By Edward Senu-Oke, MD, ABIHM
As our specialty of Integrative Holistic Medicine grows, there will be respectable acceptance and recognition of the important contribution of the works of the practitioners of Integrative Holistic Medicine. This is not only of like-minded patients, but also of physician colleagues, hospital administration, and even the general public. However, with the continued inroads that practitioners are making for the specialty, it will not be unusual to face initial criticism and resistance as it was for other pioneers of innovative practice. Newness is usually resisted even in the face of proof but perseverance and results is the fundamental basis of general acceptance. Indeed, the practice of medicine, like any other established endeavor, has always subscribed to an old adage: Is not the fallacy of yesterday, the truth of today?
As a diplomat of the American Board of Integrative Holistic Medicine, I feel it my duty to expand the consciousness of the general public, my physician colleagues, and hospital administrators and the like. On a number of occasions I have been asked to describe my particular specialization by both holistic and non-holistic physicians. As a Holistic Hospitalist, I have found it best to begin with some affirmations. I attended an accredited four year medical school. I trained at an accredited Internal Medicine Residency Program. I have had over 10 years additional training in evidence-based holistic medicine, a training that is endless as with all areas of medicine. I am boarded in both Internal Medicine and Integrative Holistic Medicine. As with all diplomats of the American Board of Integrative Holistic Medicine, my medical training was not all that different from other American made physicians. My training, however, was augmented with additional medical training that allows me to specialize as a holistic physician. This additional training combines the teachings of allopathic, homeopathic, and osteopathic medicine in a unique way. It re-codifies the principles of these disciplines into a singular system we have come to call Integrative Holistic Medicine.
Understanding that a holistic physician has additional training above and beyond the average generalist, it becomes clear that we are no different than other specialists like geriatricians, palliative care physicians, etc. All specialists are goal directed by definition. A holistic physician, however, has a fundamental goal that sets him/her apart from conventional reductionistic approach to medical practice, the goal of leading our patients to optimal health. We set out to find and assess dysfunction, maintain function, and devise a plan to enhance function with an ultimate goal of improving the patient to optimal health. We work to achieve the goal of optimal health by empowering the patient through cooperative care, patient education, and reminding the patient that ultimately he is responsible for his health care. We physicians are not Gods or healers. Rather, we are advocates who facilitate healthy living and lifestyle modification.
Integrative Holistic physicians practice preventative and interventionalistic care rather than sick care. This is a very important distinction to make about holistic physicians. We don’t see disease per se, but rather we see cascades of dysfunction. We evaluate and characterize this cascade of dysfunction from a cellular and mechanistic perspective whereby the average physician characterizes this dysfunction by stereotyped manifestation (disease). An example of how we view medicine can be seen in the characterization of the disease Congestive Heart Failure. Congestive Heart Failure is not the problem but the manifestation of the problem. It may be mechanical, metabolic, homeostatic, or a combination there of. Holistic physicians seek out the cause and design a treatment plan based on each dysfunctional pathway rather than treating the symptoms (manifestations of dysfunction) alone. This approach allows for a more accurate characterization of the dysfunctional cascade, a more robust and individualized treatment plan, and ideally a more rapid and longer lasting recovery to optimal health for the patient. This approach also allows for greater active participation of the patient in his own medical care and recovery as it is important for individuals to take ownership of their health.
As holistic physicians do have fundamental goal differences than the conventional reductionistic physicians, there is a wide range of who constitutes a holistic physician. As it stands, any conventional specialty can have a holistic counterpart. There are holistic cardiologists, neurologists, gynecologists, and many more. I happen to be a holistic hospitalist. As previously stated, one of our goals as holistic physicians is to accurately characterize the going ons in the patient as they present to us. I find that I have an easier time doing so in the hospital setting as this is the time that the cascade of dysfunction has made a stereotype presentation that is recognized by the physician type, patient, and company. Here is when the patient is most vulnerable and most receptive to change. My work as a holistic hospitalist is to educate the patient and family as to the path that lead him to this point, remind the patient that he is responsible for his state of health, and work with the patient and family to develop a cooperative care plan to improve the patient to optimal health. One additional advantage I garner as a holistic hospitalist is the opportunity to demonstrate to the conventional physician that there is a thought process that goes behind what some have characterized as “voodoo” medicine.
