What has happened to Health Care?

Over the past few months, I have received more phone calls than ever before from physicians who work within corporate health care. They ‘want out’ of this health care model. They feel it is dehumanizing for both physicians and patients.

What happened to health care?
16 years ago I left corporate health care to create a health care system within which I could practice medicine authentically from a place of integrity. I felt the dissonance (in the corporate model) between the mission it espoused to serve and its behavior towards its patients and physicians.

Physicians were caught in the middle of this dissonance and were being feared into treating patients like commodities for revenue. Two decades ago, this behavior was subtle and did not pervade all health care systems. In the past decade, this has become the normal business framework within corporate health care. Physicians adapted to this approach at first, but over the past decade, the consequences of this approach have been harder to bear. Many have had enough. More than
ever, doctors are leaving corporate health care to practice medicine in the community again, to restore meaning to their work.

When I left corporate health care, I wanted to create a system where the business model served not only my vision of health care, but was restorative of its larger vision which had been cast aside by the corporate health care system. I wanted it to be scientifically and medically grounded, yet open to growth and learning, and above all, patient-centered.

What I envisioned were two intersecting circles. One circle represented my vision and mission, and the other the business model. I wanted these two aspects to relate to one another symbiotically, with synergy and resonance.

The health care practitioner in this model would serve its vision while remaining cognizant of the need to be a healthy, sustainable, and cost effective business. It needed to be environmentally friendly and committed to creating minimal waste. [Health care is one of the largest generators of environmental waste in our country]. It would be committed to promoting health in the community. The standard of practice would be of the highest caliber and its patients and clients would be served with expertise balanced with love and compassion.

In this manner, the model I envisioned could bring meaning to both the practitioner and patient, and restore the soul of health care. This model’s success would be
reflected in a change in the health of the community served. One of the markers of this would be a rise in the health food market within the surrounding communities demanded by conscious consumers who desire organic food and options for a healthy lifestyle.

What I realized nearly two decades ago was that the mission of corporate health care and its business model were worlds apart. The separation between the two has only grown wider in recent years. Physicians are courted to join the corporate system, but soon discover that what they are serving is a model run by a ‘profit at any cost’ mission.

Administrators fear physicians into herding patients through their day to increase profit margin while compromising quality of care. The mission of health care administrators (profit) is far removed from the mission of medicine (healing).

This results in a continued loss of meaning for both physicians and patients. The current corporate model is not symbiotic, collaborative, or sustainable. In fact, it is opportunistic. When cells in the body stop collaborating and become opportunistic, we call this ‘cancer’. Corporate health care today resembles the cancer cell in its behavior towards both physicians and patients. It has lost its way.

Years ago when I left corporate health care, I was shamed by administrators who told me I was not a ‘team player’. I did not ‘tow the party line’. Even my colleagues questioned my lack of loyalty to the system to which they had adapted. I refused to adapt to the corporate practices that came between me and the mission of medicine. My conscience would not allow it. After creating The Ommani Center, I practiced alone with no collegial support for well over a decade. I directed my energy towards creating a compassionate yet scientifically grounded health care model based on integrity that embodied a synergy between my vision of health care, its business model, and the essence of Medicine. I wanted it to restore the ‘soul’ of Medicine while honoring the scientific method. This was the only way it could keep patients safe.

Now, 14 years later, my vision and hard work is bearing fruit. Our community has more health food stores, earth based,and organic food than ever before. Fitness centers are plentiful. Even the standard grocery stores have organic choices.

The consumer has awoken to the power of ‘food as medicine’ and has experienced a restoration of health and well-being with lifestyle changes. More people are seeking to be educated in how to keep themselves healthy and empowered.

I am greatly encouraged by the movement underfoot. The consumer of health care and the physicians who are squeezed to perform for profit in corporate health care are waking up to the reality of its shadow. It is only by making its shadow conscious can we transform a system.

As we continue to shine the light on corporate health care’s shadow, it will be forced to transform. My hope and dream is that we emerge on a large scale from this with a healthier and more integrative model of health care, one that honors patients, physicians, and also engages a healthy and sustainable business model.

The Ommani Center has proven that this model is a successful as well as a viable solution to the crisis in health care.

Can we Change the Course of Cancer by treating our Patients with Love?

I recently had a heart expanding moment.  In that moment, I felt a deep and wide sensation of energy radiating from the center of my chest.  I would call this a “vertical moment” one that feels powerful in its quantum nature.  Its memory has lingered and inspired me to reflect on the power that love can have on the course of an illness. As a physician, it made me wonder, “what if we engaged our love when we delivered a diagnosis?  What if we offered hope rather than fear? What if we loved our patients more?  What if we engaged wonder and mystery rather than statistical predictions?”

