Sanford C. Newmark, MD, medical director of the UCSF Osher Center for Integrative Medicine, explains what integrative medicine is (hint: it’s neither “alternative medicine” nor homeopathy) and how referred patients can benefit from its proven techniques. He enumerates Osher’s therapies to support adults and kids with chronic conditions and those undergoing cancer treatment, and describes how integrative and conventional practitioners collaborate to accelerate healing, boost wellness and improve quality of life.
Okay, hi everybody, my name is Sandy knew Mark, I am the clinical medical director at the Osher Center for Integrative Medicine, which is part of the university of California san Francisco. Um just a little background, there's actually, our center was founded in 1998 along with another center at Harvard. And now there are seven centers around the country, well six in the country and one and um in Sweden for which are Osher centers and two more have just been named. So it's, there will end up being nine across the country. Uh and the Osher center is composed of a clinic where we see patients, um research center and education. I'm gonna focus today on the clinical services we have, but if if anybody's interested you could go to the website and you'll see that we have very strong research department and we have a fellowship and we teach medical students and were highly involved in in education at UCSF. So these are some of the services we provide and I'm going to talk a little bit more about uh some of them specifically, but basically we're a consult service only. We don't do any primary care and we consult for a wide variety of issues. We have physicians, we have nurse practitioners, we have traditional chinese medicine doctors, you might think of as acupuncture, as a massage therapist and I will go through a little of the specialties right now. But before that I wanted to talk about what integrative Medicine is since we're the Osher Center for integrative Medicine, many of you probably already know, but I wanted to make the distinction between regretted medicine and some other things. So, integrative Medicine, this is the definition from Dr Weil's Center. He was one of the pioneers of Integrative Medicine, Dr Andrew Weil. So it's healing oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient. It's informed by evidence and makes use of all appropriate therapies and the all appropriate therapies. Part is very important because integrative medicine doctors do not abandon conventional medicine. If conventional medical therapy is the most appropriate choice, then that's what we would use or we might use it plus other interventions that are not necessarily conventional that are maybe lifestyle interventions or interventions from other modalities. Um and we try and be informed by evidence as much as possible. So what integrative medicine is not is just alternative or complementary medicine because those terms imply that there's no conventional medicine involved and that's not. So, as I was just saying, we're not functional medicine, functional medicine is a type of alternative medicine or maybe uh modality that is becoming extremely popular right now, it hinges very highly on a lot of laboratory testing and um I think people at Osher do some of that. Um but we are definitely not a primarily functional medicine clinic, um things like homeopathy, Osteopathic medicine and I could have listed cranial psychotherapy and Ricky and all these other things. Those are all alternative types of medicine which any particular practitioner at Osher May or may not use in any particular situation. Um I guess that's the homeopathic medicine. I should have written osteopathic manipulation because osteopaths now are trained very much like traditional like medical doctors traditional medical doctors but osteopathic manipulation is a particular modality that we have at OSHA. We call it manual medicine but it may be something we refer to but it's not primarily what we do. So that was just to kind of give you an idea of what we're really about there. Um. Mhm. So um We also by the way have online classes. Our biggest one is mindfulness based stress reduction. We run 136-8 week classes a year in mindfulness based stress reduction. And these classes are open to anyone. Uh There uh private pay a fee for service uh classes. And right now they're all online and they're extremely popular were actually filled up for the year. Uh And these classes we also offer restorative yoga and laughter yoga. And both of those programs are free for any patient who would like to sign up the laughter yoga has been going on for years. And it's it's really highly popular program and if any of you know anything about it it's really fun and actually really restorative um I thought I should get to insurance pretty up front. Um So the Osher Center as part of U. C. S. F. Accepts all private insurance. All the physicians specialties including Medicare and medical. Now the only um exception to that is psychiatry which does not accept medical and that's for kind of complex reason. But basically everybody at Osher is a member of UCF department. Like I'm in the pediatrics department. Somebody else maybe an internal medicine and the psychiatry department in Osher uh does not accept medical for reasons I'm not entirely clear about. But that means that our psychiatrists can't accept men account. Obviously we can only accept hm oh patients who haven't approved referral um because otherwise HMOs won't pay it. Um Are traditional medicine chinese medicine doctors are acupuncture except insurance where the P. P. O. S. Pay for insurance and our massage is future service. We do require a referral from even people who have P. P. O. S. Um But um oh it's all all our all insurances are accepted basically so you don't have to worry about that. So what about our general medicine consults? We see a wide variety of medical conditions. Internist or family medicine Doctor trained in integrative medicine I. B. S. Chronic fatigue central sensitization