Clinic Close-Up

The Peter M. WegeCenter for Health and Learning

A Unique Part of a Corporate SystemAnne Hendren Coulter, Ph.D.

Anne Hendren Coulter: How long hasthe Peter M. Wege Center been opera-tional?

James Moore: The facility opened August3rd of 1998. Therapies at the Wege Institutefor Mind, Body, Spirit [which is the Center]really came online in September of 1998.

AHC: Is St. Mary's Health Servicespart of a medical school? Or is it a corpo-ration?

Susan Radecky: It's part of the MercyHealth Service Corporation. And our edu-cational work is affiliated most stronglywith Michigan State University College ofHuman Medicine, which is in Lansing,Michigan, 70 miles away.

AHC: What is the genesis of the insti-tution? Why did you build it in the firstplace?140

SR: One of the works of our institu-tion—Saint Mary's Health Services—hasbeen educating physicians. We are thesponsor of a family practice residencyprogram that has been in existence forabout 28 years. We participate in otherresidencies in internal medicine, generalsurgery, orthopedics, [and] OB/GYN;and we have shared sponsorship in thoseresidencies. So there's a longstandingcommitment to educating physicians.

In family medicine, an important partof the education is the development ofoffice-based skills. Family practice resi-dents, during their 3 years of training,have increasing time in their offices so

that they can be prepared to becomeambulatory physicians. In that mode, our

prior office site for them was not ade-quate. It was too small and had few inno-vative approaches to care.

So, about 5 years ago, the CEO [chiefexecutive officer] of the organizationasked us what we needed to train prima-ry-care physicians for a new model ofhealth care. That was the trigger question.We convened a group of people toanswer [the questions]: "What will thenew model of care be? And how can we

prepare physicians to be part of that new

model?" It was from that perspective,then, that we began to talk about a modelthat would be much more highly integra-tive in many different ways. It would bemore integrative with other medical disci-plines—so they would have more sharedtime together, instead of isolation. Itwould be integrative with other types ofteam members so that nurse-practitionersand physician's assistants and pharmacol-ogists would work with the conventionalmedical team. [The model] would be inte-grative in expanding the team so that [the

approach] would be inclusive of whatwere then called alternative therapists.

AHC: Was the CEO, then, the princi-pal mover behind this?

SR: He knew that we needed a new

educational model and, as we talkedabout this vision, it was so in sync withthe hospital's commitment to the commu-

nity that it just rang true. And I think,because of that, we were able to promote[the model] through our system anddevelop a huge amount of employee sup-port and community support to make thefacility happen.

AHC: You did not have to go to himwith your hands out? He welcomed yourplea?

JM: I think the case had to be made forthe importance of the center, because it isa very new way of delivering care, andthere's really nothing that compares to itin this general geographic region. ButSaint Mary's vision statement is to "createa holistic model for well-being and com-

munity health with excellence and com-

passionate care." And, as Dr. Radeckyimplied, the concept of the center was

very much in line with what we're tryingto accomplish as a health system, so hewas very supportive and very much an

advocate.

AHC: How did you go about develop-ing plans for the Center?

SR: As we chose which modalities to

begin, in this facility, there was a multi-disciplinary taskforce that was based inthe hospital—and worked for almost 9months to work through some of theissues [concerning] what we are work-ing to accomplish, where the opportu-

EDITOR'S NOTE: The Peter M. WegeCenter for Health and Learning in GrandRapids, Michigan, opened in August 1998to provide conventional and complementarymedical services to Michigan residents. TheCenter is one among the several that are

being established by incorporated hospitalsystems. Saint Mary's Health Services,part of the nation's seventh largest Catholichealth system—Mercy Health System—has15 community health systems of which thePeter M. Wege Center is a part. Recentlyour managing editor talked with JamesMoore, Ph.D., director of the Center andSusan Radecky, M.D., a family medicinespecialist and director of the family practiceresidency program, about the genesis andwork of the Center.

ALTERNATIVE & COMPLEMENTARY THERAPIES—JUNE 1999 141

"As patients are asking more questions,we're finding that we don't have many of those answers."