We were at a small café in Madison, WI for Saturday breakfast.  The middle aged couple at the table next to us was leaving as we arrived.  The wife clearly had cancer.  She had a makeshift turban over her bald head and her skin looked pale and flat, like the skin of many patients undergoing chemotherapy.

I watched their interactions as she fumbled to stand up after her meal.  Her husband’s kindness was palpable.  He offered her support with his strong arms and loving words. He knew she was too weak to stand up by herself.  His voice was filled with love and resounded like a melody through my heart.   It was one of those numinous moments where my heart melted and I wanted to laugh and cry at the same time.  I was reminded of the depth of loving kindness that people are capable of showing each other.  I surmised many theories about their life during this sacred moment – “he was in it with her for the long haul; he loved her unconditionally; she had learned to receive his love and support; she was weakened by her treatment; she was working extra hard to stay positive.”

Many people going through a cancer journey share similar challenges.  Traditional medicine fails them in its chosen ignorance of process.  Loved one’s who care for family members with cancer go unnoticed and unacknowledged by many in health care, especially physicians.  A cancer diagnosis also affects a patient’s larger community.  This is their lifeline that carries the task of empowering and caregiving over the long haul.  They are presented with the monumental task of transcending the fear that is mindlessly handed to the patient during the delivery of the cancer diagnosis.  This fear is the shadow companion that consumes vital energy during the cancer journey.

Fear is the often handed to the patient alongside a diagnosis of cancer. Is the “fear” part of the hand out really necessary? Or has our society just normalized it?  Why haven’t we normalized love, hope, reclamation, possibility or even opportunity?  I feel that it is finally time to reframe our perceptions of cancer or any illness, so those affected can be seen as the shamans that they are, bearers of deep and sacred wisdom.  They have faced the possibility of death and chosen to live.  They are powerful alchemists.  We must be open to learning from them as we also honor their process.

Of all diseases, cancer is one that can suddenly call us to transform.  It can be seen as a sudden wake up call, one that contains “awful grace”. It can force us to reevaluate our perceptions of the world, what we eat, how we behave, how we express feelings, and how we practice self-care.  I would call these reevaluations, a kind of “medicine” that cancer carries in its powerful and tight grip.  This medicine must be uncovered and released in order for one to truly achieve wholeness.  The causes of cancer are often hidden and only present at unconscious and unseen levels.  Wouldn’t it be meaningful to explore these levels, to make them conscious for clarity and healing, so we can be guided into becoming larger versions of ourselves than before the cancer occurred?

One would think this could and should be the normalized approach in cancer, from the moment of diagnosis through recovery.  If we only view cancer as the monster we need to attack, how can we learn what it is here to teach us?  How can we reclaim our life from what we feel may be its many causes?  These are the nuggets of learning that carry the capacity for us all to free ourselves from its threat and restore wholeness during our journey. How can we awaken the alchemist within us and transform every atom in our cells into luminosity and light?  As we seek its elusive and often hidden “medicine”, we may even learn to live in a way that makes us “bad hosts” for it, to prevent it from resurfacing.  This is the framework that must accompany the diagnosis of cancer to offer patients the best outcome.

When fear is handed to patients in the exam room, a cascade of events occurs.  First, they dissociate to enable them to actually “take in” the diagnosis.  A part of them becomes paralyzed as their limbic system engages for survival.  This is the part of the brain that is activated for fight-or-flight.  Trauma enters the emotional body, disrupting their electrical system, creating an unsettled, chaotic feeling of shock that remains present for months and sometimes years.  Many describe this as a feeling of “static in their field”.  Patients have a hard time feeling settled and empowered.  They find it difficult to engage their imagination where they can access solutions and become seekers.  This is where they can also gain access to their inner wisdom, instinct and insight and the healing power of Sophia, the Divine Feminine, whose power and capacity lays dormant, waiting for connection.  Cancer or any disease carries the potential for activating this.  The fear handed out subverts their connection with this intrinsic power which regulates their inner pharmacy, capable of more healing we can imagine, more than even the medical system can understand.  It subverts their access to the ‘stuff of soul’ where quantum healing awaits.

The physiology of the stress response and the impact of chronic stress on the body/mind is well known throughout the scientific literature.  Its impact on the endocrine system is erosive and thwarts the regenerative power of cells.  Cell to cell communication is impaired and growth hormone in the pituitary gland is suppressed.  Insulin receptors malfunction and the adrenals wear out.  The entire delicate web of hormonal and endocrine communication is harmed.  Under stress, the tapestry of these delicately woven systems unravels and its threads begin to fray and tear.  Under stress, the very molecules of the body degenerate denying access to the luminous.  We become uncreative and unimaginative.  We lose faith in possibility and our lens of perception turns negative.  We risk feeling like ‘victims, waiting to be rescued’.

