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A Fond Farewell
MATTERS OF NOTE
A Fond Farewell After 14 years of working to advance the field of integrative healthcare and achieving significant success in that effort, the Bravewell Collaborative officially closed its doors on June 17, 2015. This article is a tribute to this group of remarkable people who contributed so much to the world of healthcare.
The story begins with Penny George and her experience with breast cancer. As Penny went through the conventional treatment, she consciously decided to use the best of what modern medicine had to offer, but to also take charge of her own healing process with the goal of “creating more health” in everything she did. “My conventional medical care for cancer was impeccable,” she explains. “But it focused only on the body part and the disease, not on me as a whole human being or as someone prepared to do my part to help myself heal.” Penny investigated many modalities, but central to her healing process were self-reflection, spiritual growth, and deepening her sense of and commitment to community. “As I navigated my own path toward wellness, I became convinced that what I had learned about self-care should be available to everyone. I also believed that philanthropy could help bring about the changes that needed to happen in medicine to make the experience more whole and more humanistic,” she explains. After discussing Penny’s desire to affect change, Penny and Diane Neiman, the then executive director of the George Family Foundation, decided to use some of the George Family Foundation funds to convene a think tank for the various philanthropists interested in transforming medicine. In April 2001, at Miraval in Tucson, Arizona, the two
Matters of Note
women brought together 25 physician leaders in integrative medicine with the same number of philanthropists for a two-day meeting. “We trusted that if we brought together people with good minds and good hearts and engaged in a process designed to unleash transformative ideas, positive things would happen,” says Penny. This event and the subsequent larger meeting at the Rockefeller Estate and Conference Center in Pocantico, New York, resulted in the formation of the Philanthropic Collaborative for Integrative Medicine. “During the process of meeting and talking, we realized that by pooling our resources, we could create change on a larger scale and have a greater impact than any one of us could accomplish alone,” explains Christy Mack. Subsequently renamed the Bravewell Collaborative, the founders decided that the organization would be dedicated to strategic, philanthropist-driven initiatives to advance the field of integrative medicine on a national basis. “In hindsight I realize how groundbreaking that gathering was, how it revealed the collaborative spirit of the people drawn to integrative medicine and the power of convening as a strategy,” says Penny. Between 2002 and 2015, Bravewell members—numbering between 10 and 20 individuals and family foundations— invested close to $30 million in pursuit of that vision. “Bravewell was intended to have a catalytic impact on the field of medicine. That the crisis in healthcare was accelerating at the same time that minds were opening to new ideas, including a new awareness of the importance of individuals taking charge of their own health, was fortunate,” explains Penny.
Bravewell's Initiatives William Sarnoff served as Bravewell’s first president, followed by Penny George and then Christy Mack. Under
their leadership, Bravewell launched carefully chosen initiatives designed to speed the adoption of an integrative approach to care. First, to understand how integrative medicine was emerging within the culture and how philanthropy could best move the field forward, Bravewell directed and funded four mapping studies. Throughout the years, these reports helped the members understand where and how they could best help. “We knew that to truly transform healthcare, the educational culture within medicine had to shift toward more a humanistic approach,” explains Christy Mack, “so we teamed up with a small group of eight medical schools that held the same vision and funded the development of a Consortium.” Today, the Academic Consortium for Integrative Medicine and Health has 57 members and is actively changing medical education from within. Knowing that the true test and benefit of any medicine was in the care of patients, Bravewell adopted a strategy to empower and accelerate the growth of leading clinical centers of integrative medicine, which could then serve as models for change in the larger healthcare delivery system. Today, these thriving centers not only provide integrative care to thousands of people across the nation, but they also conduct important research, develop successful models of care, and train physicians and other healthcare providers in integrative approaches. Concerned about being able to meet the demand for integrative care, Bravewell established the Bravewell Fellowship program in partnership with the University of Arizona’s Center for Integrative Medicine Fellowship in Integrative Medicine. During the life of the program, a total of 88 Bravewell Fellows were graduated. Because these graduates typically returned to leadership positions within their organizations, this program exponentially increased the availability of
EXPLORE July/August 2015, Vol. 11, No. 4 249