Entrance to the Peter M. Wege Institute forMind, Body, Spirit.

nities are, what our community wantsof us, what is consistent with some cur-

rent therapies we're offering now. Andso, I think, that's been the model we'vetried to follow—not be off by ourselvesdoing what we want but working withthe larger organization and the commu-

nity.AHC: How much did the facility cost?JM: Nearly $16 million. ,

SR: About $4 million was generatedthrough philanthropy. $1 million came

from employees, staff, physicians, volun-teers, and board members of Saint Mary'shealth services. I think that speaks ofunderstanding the commitment to reallyoffer some new ways of caring for our

patients.JM: Peter M. Wege, chairman of the

Wege Foundation, also donated a sub-stantial amount of money to the Centerand he has traditionally been very sup-portive of Saint Mary's causes. It was a

community effort because we receiveddonations from the community at large as

Atrium of the Center.

well as money from foundations, includ-ing the Kresge Foundation.

AHC: Are the physicians that walkthrough your doors mostly residents, or

are they physicians who are alreadypracticing and who come back for fur-ther education?

SR: We have both. The physicians whoare taking care of patients here will befaculty physicians who are fully creden-tialed and have their own practices.Physicians are doing [this program] in a

parallel practice. Residents, who are grad-uates of medical school and [are] in themidst of their additional training in orderto be attending physicians, are also in theprogram.

AHC: What are the modalitiesoffered here? What can the physicianslearn?

JM: We provide manipulative thera-pies, massage, acupuncture, spiritualdirection, behavioral medicine, [and]Feldenkrais®; and we're about to bring on

biofeedback services.

AHC: Do you have an herbalist on

staff?JM: We've been approved by the

board to develop business plans [for] a

number of different therapies, and herbaltherapy is among them. We are bringingthem on gradually.

AHC: You do have pharmacologists

142 ALTERNATIVE & COMPLEMENTARY THERAPIES—JUNE 1999

"We want to broaden our options for people and tryto find things that are more consistent with their belief systems."

and pharmacists in the Center. Do youhave plans for your pharmacologists tomix the herbal formulations?

JM: We haven't begun work on thatparticular therapy as yet.

AHC: What is the role of the pharma-cologist?

SR: Well, currently the pharmacologistis a faculty member and has physiciansthat he works with. They are part of theprimary-care health team, so they areavailable to teach and to be a resourcewhen we have questions. I would say—aswe've become more conscious, and work-ing to be more integrative—that they are

our prime resource now when patientsbring us questions. And so, as a patientwill ask us for advice, we will commonlyask the pharmacologist to get involvedwith that discussion.

AHC: Many people have said that per-haps the pharmacist and the pharmacol-ogist will be the consumer interface foralternative medications, as they are now

when they hand people prescriptions.Do you expect them to have this role?

SR: Well, they're actually explaining tothe doctors what's happening. I think oneof the concerns from a biomédical per-spective is that it is difficult to interpretaccurately scientific information aboutmany of the products people are using. Sothey're trying to help us find what thatinformation is, so then we can respond topatients' questions.

AHC: If patients ask whether vitaminE, for example, is appropriate for theirdiseases, then would you go to the phar-macologist to find out if that's correct?

SR: Just in order for us to learn [wewould do this], because, I think, as

patients are asking more questions, we'refinding that we don't have many of thoseanswers, and that the [conventional]methods of finding information are notvery well developed.

AHC: How did you become involvedin alternative medicine, Dr. Radecky?

SR: Well, I was actually going throughsome old files this morning to answer thisquestion. If you look at the values of pri-mary care, and family practice in particu-lar, they have to do with advocating forpeople's health and helping them maxi-mize their health within the frame of theirfamilies and their community. So, as a

family doc, I think I've always been there[in alternative medicine] in a sense. Now,obviously, as there's more knowledgeand awareness of what different thera-pists in integrative medicine can offer, I'mstill learning. I think one of the thingswe're trying to do is keep clear that it isthe relationship between doctor andpatient and the wholeness that we'reafter, to make certain that we don't justget into some new, different [mode] thatmay not actually offer help. I think that'sa real slippery slope as far as just doingmore things to people instead of doingthings differently with people.

