Congratulations to David Kilgore, MD, recipient of the first annual University of Arizona Center for Integrative Medicine Alumni of the Year award.
Dr. Kilgore, Fellowship 2011, is Health Sciences Clinical Professor of Family Medicine at the University of California, Irvine (UCI) School of Medicine and has been working to increase access to integrative health resources for underserved patients.
“We are delighted to watch our graduates change medical education and practice!” said Dr. Andrew Weil, Founder and Director of UACIM. “Dr. Dave Kilgore’s accomplishments exemplify our goals.
A collaborator and driver of change, Dr. Kilgore says of his fellow integrative community, “There are so many well-deserving other alumni I’m sure... any work I’ve done would not have been possible without all the wonderful ideas and mentorship from many people at UACIM, as well as support and encouragement at my own organization.”
When asked how he envisions the field of integrative medicine developing, Dr. Kilgore writes:
I truly believe that Integrative Health represents the pinnacle, the best that “Medicine” can be – that its philosophy of using all safe and effective therapies and healing traditions to achieve health and wellness , of viewing our patients from a whole person systems perspective with an emphasis on self-efficacy, self-empowerment and a fierce advocacy towards addressing social determinants of health and health inequity are exactly what our county, our health system – and I’ll be a bit unashamedly over the top here – what the world needs right now. It’s not some fluffy add-on therapy to bring out when conventional therapy has no further answers – it’s powerful 21st century medicine that our patients need and deserve right now.
Yet we have a long ways to go before Integrative Health is the norm, the standard of care, and I think that part of the task of the culture change that still lies ahead entails insuring our next generation of clinicians are aware and informed - misperception and uninformed bias against anything not currently taught in medical school starts early, and unfortunately easily reinforced as they go along in training and into practice. So I take a somewhat different tack these days when it comes to introducing or explaining Integrative Medicine to medical students and residents - more and more I find myself telling them that it’s now actually time that we moved beyond having labels for different kinds of medicine, that I actually eagerly look forward to a time when we don’t even use that term.
After showing them the comparison data on the dismal health outcomes of our current system along with our unsustainable healthcare spending to obtain those dismal outcomes, I then review with them a number of examples of strongly evidence-based integrative approaches to common primary care clinical problems, a number of which have at least equal if not greater efficacy than current “conventional” (i.e. mostly pharmaceutical) approaches, yet are often safer and less costly, and are increasingly being found in various national guidelines. I then introduce a simple fraction ratio, where the numerator is Effectiveness, Safety and Accessibility, and the denominator is Risk, Side Effects and Cost.
My point to them is that our obligation as physicians, as healers, is to insure that our patients are aware of and have access to interventions and treatments that have the greatest positive ratio – that is, that are the most effective, safe and accessible for the least risk, side effects and cost. Those treatments and interventions represent the best “Medicine” that we should be recommending and advocating for our patients. Sometimes the best choice may indeed be a pharmaceutical or surgery or even chemotherapy – but more often, they are (or should be) an “Integrative” approach, and point out that not only do studies, for example of the Mediterranean diet, Exercise, Mind Body therapies or healthy sleep demonstrate equal or better outcomes than medications, and are safer, more accessible and under patient control – they also address root causes of multiple chronic disease, down to epigenetic and telomere changes, with enormous potential implications for public health and community wellbeing.