Big things are going on at Ohio State University.
And for once they have nothing to do with football on the campus of 50,000 students and several thousand more faculty, staff, and other employees.
Not even a stone’s throw from Woody Hayes Drive and just across the Olentangy River from the university’s most famous building — Ohio Stadium — sits a less descript structure, but one where exciting things are happening — the OSU Center for Integrative Medicine (CIM).
The center can be likened to a supersized shopping center. If a typical one-stop shop offering chiropractic and other various medical services is like Target, the OSU center is like Mall of America.
The 6,400 square-foot center has 30 rooms, 18 of which are devoted to patient care and treatment, including chiropractic, massage, and acupuncture. It houses its own office, and has two reception and waiting areas, a large conference room, and a large classroom area that can be used for anything from educational activities to yoga.
Integrated Wellness Care
The CIM’s central purpose is found in its name — healthcare integration. It brings a little bit of every corner of the healthcare world, including chiropractic and most disciplines associated with it, into one building and makes it part of the much larger medical community.
Open less than two years, the CIM is visited by an astounding 1,400 patients per month and an eye-popping 75 new patients per week. Although the majority come to see the center’s family physicians, a growing number come to see the center’s two chiropractors and other alternative practitioners.
While not completely one of a kind (similar facilities exist at universities in Arizona, Maryland, California, and Minnesota, among others), the CIM is certainly unique in its combination of vast patient offerings and research capabilities. It is a learning lab for medical students and provides an environment for traditional med students to learn about less traditional healthcare offerings.
But the primary role of the CIM is to serve as a practice center.
Chiropractic is a small but growing part of the practice center. For the two chiropractors on staff, Drs. Robin Hunter and John Grandominico, merely being involved in what could be a trend-setting healthcare outpost is invigorating. (See page 24 to meet the chiropractors.) The opportunity to interact with and work alongside professionals from all parts of the healthcare industry merely adds to the excitement.
“It has been extraordinarily good,” Hunter says. “We’re looking at Ohio State, a very strong medical community…it’s a very strong environment. But there’s been a strong drive from the leadership, mostly the primary-care leadership, to integrate. It took some of the leaders of Ohio State University some time to get this place open.”
That’s because, like many new ventures, this one met with skepticism. It’s the Reese’s peanut-butter cup effect: Until you try combining something, you’ll never know exactly how well they’ll go together. At OSU, people are quickly learning.
Mary Jo Welker, MD, chairperson and professor of Clinical Family Medicine and associate dean for Primary Care at OSU was the prime mover in the creation of the center. She recognized the desire of patients to branch out into nontraditional fields of care, such as chiropractic and massage therapy.
But medical doctors, she said, are confronted with a problem in making referrals to complementary and alternative healthcare providers: They often don’t know where to refer for quality care.
“As physicians, we have no way of knowing who to refer to or what their credentials really are,” Welker said. “By having our own site and credentialing our own providers, I can be sure that when patients ask to see one of these providers that I can make a referral and know they will be getting good care.”
Although the center opened amid a certain amount of interdisciplinary skepticism, the focus on patient care was something all sides could agree on. Hunter said that patient care is the foremost part of the three-pronged system. The other two prongs are education and research.
Working across boundaries
At a top research institution such as Ohio State, new discoveries are being made every day. And while perhaps nobody at the CIM is reinventing the wheel, there is certainly evidence of a rapid evolution within the healthcare community. The ability to work across the boundaries of disciplines creates a provider- and patient-friendly system.
Hunter and Grandominico are both former private practitioners and know how different every patient’s needs are. They also realize that not even the best chiropractor can solve the problems of any one person.
With that in mind, it’s nice to have not only the facilities and equipment to tap into for alternative treatments, but also the knowledge base of a staff of MDs and other providers. Patients routinely see more than one practitioner at the CIM, often on the same visit.
“It does come into play quite often with the chiropractors,” Grandominico says of multi- discipline cases. “The family doctors, the massage therapists — all are involved. My specialty is in rehab. If someone has a patient who maybe needs some rehabilitation, they can refer them to me, and we’ll confer on the case. If I have a case that’s not improving, I may let Dr. Hunter evaluate. We can also refer to the family doctors.”
It’s not a perfect system and it’s ever-evolving, but that only makes sense, given the arena. “It will always be a work in progress, since medicine is a constantly changing field,” Welker says.
One thing that is left to chance is the primary goal: patient care. No matter the discipline, patients usually come to a practice, big or small, for one basic reason: They have a healthcare problem. At CIM, it is almost guaranteed that someone can solve it. And all of the doctors are focused on providing the right solution.
“When somebody comes through the door here and into our domain —chiropractic — it’s up to me as a chiropractor to get a good history and really decide if their pain syndrome is something I can treat or is it better treated by some other approach,” Hunter says.
At that point, the caregivers’ second most important skill comes into play: communication. Hunter says the lines of communication at the CIM are good and that both she and Grandominico are learning the system of collaboration and information exchange — getting notes to primary-care doctors. That system, like the center itself, is a work in progress.
Practice, not practice-building
Because of the structure of the center, all practitioners focus on practicing their specialties — not building a practice or managing a practice. They are doctors all day long, not managers, not marketers, not recruiters. They take care of patients.
“The benefits are awesome,” Hunter says. “Who wouldn’t say that? I don’t have to worry about the mechanics of running a business. If the copier breaks, it gets fixed. Here, the majority of time is spent with patients. I don’t have to worry about any of those other things. The stress level is way down.”
The one sacrifice, if you can call it that, is a bit of freedom, in terms of vacation and similar benefits. But that’s a small price to pay when the goal is to see patients and help people.
On the other side of that coin is a wide world of patient-care possibilities. With roughly 60 patients visiting every day (and growing), the doctors never know what they might see, treat, or learn about next.
“You have a more diverse population than in private practice,” Grandominico says. “You have patients who are more into holistic medicine and who are involved in not just seeing a chiropractor, but are more into health [wellness] in general. It’s nice that we can see more patients here.”
Hunter and Grandominico have been on both sides of the fence and both see the OSUCIM as the wave of the future. As the chiropractic and medical fields continue to integrate and coexist under the same roofs, large facilities with many practitioners, perhaps affiliated with universities or just other medical centers will be more beneficial to providers and patients alike.
“It’s already happening,” Grandominico said. “It’s growing. I think this is kind of the way of the future. It’s new, so getting a business model to make it all work is kind of the key. It is run different than a typical medical practice, but it’s similar to some of the medical practices that are integrating, like maybe family doctors and other medical doctors, only now you’re incorporating holistic medicine.”
Todd Stumpf is an Ohio-based freelance writer. He can be contacted at firstname.lastname@example.org.