AHC: Do you personally practice anyalternative therapies?

SR: No.

AHC: Why is it, then, that you haverequested that they be brought to thecenter?

SR: Well I think many people recognizethat our [conventional] biomédical modelhasn't offered a lot of options for peoplewith chronic diseases, for instance. Andthere are a lot of limitations to the

biomédical model of "cure and fix." I real-ly see that we want to broaden our

options for people and try to find thingsthat are more consistent with their beliefsystems.

AHC: What are the limitations of allo-pathic medicine?

SR: Well, I would say the one that getsmost in the way, from a physician's per-spective is the tendency to cure, and a

tendency to be linear, and a reluctance tounderstand the multisystem nature ofmost problems. This type of medicinebegan because there have been so manygreat successes from a linear approach.The greatest advances in health haveprobably been from some of those linearadvances. But, unfortunately, we startedsaying: "Well then, everything must bethat way." And, as you look at people'ssignificant health issues—chronic illness,spiritual issues—they are not simplistic,nor linear, so we need to move out of thatold model into another way of thinkingabout them.

AHC: What particular disease types doyou think could be helped by usingcomplementary therapies?

SR: I would think of things like hyper-tension, heart disease, [and] epidemiccancers in our society. We have gone towork with these diseases—finding somesort of the gear-up, high-level heart sys-tems to fix people once their hearts [are]broken—but we haven't been very effec-tive in identifying why they get to thatstate of ill health.

AHC: Do you view complementarytherapies as useful both in treatment ofchronic disease and for preventivemedicine?

ALTERNATIVE & COMPLEMENTARY THERAPIES—JUNE 1999 143

"We're trying to balance thepolarity of openness and discernment."

SR: Absolutely.AHC: Are there any other disease

types that might be well served by com-

plementary modalities?SR: Oh, I guess I want to clarify,

because we really are advocating an inte-grative approach so that there aren't anythat I would think of that would be solelythe work of the Wege Institute for Mind,Body, Spirit. We don't have a list like that.But I have a practice that is predominant-ly women's health care. Most of thewomen I see—who have either young-adult life issues with premenstrual syn-drome or older women with depressionor midlife changes—are all people whocould benefit from a medical evaluation, a

consideration of a therapy, but then also a

more thorough look at their whole livesand some specific therapies through theMind, Body, Spirit Institute.

AHC: What practitioners do you haveon staff other than allopathic physi-cians?

SR: What physicians other thanallopaths?

.

AHC: Yes.JM: We have no others that you would

call "physician practitioners." We haveostéopathie physicians. But we have no

chiropractors; we have no physicians thatpractice acupuncture.

AHC: Do you have naturopaths?SR: No. They are not licensed here.

We've consulted with a chiropracticphysician who is also a naturopath, andhe's been helpful to us in setting up some

of our consultation techniques and hasgiven us ideas about how to work suc-

cessfully with other practitioners.

Left: James Moore, Ph.D.; right: Susan Radecky, M.D.; both at the Peter M. Wege Center forHealth and Learning.

AHC: Do you refer people from yourcenter to complementary physicians out-side of your facility?

SR: Yes, that's part of the ongoingwork, I think, to identify the group ofpeople who are willing and interested inbeing in this integrative model. We feelit's so important to our success as a usefulcommunity medical center to contact theperson who is the primary physician andinform [that person] of the visit and toopen communication between the part-ners so that it's not done in secret.

AHC: What kinds of spiritual tech-niques do you use in your Institute?

JM: Actually, the spiritual care

provider, Jane Yonkman, M.Div., involves

herself in a number of different modali-ties or techniques. She uses one-on-one

counseling, support groups, guidedimagery, dream work, journaling, variousrituals, prayer, [and] stress management.She's trained at the Shalem Institute forSpiritual Formation in Washington, D.C.So she involves herself in a variety of dif-ferent techniques.

AHC: Then is she a minister?JM: Yes. We also have an M.S.W.

social worker that provides some coun-

seling services for people on the unitstoo. And we're working through howbetter to provide, or how to augment,his services to bring more mind into themind—body experience, right now.

