Sonoma West Medical Center Integrative Health Institute

To reverse the rising tide of illness, health, and medicine can and must align to bring the best of each system together. Dr. Bauman and colleagues co-founded an Integrative Health Institute (IHI) within their 70-bed district hospital. This featured an Eating for Health™ café to provide quality meals for patients and staff, in-patient and out-patient natural health services, wellness workshops, and prospective research. Read on to learn the blueprint Dr. Bauman used to implement this powerful innovation.

A Case Statement

Introduction to Programs and Services

The Sonoma West Medical Center: Integrative Health Institute (SWMC-IHI) is a pioneering set of programs and services that reinvent rural hospital health care. It is succeeding by providing what local and regional residents want — community-oriented health-building care that synthesizes modern, scientific medicine with integrative health, clinical, and educational programs. The Sonoma West Medical Center opened on October 31, 2015, providing emergency services, intensive care, surgical care, and a variety of specialty institutes which include the Integrative Health Institute (IHI), founded by Dr. Ed Bauman and Dr. David Murphy.

The inclusion of integrative health into the day-to-day business and the core operating mission of the hospital is fundamental to reaching the identified marketing demographic of the greater Sebastopol community, who equate personalized medicine and health-building strategies with quality care. The Integrative Health Institute will be a central fulcrum to coordinate a community-inspired solution to meeting the ever-changing health needs of our community — and subsequently boosting revenues at SWMC by expanding patronage, cultivating advocacy, and proactively pursuing strategic alliances.

The IHI will serve thousands of both SWMC internal and external populations including:

In-patients admitted for illness or surgery.
Out-patients who will receive personalized consultations during and after their stay and participate in classes and groups for chronic disease management to reduce the incidence of costly re-admission.
Community residents, especially our growing aging population.
Family practice, primary care physicians, SWMC physicians, and natural health practitioners, who will partner with IHI to refer their patients to quality clinical and educational programs and services.

Sonoma West Medical Center Integrative Health Institute will offer a consultation program for the above audiences, based on medical referrals and self-referred clients from the broader community and from afar. Program components will include:

Integrative Health Resource Center and Cafe
Individual Health Therapy Sessions at the Hospital by Appointment
Outpatient Follow-ups with Integrative Health Providers
Data Collection and Clinical Research

The Case for Integrative Health

Impact of Chronic Diseases in America

Ninety percent of the nation’s $4.9 trillion in annual health care expenditures are for people with chronic and mental health conditions. Interventions to prevent and manage these diseases can have significant health and economic benefits.

In addition to the astounding cost of preventable disease, avoidable re-admissions to hospitals, especially through emergency rooms, costs the health care industry billions annually as well. Studies show that 18% of Medicare patients are readmitted within 30 days of their discharge, costing more than $15 billion. Many of these re-admissions are considered avoidable and caused by poor transition services and a lack of individualized long-term health planning. Patients often do not receive adequate instruction on how and even why to continue their care at home with holistic and lifestyle choices.

Both prevention and re-admission costs of Medicare are such an issue that they are on the national agenda of the President, with a goal to broaden accepted care options to more than just “reimbursing drugs and surgery” and approving and promoting prevention of the root causes of disease.

The approach of Integrative Medicine (IM) — approaching the health of a person as a function of their whole body, including the mind, and applying all therapies available both natural and pharmaceutical — has the power to reduce chronic and preventable illness by up to 75%, and hence save taxpayers billions of Medicare dollars and save millions of lives, all while improving quality of life.

Dr. Dean Ornish’s 35 years of research and publications on how heart disease and other chronic conditions can be reversed and curbed with an integrative treatment plan of stress reduction, a low fat, whole food vegetarian diet, moderate exercise, and social support, have been recognized by all levels of the medical community, government, and society as real solutions. In a comprehensive study by Ornish’s Preventive Medicine Research Institute involving 8 hospitals, for example, 80% of heart disease cases destined for surgery were reversed by integrative medicine practice by patients over a year. Their insurance company saved $30,000 per patient.