syndromes, diabetes. Just about any kind of chronic issue you can think of we would see. But I do want to say we're not a pain clinic um patients who have really significant opioid requirements would not be appropriate referrals for us. We just don't have the the variety of of um practitioners and the bandwidth to accept those kind of patients. Uh And so when you make a referral to kosher, the referral b will be uh looked at by our staff and then uh the actual practitioners will go over the referrals to make sure they're appropriate. I don't know if any of you have access to kind of care everywhere. Feature where you can, we actually have um referrals that go through apex, you know apex apex and we have a standard referral kind of things that I'm not sure if you have access, but if you do then you can use those generally what happens when you prefer. Somebody else will get at least a to visit, consult if they're accepted. So that means you'll see somebody. And uh for an hour there will probably be some kind of labs just ordered or maybe just medical records and then a couple of weeks later they will be seen for another hour. And after that it really varies. That could be the whole thing and then they will be sent back to you or the patient could keep on seeing us that some uh interval usually of months rather than weeks. Um Like my active patients, I see every three or four months, generally, maybe in six months. Um And that just sort of depends on what on, you know what we what we're treating and what the patient feels like doing and what we feel like it would be appropriate. So some of our patients we see for years now the acupuncture are a little different when they start seeing the patients. They often receive them every couple of weeks for quite a long period of time depending on their issues. And in china acupuncture associate people two or three times a week until the problem of this rock resolved. And but we don't have the bandwidth to do that. As as I said before we do some functional medicine but we're not primarily functional medicine clinic. We have integrated pediatrics. It's a little limited at kosher. Uh I see kids with Ox is um A. D. H. D. Tourette's syndrome. Kind of behavioral problems. We have another pediatrician dr Becker who sees people with A. D. H. D. Kind of somatic complaints, some types of pain syndromes, depression. Um But then there's also at Mission Bay Hospital, there's a pediatric pain and palliative care service whether they'll see kids for um a much wider variety of things if you're interested in sending Children over. But my clinic is pretty much A. D. H. D. And autism ecology is one of our biggest um One of the things we do the most we have two integrative oncologists who are part time and integrative oncology nurse practitioner and uh most of our traditional chinese medicine doctors are acupuncturists are trained and work a lot with people with with psychological problems. Mostly this is we work really closely with conventional oncologists. In fact our integrative oncologists are also members of UCSF's oncology department. Fact, Donald Abrams our most experienced one was the chair of oncology at SAn Francisco general for many years. So in case anybody is worrying, we would never tell people not to get their chemotherapy not to get the radiation not to get surgery, but we're we're really in this case doing um working with patients on healing on, working with uh the side effects of chemotherapy on nutritional programs for healing. Uh And uh we mostly are very closely working with the conventional oncologists. And here we're not only integrated in our approach but integrated in the sense that um many people who come see our integrated physician oncologist will then be referred to one of our acupuncturists to our nutritionists to massage therapy. So it will be integrated in that sense as well. Um our integrative psychiatry team is really great. They do individual therapy, we have group services. Integrative psychiatry groups and in fact one of them is an integrative psychiatry aggravated medicine group. So that's really interesting. Often the psychiatrist at Osher like to work in conjunction with a primary mental health practitioner And the reason for that is that we don't have 24 hour care. We have we have one full time psychiatrists and two part time psychiatrists and they don't have, they don't have a network of care behind them. So we really, especially if you have any kind of significant mental health issues. We really prefer working with the primary thing psychiatrist and then adding the kind of services that we offer onto that are psychiatrists do do therapy. They train people in meditation and guided imagery. They one of them has a, a group that works with expressive art therapy. So there's a lot of different modalities they use that are outside of the usual domain of conventional psychiatry. We don't treat schizophrenia or you know, other severe mental illnesses for the same reason as I just mentioned, we just don't have the backup to do that. And right now we don't have any pediatric psychiatry, which is a shame. So we have more traditional chinese medicine practitioners. You might, some people just think of them as acupuncturists, but that's a little limiting. Then we have any other kind of practitioner. We have four highly trained practitioners, all of whom are working More than half time, like 65, 70, 70% of the time. We have one of them's full time. We have another full time practitioner coming. And even with that we're overwhelmed with referrals and have a hard time accepting them and keeping them up. Um as I said before that many events spend a lot of time with cancer patients, especially getting them through their chemo and that healing period shortly afterwards to chemo with the surgery and the radiation can be very, very hopeful. Um They treat chronic pain syndromes and they're they're all experts, not only at acupuncture but chinese, herbal therapy and nutrition. So they're a really important part of what we do little sure.
