When people aren’t feeling their best, they tend to seek help from their primary care docs. But how can we expect one person to be able to treat everything that can possibly ail you – from a bad case of poison ivy, to diabetes, to a gambling addiction? The simply answer is that we can’t. We can’t expect primary care docs to be superheroes. But because our system is set up to vet people through them, we have to figure out ways to make their triage easier, their methods more streamlined and essentially, the care they offer more effective and efficient.
“Integrated Care” is a buzzword that is being used in service of this conundrum in healthcare. The thing is, if most issues are diagnosed (and treated) by primary care docs, it would make sense for them to have the support of a team who has a spectrum of expertise. But how do you do this in a reductionist system that has evolved increasingly specialized silos of thinking by keeping the body, mind and spirit separate?
Lots of folks are trying to figure this out. In 2013 the Substance Abuse and Mental Health Services Administration (SAMHSA – a branch of the U.S. Department of Health and Human Services) published A Standard Framework for Levels of Integrated Healthcare. In it, SAMSHA outlined its six levels of integrated care. Basically it details how we can gradually change the culture of healthcare to bring mental health services and primary healthcare together under one team, one roof and one strategy.
This is an important step toward providing more effective, efficient, cost-saving care. Since most mental health problems are diagnosed by a primary care doctor and since most primary care visits have some mental health component, it makes sense to bring them together.
Last month the America College of Physicians published a positon paper laying out six strategies for bringing mental health and substance abuse care into primary care to better treat each patient as “a whole person.” This sort of stuff is coming out with more frequency and it’s a great step in the right direction.
So, how does yoga fit into this?
Well, maybe you see the metaphor here. There’s a yoga-ing happening – a coming together of things that have been separate. The time is ripe for yoga professionals interested in changing the trajectory of health in this country to step into the conversation and become part of integrated teams. If government agencies and physicians associations are talking about bringing healthcare together, why shouldn’t those of us who are experts in what the NIH has determined is one of most commonly utilized integrative care strategies, yoga (defined as including ethics, pranayama, asana and meditation) want to be part of this merger? You know the power of what we have to offer.
Throw into the mix the research of people like Harold Koenig at Duke University, Corey Keyes at Emory and Lisa Miller at Columbia who are leading the call for increasing our understanding of how spirituality fits into the health care solution and we have an extremely powerful case for yoga, not necessarily the fitness based stuff, but rather what I’m starting to call “public health yoga.”
IMHO, this is one of the most vital topics in the yoga world today and a natural direction of our profession. 20 million people practice yoga – but where? Gyms? Studios? These are not healthcare settings, they’re essentially recreation. And recreation is fine, but it is a pretty flimsy bulwark against the healthcare tsunami we are facing. There are more than 320 million people in this country and most of them are never gonna turn up in your class. If we want to reach more people, we have to go to where they get their healthcare needs met. And we have to start participating in this larger healthcare conversation.
I’m not in any way arguing that yoga solves all health problems, but I will argue that yoga in its broader definition can be part of a cost effective, evidenced based, integrated and integrative strategy.
BTW, these are issues which we go into in much greater depth in our RYT500 training.