As with other holists, my assessment of a patient emphasizes nutrition, lifestyle, home environment, family/relationship dynamics, patient desires, and life spectrum analysis. As with other holists, holistic hospitalists educate patients about findings, pitfalls, risks, etc. on their personal path of health. This education considers the compounded cause and effect, cellular dysfunction, metabolic dysfunction, and mechanical dysfunction. Our cooperative care plan considers GI reconstitution, metabolic reconstitution and emotional and physical stress reduction. Where a holistic hospitalist differs from an outpatient holist is that our practice is geared more towards intervention than prevention. Do not misunderstand, holistic hospitalists still practice preventative care and engage in preventative education on a daily basis, but the “pie slice” of interventional care is larger. The cooperative care plans designed by a holistic hospitalist tends to have shorter short term and intermediate term goals than the outpatient holist as our question is, “What can we do right now to intervene in this cascade of dysfunction?”
By the nature of the practice environment, holistic hospitalists also deal more directly with life spectrum analysis, geriatric issues, and pain and palliation. Keeping in mind that my job is not to induce false hope, but rather synthesize the subjective and objective information submitted by the patient and family and provide a coherent and concise report of the dysfunction occurring within the patient. My job is to remind the patient, the family, and sometimes the other medical care givers that we all live on a spectrum of life and that we are not trying to prevent death, but rather prevent suffering. We are trying to assess injury and dysfunction so we can generate solutions to get the patient to optimal health and prevent or reduce further suffering.
In summary, holistic physicians are a unique group of physicians. We, however, are not a divergent group of physicians, but rather a convergent group. Much like the dolphins and whales of the ocean, we are not fish but we do swim among them. Our goal is optimal health whether in the hospital or not, whether designing our patient’s cooperative care plan or our own. We look at the symptom presentation with in the body as a cascade of dysfunction not some stereotyped disease. When considering holistic hospitalist care and out patient holistic care our patient evaluation and assessments are no different, our long term goals are no different. Where we do differ is in our short term and intermediate goals. Though our practice of integrative holistic medicine is still looked upon with skepticism, our continued cooperative work as holist will continue to shed a positive light on this different approach to health and wellness.
About Dr. Edward Senu-Oke, MD, ABIHM, ABIM:
Dr. Edward O. Senu-Oke is a Diplomate of the ABIHM, board certified in Internal Medicine, and has been in independent practice since 2006. He began his medical career as a traditional private practice physician seeing patients inside and out of the hospital. He converted his practice to almost exclusively inpatient work in the fall of 2007. At that time he began calling for hospitalist practice reform developing nonconventional and innovative operational models. He became a founding member of the Bon Secour Hospitalist Group at Maryview Medical Center in Hampton Roads, Virginia and is their former Chief of Internal Hospitalist Affairs. As the founder of his company, Fusion Health, Dr. Senu-Oke continues his independent practice as a holistic hospitalist throughout the states of Virginia and Delaware.
Dr. Senu-Oke was introduced to holistic medicine while attending medical school at Wright State University using their organ-systems learning model and more pointedly while under the tutelage of a doctor of osteopathic medicine who succinctly describe the difference in approach of allopathic and osteopathic medicine. Dr. Senu-Oke credits these two moments as part of a cluster of events that set him on the path of a fully integrated, holistic practice model. On his journey to becoming a holistic practitioner, Dr. Senu-Oke has travelled across the country and even intercontinentally to Canada, China, and Africa becoming proficient in a number of medical modalities such as functional medicine, low velocity manual medicine, occupational medicine, nutritional medicine, pain and palliative care medicine, and sports medicine.
Dr. Senu-Oke also carries educational obligations as part of his Fusion Health Immersion Program Initiative. He provides an educational outlet for interested high school, college, medical school students in a variety of medical professions. Dr. Senu-Oke of course continues his own medical education via conferences, seminars, and even one-on-one sessions with medical professional of various holistic backgrounds. With a goal of providing committed and competent service to his patients, physician colleagues, and students; Dr. Senu-Oke believes open evidence-based holistic practice is important and necessary. Dr. Senu-Oke is honored to be an active Diplomate of the American Board of Integrative Holistic Medicine.