Health and Wellness Market Size, Intelligence, Innovations & Dynamics

The global health and wellness market size is anticipated to grow from USD 6.16 trillion in 2025 to USD 9.94 trillion by 2034, with a compound annual growth rate (CAGR) of 5.46% during the forecast period from 2025 to 2034. The growing demand for healthy lifestyles, technological advancements, and the burgeoning medical tourism sector are the major growth factors of the market.

Furthermore, the aging population is driving demand for products and services that promote overall health and well-being, including exercise equipment, healthy food options, and supplements. The rise of alternative medicine, such as traditional Chinese medicine and Ayurveda, is also a response to this trend, as people seek natural and holistic approaches to healthcare.

The growing interest in preventive healthcare is also driving growth in the health and wellness market, as people seek to prevent disease before it occurs. This includes regular check-ups, health screenings, and lifestyle changes to reduce the risk of chronic diseases.

In March 2024, Hackensack Meridian Health announced the launch of a first-of-its-kind health and wellness center at Metropark Station in Woodbridge, New Jersey. It is a $200 million project to bring riders and nearby residents access to comprehensive ambulatory care.

Since Integrative Health Services are patient driven, it does not need to rely on health insurance coverage. A 2013 Rand Corporation sponsored study by Patricia Herman, ND, MD, found that complementary and IM reduces the real cost of health care in three ways:

Direct replacement of traditional surgery or medical treatment.
Lower healthcare utilization in the future by prevention.
Reducing productivity loss in employment.

Patients hence have a direct interest, for their own health and financial sustainability, to pay for prevention and holistic treatments. If the patient, who is paying out of pocket for the IM treatment thinks it will save her money and health problems in the long-term, it is cost effective to her. Since IM treatments are inexpensive when compared to surgeries and chronic treatment, the fact that insurance does not cover the treatment may be a moot point if education and awareness can supersede.

Project History, Mission, & Vision

Integrative Health Medicine is a whole-person approach to health and wellness, designed to treat the whole person, not just the disease. Treating the body, mind, spirit, and community — not just flesh, bones, and organs — is steadily becoming a desirable and effective option for many people. The SWMC Integrative Health Institute will emphasize patient empowerment and encourage patients to take an active role in their health.

IHI will combine state-of-the-art, conventional medical treatments with other therapies that are carefully selected and shown to be effective and safe. The goal is to unite the best that conventional medicine has to offer with other healing systems, therapies and self-care education derived from cultures and ideas — both old and new. Whenever possible, integrative health therapy and education favors the use of low-tech, low-cost interventions.

We recognize the critical role the practitioner-patient relationship plays in a patient’s overall healthcare experience, and we will care for the whole person by considering the many interrelated physical and nonphysical factors that affect health, wellness, and disease — including the psycho-social and spiritual dimensions of people’s lives.

The Integrative Health Institute Wheel of Health is made up of three concentric circles that represent the primary elements of optimal health, and form the core of integrative practice:

Mindfulness: At the heart of health is mindfulness, the practice of staying alert to your physical, mental, social, and spiritual states. This non-judgmental awareness enables individuals to recognize symptoms as they emerge, which is when they are most readily treatable. This is the critical core of well-being, on which the other elements are based.
Self-Care: Individuals are encouraged to explore the dynamic interplay of the ways they can care for themselves and to develop proactive strategies to improve or maintain their health. Important areas for self-care are relationships, the physical environment, nutrition, movement, and exercise, the mind body connection, and personal growth and spirituality.
Professional Care: Recognizing symptoms early is key to diagnosing health problems when they are most treatable, and awareness of the need for professional care is an integral component of any integrative approach to medicine. Professional care includes pharmaceuticals and supplements, preventive medicine, and conventional treatments.

IHI will follow a consultative care model, where integrative physicians and practitioners work in close collaboration with the patient’s primary provider. This model has been particularly successful across the country as it lends itself to financial sustainability and incremental program growth. Some examples of successful consultative care models include the following organizations.

Osher Center for Integrative Medicine at University of California, San Francisco (UCSF)

The Osher Center’s integrative oncology program works in collaboration with the UCSF Helen Diller Family Comprehensive Cancer Center in San Francisco, California. Patients who are referred receive integrative care — mind-body therapies, nutrition, etc. — in tandem with their conventional cancer care. Osher Center integrative physicians also work with other primary providers, offering care programs across the lifespan from mindfulness-based childbirth and parenting to integrative exercise and balance training for healthy aging. In addition to these services, comprehensive care is offered for women’s health.

