My Journey
TOPICS ON HEALTH, WELLNESS, AND COMPLEMENTARY MEDICINE
My personal Journey
My current life adventure has been such a blessing and a joy to work with the team at the Sutter Health Institute for Health and Healing! This clinic provides such a wonderful balance of services and expertise to its patients and I'm grateful for the opportunity to provide what I'm able to serve its patients. For the first few months I expect I'll be getting familiar with all the new processes and computer software that makes clinics function these days but I look forward to adding more information to this post about this exciting new step in my journey.
Prior to joining the Sutter team, I had decided to open a clinic in Lehi, Utah in 2015 named White Phoenix Medical to create a sacred space and relationship with patients and to provide a care experience that would reflect how it might be if designed from the patients point of view. Getting to this point had been a path and a journey with its share of joys as well as bumps and bruises. I'm most grateful to the patients who have participated in focus groups to design this clinic and who have helped me understand the process from their perspective, what they valuable, and what they most desired in their relationship with a doctor and experience when visiting with their doctor.
Many of my patients have asked how I came to offer such a different approach to providing care. As the journey was long and winding, I wanted to offer the story to those who were interested.
My Journey:
I am a native of Colombia, South America and grew up in a family where my mother was a dentist and my father was a physician with administrative responsibilities for the national healthcare plan in Colombia. I graduated from medical school in Colombia, in December 1996 and completed a year of social mandatory service in one of the undeserved areas around Bogota. After a series of events that I called my personal miracles, I was on my way to USA to study for the boards and pursue postgraduate medical training with the goal of becoming a radiologist. I studied medicine intensively for about 5 months, and although I was able to pass the medical exam on the first try,I failed the conversational English exam a couple of times but managed to pass on the 3rd time. Realizing my conversational English needed work, I enrolled in an English class program at Barry University in Miami. and then in several medical observer-ship programs in order to get some experience and credentials to apply for the postgraduate training.
During one of the radiology rotations, I realized that I was not going talk or interact much with patients. Radiology had become a digitized profession and, at the time, there was little opportunity to interact with patients. In search of an area of medicine where I would have more interaction with patients, I turned to Internal Medicine which I considered an excellent opportunity to serve the patients in the way I loved, talking to them and getting to the core of their medical problems and cure them! Now, later in my career, I've come to understand that cure is a relative concept.
I had applied to several medical residency training programs and while I wanted to stay in Miami, the only option there was Radiology. Chicago opened its doors and I took an opportunity to study Internal Medicine in the Advocate Health program through the University of Illinois at Chicago. there,
Internal medicine residency was a great learning experience not just from the medical point of view, but a great experience to learn more about myself. I learned what it took to be a good internist, to develop the art of assessing a patient as a “whole” and then develop a diagnosis and differential diagnosis with therapeutic options. I also learned what I liked about the way I was trained and what I did not, the positives and the negatives. The information that I needed to become the doctor and internist I wanted to be, was much more than I anticipated. It is true that doctors continue school for the rest of their lives and there is no end to learning. Medicine is complex and it changes every day.
There is an inherent challenge in practicing in the medical arts in balancing the task of keeping up with the ever growing amount of information needed to provide the best care and the work of actually taking care of patients, living ones life, and maintaining ones own health. I made the same decision that most physicians make which was to push myself as much as I can with the conviction that I was strong, smart and I could do anything! I was strict in my work, and obsessed with following the rules of what a great physician and internist should be. It was a lot of pressure and a lot of stress. Not just due to the demands of our profession and the design of a traditional medical practice, but because I did it to myself. I was my worse critic and dictator.
As is happening with many physicians, I quickly became burnt out. I did not feel the way I did about medicine that I used to. I felt sick and my energy was gone, I had palpitations, tachycardia, pelvic pain, bad acid re-flux and dizziness. I kept working and pushing. I underwent several examinations and all the tests came back negative and normal. As the tests became more involved a pattern became more clear - essentially, there is nothing medically wrong with me even though I felt awful.