Cancer has been normalized by society as a terminal disease, one that leaves little hope for recovery.  Recovery is termed ‘survivorship’ and the adopted identity of ‘cancer survivor’ becomes a badge that defines the end of the battle.  Meanwhile, the energy of cancer alongside fear hangs in the rafters, waiting.  Fear is intricately linked with ‘survivorship’.  It lies huddled in the background, surfacing with the slightest symptom.  Fear ultimately causes chronic stress.  The immune system feels its cold claws, as they scrape even lightly upon the psyche and imagination.

Creating a new framework to support patients with cancer has the potential to change its face and its course.  The negative thought forms where fear and death are kept at bay, can be transmuted into opportunities for seeking the growth and healing this diagnosis evokes.  Such an approach has the potential to change its course and significantly improve its outcomes. I believe this is truly possible but will take an effort on all our parts to reframe what we accept.  Our greatest effort will be to embody the awareness that is required to shift the traction from fear that has been normalized that ultimately predicts and defines the course of cancer or any illness.

Medicine is at a crossroads, a gateway, where it needs to transform into a system that offers more love, and hope, and where exploration and education are honored as core values.  As a practicing physician, I have carried this framework alongside my expertise and have learned to love deeply and widely along the way. I have felt my heart expand and my wisdom grow, but most of all, I have grown to honor the sacred contract with my patients and their loved ones, who have chosen me as their companion, and walk with them through sickness into health and often into a transformed life.  For this, I am profoundly humbled and deeply grateful.

And regarding the couple in the café, in that moment of witnessing their love, my heart leapt towards them with a loving and supportive embrace as they left to continue their courageous journey through the hills and valleys ahead.   Their very presence was a gift and an inspiration to me as a physician and a person who feels deeply. Even though they may never read this article or know how deeply they touched my heart, somewhere in the tapestry of the Universe that weaves us all together, I hope they do.  I want them to know that their love, kindness, and courage was witnessed, and deepened many around them in more ways than they could have imagined.

The Hope of Transforming Health Care

In the words of Martin Luther King Jr., “Of all forms of inequality, injustice in healthcare is the most shocking and inhumane.”

My past few articles have been on the unhealthy infrastructure in health care today and how it adversely affects patients as well as physicians, nurses and those who work within it to serve.

Over the past few weeks, I have seen an inordinate number of patients who are hurting because of the way they are treated by administrative practices within this system.  The patterns of conditioning through ‘learned helplessness’ are pervasive and worsening as the systems continue to compete with each other for market share out of greed. 

We all comprise their ‘market’.  What they forget is that money is not a substitute for care.  Care is a choice born of intent.  But when physicians and nurses are ‘boiling frogs’, they are unable to provide the care they intended to offer.  Their care cannot be limited to a 15 minute office visit done under pressure.  When physicians take longer to problem solve, they are reprimanded and punished as it reduces revenue and threatens quarterly profits. 

A ‘boiling frog’ is a frog who is heated in water till it dies.  The teaching point is - because the torture is started in cold water and heat is applied slowly, the frog does not realize it is being boiled alive.  Its senses are sensitized to greater levels of heat.  As morbid as this analogy is, this is used to describe how people adapt to abuse.  This is no different in health care. 

Today’s physicians are no longer seen as healers.  On the contrary, they are viewed as tools that serve health care administration in all its extractive methods, merely generators of revenue, likened to Pavlov’s dog.  Today’s physicians have lost heart and meaning.  The mandates that grind them down demoralize and wound them in deep ways. 

I left corporate health care 15 years ago when this behavior was escalating.  I was unable to live under patriarchal rules.  Today, this treatment is being normalized by ‘the powers that be’.  For me, this is unacceptable.  For others, adapting is their only hope. 

It is important to lift the veil, to view the shadow beneath the blanket of illusion projected in marketing ads, with terms like ‘health’ and ‘care’.  We must wake up to what is really happening.  This is a system that purports to serve.   It offers neither health nor care. 

When patients wake up and demand authentic care, and physicians gain the courage to speak their truth, transformation will be the inevitable outcome. 

“Health care needs to be examined from the inside out, from the top down and the bottom up. There must not be any stone left unturned. When physicians analyze the current system in ways in which they were trained to analyze the body, they will be able to identify the pathology that keeps it sick. They will have to reach deep inside and stand in the face of criticism and rejection, with courage and heart to transform their system that has lost its soul.”

                                                    ~Becoming Real, 2011, by Rose Kumar M.D.

Health care is in crises.  In Southeast Wisconsin, both patients and physicians are struggling to make sense of the lack of consciousness that has taken over the health care system.  Morale is at an all-time low. 

