The Integrative Medicine Consultation
Integrative medicine is a new style of medical practice that reaffirms the importance of the doctor/patient relationship, focuses on the whole person, is informed by scientific evidence and thereby uses all appropriate therapies, healthcare professionals and other disciplines to achieve optimal healing and health
All factors such as the mind, body, spirit and community that influence health, wellness and disease are taken into consideration. The integrative medicine specialist working collaboratively with the patient employs whenever possible only evidence-based interventions from both conventional and ancient healing arts that are natural and less invasive. Integrative medicine neither rejects conventional medicine nor accepts alternative therapies uncritically because good medicine is based in good science. These concepts of treatment, health promotion and the prevention of illness are paramount to the integrative medicine specialist who they themselves are committed to self-exploration and self-development.
The Newest Medical Subspecialty
In 2016, the American Board of Physician Specialties under the auspices of the American Board of Integrative Medicine offered a national daylong examination to those physicians in good standing with their state medical associations who successfully graduated from an approved integrative medicine fellowship which generally consists of over a thousand hours of additional study over a two-year period. Attaining and maintaining this level of expertise by continuing medical education and mandatory repeat board examination every 10 years is a commitment by the integrative medicine specialists to offer the highest possible level of expertise and professionalism to their patients and fellow physicians.
The Integrative Medicine Consultation
Now that fellowship trained, board-certified integrative medicine specialists are available to consult on complex medical and surgical cases both in and out of the hospital, this time-honored practice of physicians requesting the assistance of other specialty trained physicians can now bring the principles of integrative medicine into mainstream of medical practice. The notion that integrative medicine is an unregulated marginalized medical practice is no longer true.
10. Mind-Body Focus
Integrative medicine stresses this interconnection and how it manifests symptoms and drives behaviors which in turn determine our general health and sense of well being. Failure to properly address this interplay produces perplexing symptom complexes leading to unnecessary tests and potentially harmful prescriptions.
Life is stressful, but not all stressors are harmful especially if they are balanced with daily relaxation time. Rather than medicating away life stressors, an integrative medical care plan will incorporate daily relaxation using breath work, progressive muscle relaxations, meditation, yoga, massage, self-hypnosis and botanicals.
8. Better Sleep Hygiene
Our society as a whole is sleep deprived with the well-documented illnesses, accidents and lost time at work that accompanies it. Giving the proper amount of attention to a person’s sleep quality, sleep hygiene and avoiding sleep medication is a fundamental component of integrative medical care.
7. Reduction in Environmental Toxins
Organic foods, filtered water, avoidance of inhales toxins, GMO-modified crops, nanotechnology, occupational exposures and radiation whether natural or medical are all topics addressed within a good integrative plan of care
6. Proper Vitamin & Mineral Supplementation
The integrative physician is trained to advise you on the correct forms, dosages and interactions that the many different vitamins, minerals and supplements have with each other and with prescription medications and medical therapies.
5. Anti-inflammatory Diet
“We are what we eat” is a familiar slogan. Fundamental to the integrative medical experience is a diet high in natural antioxidants, omega-3 fatty acids, monounsaturated oils and low-glycemic carbohydrates.
4. Weight Loss and Exercise
Approaching or better yet achieving a normal body mass index is one of the most important rewards of this integrative medical countdown. Combining it with regular aerobic exercise, strengthening exercises, balance training and flexibility will insure one’s ability to maintain it year after year
3. Reduction of Prescription Medication
Here the goal is to engage, motivate and work with a patient’s innate healing powers rather than over-medicate them. Done properly under the careful guidance of a well-trained integrative medicine physician many chronic medications can be eliminated.
This is the ultimate goal – not just for integrative medicine but for life. As we experience the inescapable deterioration that accompanies aging, we seek healing. This is not to be confused with treatment or curing an illness. We seek balance and harmony for our body, mind and spirit. The integrative physician provides the healing presence to make that happen.
