This fall, the world-renowned Cleveland Clinic Foundation officially opened the Center for Integrative Medicine (CIM) Clinical Practice. This groundbreaking facility located in Broadview Heights supports research, outpatient services and education in several complementary healing modalities. The Clinic consistently pioneers exceptional healthcare in nearly every traditional medical field, and for the past three years supported Dr. Joan Fox in conducting scientific research in Reiki, imagery and focused intention. Dr. Fox also developed a resource center to compile all documentation of integrative medicine studies.

Because of increasing scientific evidence supporting the many benefits of integrative medicine, Cleveland Clinic Foundation assessed a need to institute an outpatient clinic for integrative medicine and appointed Dr. Tanya Edwards as the Medical Director of CIM Clinical Practice. Dr. Edwards, a physician in the Department of Family Medicine and associate professor at Case Western Reserve University, has a special interest in nutrition and its role in preventing and treating chronic illness. She routinely used complementary therapies in her seventeen-year practice of conventional medicine. She explains, “I was raised in a family that researched and used complementary therapies, so I have always been open to the idea that there is something more than just mainstream western medicine.”

Cleveland Clinic has streamlined the flow of information between its researchers, practitioners and patients by bringing these components under one roof at CIM. The CIM staff has gone to great lengths to create a center that lives up to the Clinic's caliber of research and care. They are offering nine modalities, which all have scientific evidence confirming their effectiveness: nutritional counseling, Reiki, acupuncture, mind-body coaching, mindful cognitive therapy, massotherapy, yoga, tai chi and qi gong. Dr. Edwards explains, “Cleveland Clinic is an academic institution offering evidence-based therapies. I am not going to recommend therapies that do not have any merit in them.” She continues, “The research arm is poised to use the Center for Integrative Medicine Clinical Practice as a research site. When a practitioner notes that something works, we can gather a group of people together to conduct a randomized, controlled study.”

Each practitioner is responsible for keeping up on the latest worldwide research in their field. Practitioners meet biweekly to share updates on research, as well as to discuss patient treatment plans. This process creates a free-flow exchange of ideas on how to apply and assimilate the modalities. It also establishes a line of communication to determine the best course of treatment for each patient. They also work together to present workshops to patients who have specific diseases such as fibromyalgia, diabetes, cancer and multiple sclerosis.

“Many nurses and physicians are overwhelmingly accepting and anxious to send over complicated patients who may benefit from these therapies,” says Dr. Edwards. The Center also treats patients with common ailments and those who are healthy but interested in general wellness. Dr. Edwards states that the community has been “waiting for this, particularly with the Cleveland Clinic name behind it.” She supports this by citing the list of patients waiting for appointments many months prior to the Center's opening.

“I see myself as a change agent,” says Dr. Edwards, “with faculty development as the key.” The goal is to spread integrative therapies to all the Clinic satellites so that patients do not have to travel any further than the Cleveland Clinic office in their neighborhood. “When a patient is referred by a PCP [Primary Care Physician], with their permission, I send all of the information, my recommendations and the resources back to the PCP. For example, I may suggest that someone with diabetes start on chromium and ginseng and switch to a low-carbohydrate, anti-inflammatory diet. As the PCP sees that this works and observes the progress, they may feel comfortable applying this knowledge to another patient without having to refer to me.”

Some departments at Cleveland Clinic have been using complementary therapies for years. For example, the Pain Management Department has acupuncturists on staff and the Sports Medicine Department utilizes massotherapy and chiropractic treatment. Dr. Edwards explains, “My goal is to bring integrative medicine into mainstream medicine. It should not be separate.”

Cleveland Clinic Foundation's Center for Integrative Medicine demonstrates the scientific merit of complementary therapies to medical professionals as well as to our local community and the world. By promoting evidence-based applications, these pioneers are making unprecedented headway in the advancement and acceptance of these modalities in their use alongside traditional healthcare. We can only benefit from such immense strides.

Cleveland Clinic Center for Integrative Medicine Clinical Practice is located at One Eagle Valley Drive, Suite 201 in Broadview Heights and can be reached by calling (216) 986-HEAL. For more information about Dr. Joan Fox's research, please see Balanced Living Magazine September-October 2003 Vol. I, Issue 1, which is also on our website at www.BalancedLivingMag.com.

