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One cannot pick up a popular or scientific publication today without encountering articles on mind-body therapies, natural foods, and preventive approaches to health management. Terms such as wellness, detoxification, probiotics and immune support have entered the American lexicon along with a gamut of "alternative" health practices, from Ayurveda to Zen-meditation.

As complexities of access, reimbursement, regulation, and liability within the American healthcare system continue to grow, many physicians and patients alike are thinking outside the box: they are focusing on restoring the centrality of the physician-patient relationship, adopting the idea of personal responsibility for health, and employing a greater range of therapies and practices in support of healing.

The success of Kaiser Permanente's "Thrive" campaign, the establishment of integrative medical centers like California Pacific Medical Center's Institute for Health & Healing and the UCSF Osher Center for Integrative Medicine, as well as the presence of many conventionally trained physicians in associations of holistic healthcare providers-all demonstrate that formally unconventional ideas are becoming more mainstream.

One physician's paradigm shift

Among the modern pioneers of integrative medicine is Len Saputo, M.D. Dr. Saputo is the founder of the Health Medicine Center in Walnut Creek and of the Health Medicine Forum, a non-profit educational foundation that holds monthly events at the Lesher Center for the Arts. He is also the co-founder of the Health Medicine Research Institute, which conducts testing and funded research in a variety of "frontier medicine" fields, such as research on photon therapy, a promising and economical treatment for diabetic neuropathy.

A 1965 graduate of Duke University Medical School and board certified in internal medicine, Dr. Saputo maintained a private practice at John Muir Medical Center from 1971 to 2004. He became interested in the potential for merging conventional and complementary therapies in 1990, after his wife Vicki, an R.N., developed a severe illness that conventional medicine proved unable to resolve. Their search for, and ultimate success with, natural modes of therapy led Dr. Saputo to a paradigm shift that would redefine his life and career.

Thereafter Dr. Saputo began practicing integrative medicine, defined by the Consortium of Academic Health Centers for Integrative Medicine as, "the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing."

A whole-person focus

"In integrative medicine we look at the whole person: body, mind, emotions and spirit," says Dr. Saputo. "There are really four legs that hold up the table for this type of therapy: it is integrative, holistic, person-centered and preventive. That's our model."

Dr. Saputo stresses that he still uses all of his knowledge and skills as an internist; however he is also prepared to incorporate other, gentler therapies, like nutrition, as well as support from disciplines such as Chinese medicine, homeopathy, chiropractic, somatic psychotherapy, and other modalities in order to meet the complex needs of his patients. "You're always going to do a better job if you have more tools and you have a balanced approach...and if you listen and you care," he says.

Listening and caring: It's a phrase Dr. Saputo returns to again and again when describing the central aspect of his work as well as what distinguishes the business-oriented healthcare system Americans have today from the service-oriented system he so vociferously champions. "Listening and caring is what we need to do to be the best healthcare practitioners and the best healers."

Part modern scientist, part traditional physician, part outspoken reformist, Dr. Saputo exudes real passion about what it takes to be a good physician along with real conviction about what is wrong with the American healthcare system today-and what it will take to fix it.

Curing versus healing

"The bulk of the patients I see are people who have been every place else; they've seen as many as 20-50 practitioners and they haven't gotten better," Dr. Saputo states. "It's very rare for a person to come to me and not get better. I don't always cure their symptoms; a lot of people come to me because they have end-stage cancer, and they've tried everything. A few of them do get well, not everybody, but almost everybody who comes to me goes through a process of healing in a way that is very profound."

Dr. Saputo maintains that there is a big difference between curing and healing. "That distinction has been blurred because of the direction that medicine has taken-it's too mechanized, too standardized, too much one-size-fits-all, too restricting of what we can do as physicians. We don't have the latitude we used to anymore, because we're all worried about costs. That's a significant part of what's killing it."

The healing circle

One unique aspect of Health Medicine Center practice is what is known as the "healing circle." A healing circle is where between three and six practitioners of different disciplines meet together with a patient for two hours, free of charge. Based on a detailed history provided by the patient, each practitioner presents his or her own approach to the patient's health problems, and then they all come to a meeting of minds about the recommended course of treatment.

"We record the whole session and give the patient a CD when we're finished," Dr. Saputo says. "We write them a report of the perspective of each practitioner, and a summary of what we recommend in terms of possible therapies to help them go beyond their illness."

Dr. Saputo adds that he is conducting a clinical trial to measure the outcome of healing circles, to determine whether or not over time it is improving patients' quality of life as well as their physical, mental, emotional and spiritual health.

Outspoken advocate for reform

In addition to his work with the Health Medicine Center, Health Medicine Forum, and various research projects, Dr. Saputo records a daily radio show and two weekly cable television shows with his wife Vicki. To keep up on developments in the medical field, Dr. Saputo starts each day by reviewing every medical abstract on Reuters news, "so I know where the trends in medicine are going, and I see what's happening in the politics, economics, and social aspects of healthcare."

Part of the movement towards integrative medicine is an effort to refocus the healthcare system. In September 2009, Dr. Saputo released a new book, written for physicians and titled, A Return to Healing: Radical Health Care Reform and the Future of Medicine. Taking him 15 years to research and compile, the book documents the history of problems with the American healthcare system and sets forth his plan for getting medicine back on the right track.

"Healthcare reform is going to depend on transitioning from disease care to health care," Dr. Saputo states. It's going to take a transformation of our culture to move from financial orientation -- a business model -- to one that's service oriented. Until you see that, you're going to see people rearranging the chairs on the deck of the Titanic as it's sinking. That's what's happening today."

Rather than offering a doomsday scenario for the future, however, Dr. Saputo says he is a big believer in the power of physicians to influence the system.

"What we need to do as a group is to change the situation so that we can practice the way we want to and the way our patients want us to, so that we can keep them from getting sick and we can use safe approaches that make the most sense. We need to go back to listening and caring, and having the time to do that. I think that, within two or three years of doctors getting together and taking more responsibility for the direction that healthcare is going to take, we'll be able to impact the practice of medicine in a major way. Because, in actuality, we hold the power and always have, but we haven't really stepped up to the plate to take it."

Who's responsible?

A big part of the solution to America's healthcare problems, says Dr. Saputo, is for people to start taking responsibility for their own health.

"We need to start doing wellness and prevention, and nutrition and natural therapies," he says. "We should be using medicine, of course, because medicine has the brilliance of its technologies. Never before have we had such unbelievable gene therapies and stem cell therapies and microsurgeries and wonderful drugs for certain things -- that is a given."

However, he says, medical treatments should no longer constitute primary care. "Primary care is wellness, and we don't teach that in medical school. When I was in medical school we got an hour on nutrition, didn't get anything on exercise, and a little something on stress reduction and sleep. If we just did those simple things, America would be healthy, and we wouldn't have the high costs and the dangers of some of the treatments that lead to too many deaths -- nearly 1 million deaths every year due to the complications of our medical therapies.

"Primary care is managing lifestyle. Do that and you won't get sick."