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