Interview: Integrative Medicine Expert Champions Patient-Driven Health

_ Bill Scott

“I was never interested in medicine,” said Dr. Margaret Chesney during a recent interview – an unusual if candid admission from the director of U.C. San Francisco’s Osher Center for Integrative Medicine. “I was fascinated by biology, but I found myself focusing instead on how our behavior influences our biology, our health and life experience.”

“The big moment for me was when I was in college and I was sent to a [local] hospital by my mom to find a summer job,” she continued. “A nurse kindly showed me around and said, ‘This is a group of people who have had problems with alcohol, and they’ve come here to talk with this counselor [who helps them] deal with their problems.’

“I’m looking through the window in the door, and I was hit by lightning bolts. It was like, ‘You need to do this.' This was when I realized that I just might have something to offer within the field of medicine, that I could help others."

After receiving her PhD in clinical psychology, Chesney found herself doing just that – at first helping people prevent heart attacks by managing stress more effectively, changing their diets and getting physically active, while also being open to the use of modern medicine when needed. She describes this integrative approach as patient-driven health care.

“Not just patient-centered,” she emphasizes, “but patient-driven.”

One example of this approach is Chesney’s use of a therapy she co-developed called coping effectiveness training (CET), a program that allows individuals to choose from a variety of non-drug based strategies to reduce disease-related stress. The goal is not so much about getting rid of negative emotions as it is drawing attention to more positive feelings.

“Positive is not the opposite of negative,” said Chesney. “People can be very aware that something sad is going on and still be able to find meaning in their lives and see positive effects. [And] If you can teach people to find meaning in their lives, it sustains much better than simply getting people’s depression down.”

In one of her studies, Chesney identified spirituality as a potential source of such meaning, suggesting that the search for the sacred in our lives and not just “positive thinking” could contribute to better mental and physical health. In her report, she references the work of University of Miami professor Dr. Gail Ironson, who found that those who consciously turned to God as a result of a life-threatening diagnosis experienced significant and measurable physiological improvement when compared to those who, as a result of the same diagnosis, disavowed any spiritual connection.

This kind of patient-driven approach to health care is nothing new. As far back as the late 19th century Mary Baker Eddy, a medical maverick in her own right and founder of the Christian Science Church, recognized the importance of patient participation.

“Give sick people credit for sometimes knowing more than their doctors,” wrote Eddy in her seminal work Science and Health. “Always support their trust in the power of [the divine] Mind to sustain the body.”