Kate Biddle, RYT, LISW Yoga Kate Biddle is a Registered Yoga Teacher with special training in yoga for patients with chronic conditions, such as diabetes, cancer, obesity, heart disease, stroke and many other health concerns. She is also a Licensed Independent Social Worker, who has focused on abuse and addiction recovery issues. The practice of yoga is commonly associated with the physical postures that develop strength and flexibility. However, this is only one element of yoga. Stretching of the body while maintaining an awareness of the breath with a meditative focus encourages the mind to become still and present in the moment. Among its many benefits, yoga frees the flow of energy in the body and cultivates balance in mind, body and spirit. This is beneficial for everyone because it relieves stress and reduces physical, mental, emotional and spiritual pain, while promoting peace of body, mind and spirit. “Yoga is not just about twisting the body into different positions; it's much more about being mindful of our state of consciousness," says Ms. Biddle. "I love it because it is empowering for people. This is especially important to an organization like Cleveland Clinic, where people are coming in often because they are in crisis. This is a time when people have an opportunity to become more skillful in learning how to tend to themselves more deeply.”

Susan Cady, MM, CTCI Tai Chi for Health Susan Cady is a Certified Tai Chi Instructor and has a Master's degree in Music. She offers classes to all age groups to emphasize the connection between this gentle exercise and individual creativity. The health benefits of tai chi range from lowering blood pressure to slowing bone loss, improving balance to boosting immunity. Tai chi is slow motion, gentle physical movement which combines breath, imagery, and playful mental and spiritual intent. This calms and unifies the body and mind to maintain energy balance, while it massages and exercises the joints and internal organs. “I often ask my students to make up a move, just as long as it is in the slow tradition,” Ms. Cady explains. “If we can learn the general principles, it becomes a gift to your creative brain to send down wonderful thoughts to your body while you are doing an exercise. It is a way to alter your mind-body, your whole energy system, in a few moments with breath, motion and imagery. Together this has a huge impact on the human body.”

Tanya Edwards, MD, MEd Medical Director Dr. Edwards is a family practice physician and associate professor at Case Western Reserve University School of Medicine. She is also the Vice-President of the Mind·Body·Spirit Connected (MBSC) Board of Directors. Her clinical research interests are in diet and nutrition for maintaining health and treating specific conditions. She explains, “Much of what I do is based on an anti-inflammatory diet. Most of the diseases associated with aging have their basis in inflammation.” Dr. Edwards provides a one-hour consultation that addresses all areas of the patient's body, mind and spiritual health and well being. She then makes recommendations to improve the patient's self-care through better diet and nutrition, exercise, vitamins and supplements, as well as other integrative medicine modalities when necessary.

Jane Pernotto Ehrman, M.Ed. Mind-Body Coaching Jane Pernotto Ehrman is a Certified Health Education Specialist and a National Board Certified Clinical Hypnotherapist. She also has post-graduate training at the Harvard Mind Body Medical Institute and at the Academy for Guided Imagery in California. She is a member of MBSC and has been doing this work for over 10 years. Mind-Body Coaching techniques include guided imagery, progressive relaxation and breath work. Ms. Ehrman explains, “I work one on one with clients, teaching them how to connect in mind, body and spirit in order to recognize that the answers are within themselves. I address stress-related illnesses like recurrent headaches, insomnia and irritable bowel, and issues such as preparing women for childbirth, pain management, chronic pain, cancer treatment and recovery, other life-threatening and serious health issues, and end of life issues.” “Cleveland Clinic Foundation provides world-class care and this is an integral part of world-class care,” Ms. Ehrman emphasizes. “This is also self-care. For every dollar that is spent on teaching people about self-care, $2.50 is saved in medical costs.”

Karen Fink, RN, BSN, LMT Massotherapy Karen Fink is a Registered Nurse and a Licensed Massage Therapist. She is an instructor at the National Institute of Massotherapy, and also a continuing education instructor for nurses at Cleveland Clinic on the topics of Massage, Stress Reduction and Self Care. The healing touch of massage relaxes the mind and body, relieves muscle tension and improves circulation, immune and nervous system functioning. It has been found to help patients with stress, anxiety, depression, fibromyalgia, chronic fatigue syndrome and more. “In my practice,” Ms. Fink explains, “I work with all ages on wellness, stress reduction and specific issues. I put together an individualized program for each patient and work with other practitioners so that each patient really experiences the mind-body connection. My treatments are not just about touching the skin or working the muscles. For example, someone might come in with a headache that can be released through massage, but I also try to teach them something they can do at home to prevent or relieve it through self-release, self-massage, visualization or other mind-body techniques.”