Integrative Medicine Program at the Mayo Clinic

More than 90% of its patients are referred from within the larger Mayo Clinic health system. The program specializes in integrating wellness-promoting services — such as meditation and other mind-body therapies, resilience training, massage therapy, acupuncture, and herbal/nutritional medicine — into the whole person plan of care for interested patients. The program’s staff work collaboratively with patients and healthcare teams to manage symptoms such as pain, anxiety, stress, insomnia, or nausea associated with illness or treatment.

Osher Clinical Center at Brigham and Women’s Hospital

The Osher Clinical Center receives referrals from within the Brigham and Women’s Hospital (BWH) hospital in Chestnut Hill, Massachusetts and the surrounding community, working in collaboration with the patient’s primary provider to treat musculoskeletal disorders — especially back pain, chronic pain, headaches, women’s health issues, stress, sleep disorders, gastrointestinal disorders, and depression.

Project Details, Primary Goals, Population Service Target

The IHI will serve three population groups:

Services provided to in-patients admitted to the hospital for illness or surgery. This could include hypnosis, guided imagery, massage, acupuncture, energy healing by trained nurses or specialists, and other mental and behavioral health evaluations and support which frequently emerge in an acute care setting.
Classes and groups for recently discharged and others in the community who are diagnosed with a chronic condition. This would include classes and workshops focused on nutrition, wellness, prevention, and self-management of conditions such as diabetes, chronic obstructive pulmonary disease, arthritis, heart disease, etc. Each patient would be assigned a patient navigator and/or health coach who would help them develop a plan for healing. This could include specialists at the Institute, group and individual education and support, and referrals.
Referrals to a network of integrative health providers who provide these alternative and complementary services within the community.

Integrative Health Therapies Offered at SWMC

The key to making the most of Integrative Health is to pursue therapies proven to be safe, effective, and appropriate for a patient’s individual health status. Evidence-based therapies often used in tandem with conventional medical care include the following:

Acupuncture

Acupuncture is the insertion of hair-thin, stainless-steel needles into the skin at specific locations to manipulate the flow of energy in the body. The National Institutes of Health (NIH) states that acupuncture is proven to treat pain, nausea, and vomiting. Other conditions for which acupuncture appears promising include asthma, menstrual cramps, and osteoarthritis. Conventional medicine asserts that acupuncture stimulates the nervous system, which releases chemicals that change the perception of pain and influence the body’s internal regulation system. Chinese medicine says it restores the body’s proper energy flow, which stimulates its natural healing abilities.

Biofield Therapies

Biofield Therapies are techniques that seek to tap into and manipulate the body’s own healing energy. Biofield therapies fall under the National Center for Complementary and Alternative Medicine’s category of energy medicine, and they include Reiki, healing touch, qigong, and polarity therapy. Many biofield techniques involve gentle touch aimed at promoting mental and physical well-being. The goal is to facilitate unrestricted energy flow throughout the body; promote balance, peace, and relaxation; and stimulate the body’s healing energy. Studies have shown some types of touch therapies to be beneficial to patients ranging from premature infants to chronic pain sufferers to cancer patients.

Guided Imagery

A visualization technique that teaches people to focus on positive mental pictures, guided imagery is based upon the belief that the mind can affect the body’s functions. It is used to promote relaxation, reduce stress, and help the mind effect positive changes in the body. Proponents suggest that stimulating the brain in this way can affect the endocrine and nervous systems, which can lead to improvements in immune system function. There is also evidence that guided imagery can lower blood pressure. The best available research indicates that guided imagery is a valuable relaxation technique and is useful as a complementary therapy. At least one major health maintenance organization is now offering visualization tapes to all pre-surgical patients.