144 ALTERNATIVE & COMPLEMENTARY THERAPIES—JUNE 1999

"Connection with nature is a

theme that runs through the entire building."

AHC: Is your connection with themedical center of benefit to the Insti-tute?

SR: I think it is a benefit, and it's also a

responsibility. That's what I was trying tocommunicate regarding the issue aboutcredible information. There are so manytensions we're trying to balance, and one

in the field of medicine is this whole issueof evidence-based medicine. Is that a

phrase that you've heard before?

AHC: Do you mean clinical trial-basedevidence?

SR: It would be a little more broad. Evi-dence-based medicine is a process of eval-uating information that's published for itsvalidity. And it was first begun throughsome of the people at McMaster Universi-ty in Hamilton, Canada. This process hasraised an awareness that a great deal ofpublished scientific information is of verylittle value. We are working actively tosort through information in order todetermine how much it offers. So, giventhat focus in medicine, I think what we'retrying to do is be more open, and yet alsoraise questions about what the supportingevidence is that will lead us to [deal with]certain issues and not [confront] others.We're trying to balance the polarity ofopenness and discernment, I guess.

AHC: How does the Mercy Systemwork? And what is the role of the PeterWege system within it. Are you a facilitythat is connected to hospitals and isthere cross fertilization?

JM: The Mercy System is in Michiganand Iowa, so we're part of a corporategroup of health care facilities.

AHC: Do you have inpatient activity?JM: Massage is currently in the inpa-

tient setting. The hospital is located rightacross the street from the Wege Center.

The Center and hospital are connected bya walkway that runs beneath the street.So we're very close geographically to thehospital.

AHC: Are most of the people whowalk through your doors, however, out-patients?

SR: Yes.

AHC: What does the facility look like?Is it hospital-like, is it allopathic office-like? Many of the other centers havetried to break down the allopathicimage. Has this been the case at thePeter M. Wege Center?

SR: I think the facility does look differ-ent from a conventional "doctor's office."The atrium of the building is designed tobe an Italian garden and has a specially-designed acoustic system, and a beautifulfountain, and a sculpture that is movedby air currents that are kind-of cycled on

and off. As you enter the building, you'llbegin to understand that this is a differentenvironment. There has been a greatamount of work that's been put into cre-

ating it as a beautiful space. It truly is a

beautiful space with a great amount oforiginal art. We worked with some con-sultants from San Diego, California, Aes-thetics—a firm that specializes indevelopment of complementary carefacilities—that helped us create themes on

each of the floors of the building.JM: Connection with nature is a theme

that runs through the entire building.There are subtle "fallen leaf" patterns inthe carpet and small handmade tiles ofanimals on the vertical counter surfaces atthe receptionist's area and nurses' sta-tions. There is a freshwater aquarium inthe wall between the waiting area ofMind, Body, Spirit, and the Center forDiabetes and Endocrinology. Webelieve—and studies show—that nature

themes have a very soothing effect on

people.AHC: I have been led to believe—and

frankly I happen to agree—that how one

feels when one walks into the establish-ment makes a difference in how one per-ceives one's illness. Would you describesome of the facility?

SR: The Mind, Body, Spirit Instituteitself is the most "fun" module. It hascurvilinear walls and meditation spacesand is just extraordinary.

.

.being differentand beautiful. And [here is] a funny story[about] that: The common area where thepractitioners have their office space isseparated from the meditation space by a

curvilinear hallway. When we referred tothat corridor, one of the workers, steepedin allopathic tradition, who helped tobuild it asked: "Oh, do you mean thelumbar area of the spine?"

AHC: He was trying to turn the facili-ty into a medical analogy, not a work ofart?

SR: Yes.

AHC: What is the attitude of theallopaths in your facility vis-á-vis thecomplementary practitioners? Are youable to look the alternative practitionersin the eyes instead of looking over

them?SR: Well, I think right now every-

body is open and interested to learnand I view it with that point of eager-ness. We are working together. TheMind, Body, Spirit practitioners are

busy and each time that we worktogether I think we learn more aboutone another. That is just going to gainmomentum as we begin to open thedialogue about how to enhance thatworking. So I'd describe us as "openand learning."

