From The Field O C T O B E R 2 0 , 2 0 1 4 The Legacy of The Bravewell Collaborative:Transforming Health Care through Integrative Medicine PENNY GEORGE Board President, George Family Foundation THE CREATION OF A PHILANTHROPIC In hindsight I realize how remarkable an undertaking it was COLLABORATIVE and how it reflected the collaborative values of the people A sea change is well underway in the United States regarding attracted to integrative medicine—that those seeking funding health, medicine, and health care delivery. By the early 2000s and those with financial resources to offer could work harmo- it was inescapable that obesity rates were climbing while med- niously together to achieve collective impact. ical costs were becoming unsustainable. Readers might not be What transpired was that the philanthropists found common ground and wanted to continue to work together. In aware, however, of one philanthropic effort that began to help fact, one of the strategies the group advanced was to create a tip the country toward well-being, prevention, and wellness: philanthropic collaborative that would pool resources to create The Bravewell Collaborative. The Bravewell Collaborative is an operating foundation of philanthropists who have been With the audacious vision of bringing about optimal health and healing working together for the past 13 for individuals and society, our goal was to build a learning community of years to change how Americans philanthropists dedicated to advancing the principles and practices of think of health and health care integrative medicine. and to effect cultural change to create a healthier nation. It began with my transformative encounter with breast systemic change beyond what was possible for any individual cancer, a journey that made clear to me how medicine needs or foundation. Following a second, funders-only meeting to change, and a journey that was similar to that of many in the fall of 2001, the Philanthropic Collaborative for other people at the time, some of them wealthy enough to Integrative Medicine was officially created in the spring of bring philanthropic resources to bear on the issue. 2002. It was later renamed The Bravewell Collaborative. While on a conventional level, medical care for cancer was Together we decided on the structure of an operating founda- remarkable; on a human level, it focused entirely on the body tion, hired talented staff, and agreed upon the strategies we and the disease, not on the body-mind-spirit-connected indi- would pursue. Over the years we have numbered between 10 vidual or that person’s desire to be central to the medical and 20 individuals and family foundations committed to this encounter. As I navigated my own path toward wellness, I work, and together we have invested close to $30 million in soon became convinced that philanthropy could help create a pursuit of our vision. new way of caring for and working with patients. With our philanthropic advisors, the George Family STRATEGIES FOR SYSTEMIC CHANGE Foundation spent a year planning a convening of progressive With the audacious vision of bringing about optimal health medical leaders and funders who believed as I did in the and healing for individuals and society, our goal was to build a change that needed to happen. The goal was to share ideas for learning community of philanthropists dedicated to advancing strategies that could lead to sustainable change. We had no the principles and practices of integrative medicine and pursu- preconceived idea of where this would lead; we just trusted ing specific strategies, some of which emerged from two pro that if we brought together people with good minds and good bono studies done for Bravewell by McKinsey and Co. hearts, positive things would happen. What has become known as “Miraval I” took place in the spring of 2001 at a ® Identifying and Disseminating Leading Models of mindfulness spa in Tucson, Arizona. Integrative Care: We conducted a mapping of the field of integrative medicine in a variety of settings and published scientific base that exists for such practices. Bravewell also Integrative Medicine in America: How Integrative Medicine created publications that are widely available about various Is Being Practiced in Clinical Centers Across the United aspects of integrative medicine. States, available at www.bravewell.org, detailing the features of the leading centers across the country. SUNSETTING BRAVEWELL ® Strengthening Integrative Medicine Programs: We Bravewell was always intended to have a catalytic impact on created a network of the leading centers and brought them the field of medicine. That the crisis in health care was together twice a year with expert facilitation in order for occurring simultaneously was a felicitous opportunity to move them to share and disseminate best practices. This led to through doors that were suddenly opening to innovation and publishing Best Practices in Integrative Medicine: A Report a new consciousness about the importance of individuals from the Bravewell Clinical Network, also available on the assuming responsibility for their own health. Bravewell website. Bravewell members decided that our principal strategies were essentially completed and that we should sunset in 2015. Some ® Developing the Research Base for Integrative Medicine: funds remained, so we queried our strategic partners about While Bravewell does not directly fund research, we what would be most helpful as a legacy of Bravewell. Together believe that demonstrating the effectiveness of integrative we settled on two efforts. The first is a data repository, which approaches to patient care is crucial to sustainability. To would compile the clinical outcomes of integrative medicine. this end, we created BraveNet, a practice-based research Called PRIMIER, the repository uses a research tool developed network of 14 leading clinical centers, to collect data to by the National Institutes of Health and is a framework for build the case for how integrative care addresses the Triple discovering what approaches to patient care are best for which Aim of improved outcomes, lowered costs, and patient specific conditions. engagement. The other legacy effort is the Leadership Program in ® Changing the Way Physicians Are Educated: We pro- Integrative Medicine at Duke University, a yearlong cus- vided 10 years of funding to support the growth of the tomized program that will train the next generation of health Consortium of Academic Health Centers for Integrative care leaders to create cultural change and develop sustainable Medicine, during which membership grew from an initial integrative health and healing programs within large health 8 schools to 55 schools. The consortium is ideally posi- care institutions and clinics across the United States. The first tioned to transform how physicians are educated because cohort will begin in early 2015. this is their purview. It has made such a significant impact that most medical students in the United States are now BRAVEWELL’S LEGACY exposed to integrative medicine during their training. Reflecting on the past 13 years, I believe that Bravewell’s In addition, Bravewell partnered with the Center for success has been due to a number of factors: a shared vision, Integrative Medicine at the University of Arizona to pro- membership limited to those with the authority to make vide fellowships for physicians, nurse practitioners, and funding decisions, a commitment to stay on solid scientific physician assistants to receive training in Dr. Andrew ground, explicit norms for how we would work together, clear Weil’s well-regarded distance fellowship program. Over the strategies that we had the capacity to deliver in a timely fash- years of this initiative, 88 Bravewell Fellows were trained ion, and a commitment to a model that was and clinically supervised. They are now expanding access to philanthropist-driven but staff-led. integrative care to patients across the country and educat- As for me, the last 13 years have been among the most ing their professional colleagues. satisfying in my life. Working alongside like-minded change ® Championing Physician Leaders: In 2003 we created the agents from within medicine and philanthropy has been Bravewell Leadership Award to recognize and financially spiritually rewarding, intellectually stretching, and socially reward top leaders in integrative medicine. We presented rejuvenating. Bravewell’s role in bringing about social the awards in a biannual community-building event in change is an example of what philanthropy in America does New York. A total of 12 individuals, of which 11 are at its best. physicians, have been honored. ® Educating the Public: To increase public demand for integrative care, we sought to educate people about integrative medicine. In partnership with PBS we produced an award-winning two-hour documentary called The New Medicine, which was seen by millions of people. We partnered with the Institute of Medicine to sponsor Views from the Field is offered by GIH as a forum the Summit on Integrative Medicine and the Health of the for health grantmakers to share insights and experiences. If you are Public, which among other things validated the strong interested in participating, please contact Osula Rushing at 202.452.8331 or orushing@gih.org.