Episode #130: Whole Health – ‘Changing the Conversation’ in Healthcare with Dr. Benjamin Kligler, Executive Director of the Office of Patient Centered Care and Cultural Transformation, Veterans Health Administration

Creating a New Healthcare

Friends,

We open up this podcast talking about a yearning on the part of people for a different type of dialogue, interaction & relationship in the delivery of healthcare. In all of the interviews I’ve conducted over the past 5 years – underneath all of the discussions about value-based payment, reframed clinical and business models, advanced analytics and digital enablement, patient/customer experience, health equity and social determinants of health – underneath all of it is a deep yearning to be understood as a whole person. To have our healthcare be guided by the meaning and context of our lives. To be respected, enabled and empowered as autonomous beings. To be healthy – physically, emotionally and relationally – so we can live our best life.

Our guest in this podcast dialogue, Dr. Ben Kligler, provides a framing of the fundamental problem that is preventing providers from delivering this type of healthcare, and a reframe that will enable us to experience a more humanistic approach to healthcare delivery. What you’re going to hear in this interview may be the most significant humanistic shift occurring in the American healthcare system.

Benjamin Kligler, MD, MPH, is a board-certified family physician who has been working as a clinician, educator, researcher and administrative leader in the field of complementary and integrative medicine for the past 25 years. In May 2016 he was named National Director of the Integrative Health Coordinating Center (IHCC) in the Office of Patient Centered Care and Cultural Transformation (OPCC&CT) as well as Director of Education and Research for Whole Health. In May 2020 Dr. Kligler was named Executive Director of the Office of Patient Centered Care & Cultural Transformation (PCC&CT.) He is a Professor of Family and Community Medicine at Icahn Mount Sinai School of Medicine, and was Vice Chair & Research Director of the Mount Sinai Beth Israel Department of Integrative Medicine. He is currently a core faculty member of the Leadership Program in Integrative Healthcare at Duke University.

In this interview, we’ll hear about:

1. The Whole Health System that the Veteran Health Affairs is in the midst of deploying on a national scale.

2. The 1 fundamental reframe and the 2 key questions that are at the core of how the Whole Health movement is changing the conversation in healthcare delivery.

3. How this approach is being digitized and integrated into the electronic medical record.

4. How the Whole Health System is not only improving the health and well-being of patients, but is also creating a ‘best place to work’ for providers and staff in the Veterans Health Affairs (VHA).

In this interview with Dr. Ben Kligler, we are witnessing a profound inflection point. Whole person and whole health care has shifted from being a theme or movement to an actual system of care that is being heavily resourced, organized, deployed and integrated into one of the largest healthcare systems in the country: the national Veterans Health Affairs (VHA). For those who are not familiar, the ~350,000 VHA employees provide care to over 6 million actively engaged veterans, across ~140 large medical centers, and over a thousand outpatient clinics. Far from being a strategy in name only, Dr. Kligler and his colleagues have already trained 32,000 people in the Whole Health System and have touched nearly 8% of all Veterans in the country. That’s over half a million Veterans who have experienced the Whole Health System during their care journey.

I am impressed not only with the progress being made, but also with the flexible approach that the VHA has taken in deploying and scaling this new approach. For example, they’re not just training providers and staff, they’re having them participate through a portion of the program itself. When I asked Dr. Kligler, if providers and staff might feel like this is just another item on their ‘to-do’ list or another box to check, he shared that the goal is not to add more to the clinical workload, but instead to change the orientation to clinical encounters. He also shared that it was the entire care team being trained to deliver this, not just the primary provider.

The whole person/whole health approach reminds us that human beings thrive when they have meaning and purpose in their lives. It reminds us that if we don’t reframe healthcare within the context of what enables people to thrive, we will be treating the superficial symptom rather than the disease itself.

There has been a lot of verbiage over the past two or three years around the notion of ‘connected care’. This generally refers to 24/7 omni-channel access to care. The whole health/whole person approach reminds us that truly meaningful access to care will require not only a digitally-enabled, omni-channel platform; but also an intentional, systematic, resourced and integrated platform for relational connectivity.

The VHA is on an accelerated path to deploying the Whole Health System in every one of its medical centers and clinics. It’s incredibly inspiring. What’s also inspiring is the thought of adapting and scaling the whole health/whole person approach to other healthcare systems across the country. I, for one, plan to share this podcast and the VHA’s Whole Health System initiative with the leadership at my own institution. What’s your next step?

Until Next Time,
Wishing you Whole Health

Zeev Neuwirth, MD