “We have, at this point, a prescription for a healthy building and architects and designers are receiving it with open arms. They want to build healthy buildings and position themselves in the marketplace to show that they care about occupants.” Fittingly, the new center is designed by Line and Space, a Tucson architectural firm led by UArizona grads who also built the Poetry Center on campus. The firm strives for sustainability and environmental stewardship. Donated monastery bells that have resided on the ground floor of the Arizona Cancer Center could move to a planned meditation chapel within the AWCIM center. The university’s Center for Buddhist Studies will also find a new home there. “They needed a home and we saw a lot of synergy with them,” Richardson said. “Our building will serve as a model for healthy buildings and we look forward to welcoming in the community,” he said. “We also plan to connect more closely with the College of Medicine and the hospital. We plan to offer classes and workshops in the educational spaces and make it a community hub.” Biz www.BizTucson.com
Spring 2020
>>>
BizTucson 105
CONCEPTUAL DESIGN IMAGERY: LINE AND SPACE
continued from page 103
BizHEALTH Andrew Weil Center for Integrative Medicine Capital Project
We are currently in the design phase of a new, landmark capital project that will be home to the Andrew Weil Center for Integrative Medicine. The center’s design will reflect the pioneering, innovative spirit of Dr. Andrew Weil and will support AWCIM’s work to inspire the pursuit of health and the transformation of healthcare. We believe the built environment is an essential component of integrative health, central to disease prevention and health promotion. Our research has proven that the design of the office environment can affect people’s stress and activity levels, their posture, even their sleep quality. This state-of-the-art campus will embody all these data-driven, science-based principles and will be an innovative model for buildings anywhere.
FOR LIMITED NAMING OPPORTUNITIES PLEASE CONTACT LaToya L. Singletary Director of Development University of Arizona Foundation Principal Giving at (520) 621-5996 or LaToya.Singletary@uafoundation.org. Other giving opportunities are also available at integrativemedicine.arizona.edu.
From left – Dr. Robert C. Robbins, President, University of Arizona; Dr. Andrew Weil, founder of UArizona Center for Integrative Medicine; Dr. Michael D. Dake, UArizona Senior VP for Health Sciences, and Dr. Victoria Maizes, Executive Director, Andrew Weil Center for Integrative Medicine.
Thanks to Dr. Weil, University of Arizona the Heart of Integrative Medicine Just one year ago, Dr. Andrew Weil ensured the University of Arizona would be the epicenter of the integrative medicine movement with a $15 million gift to the school where his vision began 25 years ago. The noteworthy gift, which Weil said was the high point of his career, has made possible a modern new home for what will now be called the Andrew Weil Center for Integrative Medicine. The money, combined with his earlier $5 million donation, also established the Andrew Weil Endowed Chair in Integrative Medicine, the Andrew Weil Endowed Chair for Research in Integrative Medicine and the Andrew Weil Endowed Program Fund for Integrative Medicine. But more than that, the Harvardeducated physician turned visionary health guru further bolstered his dream for simply good medicine that began with a fellowship here in 1994.
As UArizona President Dr. Robert C. Robbins said in BizTucson in 2019, “All of what Andy has thought of and built upon over the years – you should eat the right foods, you should exercise, you should not smoke, you should get enough sleep, you should manage stress – if we all follow the guidance of our sage leader here, we’ll end up living longer, healthier lives that will be more productive and more fulfilling.” “To have the University of Arizona be the epicenter for this movement around the world, we have derived incredible benefits as a university,” Robbins said. “Andy is right. When you train others to go out all over the world, you can go to any city, any region of the world and find one of your fellows and they’re evangelizing your message all over the world and it came from the University of Arizona.”
Biz 106 BizTucson
<<<
Spring 2020
www.BizTucson.com
PHOTOS: CHRIS MOONEY
Naming Opportunities Available
www.BizTucson.com
Spring 2020
>>>
BizTucson 107