Online Program

A view from the desk of a medical director: Integrative centers and accountable care organizations as approaches to OA

Monday, November 4, 2013 : 10:50 a.m. - 11:00 a.m.

Donald Levy, MD, Osher Clinical Center for Integrative Medicine at Brigham and Women’s Hospital, Brigham and Women’s Hospital, Boston, and Harvard Medical School, Chestnut Hill, MA
Osteoarthritis (OA) presents a clinical dilemma, in part, because our high tech imaging studies and biomarkers of pathology do not correlate well with actual suffering and disability. As a result, purely technological clinical solutions are often disappointing in the long term. Much energy is expended debating “appropriateness criteria” for the latest procedures rather than assessing the nature of the suffering and the actual goal and best type of care needed by each individual patient.

A multidisciplinary integrative healthcare team may be best suited to managing patients with OA. An effective team is comprised of selected “complementary and alternative” providers working side by side with conventionally trained medical doctors. Practitioners have no single shared healing paradigm or philosophy, but may have roots in Western, Asian, naturopathic, manual, functional, nutritional and behavioral medical traditions. All clinicians practice experienced-based and evidence-informed health care with an attitude of mind that preferentially seeks those therapies or therapeutic lifestyle changes that enhance one's innate ability to recover from illness and maintain good health. For OA there is a focus on the patient's physical and emotional experience of illness, education, self-management, prevention and manual and non-pharmacological therapies that strengthen the endogenous joint and supporting structures. This presentation explores the substantial challenges associated with recruiting, credentialing and developing a cooperative team that is capable of effectively caring for patients with OA and communicating via a shared hospital-wide electronic medical record and participating in ongoing education and research.

Learning Areas:

Administer health education strategies, interventions and programs
Administration, management, leadership
Clinical medicine applied in public health
Other professions or practice related to public health
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe osteoarthritis from a medical director's viewpoint, using a social-ecological model (society, community, organization, interpersonal, individual). Explain healthcare issues related to osteoarthritis management and prevention through multidisciplinary integrative healthcare teams.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a practicing and teaching primary care internist for over 30 years at Harvard Medical School and at Harvard affiliated teaching hospitals. In 1996 my career in internal medicine began to evolve into a one more accurately labeled Integrative Medicine. During this period I have taught medical students, interns, residents and Fellows in a variety of settings. I have also taught peers locally and nationally at Continuing Medical Education Courses.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.