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Explores the role of unconventional therapies in the practice of medicine in the United States. Provision of legal framework for integrating alternative practices; Description on the process of health contract; Alteration of the collaborative planning and shared decision in the concept of malpractice.

Background • Stroke, diabetes, and coronary heart disease (CHD) remain leading causes of death in the United States and are largely attributable to lifestyle behaviors. Integrative medicine can provide a supportive partnership that focuses on improving health by identifying and implementing lifestyle changes based upon personal values and goals. Objective • This prospective observational study was designed to assess the effectiveness of an integrative medicine intervention on modifiable disease risk, patient activation, and psychosocial risk factors for stroke, diabetes, and CHD. Design • Sixty-three adults participated in a 3-day comprehensive, multimodal health immersion program at Duke Integrative Medicine, Duke University Medical Center, Durham, North Carolina. Participants received follow-up education, physician support, and telephonic health coaching between the immersion program and the endpoint 7 to 9 months later. Primary Outcome Measures • Psychosocial functioning, readmess to change health behaviors, and risk of developing diabetes, stroke, and CHD were assessed at baseline and endpoint. Results • Although cardiac risk remained unchanged (P = .19) during the study period, risk of diabetes (P = .02) and stroke (P < .01) decreased significantly. Perceived stress remained unchanged, but improvements were seen in mood (P <. 05) and relationship satisfaction (P < .004). Patients became more activated towards self-management of health (P < .001), endorsed greater readiness to change health behaviors (P < .01), and reported increased aerobic exercise (P < .001) and stretching (P = .006) following the intervention. Conclusion • An integrative health model can help patients become more engaged in self-management of health and support them in making and maintaining healthy lifestyle changes. These findings provide support for use of an integrative health model in adult disease risk reduction. [ABSTRACT FROM AUTHOR]

Personalized health planning can be operationalized as a health care delivery model to support personalized, proactive, patient-driven care., Competing Interests: Author disclosures The authors report no actual or potential conflicts of interest with regard to this article.