A descriptive analysis of an integrative medicine clinic.
OBJECTIVE
To evaluate and describe an integrative medicine clinic including its patients; their presenting problems, medical objectives, treatment recommendations; whether recommendations were recalled and adhered to; and patients' self-reported health outcomes.


METHODS
A prospective cohort study of 160 new clinic patients were treated using a wide range of integrative medicine therapies. Patients were interviewed at intervals of 1, 3, and 6 months after their initial visit.


METHODS
The study was conducted at the Institute for Health and Healing clinic, at California Pacific Medical Center located in San Francisco, CA.


METHODS
The subjects were new clinic patients seeking care for a variety of symptoms and diagnoses.


METHODS
Patients presented with an average of 4.0 symptoms and 2.9 diagnoses; physicians recommended 9.5 "treatments" per patient.


RESULTS
At 6-month follow-up, symptom intensity decreased from 6.5 to 4.2 (on a 10-point scale; p < 0.005); and 57% of the patients had made "substantial" progress or had completely achieved their health objectives (p < 0.005). The Short Form 12 (SF-12) measure of mental and physical functioning improved significantly from baseline to one month (p = 0.05; p = 0.001, respectively) and maintained this improvement at 3 (p = 0.01; p = 0.01) and 6 months (p = 0.001; p = .001). At 1-month follow-up, patients recalled 57% of the actionable statements from the physician without a prompt and they followed 55% of all recommendations well (90% or above). Over the follow-up period, patients increasingly attributed the reductions in symptoms (p = 0.01) and achieving their health objectives (p = 0.01) to the treatment plan. Self-reported measures of days ill and days missed at work/school did not differ significantly from the year before coming to the clinic.


CONCLUSIONS
The results indicate that patients can recall and follow a complex treatment regimen. Subjective and objective measures of patients' health status improved after one month and this effect was sustained or improved further at 6 months follow-up. Further study is needed to determine whether patients' improvement was the result of the treatment regimen.
Scherwitz
Larry W
LW
Institute for Health and Healing, California Pacific Medical Center, San Francisco, CA, USA. larrys@cooper.cpmc.org
Cantwell
Michael
M
McHenry
Pamela
P
Wood
Claudia
C
Stewart
William
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002648:Child; D015331:Cohort Studies; D003151:Community Health Centers / Q000592:standards*; D000529:Complementary Therapies / Q000592:standards / Q000706:statistics & numerical data; D019033:Delivery of Health Care, Integrated; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000592:standards*; D011369:Professional-Patient Relations; D011446:Prospective Studies; D012495:San Francisco; D013997:Time Factors; D016896:Treatment Outcome