As modern medical standardization continues, the field of traditional Chinese medicine has the advantage of comprehensive personalization. For rare or complex cases, deeper consideration of constitution is invaluable. Proper constitutional assessment, especially with first-time clients, can guide desirable and predictable outcomes. This leads to a higher rate of return, and greater trust between you and your patient.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services. Atlantic Health System in Morristown, N.J. takes this theme directly into maternity, cardiac, orthopedic, pediatric, ICU and emergency room inpatient settings, offering unique services such as: therapeutic massage, acupressure, reflexology, aromatherapy, guided imagery and more.
The Chambers Center for Well Being, at Atlantic Health, offers traditional Chinese medicine, (in addition to other options like massage, nutrition education and counseling) as outpatient services.
Patients are often referred directly by Atlantic Health Western medical doctors, to practitioners in the Chambers center for treatment. In many cases there is consistent collaboration between an MD, and a licensed acupuncturist in regards to patient prognosis and progress.
For this interview I spoke with integrative cardiologist Dr. Giovanni Campaniles, MD, and integrative TCM acupuncturist/herbalist Jutta Gasner, LAc, of Atlantic Health about their published cardiac patient case study collaboration.
Jutta practices integrative TCM with the support of her hospital administration, and clinical physicians like Dr. Campaniles to achieve extraordinary patient results illustrated with clinical lab findings. I uncovered how these relationships have emerged and grown in confidence.
Shellie: Dr. Campaniles, as a well-accomplished interventional cardiologist, how did you find your way into integrative cardiology?
Dr. Campaniles: I have been practicing integrative functional cardiology for over 15 years. I was introduced to this type of medicine when I met Dr. Joseph Pizzorno, President of Bastyr University in Seattle, WA. My partner and I at the time created the first integrative cardiology practice in the country.
Shellie: What is your comfort level with cardiac patients taking both prescription medications and Chinese herbal prescriptions?
Dr. Campaniles: I am very comfortable with patients taking both prescription medications and Chinese herbal medications, as long as the prescribing practitioner is familiar with possible interactions.
Shellie: Do you envision the practice of integrative TCM cardiology growing in the U.S.?
Dr. Campaniles: Based on my personal practice I do feel that integrative and TCM cardiology will continue to grow in the coming years. More and more patients are demanding a different approach to their care; wish to have less medicines and testing; and appreciate being at the center of their care; and collaborating with their healthcare provider in all aspects of their personal care.
The factors that came into play for the patient Jutta and I reported on were the same as for any patient in our care. We first turned to the most natural modalities with the least side effects and with the maximum side benefits, before resorting to pharmaceuticals or procedures.
Shellie: Jutta, you and Dr. Campaniles have written a conclusive case report about a cardiac patient that illustrates positive outcomes as a result of the intervention of TCM herbal formulations. This study offers both subjective and objective findings. What was your method for this patient that led to successful outcomes?
Jutta: I began my work with the patient with a differential diagnosis, and this helped guide my prescription. The patient exhibited primarily Kidney Yin deficiency symptoms, with slight Kidney Yang deficiency and underlying Spleen Qi deficiency.
Based on this diagnosis, I selected the formula Liu Wei Di Huang Wan and added six grams of Du Zhong to nourish and support Kidney yang. By nourishing the patient's Kidney Yin deficiency signs, the traditional Spleen Qi symptoms, such as fatigue, loose bowls, and flatulence also improved.
Shellie: Some hospitals have concerns about Chinese herbs being used in conjunction with Western therapies. What challenges do you face when prescribing Chinese herbs in the medical setting?
Jutta: This is an important question. Safety is our first concern at Morristown Medical/Atlantic Health Care. We put safety regulations in place that assure the herbs prescribed are the highest quality with minimal risks. If a patient is on prescription medications other than thyroid medications, or oral birth control pills, we do not prescribe Chinese herb prescriptions unless the prescribing medical doctors allow it. In this particular situation, Dr. Campanile authorized the prescription of Chinese herbs.
Shellie: How was your case report received in the medical community?
Jutta: I think it was received very well. Many medical professionals commented on it in a very positive manner. Many were surprised that co-factors such as high blood pressure could be treated with acupuncture and Chinese herbals.
Shellie: Do you see this case report leading to a larger study, or perhaps even more like it?
Jutta: It is my intention to continue my collaborative efforts at the center, and expand this work into a larger study.
Shellie: How has TCM developed for you at your hospital and where would you like to see the TCM profession develop in the future?
Jutta: I have been working in a major medical institution for over 10 years now. When I started, I was the solo TCM practitioner, and worked only four hours per week. Now, a decade later, the medical institution has two full-time practitioners on staff and one contractor. Initially, I didn't get referrals from medical professionals.
Now, 10 years later, our practitioners are well known across various departments, and get many MD/DO/NP/nurse referrals. That is a strong indicator that the established medical professionals have come to respect and value TCM practitioners.
It is not uncommon for any of our TCM professionals to speak at educational events held by the medical community. As of now, TCM serves as a value added modality in chronic disease management especially where "pain" is the primary complaint.
With all of this growth it is easy for me to envision the TCM profession developing further into more of a primary care role. Even as of now, in certain states such as California, New Mexico and Florida, a TCM professional can act as a primary care provider, so the future is bright for TCM.
With continued improvements to the educational requirements of TCM professionals, TCM providers have a great opportunity to fill the role of a primary care provider on a national scale. Such opportunity could strengthen our profession greatly.
Shellie: Jutta, your persistent and humble nature played a key role in your ability to foster relationships with decision makers that promoted your work.
Dr. Campaniles, your curiosity and patient centered approach made this integrative service possible. As a result, your collaborative case study was published by Elsevier publishing last November, and you have both been invited this year, to speak at the 9th annual Congress in Cardiology in Singapore.
I look forward to staying in touch with you both and following your work at The Chambers Center for Well Being, at Atlantic Health in New Jersey, as the center grows!
Jutta and Dr. Campanile: Thank you! It's great to have a chance to share what we are doing with the TCM community and remind practitioners to find relationships where collaboration is possible! You can learn more about our case study at Elsevier.