Summary: Just as the corner of the covers was lifted off 2008 in January, mind-body medicine and guided imagery pioneer Marty Rossman, MD, sent the Integrator "a little rant." Rossman's statement of his credo from 40 years of holistic practice came as a response to an Integrator comment forum on the failure of business models for integrative clinics. Rossman's perspective is a good companion piece to the hopeful column by trends expert Gerald Celeste: Rossman describes what needs to be the center of a practitioner's commitment if he or she wishes to abet the arrival of the "Heal Yourself Health Care" Celeste sees coming.

Martyin Rossman, MD

I learned of the work of Martin Rossman, MD nearly 25 years ago through Peggy Smith, ND, LAc, then a colleague at what is now Bastyr University but was, in 1984, a single purpose naturopathic school with a budget that had just hit $1-million. Smith was traveling regularly from Seattle to Rossman's Bay Area base to gain certification from the Academy for Guided Imagery which Rossman co-founded. "Guided imagery" seemed even more obscure than Bastyr's specialty at that time. Rossman, a medical acupuncturist and holistic physician, was Smith's teacher. He has educated and certified hundreds of practitioners since. Through his Healing Mind organization,he's directly serving the body-mind health of thousands of individuals.

Earlier this month, Rossman sent me an e-message in response to an Integrator commentator, Mary Lawlor, CPM. Lawlor had been part of a discussion published December 11 based on an article on the failure of Wellspace

"I wanted to thank Mary Lawlor for her clear perspective on what differentiates real, human, integrative healthcare from a so-called 'healthcare industry' that attempts to adopt economic and treatment models more suitable to fast-food chains. As a medical doctor who has attempted to practice holistic (now 'integrative') medicine for nearly 40 years, I have come to believe a few simple-minded things about our approach to medicine and health care:

	"A truly integrative approach optimizes and amplifies the healing effects of belief and expectation through the medium of the practitioner-patient relationship." - Martin Rossman, MD

"While I believe that many modalities used in integrative medicine have effects of their own, a truly integrative approach optimizes and amplifies the healing effects of belief and expectation through the medium of the practitioner-patient relationship. A therapeutic relationship that engenders mutual caring and confidence allows for not only enhanced healing effects but for the transfer of knowledge, and trust in our innate potential for healing.

"This optimization of the placebo effect (better thought of as the 'healing effect' as the good Dr. Weil has suggested) is largely dependent on the interacting belief systems of practitioner and patient, which is held, molded and supported by the nature of their relationship on both human and archetypal levels. The understanding of, and skillful utilization of, this relationship and its effects is the art of the practitioner, which adds to the effect of whatever material science or therapeutics they can bring to bear on the situation.

"While natural health care practitioners vary as widely in their ability to relate to patients as do MDs, I would suspect that if they were studied we would find that there is a general tendency for holistically-oriented practitioners to be more people-oriented than disease, condition, or modality oriented. Holistically-oriented people are more likely to be generalists rather than specialists, and thus more likely to be interested in spending time with patients, listening to them, and supporting a meaning-based and caring approach to medicine, all of which tends to support healing. Of course, there are many exceptions, but in general, therapeutic relationship is nurtured by focused yet unhurried attention, listening, and communication in language that is understood and accepted by the patient.

"Needless to say, none of this fits into the economic dream of setting up health clinics with a menu of therapeutic choices prescribed according to standardized protocols with interchangeable practitioners. This model is based on the same fallacy that has generated the dominant medical model -- the belief that disease and cure both come from external forces and the patient is a passive recipient of the expertise and ministrations of an expert in medicine, supplements, herbs, homeopathy, acupuncture or whatever modality they choose. I think it's becoming clear that this model does not seem to work, with either conventional or CAM [complementary and alternative medicine] modalities.

"The bigger picture, as we know, is that 80% or more of all afflictions get better by themselves, and 80% or more of what remains would get better if people changed their ways of eating, moving, and managing stress and emotions." - Rossman

"Some people do indeed have bad illnesses and injuries visited upon them for reasons we do not comprehend or control, and conventional medicine does have some remarkable life-saving capabilities in certain circumstances. But the bigger picture, as we know, is that 80% or more of all afflictions get better by themselves, and 80% or more of what remains would get better if people changed their ways of eating, moving, and managing stress and emotions. Above and beyond the specific effectiveness of acupuncture, homeopathy, nutrition, and other CAM modalities, perhaps the greatest two values that integrative practitioners bring to the healthcare table are these -- they (in general) do no harm (as opposed to being the third or fourth leading cause of death in America as is conventional medical care), and they support people to learn more about their innate healing abilities and in developing lifestyles that support those abilities.

"This is in no way meant to demean my respect for fish oils, herbs, acupuncture, bodywork or the people who use them (including me) but to underscore the very real possibility that health cannot be created or sold like caramel macchiatos or In N' Out Burgers. It's too bad, in a way - it would be so much easier!"

Marty (Rossman, MD)
www.thehealingmind.org