I implore you all to awaken to what the reality of today’s health care system.  Nothing can transform without holding the light to it, including the shadow.  It is the only way to transform this system into one that actually serves the mission of its vocation.  When a critical mass of conscious consumer’s expects real care, the system will be forced to deliver what is expected.   

 I believe this is the only hope we have to transform health care.  This is also how it will ultimately recover its soul.

A DEEPER KIND OF HEALTH CARE REFORM

Many of us are disheartened by the state of health care today.  The solutions being proposed to repair and reform it are not sustainable for physicians or patients.  Every system functions from operating principles that govern and direct its mission.  In order for us to understand why health care is dysfunctional, we need to analyze and understand its business model as it relates to is mission.

Nearly two decades ago, physicians delegated the business of health care to administrators and accounting experts to manage and run it.  Unfortunately, their mission was in conflict with that of the health care system. Theirs was profit centric rather than patient centric.  They believed that patient care interfered with generation of profit.  They began to see time spent with patients as a compromise of their mission.  They began to value numbers over people. Health care’s mission became disjointed when two contrasting missions were being served. Profit became the dominating mission for health care as business managers established control over physicians and regulated and limited their time with patients for maximal revenue.

When I worked in this system, I was unable to find meaning in my work.  I was also unable to sacrifice my mission as a physician for the mission of health care administrators.  I was told that my work in their health care system was a conflict of interest to their mission.  My patients were staying well and not generating enough hospital dollars.  I left traditional health care to create my own business model.  As a physician who remains devoted to my patients I wanted to create a model that generated value for both my patients and my business creatively.   I have never sacrificed mission for profit. I run my business with good business savvy, all the while devoted to my purpose as a physician.  A health care business model risks losing its way when it becomes profit centric.  For healthcare to be successful and sustainable, mission must never be compromised for profit. Our health care system has lost its way.

We have many examples of profit driven health care in our country today and especially in southeastern Wisconsin.  These systems purport to care about health, but on closer examination, we see otherwise – they rely on sick care.  Health care is a conflict of financial interest. Currently, the highest expense in health care are administrative costs.  Many layers deep, administrators manipulate and control physicians, nurses and employees  serve their mission of profit over health or care.  This has demoralized physicians and nurses and driven away patients. Moreover,  it has increased the incidence of medical errors, placing patients and physicians at risk. 

Author and president of Business Ethics Magazine, Marjorie Kelly, defines a business model that functions with this type of focus as ‘extractive.’  Its’ purpose is merely financial – maximization of profits.  Worth is extracted from workers to generate profit by layers of administrative hierarchy.  The extractive business model is prevalent in most corporations today.  Outsourcing work to Third World countries for cheap labor to increase profit-margin is extractive.  Extractive economics are bad for our country’s economy.  It displaces domestic workers and extracts as much work as it can from the remaining workforce to serve profit margin.  Extractive economics deplete meaning from work.  Employees find themselves working merely to pay the bills for survival.  They lose pride and meaning in their work. As a result their physical and mental health suffers.  We all pay the price for extractive economics.  The state of our country’s middle class is a result of extractive economics. 

The majority of health care systems function from this extractive model.  Health care employees are currently working merely to meet quarterly projections.  For health care to operate in this manner is unethical.  Health care’s mission is to serve and heal.  When the vulnerability of patients is used to generate profit, they are deeply harmed. The ‘care’ they receive is motivated by the drive to maximize testing and treatment.  Physicians are unable to diagnose and treat cost-effectively when working for an administrative system based on extractive economics.  They must follow the rules of the game to keep their jobs.  Patients are left with super-sized bills for mere symptom management.  Administrative bonuses depend on this.

A ‘generative’ business model provides services that generate value.  Health care based on generative economics focuses on health and healing rather than maximization of profit.  The focus shifts from one of greed to one of service. Patient care is not provided at the cost of profit, and there is a balance between both without compromising either.  A health care model based on generative economics operates from the principles of sustainability.  There is a fair exchange between doctor and patient. 

What this would look like in the health care system is already visible at The Ommani Center for Integrative Medicine.  Patient care as well as sound business principles are utilized to serve patients cost effectively.  In addition, the most cost-effective diagnostics available in the community are recommended to patients.  Small businesses in the community, such as organic grocers, complementary practitioners and businesses dedicated to health and sustainability that operate from a high standard-of-care, receive support and collaboration by practitioners through patient referrals.  Education and empowerment are of foremost value and achieving optimal health at all levels is served.  All retail profits are used to subsidize business overhead to keep health care visits affordable for patients.

Practitioners work collaboratively with patients to uncover the causes of illness and empower patient responsibility.  The mission of health care is served and all profits are reinvested to support the staff and employees of the Center.  The business is also dedicated to the health of the environment and recycles to reduce its carbon footprint. 

The Ommani Center is a generative business. 