During this whole experience I was pursuing a fellowship in cardiology, one of the most demanding sub-specialties in medicine. I did not get in which has turned out to be a wonderful blessing. I believe in God, and God knows what is best for me. I took an opportunity for a chief residency position and since I was in a training visa, wanted to maintain my relationships and continue training in the USA,
Chief residency provided a good work-life balance at the time and allowed me to keep learning, practice in a rather protected environment and allowed time for myself. Surprisingly, after years of structured studying and the never ending responsibilities while in training, I had forgotten how to enjoy myself or what to do with free time. I had been so focused on my career goals since I finished high school that I had little room for anything else. These were stressful times, but the universe again and again put me in the perfect job or situation, preparing the road for me and giving me exactly what I needed at the time. The year serving as a Chief resident provided the needed time for reflection and personal self assessment.
After my year as a Chief resident, an opportunity opened up with a small community hospital focused on the under served and a mostly Hispanic population in their area. This provided the ability to work in a city clinic for the poor a couple of days a week. I loved helping the patients, seeing smiles, an appreciated both the small and big improvements that my patients were able to achieve, I loved seeing their hope and witness their change, The love I gave to my patients was returned many times over. However, it was still a precarious situation. Even though it was much better than community care in Colombia, there was pressure to see more and address all their health needs in less and less time.
The universe still was watching out for me as it watches out for all of us. Each step was a building block for the next one. The community hospital gave me the great opportunity to nurture another love my life which is to be a teacher. They had a contract and friendship with Rush University and I was made a clinical instructor and later associate professor of Medicine and had the opportunity to get back to teaching medical students. While the joys were there, the pace and demands were unchanged and after 4 years, I could sense the similar feelings I had before of getting burned out and losing my passion. Our clinic was so busy that it was being overbooked with multiple patients scheduled for the same time slot. Lots of patients with lots of problems and little time.
Then other door opened, my residency program director hired me for the University of Illinois at Chicago as associate professor of clinical medicine. In this practice I saw my private patients, patients with residents and I rounded in the hospital few months a year with residents and students. Again, I loved the patient care, I loved the teaching, I loved the love of patients, staff and colleagues, But the practice style remained - limited time with any patient, lots of paperwork, do more with less. As many physicians do, I made the best of the situation and tried to do my best and teach by example, serving my patients in a thoughtful and meaningful way.
By this point in my career I had gotten married and was having problems getting pregnant. I came to the conclusion that work stresses and the effect on my body were a significant reason why. I was hardly in a position to keep myself healthy let along provide an appropriate environment to grow a baby. I was too stressed and if I wanted to conceive and get healthier I needed to manage stress and have more time. There comes a point where after failing to figure things out yourself for long enough that you surrender and finally allow God to shape your life (without your interference).
With the support of my husband, I cut down my hours to 50% which allow time to learn about other healing techniques that the universe had exposed me to and provided the time needed to grow. God brought wonderful people into my life and I learned about and had the time to practice meditation. This exercise provided a deeper understanding of my spirituality and how faith was aligned with health and healing. I've used yoga asanas and various forms of meditation that resonated with me. One day I received information on the mail about medical acupuncture offered by Harvard medical School. Eager to continue to add to my growing list of knowledge, I enrolled and for 9 months I was dedicated to the study of acupuncture. I was still very busy but the course was flexible, which allowed me to maintain a more healthy balance.
After 1 miscarriage and months of dedicating time to learn and heal myself, I was able to get pregnant. It was a joy! I learned so much being pregnant. Too often traditional medicine treats pregnancy like a temporary disease state but I understood is a different state, I realized that your whole body changes, even your nails, your hair, it was revelation and I apologize to all the pregnant women I saw as patients before, I really did not know what I was talking about, once I experienced it, my take on pregnancy changed drastically.
When I was in my 8th month of pregnancy, my husband took a job opportunity here in Utah. We were ready for a change; we wanted to be in a more peaceful place and the idea of being surrounded by beautiful mountains and have a better space for our little one was great. So we moved at end of December in 2011 to the beautiful Salt Lake City. Our daughter was born 1.5 months later and another chapter of our life started. She is the most amazing teacher I ever had and has taught me unconditional love! So this is a taste of what God's love for us is!