The countdown would stop here if certain questions and issues were not asked or addressed. “What nourishes your soul?” “What matters most to you?” These and similar such questions can empower us and sustain us if energy is directed their way. That is positive spirituality
2. Positive Spirituality
Holistic Management/Health Coaching
The average, traditional primary care or specialty care physician manages many aspects of a patient’s care plan such as their medications, support services, care location and communication to name just a few. However, none are trained nor have the time to manage the “holistic” component of a patient’s care. Arguably, this component which encompasses the spiritual values, community, family connections and life purposes of a patient is equally as important. That is where the fellowship trained, board-certified integrative medicine specialist is needed. As a respected member of the medical care team, the integrative medicine specialist interjects and manages this all-important and often forgotten component of a patient’s care. This is particularly true in cancer patients either during treatment or in their survivorship, chronic pain patients, those patients with chronic inflammatory diseases and certainly the elderly who crave independence, dignity and compassion.
Integrative Health Coaching
This is a unique therapeutic process were various medical personnel such as nurses, dietitians, various therapists and physicians undergo special training and eventual certification in this scientifically proven interviewing technique that addresses the health and well-being of the whole person utilizing a client-centered partnership that is nonjudgmental that emphasizes the inner wisdom and healing potential within every individual and emphasizes self-care and self empowerment. The 7 core areas of health that coaches address our nutrition, exercise, sleep, resiliency, relationships, environment and spirituality. This form of therapy is organized into 4 stages. Stage I focuses on the aspirations and purposes of a clients life; Stage II utilizes a rating system to narrow down those parts of the patient’s core health that needs priority attention, Stage III is the formation of A SMART plan and finally Stage IV deals with the barriers and workarounds necessary to achieve the coaching goal. This form of therapy is available at WASA in conjunction with its membership or simply as a standalone strategy to improve an individual’s core area of health.
Wellness and Successful Aging (WASA) was started in May 2012, two years after its founder, Joseph F Mambu MD, completed the prestigious integrative medicine fellowship at the University of Arizona‘s Center for Integrative Medicine (AzCIM). Under the leadership of its creator, Andrew Weil MD, and consistent with its mission to teach, heal and transform, the fellowships comprehensive two-year curriculum was further developed by an outstanding and dedicated faculty from the various disciplines that collectively comprise the field of integrative medicine.
What started as an attempt by Dr. Mambu to introduce traditional primary care patients to the purest form of integrative medicine quickly developed into a robust consultative service with a powerful synergy resulting in extraordinary positive outcomes. The healing power of this clinical scenario is now an innovative medical delivery model that finally allows both primary and specialty medical offices to consult fellowship trained board-certified integrative medicine clinicians to introduce appropriate holistic evidence-based CAM therapies to their patients.
This model although still a work in progress is an integrative medicine consultation practice with a one-of-a-kind highly developed operational design which refines itself as it expands from one medical office to another.
Its proprietary Health Risk Assessment collects data from 12 different health domains and documents to progress its WASA members make from one membership year to the next. Another new exclusive resource being developed at WASA is Wellness Trakker℠, and Internet-based, bidirectional, user-friendly patient engagement program which ensures up-to-date medical records between consultation visits. The personal health information of each WASA member is encrypted for high level security and fully compliant with HIPAA. This feature provides password-protected, real-time, no cost access to each member’s medical record wherever and whenever and by whomever they choose.
In summary, WASA patients can now access the knowledge and health benefits of a properly implemented, comprehensive, continuous integrative medicine program in their own neighborhood
All WASA physicians and practices are guided by certain core values. 1st and foremost is board certification or board eligibility by the American Board of Physician Specialties (ABPS) which requires graduation from an accredited integrative medicine fellowship along with a valid medical license, DEA certificate, malpractice insurance and continuing medical education credits in their medical specialty in addition to recertification by the ABPS every 10 years. WASA physicians always conduct themselves as patient advocates while remaining respectful of the extensive parameters of care due the member’s primary care physician.