integrative medicine for the American people. Understanding the need for evidence and how evidence could help tip the scales, Bravewell also created the nation’s first practice-based research network in integrative medicine—BraveNet. This group has since gone on to complete several important studies that demonstrate integrative medicine’s ability to address chronic disease. “We also created the Bravewell Leadership Award and the Bravewell Pioneer Award,” explains Christy. “These awards not only empowered the recipients, they inspired others to greater heights.” Early in their existence, the members identified public television as a key strategic venue for presenting the integrative medicine message. As a consequence, Bravewell organized and helped fund an award-winning two-hour PBS Special on integrative medicine. The Called The New Medicine, this production was awarded a FREDDIE for excellence in health and wellness media and won the 2007 Silver World Medal in Health and Medical Issues category at the New York Film Festival. It was also nominated for both a News & Documentary Emmy Award and the prestigious Peabody Award. The New Medicine has now been viewed by over five million people. Funding the IOM’s National Summit on Integrative Medicine and the Health of the Public was another key strategy. It turned out to be the largest event of its kind produced by the IOM, and it brought together distinguished researchers, practitioners, and leaders from multiple sectors to present the vision, challenges, evidence base, and opportunities for integrative medicine to improve healthcare in the United States. “This is how we made a difference. By first understanding the landscape and then choosing to support those pockets of excellence that were already emerging. We partnered with the right people at the right time and together we were able to accomplish much,” says Christy.
The Decision to Sunset
“But even from its very beginning Bravewell’s vision was to one day not exist,” explains Christy. “We hoped that at some point we would have
accomplished our goals and at the appropriate time, would shut our doors.” When their principal strategies were essentially completed, when integrative medicine was finally part of the national conversation on healthcare, the members of Bravewell collectively decided when it was time to sunset the organization. “It had always been our intention to come together, do the work, and then disband. So we set the sunset date for June 2015,” explains Christy. As part of its sunsetting process, Bravewell chose to underwrite two legacy projects as their parting gift to the nation— PRIMIER, a patient-reported outcomes registry, and the Leadership Program in Integrative Healthcare at Duke University. The highest standards of care, determination of best practices and protocols, and informed decision-making in healthcare settings are dependent on rigorous clinical research. Consequently, observational, practice-based data collection is used widely across many clinical settings for monitoring diseases, outcomes, health services, and device and medicine safety. It is a critical process in the healthcare system. Understanding that a national registry system needed to be established in order to demonstrate and document the full potential of integrative medicine, Bravewell worked with its practice-based research network of 14 centers throughout the country to launch a data registry project called PRIMIER, which stands for Patients Receiving Integrative Medicine Interventions Effectiveness Registry. The purpose of PRIMIER is to uniformly collect patient-reported outcomes and extracted electronic health record data into a large data set that can be used for quality improvement, evidence-based research, and determination of Best Practices. PRIMIER is now providing foundational new knowledge on how integrative medicine is used in real-world settings, data that will ultimately inform future clinical trials as well as decision-making in clinical settings. This project has now been relocated to the Albert Einstein College of Medicine. The second legacy project was the creation of the Leadership Program in Integrative Healthcare at Duke. Integrative healthcare holds the key to resolving many of the clinical and cost
250 EXPLORE July/August 2015, Vol. 11, No. 4
issues facing our healthcare system. However, making a pervasive cultural shift requires innovators with strong leadership skills. Having clinical expertise is not enough. In assessing the future, Bravewell members recognized that the nation needed a host of integrative healthcare leaders with business acumen who could think critically, create collaborative environments, actively involve patients and families in their own care, develop strategic approaches to change, and inspire excellence throughout an organization. So Bravewell conceived of a leadership program that would address this need and awarded a grant to Duke Integrative Medicine to create “The Leadership Program in Integrative Healthcare at Duke University.” Created in collaboration with the Duke Fuqua School of Business, the program integrates personal transformation and mentorship with business and leadership tools for systems reorganization. “Graduates of this program are destined to change our healthcare system for the better,” says Christy. “Looking back, I believe that Bravewell’s success was due to a number of factors: a shared vision, membership limited to those with the authority to make funding decisions, an excellent staff, a commitment to stay on solid scientific ground, explicit norms for how we would work together, and clear strategies that we had the capacity to deliver on ourselves in a timely fashion,” explains Diane Neimann, Bravewell’s founding executive director. “It has been the most fulfilling journey for all of us. Now that Bravewell’s doors are closed, we, as individuals, will continue to work for the transformation of healthcare as the committed and passionate people that we are. We are confident that those who have partnered with us over these years are now well positioned to advance their work in transforming the health of this nation and the way we deliver its care,” says Christy Mack. Bravewell’s role in changing how Americans think about health and medicine is an example of what philanthropy is capable of accomplishing at its very best. For more information please visit www.bravewell.org.