After being so busy in medical practice my initial reaction was that holding a baby and taking care of was somehow a waste of my time. Of course I soon realized that not only is it not a waste of time, it was the most important thing I could be doing. Our baby had a very hard time breastfeeding and required us to supplement her feedings with a tube for the first 3 months. Finally I was able to just breastfeed alone. Sleeping (or lack of it) remained an issue and our little one did not sleep through the night until she was almost 3. I wanted to give her the best as any parent does, so in agreement with my husband I decided to dedicate my other time to study for my internal medicine boards.
The time with my newborn provided a lot of opportunity to continue my reflection on healthcare and how frustrating it was with the limitations of "modern medicine". I felt there was still something missing. I was aware of Andrew Weil's teachings and as I learned more about his philosophy it really made sense to me. It also echoed my first lesson in medical school that "Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity". I suddenly realized how far from that ideal our modern style of health care delivery had come with clinics trying to see patients as fast as possible and solving problems pills whenever that was the acceptable option. As with most things in the universe, quick and easy is not always the best way. Wanting to learn more how Dr. Weil incorporated his thinking into a medical practice, I enrolled into his program, the Integrative Medicine Fellowship at the University of Arizona and graduated in August of 2015 with an amazing assortment of new tools to help our patients as well as ourselves to heal. I was also introduce to a new approach to practicing medicine in the way I've always felt that I would love it to be, a sacred space to develop a sacred relationship between the physician and the patient in order to promote healing.
Health reflects your life, sometimes there is a quick fix, most of the time is a process, a journey. Health is an aspect of your life and is there all the time - not just when you are sick. Depending on how you live every aspect of your life is reflected in your state of health. It is a mirror of your choices. That is why I decided to change how I live my life and get healthier. We have the tools to face life but experiencing it is what really get us to know how that feels. I still make choices every day and still feel the lure to sacrifice healthy choices to meet the pressures of work and responsibilities.
As a healer, I've gathered as many tools as I could where guided by the universe. This to fulfill my life purpose to heal myself and to help others to heal so we can feel better and to attain the best state of physical, mental and social well being that we are capable of and as our situation allows us to. Our thoughts, our actions, our feelings, create our health, our life. It’s never too late or too early to make it happen. The first step is faith. As Gandhi said, “be the change you want to see in the world”, transformation is our goal, to create together a healthier you and a healthier world. We hope you join us to co-create this experience and we can grow together.
I look forward to walking with you along your own journey towards a state of physical, emotional, and social wellness, addressing disease where needed, and transforming your approach to a healthy life.
With love and gratitude,
Johanna Fuentes-Valdes
Prior to joining the Sutter team, I had decided to open a clinic in Lehi, Utah in 2015 named White Phoenix Medical to create a sacred space and relationship with patients and to provide a care experience that would reflect how it might be if designed from the patients point of view. Getting to this point had been a path and a journey with its share of joys as well as bumps and bruises. I'm most grateful to the patients who have participated in focus groups to design this clinic and who have helped me understand the process from their perspective, what they valuable, and what they most desired in their relationship with a doctor and experience when visiting with their doctor.
Many of my patients have asked how I came to offer such a different approach to providing care. As the journey was long and winding, I wanted to offer the story to those who were interested.
My Journey:
I am a native of Colombia, South America and grew up in a family where my mother was a dentist and my father was a physician with administrative responsibilities for the national healthcare plan in Colombia. I graduated from medical school in Colombia, in December 1996 and completed a year of social mandatory service in one of the undeserved areas around Bogota. After a series of events that I called my personal miracles, I was on my way to USA to study for the boards and pursue postgraduate medical training with the goal of becoming a radiologist. I studied medicine intensively for about 5 months, and although I was able to pass the medical exam on the first try,I failed the conversational English exam a couple of times but managed to pass on the 3rd time. Realizing my conversational English needed work, I enrolled in an English class program at Barry University in Miami. and then in several medical observer-ship programs in order to get some experience and credentials to apply for the postgraduate training.