The WASA physician – patient relationship is paramount in one that remains patient centered comprehensive with continuing care focusing on disease prevention, health promotion and integrative medicine countdown. The complementary and alternative therapies will consist of the skillful use of energy medicine, mind-body strategies, physical medicine and all appropriate evidence – based modality directed towards achieving a spiritual, psychophysiological state conducive to healing. These will include the potential advantages of other healthcare systems such as Traditional Chinese Medicine, homeopathy and Ayurveda. Lastly, the WASA physician will always engage personal behaviors and self-care practices that promote optimal health and healing on incorporating ethical standards of practice into their interactions with individuals, organizations and communities.
Dr. Joseph Mambu MD CMD CHE
Dr. Joseph Mambu is the founder and president of Wellness & Successful Aging, LLC and Family Medicine, Geriatrics & Wellness. Triple board-certified in Family Medicine (1976) with a Certificate of Added Qualification in Geriatrics (1990) both from the American Board of Family Medicine and most recently Integrative Medicine (2018) from the American Board of Physician Specialties, Dr. Mambu blends four decades of clinical experience as a primary care physician and geriatrician with integrative medicine to offer patients an array of options for promoting health and wellness.
Prior to receiving his doctorate of medicine degree from Jefferson Medical College in 1973, Dr. Mambu received his undergraduate degree in Biology from Villanova in 1969. Later he completed advanced clinical and health care management programs to earn his Certified Medical Director (CMD), Certified Health Executive (CHE) designation, and Executive Healthcare Business Administration degree from Wharton. A leader in healthcare reform, Dr. Mambu’s practice was one of 36 nationally to participate in the American Academy of Family Practice ‘s National Demonstration Project in 2006 which help launch the patient centered medical home movement. His practice was the 8th practice in United States to be awarded a level III medical home designation by the National Committee for Quality Assurance (NCQA). Pursuing a lifelong interest in Complementary and Alternative Medicine (CAM), in 2010 Dr. Mambu completed the premier Fellowship in Integrative Medicine at the University of Arizona Center for Integrative Medicine.
Dr. Mambu is a leader in that select community of dedicated health professionals who are in the vanguard transforming health care by incorporating patient centeredness and integrative medicine into their practices.
Angela C Palmgren RN
Ms. Palmgren graduated from Pennsylvania Hospital School of Nursing in 1971. After raising her children, she did office based nursing for cardiologists at Graduate Hospital for two years. She returned to work by starting her own business that focused on nutrition, whole foods, weight loss and behavior modification. Returning to the hospital setting after five years, she worked as a staff nurse at Elkins Park Hospital in the rehab department for over three years.
Taking that knowledge, she then worked for Jeanne's Hospital Home Care for the next ten years. During this time, she became certified in geriatric nursing and acquired a certification in teaching yoga. She also studied multiple complementary modalities. Ms. Palmgren returned to office nursing in 2000 where she was the RN that helped supervise and instruct patients to manage their complex diagnoses. She currently administers the Health Risk Assessments in addition to assisting with daily office operations at WASA.
As an integrative medicine consultant, WASA clinicians work in collaboration with a patient’s other medical specialists, surgeons and primary care physicians and advocate for a more balanced comprehensive style of medicine. The programs at WASA are varied but primarily feature a wholesome diet, better sleep hygiene, more exercise, stress reduction without medications and awakening our inner self to the importance of connection with our spirituality as well as our family and friends. All of this translates into a message of healing and hope rather than simply treating the symptoms of a disease process.
Typical reasons members enroll in WASA:
Optimize and maintain a new level of health by adding collaborative integrative medical expertise to their routine primary healthcare
Successfully achieve a health promoting change in their daily lifestyle utilizing motivational health coaching
Holistic annual executive-level physical examinations
Expedite a recovery from a recent serious illness
Complex chronic medical problems requiring extra time and customized care
A broader approach to the rehabilitation of complicated physical disabilities associated with strokes and CNS injures
• Holistic palliative care with end-of-life goalsetting and hospice
60-minute one on one sessions with the physician - These sessions will establish, measure, and adjust as needed, a personalized integrative treatment plan. Any necessary referrals to other Complementary and Alternative Medicine (CAM) practitioners will be discussed and made accordingly at that time.