Matters of Note
New Leadership Column to be Published in Explore Starting with this issue, July 2015, EXPLORE will begin publishing a column on Integrative Leadership. The column originates from the Leadership Program in Integrative Healthcare at Duke University, a program that was established with a grant from the Bravewell Collaborative. Integrative healthcare holds the key to resolving many of the clinical and cost
Matters of Note
issues facing our healthcare system. However, making a pervasive cultural shift requires innovators with strong leadership skills—leaders with business acumen who can think critically, create collaborative environments, actively involve patients and families in their own care, develop strategic approaches to change, and inspire excellence throughout an organization. The Leadership Program at Duke was developed to develop such leaders. The column will be written by program faculty and graduates. The first
column, which is from Adam Perlman, MD, MPH, begins this month.
Matters Of Note is written and compiled by Bonnie J. Horrigan, Editorial Director for EXPLORE and author of Voices of Integrative Medicine: Conversation and Encounters.
EXPLORE July/August 2015, Vol. 11, No. 4 251
A Fond Farewell After 14 years of working to advance the field of integrative healthcare and achieving significant success in that effort, the Bravewell Collaborative officially closed its doors on June 17, 2015. This article is a tribute to this group of remarkable people who contributed so much to the world of healthcare.
The story begins with Penny George and her experience with breast cancer. As Penny went through the conventional treatment, she consciously decided to use the best of what modern medicine had to offer, but to also take charge of her own healing process with the goal of “creating more health” in everything she did. “My conventional medical care for cancer was impeccable,” she explains. “But it focused only on the body part and the disease, not on me as a whole human being or as someone prepared to do my part to help myself heal.” Penny investigated many modalities, but central to her healing process were self-reflection, spiritual growth, and deepening her sense of and commitment to community. “As I navigated my own path toward wellness, I became convinced that what I had learned about self-care should be available to everyone. I also believed that philanthropy could help bring about the changes that needed to happen in medicine to make the experience more whole and more humanistic,” she explains. After discussing Penny’s desire to affect change, Penny and Diane Neiman, the then executive director of the George Family Foundation, decided to use some of the George Family Foundation funds to convene a think tank for the various philanthropists interested in transforming medicine. In April 2001, at Miraval in Tucson, Arizona, the two
Matters of Note
women brought together 25 physician leaders in integrative medicine with the same number of philanthropists for a two-day meeting. “We trusted that if we brought together people with good minds and good hearts and engaged in a process designed to unleash transformative ideas, positive things would happen,” says Penny. This event and the subsequent larger meeting at the Rockefeller Estate and Conference Center in Pocantico, New York, resulted in the formation of the Philanthropic Collaborative for Integrative Medicine. “During the process of meeting and talking, we realized that by pooling our resources, we could create change on a larger scale and have a greater impact than any one of us could accomplish alone,” explains Christy Mack. Subsequently renamed the Bravewell Collaborative, the founders decided that the organization would be dedicated to strategic, philanthropist-driven initiatives to advance the field of integrative medicine on a national basis. “In hindsight I realize how groundbreaking that gathering was, how it revealed the collaborative spirit of the people drawn to integrative medicine and the power of convening as a strategy,” says Penny. Between 2002 and 2015, Bravewell members—numbering between 10 and 20 individuals and family foundations— invested close to $30 million in pursuit of that vision. “Bravewell was intended to have a catalytic impact on the field of medicine. That the crisis in healthcare was accelerating at the same time that minds were opening to new ideas, including a new awareness of the importance of individuals taking charge of their own health, was fortunate,” explains Penny.