During one of the radiology rotations, I realized that I was not going talk or interact much with patients. Radiology had become a digitized profession and, at the time, there was little opportunity to interact with patients. In search of an area of medicine where I would have more interaction with patients, I turned to Internal Medicine which I considered an excellent opportunity to serve the patients in the way I loved, talking to them and getting to the core of their medical problems and cure them! Now, later in my career, I've come to understand that cure is a relative concept.
I had applied to several medical residency training programs and while I wanted to stay in Miami, the only option there was Radiology. Chicago opened its doors and I took an opportunity to study Internal Medicine in the Advocate Health program through the University of Illinois at Chicago. there,
Internal medicine residency was a great learning experience not just from the medical point of view, but a great experience to learn more about myself. I learned what it took to be a good internist, to develop the art of assessing a patient as a “whole” and then develop a diagnosis and differential diagnosis with therapeutic options. I also learned what I liked about the way I was trained and what I did not, the positives and the negatives. The information that I needed to become the doctor and internist I wanted to be, was much more than I anticipated. It is true that doctors continue school for the rest of their lives and there is no end to learning. Medicine is complex and it changes every day.
There is an inherent challenge in practicing in the medical arts in balancing the task of keeping up with the ever growing amount of information needed to provide the best care and the work of actually taking care of patients, living ones life, and maintaining ones own health. I made the same decision that most physicians make which was to push myself as much as I can with the conviction that I was strong, smart and I could do anything! I was strict in my work, and obsessed with following the rules of what a great physician and internist should be. It was a lot of pressure and a lot of stress. Not just due to the demands of our profession and the design of a traditional medical practice, but because I did it to myself. I was my worse critic and dictator.
As is happening with many physicians, I quickly became burnt out. I did not feel the way I did about medicine that I used to. I felt sick and my energy was gone, I had palpitations, tachycardia, pelvic pain, bad acid re-flux and dizziness. I kept working and pushing. I underwent several examinations and all the tests came back negative and normal. As the tests became more involved a pattern became more clear - essentially, there is nothing medically wrong with me even though I felt awful.
During this whole experience I was pursuing a fellowship in cardiology, one of the most demanding sub-specialties in medicine. I did not get in which has turned out to be a wonderful blessing. I believe in God, and God knows what is best for me. I took an opportunity for a chief residency position and since I was in a training visa, wanted to maintain my relationships and continue training in the USA,
Chief residency provided a good work-life balance at the time and allowed me to keep learning, practice in a rather protected environment and allowed time for myself. Surprisingly, after years of structured studying and the never ending responsibilities while in training, I had forgotten how to enjoy myself or what to do with free time. I had been so focused on my career goals since I finished high school that I had little room for anything else. These were stressful times, but the universe again and again put me in the perfect job or situation, preparing the road for me and giving me exactly what I needed at the time. The year serving as a Chief resident provided the needed time for reflection and personal self assessment.
After my year as a Chief resident, an opportunity opened up with a small community hospital focused on the under served and a mostly Hispanic population in their area. This provided the ability to work in a city clinic for the poor a couple of days a week. I loved helping the patients, seeing smiles, an appreciated both the small and big improvements that my patients were able to achieve, I loved seeing their hope and witness their change, The love I gave to my patients was returned many times over. However, it was still a precarious situation. Even though it was much better than community care in Colombia, there was pressure to see more and address all their health needs in less and less time.
The universe still was watching out for me as it watches out for all of us. Each step was a building block for the next one. The community hospital gave me the great opportunity to nurture another love my life which is to be a teacher. They had a contract and friendship with Rush University and I was made a clinical instructor and later associate professor of Medicine and had the opportunity to get back to teaching medical students. While the joys were there, the pace and demands were unchanged and after 4 years, I could sense the similar feelings I had before of getting burned out and losing my passion. Our clinic was so busy that it was being overbooked with multiple patients scheduled for the same time slot. Lots of patients with lots of problems and little time.