Those who administer the business of traditional health care state that a mission centric model cannot succeed financially, that a generative business model is not profitable.  Nothing could be further from the truth.  Shifting the focus of a business from profit to mission, from extractive to generative can actually draw in more revenue in service of its patients.  In addition, in a model like this, patients are truly served by physicians practicing from heart without the demoralization they currently experience within an extractive model of health care.

This is health care reform at the level of its core mission.

I believe this is one of the key solution’s to healing our broken system of health care.  This can also restore the soul of our sacred vocation.  

The Intention Behind The Ommani Center

How does one adapt to being uprooted and unearthed?  The human spirit strives to survive, to continually move towards its destiny to carve out a course that reclaims ones sense of meaning.  My mother is a person who experienced this.  At the age of 10, her parents were killed in the India-Pakistan partition, leaving her orphaned and terrified.  As life presented her with gateways, she was able to walk through some, and not others, due to the fears resulting from the acts of violence she had experienced that had been imprinted upon her.  She engaged her courage as she grew large at the wounded places and carved a course for her life that offered her meaning and purpose.  Over the history of the human race, millions like her have been left with varying levels of paralysis in our world with little emotional context. The context with which the unknown was encountered for them was through the experience of terrifying loss.
We may think that our generation is protected from this level of loss, that it is from a more distant time, but this is far from the truth. Our world has been warring for decades, leaving casualties of violence and encounters with the terrifying unknown embedded in our collective psyches.  We are living in a virtual reality.  We have learned to cover up our feeling function and learned to deny our deep emotions with creature comforts, with superficial solutions, none of which endure.  Eventually we must stand naked before ourselves, confront our gateways and step into our largeness, reclaiming what was taken from us and redirect our course consciously into the unknown.  This is what midlife expects of us.  In the areas my mother was unable to choose, due to her circumstances, I must.  Where she could not reclaim, I must.  We, the children of the last generation, now in midlife, must find the courage to engage our consciousness in the areas where we become stuck, and live  from our superficial yet familiar cultural framework and believe in the potential of our souls.  To redefine health from this context is our sacred task.  This is how REAL Health Care can be accessed.
The Ommani Center for Integrative Medicine was born from my strong intention to create a context for health that is deeper than just the physical level.  Health is more than just symptom management through integrative methods.  As important and vital as this is, it does not access true health or healing.  Being conscious of how and where one lives and relates to life from may be the more important and deeper context that determines one’s state of true health.  This can and must be evoked.
If those that killed my grandparents and irrevocably changed the course of my mother’s life had this level of consciousness and asked the important and REAL questions, needless suffering could have been averted.  We cannot go back in time and change history.  We can, however grow strong at the places where we have been wounded.  We can use our wounds to acknowledge our humanness and engage our courage to grow in consciousness and health.  We must engage our wounds in order to offer ourselves a larger context for empowerment, reclamation and ultimately for healing.  This will uncover a deeper sense of meaning in our lives.
A Health Care System that can hold this level of space from a context such as this, inclusive of modern technological advances with high-standard –of –care, is what we all deserve.  It is a place where meaning is restored.  Cultivating and supporting a system like this is sacred work.  For me, it is a vocation.  Where my vocation aligned with my mother’s biography is where I found meaning and an opportunity to create a larger context in the form of The Ommani Center where true health and meaning could be accessed that was inclusive of my love of medicine and my devotion to high quality health care.
If we want a system that cares and offers us more than what our current system offers, this needs to be our collective work.  Together, we must  support and expect health care to be REAL for us so it can  address our REAL needs and ask the REAL questions of us, questions that we can live out in our destinies from a place of health and meaning.  I encourage all of you to expect this from our Health Care System.  Our expectations of what is REAL will truly change our world for the better.

The Ommani Center – A New Model for Healthcare

Rachel Remen M.D. is a physician and mentor who inspired me 23 years ago. An article about her current work, Medicine’s Search for Meaning was recently published in The New York Times. It made me reflect on where I started as a young physician, and where I have arrived today as a physician who holds a vision of a healed health care system in my heart. I was a fledgling 3rd year resident in Internal Medicine at Stanford when I attended the talk that Rachel gave on ‘patient-centered’ medicine. I sat on the steps in the auditorium, listened to her and wept. My heart has remained open wide since that day at Stanford and I have pursued a path of LOVE and DEVOTION for my patients and it has been my hope for health care ever since.

As stories of entrepreneurs go, mine has been lined with challenges as well as immense creativity. I weaved in and out of corporate medicine after residency and left it forever in 1998 when I was told that “wellness is a conflict of interest for health care” and “preventive medicine does not generate hospital dollars”.
I suddenly realized that the business model that corporate health care serves is exclusively a financial one. The dollar is what is served, not health, healing or patient care. Physicians are merely assembly line workers who generate money for the health care systems quarterly profits. My heart continually breaks for my colleagues who work in a corporate model that serves administrators and policies, not patients.

