Bridging Yoga Medicine & Western Medicine: Part II

Part 2: Positioning Yourself in Healthcare

This is the second of a four-part series of articles for yoga teachers on networking within the medical community. In the first installment we explored defining the types of patients you can best help and using Evidence-Based Medicine (EBM) to validate the ways in which you can support them. Although medically trained ears may find that information intriguing, they may not be able to picture how your services can fit in to their practice. Sometimes it can be helpful to explain how you and your yoga services can align with the overarching goals of today’s healthcare world.

HEALTHCARE TRENDS

Patient Centered Care

In addition to providing care that is safe, effective, timely, efficient, and equitable, in 2001, the Institute of Medicine (IOM) included patient-centered as one of the six aims of healthcare quality in the United States for the 21^st Century. The IOM defined this key element of high-quality care as “care that is respectful of and responsive to individual patient preferences, needs, and values and [ensures] that patient values guide all clinical decisions ¹.”

Since then, the concept of patient-centered care has taken a prime role as health care institutions, medical providers, community health planners, insurance companies, and hospital administrators have all made this quality indicator a priority. To this end, new models of medical care have been evolving, including the Patient-Centered Medical Home or Primary Care Medical Home (PCMH)².

A PCMH provides a team-based, comprehensive and coordinated approach to meet the healthcare needs of each patient as a whole person.   The core team may include physicians, nurses, pharmacists, nutritionists, mental health professionals, and more who work together with patients and their families to optimize health.

It can be easy to see how yoga can align with these concepts of patient-centered, whole-person care. Bringing together physical activity with psychosocial well-being, yoga can provide a supportive care measure that fits into patient-centered ideals of comprehensive wellness and prevention. The US Veterans Affairs (VA) even features yoga as patient-centered whole health approach ³.

Additionally, as a Yoga Medicine-trained teacher, you have the knowledge and vocabulary to be an essential team player in the healthcare team. Dr. Stephen Dahmer MD, a family medicine physician in Manhattan, cites “soft style, anatomical knowledge, ability to spot red flags (and ability to effectively communicate this with medical providers) and overall compassion,” as key qualities one of his medical practices looked for when working with yoga teachers.

Self-Management

A large part of patient-centered care is also inviting patients take a more active role in their personal health care. Medical homes, clinics, community organizations, and even insurance companies have started to employ health coaches and/or provide group classes for patients on self-management and self-care. They teach patients how to manage their illnesses and make lifestyle changes to support their health. A classic example is the Dean Ornish Program for Reversing Health Disease, an intensive cardiac rehab class developed by Dr. Dean Ornish, MD, incorporating yoga, meditation, plant-based diet, exercise, and social support to alter patient risk profiles after heart attacks.

Yoga can be a creative add-on to existing self-care programs or may even be integrated in new, novel ways to support patients. Dr. Dahmer worked together with health coaches, who were also trained yoga teachers, at one of his offices to develop an innovative group program for his patients. “We started a class, called Body Lab, where I co-led with a yoga teacher – incorporating yoga, physical exam, anatomy, self-care – all in a group session, “ shares Dr. Dahmer.

Reducing Healthcare Costs

In addition to quality improvement, self-management, and patient-centered care, another broader goal of today’s healthcare is managing skyrocketing costs and reducing burden on the healthcare system as a whole. Fortunately, support is beginning to amount for mind body practices as potential ways to cut medical costs.

In October 2015, a retrospective study by researchers at Harvard showed that amongst a group of over 4000 patients who participated in Harvard mind body programs incorporating yoga and meditation, total healthcare utilization decreased by 43% one year after participation in the programs. In subgroup analyses, high utilizers of healthcare within the intervention group were 25% more likely to significantly reduce healthcare utilization when compared to high utilizers within the control group of over 13,000 patients from Boston-area health-care facilities ⁴.

Because studies like this one are observing broad statistical links, they cannot prove that mind body modalities were the sole contributor to reductions in healthcare demand. Regardless, this study offers hope and the possibility that safe and inexpensive interventions like yoga and meditation may help to control rising healthcare costs. That is music to any healthcare administrator’s ears, and another way to align your practice with broader healthcare ideals and trends.

Join me in my next installment of this series where we will explore further ways of positioning yourself as an ideal partner in wellness with the medical world.

References:

1. Institute of Medicine (IOM). Crossing the Quality Chasm: A New Health System for the 21^st Century. Washington, D.C.: National Academy Press; 2001.
2. US Department of Health and Human Services. Defining the PCMH. https://www.pcmh.ahrq.gov/page/defining-pcmh
3. US Department of Veterans Affairs. VA Patient Centered Care: A Life-Changing Solution. http://www.va.gov/PATIENTCENTEREDCARE/features/A_Life_Changing_Solution.asp
4. Stahl JE et al. Relaxation Response and Resiliency Training and Its effect on Healthcare Utilization. PLoS ONE 10(10): e0140212. Oct 2015.