Then other door opened, my residency program director hired me for the University of Illinois at Chicago as associate professor of clinical medicine. In this practice I saw my private patients, patients with residents and I rounded in the hospital few months a year with residents and students. Again, I loved the patient care, I loved the teaching, I loved the love of patients, staff and colleagues, But the practice style remained - limited time with any patient, lots of paperwork, do more with less. As many physicians do, I made the best of the situation and tried to do my best and teach by example, serving my patients in a thoughtful and meaningful way.
By this point in my career I had gotten married and was having problems getting pregnant. I came to the conclusion that work stresses and the effect on my body were a significant reason why. I was hardly in a position to keep myself healthy let along provide an appropriate environment to grow a baby. I was too stressed and if I wanted to conceive and get healthier I needed to manage stress and have more time. There comes a point where after failing to figure things out yourself for long enough that you surrender and finally allow God to shape your life (without your interference).
With the support of my husband, I cut down my hours to 50% which allow time to learn about other healing techniques that the universe had exposed me to and provided the time needed to grow. God brought wonderful people into my life and I learned about and had the time to practice meditation. This exercise provided a deeper understanding of my spirituality and how faith was aligned with health and healing. I've used yoga asanas and various forms of meditation that resonated with me. One day I received information on the mail about medical acupuncture offered by Harvard medical School. Eager to continue to add to my growing list of knowledge, I enrolled and for 9 months I was dedicated to the study of acupuncture. I was still very busy but the course was flexible, which allowed me to maintain a more healthy balance.
After 1 miscarriage and months of dedicating time to learn and heal myself, I was able to get pregnant. It was a joy! I learned so much being pregnant. Too often traditional medicine treats pregnancy like a temporary disease state but I understood is a different state, I realized that your whole body changes, even your nails, your hair, it was revelation and I apologize to all the pregnant women I saw as patients before, I really did not know what I was talking about, once I experienced it, my take on pregnancy changed drastically.
When I was in my 8th month of pregnancy, my husband took a job opportunity here in Utah. We were ready for a change; we wanted to be in a more peaceful place and the idea of being surrounded by beautiful mountains and have a better space for our little one was great. So we moved at end of December in 2011 to the beautiful Salt Lake City. Our daughter was born 1.5 months later and another chapter of our life started. She is the most amazing teacher I ever had and has taught me unconditional love! So this is a taste of what God's love for us is!
After being so busy in medical practice my initial reaction was that holding a baby and taking care of was somehow a waste of my time. Of course I soon realized that not only is it not a waste of time, it was the most important thing I could be doing. Our baby had a very hard time breastfeeding and required us to supplement her feedings with a tube for the first 3 months. Finally I was able to just breastfeed alone. Sleeping (or lack of it) remained an issue and our little one did not sleep through the night until she was almost 3. I wanted to give her the best as any parent does, so in agreement with my husband I decided to dedicate my other time to study for my internal medicine boards.
The time with my newborn provided a lot of opportunity to continue my reflection on healthcare and how frustrating it was with the limitations of "modern medicine". I felt there was still something missing. I was aware of Andrew Weil's teachings and as I learned more about his philosophy it really made sense to me. It also echoed my first lesson in medical school that "Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity". I suddenly realized how far from that ideal our modern style of health care delivery had come with clinics trying to see patients as fast as possible and solving problems pills whenever that was the acceptable option. As with most things in the universe, quick and easy is not always the best way. Wanting to learn more how Dr. Weil incorporated his thinking into a medical practice, I enrolled into his program, the Integrative Medicine Fellowship at the University of Arizona and graduated in August of 2015 with an amazing assortment of new tools to help our patients as well as ourselves to heal. I was also introduce to a new approach to practicing medicine in the way I've always felt that I would love it to be, a sacred space to develop a sacred relationship between the physician and the patient in order to promote healing.
Health reflects your life, sometimes there is a quick fix, most of the time is a process, a journey. Health is an aspect of your life and is there all the time - not just when you are sick. Depending on how you live every aspect of your life is reflected in your state of health. It is a mirror of your choices. That is why I decided to change how I live my life and get healthier. We have the tools to face life but experiencing it is what really get us to know how that feels. I still make choices every day and still feel the lure to sacrifice healthy choices to meet the pressures of work and responsibilities.