Bravewell's Initiatives William Sarnoff served as Bravewell’s first president, followed by Penny George and then Christy Mack. Under
their leadership, Bravewell launched carefully chosen initiatives designed to speed the adoption of an integrative approach to care. First, to understand how integrative medicine was emerging within the culture and how philanthropy could best move the field forward, Bravewell directed and funded four mapping studies. Throughout the years, these reports helped the members understand where and how they could best help. “We knew that to truly transform healthcare, the educational culture within medicine had to shift toward more a humanistic approach,” explains Christy Mack, “so we teamed up with a small group of eight medical schools that held the same vision and funded the development of a Consortium.” Today, the Academic Consortium for Integrative Medicine and Health has 57 members and is actively changing medical education from within. Knowing that the true test and benefit of any medicine was in the care of patients, Bravewell adopted a strategy to empower and accelerate the growth of leading clinical centers of integrative medicine, which could then serve as models for change in the larger healthcare delivery system. Today, these thriving centers not only provide integrative care to thousands of people across the nation, but they also conduct important research, develop successful models of care, and train physicians and other healthcare providers in integrative approaches. Concerned about being able to meet the demand for integrative care, Bravewell established the Bravewell Fellowship program in partnership with the University of Arizona’s Center for Integrative Medicine Fellowship in Integrative Medicine. During the life of the program, a total of 88 Bravewell Fellows were graduated. Because these graduates typically returned to leadership positions within their organizations, this program exponentially increased the availability of
EXPLORE July/August 2015, Vol. 11, No. 4 249
integrative medicine for the American people. Understanding the need for evidence and how evidence could help tip the scales, Bravewell also created the nation’s first practice-based research network in integrative medicine—BraveNet. This group has since gone on to complete several important studies that demonstrate integrative medicine’s ability to address chronic disease. “We also created the Bravewell Leadership Award and the Bravewell Pioneer Award,” explains Christy. “These awards not only empowered the recipients, they inspired others to greater heights.” Early in their existence, the members identified public television as a key strategic venue for presenting the integrative medicine message. As a consequence, Bravewell organized and helped fund an award-winning two-hour PBS Special on integrative medicine. The Called The New Medicine, this production was awarded a FREDDIE for excellence in health and wellness media and won the 2007 Silver World Medal in Health and Medical Issues category at the New York Film Festival. It was also nominated for both a News & Documentary Emmy Award and the prestigious Peabody Award. The New Medicine has now been viewed by over five million people. Funding the IOM’s National Summit on Integrative Medicine and the Health of the Public was another key strategy. It turned out to be the largest event of its kind produced by the IOM, and it brought together distinguished researchers, practitioners, and leaders from multiple sectors to present the vision, challenges, evidence base, and opportunities for integrative medicine to improve healthcare in the United States. “This is how we made a difference. By first understanding the landscape and then choosing to support those pockets of excellence that were already emerging. We partnered with the right people at the right time and together we were able to accomplish much,” says Christy.