Let me tell you something about what a doctor’s heart is like. As I talk about mine, I can assure you that many doctors entered their profession with similar stories and experiences and were seeking the grace in their work that fulfilled their passion to heal.

When I was little, I remember the first inklings of how I knew I wanted to serve in this capacity. When I was around people, I felt a deep ache in my heart. I didn't understand what this was for a long time. I knew I was always searching for why people got sick and how they could get well. I think I came into the world this way in addition to being raised around the scientific inquiry of my parents who are brilliant scientists. Because I loved science so much, I voraciously read everything I could get my hands on to help guide my understanding. Nothing was as fulfilling for my soul as seeking answers to difficult questions. I knew I had to spend every day of my life in this numinous place. Going to medical school felt like a natural extension of my passion for learning within the healing model available in our society. To be immersed in it and to be able to feel the joy that accompanied complicated problem solving was nothing short of bliss. When I was on the wards during my clinical rotations, that old familiar ache in my heart from childhood resurfaced. I now recognized it as LOVE. This strong and deep feeling, this ache, this love that I discovered I had for my patients has never stopped flowing.

I feel privileged and honored every time I am with them, ever since the first patient I ever saw. She privileged me as a medical student, to study her condition and honored me with her patience during my very green inquiry. Since that very first day, my patients have made it possible for me to explore answers with them. The closest I came to this with colleagues was with nurses during night shifts on call. I watched their dedication and devotion – a Florence Nightingale energy that held their patients in their hearts embrace. I followed them on the wards to learn how to balance intellect with love and to this day, owe my deep learning to them. They
mentored me on how to hold space and how to stay real in times that were stressful, during life and death, illness and health.

When Rachel Remen spoke of patient-centered care in her talk at Stanford, I was just getting ready to graduate from residency and enter my medical destiny track. That day, was the beginning of the rest of my career. It was as if it all came together inside of me and I received an ‘initiation’ of sorts into practicing medicine to honor the soul of my sacred vocation.

After I completed my training, I worked in corporate health care. No such feeling was present in that system. The numinous was unreachable. In fact, if my patients needed time and attention, I was penalized. I soon realized that I was now a worker on the assembly line, towing the party line and making money for administration that served the dollar, not the soul of medicine. After 7 years of experiencing this heartless model, I left it forever. Without a degree in business or any experience in running a medical practice, I took a leap of faith and designed The Ommani Center for Integrative Medicine – a place where I could practice medicine from that same sacred place that unfolded my path through medical school and residency, initiating me in this sacred vocation of science and healing.

Today, my intention for creating this Center permeates its presence. Despite my lack of confidence in running a business, I discovered that in addition to loving it, I was also a fierce advocate for patients. The Ommani Center was born as an answer to what I felt is missing in health care- my love for my patients and for being able to practice with heart and meaning without compromising the scientific method or patient safety.
The Ommani Center is a unique health care model. I created it with a mindset for sustainability, both from a financial and environmental context. The architecture was designed to give the feeling of ‘flow’. The paint used on the walls, the water and teas served, cleaning products and even the soap we use to wash hands and cotton gowns are all environmentally friendly. We recycle everything we can and are fiscally responsible in how we manage overhead and even where we refer patients for lab and diagnostic tests. I believe that we all have a responsibility to keep health care costs down. It takes extra work, time and energy for all. On my end, I pay extra to have my medical assistants enter lab and diagnostic data (into electronic medical records) performed at labs that cost my patients significantly less compared to hospital based tests. I would rather pay the $6000 – 7000 per year for staff time to save hundreds of thousands in health care costs. We must all do our part to transform health care. We cannot underestimate the power of one.

As a physician, I knew I would be sacrificing financial security to do what felt ethically correct for me. My moral compass came at a financial price. As a response to this, I shifted from a profit mindset to a sustainability one. The Ommani Center's sustainable business model has proven to be solid for more than a decade. Since 2001, it has sat gently on the earth, served patients with heart and meaning and kept its carbon footprint light.

Meanwhile, my colleagues in corporate health care, struggle to adapt to endless policies that micromanage them and restrictions that make it nearly impossible for them to practice from heart. Corporate health care is an experiment gone awry. In my least optimistic moments, I gain solace in knowing that The Ommani Center, a sacred health care model that stands in the heart of Pewaukee,Wisconsin is poised to be replicated in communities across America where patients and physicians are hungry to access sustainable, cost and therapeutically effective health care. This is my contribution to restoring the soul of medicine and for bringing meaning back into physicians’ lives who have sacrificed so much to heal others and are less than able to in the corporate system today.