As a healer, I've gathered as many tools as I could where guided by the universe. This to fulfill my life purpose to heal myself and to help others to heal so we can feel better and to attain the best state of physical, mental and social well being that we are capable of and as our situation allows us to. Our thoughts, our actions, our feelings, create our health, our life. It’s never too late or too early to make it happen. The first step is faith. As Gandhi said, “be the change you want to see in the world”, transformation is our goal, to create together a healthier you and a healthier world. We hope you join us to co-create this experience and we can grow together.
I look forward to walking with you along your own journey towards a state of physical, emotional, and social wellness, addressing disease where needed, and transforming your approach to a healthy life.
With love and gratitude,
Johanna Fuentes-Valdes
MORE ABOUT INTERNAL MEDICINE
WHAT IS INTERNAL MEDICINE?
“ Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness”
.
Although internists may act as primary care physicians, they are not "family physicians," "family practitioners," or "general practitioners," whose training is not solely concentrated on adults and may include surgery, obstetrics and pediatrics. Family Practice doctors, specialized in caring for the family and they train on this for 3 years. Internal Medicine doctors train for 3 years specifically on adult medicine, focusing on prevention, diagnosis and comprehensive treatment of diseases of the internal organs and systems (heart, lungs, kidneys, liver, stomach, intestines, pancreas, lungs, endocrine system, etc). Internists are often called upon to act as consultants to other physicians to help solve puzzling diagnostic problems.
Internists are equipped to deal with whatever problem a patient brings -- no matter how common or rare, or how simple or complex. They are specially trained to solve puzzling diagnostic problems and can handle severe chronic illnesses and situations where several different illnesses may strike at the same time. They also bring to patients an understanding of wellness (disease prevention and the promotion of health), women's health, substance abuse, mental health, as well as effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Internists can choose to focus their practice on general internal medicine, or may take additional training to "subspecialize" in one of 13 areas of internal medicine. Cardiologists, for example, are doctors of internal medicine who subspecialize in diseases of the heart. The training an internist receives to subspecialize in a particular medical area is both broad and deep. Subspecialty training (often called a "fellowship") usually requires an additional one to three years beyond the standard three year general internal medicine residency.
https://www.acponline.org/patients_families/about_internal_medicine/
The specialty of internal medicine covers a wide range of conditions affecting the internal organs of the body - the heart, the lungs, the liver and gastro-intestinal tract, the kidneys and urinary tract, the brain, spinal column, nerves, muscles and joints. Although some diseases specifically affect individual organs, the majority of common diseases - arteriosclerosis, diabetes, high blood pressure and cancer may affect many internal organs of the body. The internist must then be trained to recognize and manage a broad range of diseases and, with the aging population, many patients with chronic and multiple disorders.
The specialist in internal medicine - the internist - most commonly practices in hospitals where he may care for the patients during an acute illness or supervise their care in out patient clinics
http://www.efim.org/about/what-internal-medicine
An Internist is a personal physician who provides long-term, comprehensive care in the office and in the hospital, managing both common and complex illnesses of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and the digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
http://www.abms.org/member-boards/contact-an-abms-member-board/american-board-of-internal-medicine/
- The American College of Physicians definitions:
“ Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness”
.
Although internists may act as primary care physicians, they are not "family physicians," "family practitioners," or "general practitioners," whose training is not solely concentrated on adults and may include surgery, obstetrics and pediatrics. Family Practice doctors, specialized in caring for the family and they train on this for 3 years. Internal Medicine doctors train for 3 years specifically on adult medicine, focusing on prevention, diagnosis and comprehensive treatment of diseases of the internal organs and systems (heart, lungs, kidneys, liver, stomach, intestines, pancreas, lungs, endocrine system, etc). Internists are often called upon to act as consultants to other physicians to help solve puzzling diagnostic problems.
