Step by step efforts win advances in integrated healthcare

Townsend Letter for Doctors and Patients,  July, 2005  by Elaine Zablocki

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When people get together to plan advances in integrated healthcare, Sheila Quinn is likely to be there in a leadership role. A writer and organizer who strongly believes in bringing all the licensed disciplines fully into our healthcare system, she's often the person who summarizes the discussion and proposes specific action steps. She just has a knack for efficient planning. "I've always been like that," she says.

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Quinn's older brother, mother and father were all MDs, so she was raised in a very medical household. "While I was growing up I hardly knew about the alternative disciplines," she recalls. "But somehow I never liked taking medications; I never felt an affinity for that kind of medicine. When I began to learn about CAM, it felt like an intellectual home for me. I raised my children relying on naturopathic medicine."

Her special knack for efficient planning was especially useful back in 1978, when Joseph Pizzorno, ND, first developed plans for what became Bastyr College. Quinn became a co-founder and served as Bastyr's vice president for finance and administrative affairs for its first 12 years. "One reason Joe and I made a good team is that he had the long-term vision, while I focused on building the steps between where we were and where we wanted to be," Quinn says.

Today, as Bastyr University, the school has more than 1,200 students working for graduate and undergraduate degrees in subjects such as nutrition, herbal sciences, naturopathic medicine and acupuncture/Oriental medicine. But Quinn recalls the early years, when each step was a challenge. "At first, developing faculty was a huge issue," she says. "While many dedicated naturopathic physicians were excellent clinical practitioners, they didn't have the background in basic medical sciences and training in educational methods they needed to educate the next generation of students. When we called conventional medical schools seeking PhDs in biochemistry and physiology to offer courses at Bastyr, they hung up on us."

Institute for Functional Medicine

Today, Quinn is the senior editor and manager of special projects for the Institute for Functional Medicine (IFM), in Gig Harbor, Washington. "I wanted to work for the institute because it focuses on ways to improve prevention and management of complex chronic diseases. The IFM approach emphasizes looking at the real causes of these conditions--such as poor diet, stress, and lack of exercise--instead of just dealing with the symptoms."

The institute welcomes all healthcare practitioners, both conventional and complementary. "If you want to reverse chronic disease, you have to look at the basic functionality underlying the disease," Quinn says. "We don't teach algorithms. We don't offer flow charts. What we say is, first you need to understand the patient: their family history, their genetic predispositions, their environment, their biochemistry and physiology. Once you understand how they got to where they are, then you can intervene to produce change." (For more information about the functional medicine approach, see the "Resources" section, below.)

The institute hosts an annual symposium featuring topics such as "reversing the rising pandemic of diabetes and metabolic syndrome" and "modifiable factors beyond cholesterol." The symposium theme for 2005 will be "The immune system under siege: new clinical approaches to immunological imbalances in the 21st century." IFM also offers educational programs in major cities throughout the United States, including a six-day intensive on "Applying Functional Medicine in Clinical Practice," plus additional one- to three-day clinical modules.

Quinn is currently coordinating the work of 40 authors to produce a 400-page "Textbook of Functional Medicine," which will be available by the end of the year.

Public Policy Initiatives

For the past ten years, Quinn and a team of innovative thinkers have been working towards an integrated healthcare system, in which conventional medicine and the CAM professions would work together as a team, with effective co-management and full communication in place to bring the best of each discipline to people in need of care. This work originated when she was executive director of the American Association of Naturopathic Physicians, working along with Pamela Snider, ND (then associate dean of naturopathic medicine and public affairs at Bastyr University) and Candace Campbell (then executive director of the American Preventive Medical Association).

When they first tried to interest legislators in this vision, they were told, "we need more information," so they developed a 22-page "National Plan to Advance Integrated Healthcare." The next big step was a meeting in 2001 at Georgetown University, when nearly 60 people from a wide range of healthcare interests came together for the "National Policy Dialogue to Advance Integrated Healthcare: Finding Common Ground." Those discussions were particularly successful because of the attitude of the participants, Quinn recalls. "We decided we weren't there to solve territorial disputes between different professions. We met to find out where we already agree, and to get people working together based on the common ground that already exists." The report from the meeting was distributed to every member of Congress, with a cover letter from the bi-partisan leadership of the Congressional Caucus on Complementary and Alternative Medicine.