Can the VHA Be a Model for Integrative Healthcare?

Gaining Perspective From Tracy Gaudet, MD

By Karolyn A. Gazella

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Tracy Gaudet, MD, spoke to a capacity crowd of 300+ attendees of the recent International Congress for Clinicians in Complementary & Integrative Medicine held in Chicago. Gaudet, who joined the Department of Veterans Affairs in 2011 as their director of the Veterans Health Administration (VHA) Office of Patient Centered Care and Cultural Transformation, kicked off the conference with a lively keynote about how the VHA is attempting to transform healthcare by utilizing an integrative, holistic approach.
 
In her role leading this newly created office within the VHA, Gaudet will help the VHA transition from a physician-centered model of care to one that focuses on personalized, proactive, patient-centered care. “This is an opportunity unparalleled in the history of medicine, and a radical departure from the VHA’s current approach,” Gaudet explained.
 
Before joining the VHA, Gaudet was the executive director of Duke Integrative Medicine and is recognized for leading that center to the forefront of the field. She is also the founding executive director of the University of Arizona Program in Integrative Medicine where she was instrumental in designing the country’s first comprehensive curriculum in integrative medicine.
 
“Our present healthcare system is not designed to fix the problems we face,” Gaudet told the audience. “We have to completely rebuild the system.”
 
Gaudet explained that the VHA can act as a “living laboratory” to help demonstrate efficacy of changes that could positively impact healthcare nationwide. The VHA can potentially act as a model for integrative care throughout the United States, she said, but for that to happen, a “massive change in philosophy and structure is required.”
 
The VHA itself is massive, with more than 100,000 physicians treating about 25% of the nation’s population. It provides healthcare benefits to veterans and their families and is the second largest of the 15 U.S. Cabinet departments.
 
Gaudet told the audience that the VHA presently outperforms the private sector on many levels. She said it has the capacity to take on the challenges that need to be addressed to successfully rebuild healthcare.
 
“The veterans are really serving their country again by helping us fix our broken healthcare system,” she said. Gaudet explained that she and her team will use the next five years to develop a plan that creates a personalized, patient-driven system that no longer puts disease at the center.
 
Gaudet admits there is a lot of work that needs to be done to achieve healthcare transformation that truly embraces an interprofessional and integrative approach. For example, there are presently no guidelines in place as to which integrative services a hospital will offer. She said national criteria need to be established to determine integrative services. “Setting up national policies will help us get there,” she said.
 
Gaudet told the audience that the VHA is taking the first critical step in transforming a broken healthcare system, which is to adopt a dramatic change in perspective. “The soul and the heart are the doorways to health and healing,” she said. “To fully optimize health is to address the full range of physical, emotional, mental, social, spiritual, and environmental influences.” And in the process we will also transform a healthcare system in desperate need of healing.
 
Tracy Gaudet, MD, at the recent International Congress for Clinicians in Complementary & Integrative Medicine.

About the Author

Karolyn A. Gazella has been writing and publishing integrative health information since 1992. She is the publisher of the Natural Medicine Journal and the author or coauthor of hundreds of articles and several booklets and books including her latest book The Definitive Guide to Thriving After Cancer that she wrote with Lise Alschuler, ND, FABNO. Gazella is the co-creator and Chief Executive Officer of the iTHRIVE Plan, an innovative online wellness program specifically for cancer survivors.