ALTERNATIVE & COMPLEMENTARY THERAPIES—JUNE 1999 145

"Much of what attracted people to be inalternative therapies was that ability to be autonomous."

AHC: What's the future of comple-mentary medicine?

JM: I think that, from my perspective,we're getting a glimpse of the future rightnow. As Dr. Radecky intimated, essentially,we're pretty ready and eager to work, andthat's true. We get a lot of referrals fromallopathic physicians for their patients to beseen by Mind, Body, Spirit practitioners inthe Wege Institute. I think that you'll see

much more of that in the years to come. Ithink that it will be a more collegial-teamkind of environment and that people willfeel more comfortable referring across linesbetween allopathic and complementarycare. I think that the public will becomemore savvy and educated about that andthe demand for that kind of collegiality willbe something that they will come to expect.I think that there have been huge leaps interms of having complementary therapiesbecome more mainstream, if you will. AndI believe that that will only continue in thenext several years.

AHC: One of my favorite commentson the subject of integrative medicinewas from a naturopath who said, "I havea garden in front of me because as we

[naturopaths] become part of the allo-pathic paradigm, I have to go out andremind myself what brought me to be a

naturopathic physician in the first place."Dr. Radecky, how does this fit into yourconcept of complementary medicine?

SR: Well, building on what you said, Ithink sometimes it's easy to see all themovement going from allopaths to other[practitioners]. What I really see as thegreatest challenge is having both partnersreach out to [create] a different model.Much of what attracted people to be inalternative therapies was that ability to beautonomous. It's always fun if you can beautonomous, but I think our challengewill be to really figure out ways that we

can truly be collaborative for the benefit ofpatients. That will create a great amountof stress on both sides. It's not all theallopaths reaching to others, but manypractitioners have not had the interest inreaching back. That's what we're reallytrying to create: Ways where we have one

medical record and one system of lettersthat travels back and forth, so that we can

really make sure that all of the pieces of a

person's health plan are working together.AHC: What are the stumbling blocks

to this open-ended communication?SR: In some ways we need to learn new

languages. I think it's real obvious to us

that we've put together a team where one

speaks French, one German, three Span-ish.

JM:What we need to do is set up a

model in which crossfertilization is possi-ble. When you're talking about the medi-cal team—the team of the future—there'sthis creative tension that we're always try-ing to balance in our program. I describethat by saying: "If I'm ever in a bad autoaccident, and they bring me into St. Mary'semergency, I want the trauma team therewaiting for me, not a hypnotist."

Although it might be nice, perhaps, tohave a hypnotist offer him or herself inmy ongoing recovery—I'm bleeding andhave broken bones—I want the traumateam there.

AHC: What is especially uniqueabout the Peter M. Wege Center?

JM: One of the things that's veryintriguing and that we have to define bet-ter is the relationship to the centered care

aspect of the care that we deliver. Thatspeaks not only to the care of the patientbut also to our interactions with one

another and our interactions with thecommunity. Because we think that envi-ronment has a great deal to do with the

To Contact the Center...Peter M. Wege Center for Health

and Learning300 Lafayette SEGrand Rapids, Ml 49503(616)752-6868Fax:(616)752-6972

healing and curing of patients and that, ifyou have a good, healthy environmentthat will benefit the patients, they will feelbetter about coming here for care, andthey will actually get better quicker. Andthere's some clinical evidence to suggestthat that's true.

SR: Creation of a healing environmentis really the value that will help the build-ing be different from just another build-ing. The way that we care for one another,and how we take responsibility for our-

selves as healers is also an integral part ofour practice. These are probably the most

exciting segments of our intention—all ofwhich will be a vital part of the building.

AHC: It sounds like you are quitealone as a complementary and allopathicfacility, right now, in that Great Mid-west. Is that true?

JM: I think that's generally accurate.There is some other activity within theMercy System looking at what we'redoing. The Mercy System in northernMichigan has done, and continues to do,some similar work in a little different way.St. Joseph Mercy Oakland is also doingsome interesting work in this area. D

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