Stephanie Richards, RD Nutritional Counseling Stephanie Richards is a Registered Dietician and a member of MBSC who emphasizes a preventive nutritional “whole foods” approach through one-on-one counseling and lectures. She stresses the importance of eating foods in unadulterated, unprocessed forms for maximum nutritional benefit. Ms. Richards addresses proper dietary habits in promoting general wellness, a vegetarian diet, disease prevention and treatment of chronic conditions. “I have the philosophy that anybody can make an improvement in nutrition,” she explains. “By looking at lifestyle, likes, dislikes and goals, I can determine how to incorporate better food choices. I help people reach their maximum health potential by improving their nutritional choices in small steps.” “I have the philosophy that anybody can make an improvement in nutrition,” she explains. “By looking at lifestyle, likes, dislikes and goals, I can determine how to incorporate better food choices. I help people reach their maximum health potential by improving their nutritional choices in small steps.”

Rachel Rizzi, MS, RAc Acupuncture Rachel Rizzi is a graduate of Tri-State College of Acupuncture in New York City. She is a registered acupuncturist with the Ohio State Medical Board and the National Certification Commission for Acupuncture and Oriental Medicine. She is also on the MBSC Board of Directors. Acupuncture is an ancient Chinese system of healing based on the theory that “chi” (also spelled “qi”), or energy within the body, flows along pathways called meridians. A blockage or imbalance results in pain and/or illness. An acupuncturist places thin needles (filaments) at specific points to redirect the flow of energy. The World Health Organization and the National Institute of Health have identified over forty common conditions that can be effectively treated with acupuncture. "By addressing the underlying cause of a disorder, I help people regain balance in their lives, get relief from pain and free themselves from their symptoms," Ms. Rizzi says. "I believe acupuncture is important at Cleveland Clinic because it is safe, the benefits are many and the risks are few. Acupuncture also integrates well with many types of medical treatments, promoting and supporting the overall health of the patient.”

Carol Spears, MS Reiki Carol Spears is a Reiki Master and Teacher. She is a member and Certified Master Teacher of the International Association of Reiki Professionals, receiving her Reiki training in traditional Usui Reiki. Sh e is a certified Music Practitioner of the Harp, as well as a meditation instructor. She is also on the MBSC Board of Directors. Reiki is an ancient form of natural, energy-based healing involving the laying on of hands by the practitioner, which promotes a deep sense of relaxation and helps the client access their abilities to promote their own healing in body, mind and spirit. During a Reiki treatment, the client usually lies on a massage table, fully clothed. There is no pressure, massage or manipulation during the treatment. The energy does not come from the practitioner; it comes through the practitioner. Ms. Spears explains, “Reiki plays an important role in increasing a patient's overall health and ability to recover from medical problems and treatments. It helps to supply the energies needed to cope with illness or emotional distress and enhances the body's responsiveness during allopathic, homeopathic and detoxifying therapies. Reiki is also effective preventive medicine, promoting the harmonious distribution of energy.”

Mind·Body·Spirit Connected Mind·Body·Spirit Connected (MBSC) is a local nonprofit that promotes health and wholeness through an understanding of mind, body and spirit connectivity. The organization was incorporated in 2002 for the advancement and education of holistic practitioners and is dedicated to high standards of professionalism, integrity and competence. MBSC is helping bridge the gap between conventional healthcare and complementary and alternative medicine. Several CIM staff members are on the MBSC Board of Directors, serving as officers or holding key positions on governance committees. Dr. Edwards explains, “Although MBSC is an educational organization rather than a business league, it promotes credentialing and ethics as a part of its mission, so I felt that it was very important to look at MBSC members when hiring practitioners.” MBSC is responsible for collecting the library of reading materials at CIM. These books are available in the comfortable CIM reading room.