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Healing the oak tree

Dr. David Rakel treated patients at a four-bed family hospital in rural Idaho for five years, and often felt unprepared to treat some of his patients.

He spent most of his time dealing with problems he simply couldn't treat, such as chronic pain, cancer and auto-immune disease.

Rakel finally concluded that his traditional medical education was not enough.

He is one of about 85 physicians to apply to the University of Arizona Program in Integrative Medicine, and was accepted into the third class of fellows.

Dr. Andrew Weil founded the program in 1997 to train doctors in new approaches to practicing medicine.

Rakel hopes the two-year program, which focuses on treating patients as people, rather than curing illnesses, will enable him to learn what he couldn't anywhere else.

He compares the human body to an oak tree that is either strong and nourished or brittle.

"If that oak tree is not getting the nutrition and the water that it needs, the whole tree is going to be brittle, and if one of those branches breaks, it's not going to heal and another branch is going to break just as easily," Rakel said.

"We're trying to get at the root of whatever is preventing that oak tree from flourishing." he said. "If we can get at the root, the branches are going to heal on their own."

Rakel's is one of many interpretations of the often-debated UA program, which is in high demand by patients and physicians.

It comprises a post-graduate clinical fellowship in which doctors learn about theories such as acupuncture, nutritional therapy, visualization, medicinal plants and homeopathy, according to program literature.

The first class of four doctors graduated in June, just as another class of four ended their first year in the fellowship. Rakel and four other doctors began their education in July.

In his first four months of training, Rakel has spent much of his time in the Integrative Medicine Clinic, spending more time with each patient than he normally would, forming a relationship with the person and discussing appropriate treatment.

Although integrative medicine explores "non-traditional" forms of treatment, one aspect of the program Rakel appreciates most is the emphasis on forming personal bonds with patients - something he didn't have time for at his practice in Idaho. Rakel was one of two doctors at his town's hospital.

"It's very rewarding to have the time to truly get to know them," he says. "If I only have 10 minutes, I'm going to fall back on an expensive test. I don't have time to get at the root of the problem."

He describes how a personal relationship can be more effective than traditional treatment for illness.

If he sees a mother with back pain because of stress related to a divorce, and then sees her child with constipation, his knowledge of the family's problems can help his diagnosis, he says.

"I'll have some insight that that family is going through some difficult times, and I need to approach the psychological stress rather than putting that child through a lot of inappropriate medical tests," Rakel says.

He says he hopes that by investing more time in the patient, and treating larger problems within him or her, he can complement his traditional medical skills, and become a more complete physician.

Doctors come from all over the world to study Weil's curriculum.

Dr. Opher Caspi, an internist from Israel, is in his second year of the fellowship. Caspi says the second part of the program allows fellows to pursue specific studies that interest them. Caspi has decided to pursue a doctoral degree in psychology, studying the placebo effect.

Caspi says he interviewed Rakel, who was one of 85 doctors who applied to the program. Twenty physicians were interviewed for the fellowship.

"This 85 really doesn't reflect much the amount of interest that is growing exponentially in integrative medicine," he says.

Caspi agrees with Rakel's assessment of integrative medicine's goal.

"I respect the innate wisdom of the body to heal itself," he says. "Whatever I'm doing is... helping the body to do the work. Whatever intervention is done within that context."

He became interested in non-traditional medicine while studying Chinese medical treatment and acupuncture.

"I was blessed to spend a year in China," he says. "I was exposed to different approaches toward health and wellness and disease."

In China, he saw the practice of acupuncture at its highest form, Caspi says.

"That didn't trigger in me any disappointment from Western medicine," he says, but a curiosity about whether "things can be approached from different angles and actually contribute one to each other."