Hypnotherapy

A state of focused attention during which consciousness is altered, and distractions are blocked, hypnosis enables people to focus deeply on one thing and is a means of promoting relaxation and reducing pain and stress. The health-promoting benefits of hypnotherapy are widely accepted. Hypnosis can divert patients’ attention away from pain by inducing a state of deep relaxation. It has been proven to alleviate nausea and vomiting. There are even documented cases of hypnotized patients undergoing surgery without anesthesia. Some scientists believe that hypnosis causes the brain to release natural painkillers, while others think hypnosis works through the unconscious mind and the power of suggestion.

Mindfulness Practices

Mindfulness refers to moment-to-moment awareness that enables people to engage fully with the present moment, the fullness of life, and their own inner resources for healing, adapting, and growing. Through practices such as meditation, participants develop skills that enable them to relax deeply and truly experience what is going on both inside and outside themselves. Mindful eating and mindfulness-based stress reduction (MBSR) have proved to be effective tools in whole-person medicine.

Yoga and Gentle Movement

Yoga, which means “to yoke” or “to unite,” is an ancient practice designed to unify the body and mind, the individual, and the universe. While Westerners typically think of hatha yoga, which stresses physical postures, breathing exercises, and meditation, there are actually many types of yoga, most of which can be practiced by people of all levels of health and fitness. Overall, the practice seeks to balance and integrate mind, body, and spirit; to enhance energy flow; and to stimulate the body’s natural healing processes by teaching people how to release tension, relax, strengthen weak muscles, and stretch tight ones.

Integrative Nutrition

The practice of integrative nutrition takes a holistic approach to wellness by recognizing that the foundation for optimal health and healing, and the recovery from illness and injury begins with a health promoting diet. Attention to both the individual preferences of the patient and the targeted foods and nutrients to support recovery will be provided by a certified Nutrition Consultant in a gentle and gradual way.

Dr. Bauman’s Observations

Integrative health services can be the difference between a hospital or clinic meeting both the needs of their patients and managing the spiraling costs of preventable illness. Working with hospital administrators, doctors, nurses, staff and patients is a team building exercise. Bringing in a new system of care is best introduced to various departments, one by one to respond to their questions and role delineation and procedural concerns. Support from the top down (foundation board, management team, physician and nurse leadership, billing department) is crucial to successful implementation.

Dr. Bauman held several orientation meetings to acquaint the existing medical team on the benefits of working side by side with wellness practitioners and educators. He also held several orientation sessions for a list of eighty or more holistic health providers who wanted to offer services in the hospitals. Only six were selected. Dr. Bauman was assisted orienting his wellness workers to the hospital culture, with rules, roles, and procedures. Those licensed wellness providers chosen had to be screened and hired by the hospital to work as independent contractors, who handled their own billing.

In theory, the hospital workers supported the idea. In practice, it took a gradual process of building trust, clarifying roles, learning procedures, and getting referrals from the hospital discharge team to have a patient make healing connections at the hospital and learn how to be well when they went home.

Impact

Everyone loved the Eating for Health™ Café. Fresh-made, local, organic meals were available to the staff, families, patients and community walk-ins for $8. In today’s economy that would be $12. The patients and families loved the bedside wellness services, which they had to request and pay for. The management team loved the brand recognition that our small, person-centered district hospital offered integrative health services. This was used to market to patients wanting profitable elective surgeries such as hip and knee replacement, or other out-patient surgeries.

The free nutrition and wellness classes were very well received by the community, and by many patients, nurses and staff at the hospital. The outpatient referral and research component of the model fell short of expectations due to insufficient discharge referrals, the out of pocket cost of restorative health treatments, and health maintenance organization’s (HMO’s) market share domination. Two and a half years after the inception of the Integrative Health Institute, the District Supervisors elected to close the hospital, sell it to a private long term care facility, who did not continue the Integrative Health Institute.

In conclusion, integrating health and medicine is an idea whose time has come. Dr. Bauman continues to work for the wellness of all, offering expertise and team building skills to do create better ways create systems that are humane, sustainable and results driven. He follows the guidance of these inspired leaders:

“In the middle of difficulty lies opportunity.”

— Albert Einstein

“The future belongs to those who believe in the beauty of their dreams.”

— Eleanor Roosevelt

“You are braver than you believe, stronger than you seem, and smarter than you think.”

— A.A. Milne

WHITE PAPER PDF

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