Internists are equipped to deal with whatever problem a patient brings -- no matter how common or rare, or how simple or complex. They are specially trained to solve puzzling diagnostic problems and can handle severe chronic illnesses and situations where several different illnesses may strike at the same time. They also bring to patients an understanding of wellness (disease prevention and the promotion of health), women's health, substance abuse, mental health, as well as effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Internists can choose to focus their practice on general internal medicine, or may take additional training to "subspecialize" in one of 13 areas of internal medicine. Cardiologists, for example, are doctors of internal medicine who subspecialize in diseases of the heart. The training an internist receives to subspecialize in a particular medical area is both broad and deep. Subspecialty training (often called a "fellowship") usually requires an additional one to three years beyond the standard three year general internal medicine residency.
https://www.acponline.org/patients_families/about_internal_medicine/
- The European Federation of Internal Medicine definition:
The specialty of internal medicine covers a wide range of conditions affecting the internal organs of the body - the heart, the lungs, the liver and gastro-intestinal tract, the kidneys and urinary tract, the brain, spinal column, nerves, muscles and joints. Although some diseases specifically affect individual organs, the majority of common diseases - arteriosclerosis, diabetes, high blood pressure and cancer may affect many internal organs of the body. The internist must then be trained to recognize and manage a broad range of diseases and, with the aging population, many patients with chronic and multiple disorders.
The specialist in internal medicine - the internist - most commonly practices in hospitals where he may care for the patients during an acute illness or supervise their care in out patient clinics
http://www.efim.org/about/what-internal-medicine
- The American Board of Medical Specialties definition:
An Internist is a personal physician who provides long-term, comprehensive care in the office and in the hospital, managing both common and complex illnesses of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and the digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
http://www.abms.org/member-boards/contact-an-abms-member-board/american-board-of-internal-medicine/
More about integrative medicine
Integrative Medicine defined by the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM):
Integrative Medicine is the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing.
Integrative Medicine defined by the Arizona Center for Integrative Medicine:
Integrative Medicine is healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative.
Integrative Medicine is the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing.
Integrative Medicine defined by the Arizona Center for Integrative Medicine:
Integrative Medicine is healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative.
For more information:
http://integrativemedicine.arizona.edu/about/definition.html
http://nccih.nih.gov/health/integrative-health
http://www.medscape.com/viewarticle/807102
http://www.webmd.com/a-to-z-guides/features/alternative-medicine-integrative-medicine
Find an Integrative Medicine Provider in your area
http://www.integrativemedicineexchange.com
What is Health and Wellness?
In the early part of the 1900's, medical professionals and others started talking about "health" beyond the simple concept of being physically free of disease. A number of ways to describe health have been published in the scientific literature over the past hundred years so a very brief summary is all that is possible here.
Health Is Multidimensional: The idea that health is multidimensional simply means that we are more than just a state of disease or absence of disease. Our state of health and well-being is a combination of our physical, mental and social well-being. Richard Eberst discussed his view on this model in an article in the Journal of School Health written in 1984 and makes note of the previous 60 years of work n this topic. The point isn't whether there are four, five, or six particular dimensions, but that we are complex individuals with many things that affect our lives and sense of health and well-being.
Health Is Multi-determined: The idea that our health and well-being at any given moment is determined by many factors, including:spiritual belief ,s and practices, social support, relationships, peace, justice, the economy, income, the environment, policies, citizen participation in decision making.
Health Is Dynamic: The idea that our state of health and well-being shifts freely and frequently. A sense of well-being isn't something that is achieved but more of a state that is maintained. There are many things in life that can move us away from a sense of health and well-being. The goal is to identify those things and find a pathway to a new state of balance that is right for each us as an individual. We will often speak of "meeting the individual where they are" and an important part of that is "where you are" changes freely and frequently. Thus, the pathway toward balance today may need to adapt for tomorrows challenges.
Health Is Subjective: We are complex individuals and each person's experiences of health can differ widely, even when the "dimensions" appear to be similar. Often the goal of a scientific process is to put similar things into the same category and expect those categories to act the same. Life is much more complex and at the individual level, we are all unique. The process of an integrated approach to medicine reflect a commitment by your provider an integrated approach to "your" personal medicine decisions given your unique experiences, expectations, and options.