The Decision to Sunset
“But even from its very beginning Bravewell’s vision was to one day not exist,” explains Christy. “We hoped that at some point we would have
accomplished our goals and at the appropriate time, would shut our doors.” When their principal strategies were essentially completed, when integrative medicine was finally part of the national conversation on healthcare, the members of Bravewell collectively decided when it was time to sunset the organization. “It had always been our intention to come together, do the work, and then disband. So we set the sunset date for June 2015,” explains Christy. As part of its sunsetting process, Bravewell chose to underwrite two legacy projects as their parting gift to the nation— PRIMIER, a patient-reported outcomes registry, and the Leadership Program in Integrative Healthcare at Duke University. The highest standards of care, determination of best practices and protocols, and informed decision-making in healthcare settings are dependent on rigorous clinical research. Consequently, observational, practice-based data collection is used widely across many clinical settings for monitoring diseases, outcomes, health services, and device and medicine safety. It is a critical process in the healthcare system. Understanding that a national registry system needed to be established in order to demonstrate and document the full potential of integrative medicine, Bravewell worked with its practice-based research network of 14 centers throughout the country to launch a data registry project called PRIMIER, which stands for Patients Receiving Integrative Medicine Interventions Effectiveness Registry. The purpose of PRIMIER is to uniformly collect patient-reported outcomes and extracted electronic health record data into a large data set that can be used for quality improvement, evidence-based research, and determination of Best Practices. PRIMIER is now providing foundational new knowledge on how integrative medicine is used in real-world settings, data that will ultimately inform future clinical trials as well as decision-making in clinical settings. This project has now been relocated to the Albert Einstein College of Medicine. The second legacy project was the creation of the Leadership Program in Integrative Healthcare at Duke. Integrative healthcare holds the key to resolving many of the clinical and cost
250 EXPLORE July/August 2015, Vol. 11, No. 4
issues facing our healthcare system. However, making a pervasive cultural shift requires innovators with strong leadership skills. Having clinical expertise is not enough. In assessing the future, Bravewell members recognized that the nation needed a host of integrative healthcare leaders with business acumen who could think critically, create collaborative environments, actively involve patients and families in their own care, develop strategic approaches to change, and inspire excellence throughout an organization. So Bravewell conceived of a leadership program that would address this need and awarded a grant to Duke Integrative Medicine to create “The Leadership Program in Integrative Healthcare at Duke University.” Created in collaboration with the Duke Fuqua School of Business, the program integrates personal transformation and mentorship with business and leadership tools for systems reorganization. “Graduates of this program are destined to change our healthcare system for the better,” says Christy. “Looking back, I believe that Bravewell’s success was due to a number of factors: a shared vision, membership limited to those with the authority to make funding decisions, an excellent staff, a commitment to stay on solid scientific ground, explicit norms for how we would work together, and clear strategies that we had the capacity to deliver on ourselves in a timely fashion,” explains Diane Neimann, Bravewell’s founding executive director. “It has been the most fulfilling journey for all of us. Now that Bravewell’s doors are closed, we, as individuals, will continue to work for the transformation of healthcare as the committed and passionate people that we are. We are confident that those who have partnered with us over these years are now well positioned to advance their work in transforming the health of this nation and the way we deliver its care,” says Christy Mack. Bravewell’s role in changing how Americans think about health and medicine is an example of what philanthropy is capable of accomplishing at its very best. For more information please visit www.bravewell.org.
Matters of Note
New Leadership Column to be Published in Explore Starting with this issue, July 2015, EXPLORE will begin publishing a column on Integrative Leadership. The column originates from the Leadership Program in Integrative Healthcare at Duke University, a program that was established with a grant from the Bravewell Collaborative. Integrative healthcare holds the key to resolving many of the clinical and cost
Matters of Note
issues facing our healthcare system. However, making a pervasive cultural shift requires innovators with strong leadership skills—leaders with business acumen who can think critically, create collaborative environments, actively involve patients and families in their own care, develop strategic approaches to change, and inspire excellence throughout an organization. The Leadership Program at Duke was developed to develop such leaders. The column will be written by program faculty and graduates. The first
column, which is from Adam Perlman, MD, MPH, begins this month.
Matters Of Note is written and compiled by Bonnie J. Horrigan, Editorial Director for EXPLORE and author of Voices of Integrative Medicine: Conversation and Encounters.
EXPLORE July/August 2015, Vol. 11, No. 4 251