When I see them working under emotionally abusive conditions in the current system, I feel an unbearable pain in my heart. I want them to know that it is now possible to practice with heart and soul and to serve patients rather than policies and administrators. The Ommani Center is like a lighthouse for health care. As it grows and expands in the near future, it will become a haven for physicians looking to restore their souls and reclaim their hearts as they follow the golden thread of their purpose for choosing their sacred craft.
I have come a long way since that threshold day on the steps of the Stanford auditorium. The vision in my heart that was ignited there continues to burn bright and is brighter each day as my beloved patients add their light to it.

Let us create the new model for health care together. Let us all remain true to its sacred purpose and mission so we can finally gain access to health and healing.

http://opinionator.blogs.nytimes.com/2013/09/18/medicines-search-for-meaning/?smid=fb-share&_r=1

What it Feels Like to BE with My Patients

Today I was thinking about the animating force in my body, in all our bodies, in life itself.  This animating force is SOUL.

Rumi says from the moment we are born, our soul is seeking union with Source.  This is the driving force of seekers.  I feel that the closest we can connect to Source in this life is through LOVE.  Music, poetry and art are all ways that come close to feeling the energy of Soul and connection with Source.  Another way to feel it is with people we love.  When I am with my patients, I always feel it.

I began feeling this sensation in my heart early on in my career.  It felt like the bliss of union, of connection and resonance.  It brought with it joy and lightness of being within me – a numinosity.  The moments I spent and still spend with my patients are indescribable, priceless and timeless.  These moments of soulful union are blessings in my life.

It feels something like this – “we are both here in this sacred space together, connected in a ‘soul contract’ to explore and seek a path to healing and wholeness.”

I can say that there is no other feeling quite like this one.  Maybe I can venture to say that it emerges from a portal in my heart that flows from my Life’s Work.  I don’t quite have the words to express what it feels like inside of me to be with my patients. Maybe BLISS is the best descriptor. Of course bliss is borne from LOVE.  Love flows from Soul as it seeks union with Source.  Being with my patients connects me to Source.

I am sure many other physicians feel this way; at least I hope they do.

The Dark Side of Healthcare

Most people don’t realize what it is like to maintain a private practice in today’s health care climate.  I applaud and honor any physician who has the courage and audacity to do so.  As a private practitioner myself, I know and love the challenges of growing and maintaining a medical practice.  I know what it takes to swim upstream and settle for a fraction of what employed physicians get paid.  The trade-off they make is a large salary with little to no freedom to work from the soul.  They work for a system that is heartless and expects them to meet quarterly projections.  Many physicians feel trapped by the organizational limitations placed upon them, but have difficulty leaving to work independently.

It would be accurate to say that private practitioners belong to a sacred tribe, one that is preserving the heart and soul of Medicine.  I have experienced being an employed physician long enough to know that the heart and soul of medicine are absent in corporate health care.  After 6 years of practicing in that setting, I left that system and have never looked back.  I remember the immense initial adjustment this took. I had to rearrange my definition of success and put meaning in the forefront.  I remember feeling the tension between the financial freedom that being an employed physician offered versus the financial stresses of being in private practice. I also remembered the tension between what the ‘system’ expected of me –patient numbers- and my longing to be able to truly connect with my patients – a sense of meaning.  I opted for the latter, sacrificing the former.  The payoff was priceless.  15 years later, I can’t imagine working any other way.  My life is simple and sustainable.  My medical practice also operates from a model of sustainability.  Most importantly, I don’t work for the medical system’s financial projections.  I work to serve my patients, the vocation of medicine and the health of my community.

Two decades ago, our medical system embodied the scientific method, valued the doctor-patient relationship and practiced from soul.  Today, money and profit is what health care is serving.  Neither health nor care is its goal.  It is a ‘sick care’ system that manages symptoms in the ‘name of health care’.  The scientific method has fallen by the wayside.  Health care today has become a ‘closed system’ where even scientific evidence of harm is sidestepped in the name of profit.  Preventive medicine is a conflict of interest for this model.  Symptom management does not involve patient education, lifestyle change, patient responsibility or healing.  It involves using prescription drugs to manage symptoms.

Today’s health care consumer is waking up to the reality of this dark side of health care.  When people experience the lack of care from their physician who practices under pressure within a corporate health care system, they look elsewhere for a doctor who can take the time to problem solve with them.  Many people want more than what the current distortion of healthcare is offering. They want to learn what made them sick, how to heal, how to stay healthy and how to live consciously.  This is what patients, the consumers of health care, deserve.

One of the biggest crises in America today is the contamination of our food supply by the food industry.  We are all discovering that the large corporations running our food industry are no different than the pharmaceutical industry.  Our food supply is contaminated with hybridized plants, chemicals, pesticides and additives. If food is medicine, eating these foods is making us sick.  The incidence of food related illnesses in our country has skyrocketed.  The medical systems answer to this is pharmaceutical management.  Today’s medical paradigm still does not see the connection between food and health.  One broken system supports another.