Health Is Multidimensional: The idea that health is multidimensional simply means that we are more than just a state of disease or absence of disease. Our state of health and well-being is a combination of our physical, mental and social well-being. Richard Eberst discussed his view on this model in an article in the Journal of School Health written in 1984 and makes note of the previous 60 years of work n this topic. The point isn't whether there are four, five, or six particular dimensions, but that we are complex individuals with many things that affect our lives and sense of health and well-being.
Health Is Multi-determined: The idea that our health and well-being at any given moment is determined by many factors, including:spiritual belief ,s and practices, social support, relationships, peace, justice, the economy, income, the environment, policies, citizen participation in decision making.
Health Is Dynamic: The idea that our state of health and well-being shifts freely and frequently. A sense of well-being isn't something that is achieved but more of a state that is maintained. There are many things in life that can move us away from a sense of health and well-being. The goal is to identify those things and find a pathway to a new state of balance that is right for each us as an individual. We will often speak of "meeting the individual where they are" and an important part of that is "where you are" changes freely and frequently. Thus, the pathway toward balance today may need to adapt for tomorrows challenges.
Health Is Subjective: We are complex individuals and each person's experiences of health can differ widely, even when the "dimensions" appear to be similar. Often the goal of a scientific process is to put similar things into the same category and expect those categories to act the same. Life is much more complex and at the individual level, we are all unique. The process of an integrated approach to medicine reflect a commitment by your provider an integrated approach to "your" personal medicine decisions given your unique experiences, expectations, and options.
The World Health Organization definition for "Health"
The World Health Organization defines "health" as “…a state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity.” This definition takes an important philosophical position important to the concept of an integrative approach to ones health and well-being. The integration of body, mind, and spirit encompasses much more than what traditional "Western" medicine's physician-patient relationship is currently designed to service.
This definition also points out that a person with no identifiable disease or syndrome, as defined by traditional Western medicine's list, can still be in an "unhealthy state" due to social or mental barriers in their life. Consequently, a person with a terminal disease with multiple active physical aliments can still find a state of mental and spiritual health and well-being.
This definition also points out that a person with no identifiable disease or syndrome, as defined by traditional Western medicine's list, can still be in an "unhealthy state" due to social or mental barriers in their life. Consequently, a person with a terminal disease with multiple active physical aliments can still find a state of mental and spiritual health and well-being.
Statistics on complementary medicine from the National Health Interview Survey (NHIS)
The National Health Interview Survey (NHIS) is a study done every five years in which tens of thousands of Americans answer questions about their health. This survey includes a special section on complementary health approaches. The most recent data on complementary approaches were collected in 2012. The 2012 NHIS Highlights can be reviewed here: https://nccih.nih.gov/research/statistics/NHIS/2012/key-findings
Key findings:
More Key Facts about Adults:
Natural Products
Mind and body approaches
Key findings:
- In 2012, 33.2% of U.S. adults used complementary health approaches. This is similar to the percentages in 2007 (35.5%) and 2002 (32.3%)
- 11.6% of U.S. children age 4 to 17 used complementary health approaches in 2012. There was no meaningful change from 2007, when 12.0% used them
- In 2012, as in 2007 and 2002, the most commonly used complementary approach was natural products (dietary supplements other than vitamins and minerals). 17.7% of adults and 4.9% of children age 4 to 17 used natural products
- Pain—a condition for which people often use complementary health approaches—is common in U.S. adults. More than half had some pain during the 3 months before the survey
More Key Facts about Adults:
Natural Products
- Fish oil was the #1 natural product among adults, with 7.8% using it in 2012
- Adults’ use of fish oil, probiotics or prebiotics, and melatonin increased between 2007 and 2012
- Adults’ use of glucosamine/chondroitin, echinacea, and garlic decreased between 2007 and 2012
Mind and body approaches
- The most commonly used by adults include yoga, chiropractic or osteopathic manipulation, meditation, and massage therapy.
- The percentage of adults who practice yoga has increased substantially, from 5.1% in 2002 to 6.1% in 2007 and 9.5% in 2012.