The solution to this seemingly insurmountable problem is already underway.  A critical mass of people is formed and demanding change.  They are simplifying their diets.  They are eliminating chemicals and processed foods from their grocery lists.  They are eating clean, organic and local foods. They are living more in harmony with nature.  They are making choices to promote health.  They are discovering that many of their diseases are diseases of lifestyle; that the body is more resilient and regenerative than they have been led to believe.

Healing and transformation require work.  As adults, we must recognize that our choices will determine the kind of world in which our children will live.  We must do the good and hard work of creating a shift in our current societal paradigm.  Society and all of its systems are currently broken.  They have gotten so far off course that the lack of soul is palpable within them.  But I and many others, who refuse to compromise health and meaning in favor of money, are changing the organizational sickness by serving what is important and real.  I encourage all of you to see through the illusion of our health care system, demand the kind of care that you rightfully deserve and do the hard work required to restore the soul of our world by making personal choices for health and healing without compromise.  It is the only solution for correcting our collective course and restoring wholeness to our personal and collective lives.

As Margaret Meade said, “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.”

We are those people.  This is our time.

The Hippocratic Oath is NOT Served by the Corporate Healthcare System

This is the oath physicians honor when they graduate from medical school.
This is the oath that I have served since I graduated 30 years ago, that I hold sacred and expect the healthcare system to also serve.
I also expect all hospital administrators to remember that this is the oath that they serve, not the policies that are based on power and greed.
Employed physicians are unable to serve patients from this oath when administrators that control them have an agenda that is not in alignment with the Hippocratic oath.

THE HIPPOCRATIC OATH (modern version)

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

—Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University

http://opinionator.blogs.nytimes.com/2013/10/02/who-will-heal-the-doctors/

Midlife as Alchemy

What is Midlife? What is Menopause? What is at stake?
What is our Conditioned-Self?  What is our Authentic-Self? How do they differ?
In my 22 year history as a physician who has worked with thousands of brave and courageous men and women with stories of wounding, suffering and healing, I can say that I have been able to identify the differences between these selves and the intrinsic power that emerges when one leaves the Conditioned for the Authentic Self.  The Conditioned-self is who you were told you SHOULD BE. The Authentic-Self is WHO YOU ARE.   For the first half of our lives, the Authentic-Self is buried beneath the Conditioned.  In the second half, we must re-emerge Authentic.
There is a powerful shift that occurs in midlife when our physiology and soul intersect at this gateway to make room for the REAL to emerge.  This creates a felt space between the Conditioned and Authentic selves.  The traction of the conditioned one pulls at us, urging us to behave from familiarity based in FEAR.  All the ‘shoulds’ fear us into staying stuck.  Fear is the feeling that adapts us in the first half of our lives.  We adapt to be accepted.  Adaptation conditions us. It creates a shell around our Authentic –self that waits patiently for us to awaken.  We learn to withhold our truth; we say ‘yes’ when we want to say ‘NO’. We over-ride our true feelings to be accepted and loved.  For decades we live this way.  We construct our lives from choices that emerge through our conditioning.  We become part of society’s ‘herd’.   We normalize this identity and close our eyes.
When we turn 40, something changes.  A soft whisper fleets through our body and mind, suddenly with no warning.  Sometimes we don’t really hear it, sometimes we try not to.  It beckons us to awaken, to bring LIGHT to our choices.  It says, ‘Who are you really?’  This frightens us.  If we don’t listen, it moves in deeper, rises stronger – as fire, as density -anxiety, depression –in our bellies, pulling us in.  We begin to sweat, to hot-flash; we awaken at 3 am with minds racing and fear coursing in this unknown place.  In the middle of the dark rises a whisper of comfort, the voice of our Soul pulling us in – to connect, to open, to awaken and deliver us finally to our Voice and our Truth.
If we do not listen, it may call to us as cancer, divorce, tragedy, devastation, that forces us inward to evaluate, deconstruct and  make ourselves new.
All this sorting and sifting, transforming and reinventing – THIS is midlife.
This is menopause.
This is not a sickness or a  deficiency. This is NOT a pathology.
This can NOT be medicated away.
This is HERE to stay and it will offer us the fire of alchemy into which we must step to make ourselves WHOLE.
The voice of the Authentic-Self will rise from ashes of the conditioned one as adaptations fall into the fire to be transformed.  If we willingly lean into this, our voice will emerge – FINALLY- the TRUE voice we will use to heal the world.
We will spread our wings and fly out from this fire into life again with wisdom and an inner eye that can never be closed.