Exclusive WASA Membership Hotline - Members have access to a 24/7/365 private telephone hotline to WASA clinicians for health and wellness issues and any questions related to their integrative medical care plan.
Health Risk Assessment© (HRA) - The HRA is given at the beginning and end of each membership year. It is a 2-hr visit conducted by a licensed clinician that measures 12 areas of health risk resulting in an aggregate health risk score. Various diagnoses, medications and supplements, nutrition, exercise, pollution awareness, sleep, spirituality are just some the domains measured. Answers from each domain are weighted and scored annually allowing WASA members to monitor changes in their respective health risks over time.
Access to WASA's Archive of Scientific Publications - Exclusive access to critically reviewed articles from the extensive library at the Arizona Center for Integrative Medicine discussing the pros and cons of various Complementary and Alternative therapies
Wellness Trakker℠ -
Members have access to an exclusive bidirectional Internet-based communication system. This electronic system’s capabilities are numerous with the most important feature allowing members and clinicians to be continuously engaged. Whether seen every month, 3 months, 6 months or yearly – a member’s interim medical information and chart will remain up-to-date.
An additional attractive feature will be its member-friendly but highly secure repository for personal health information. Wherever and whenever a member needs it, their medical record will be quickly accessible via the internet through WASA’s website. Even while travelling, using any computer access (even a smart phone), a member’s medical records and related data will be accessible. With a member’s permission, any health care provider will be able to access their history, EKG’s, imaging reports, consultation letters, etc. and thus provide the most timely and appropriate medical care without duplication of services and with no additional costs to the member.
Full Membership (Four visits annually)
$2500 annually, or ($1300 semiannually) per Member
Additional Patient Family Members* (Four visits annually)
$2000 annually, or ($1050 semiannually) per Member
Half-WASA Membership (Two visits annually)
$1250 annually, or ($675 semiannually) per Member
Additional in-office WASA visits
$300 per visit for Full Members, $600 for Half Members
Home bound WASA membership
$150 per visit additional
Integrative Health Coaching
$500 per three 1-hour sessions
One Time Executive Level Annual Physical Examination**
*Available only to spouse, significant other, or offspring. Family members must share a primary residence.
**Echocardiogram, carotid ultrasound, abdominal/pelvic ultrasound, Arterial Doppler’s lower extremities are extra charges payable by most third party insurers.
Is this a "concierge" or "boutique" practice?
No. Although the 24/7 telephone service and WASA physician exclusivity are characteristic of such practices, WASA is an annual membership consultative office. WASA complements a member's primary medical care with integrative medicine advice and chronic disease management.
Will WASA be selling vitamins or other Complementary and Alternative Medicine (CAM)-related products?
No, we do not sell any vitamins or CAM related products. WASA clinicians can instruct members how to most economically purchase high quality vitamins, supplements, botanical and other CAM-related products online or from various local, reputable retailers.
Why do I still need a primary care physician (PCP) if I am a member of WASA?
WASA is not an acute care office. The integrative medical advice from WASA is a consultative service that requires its members to have a primary care physician.
How will I and my PCP be informed of my integrative medicine care plan?
Each WASA member and their PCP will receive a consultation letter comparable to visiting any other specialist. Additionally, each member and any of the member's primary or specialty physicians can access these letters via WASA's web portal. In case of questions, email access to WASA clinicians will also be available for every WASA member and their physicians.
May I use funds from my Medical Flex Spending account to purchase my WASA Membership?
Yes. Wellness and Successful Aging will provide all information and paperwork needed to file for reimbursement from your HSA/FSA company. The member is responsible for filing the claim as required by their specific companies policies.
Why can't my medical insurance cover Dr. Mambu's services?
WASA has chosen not to participate with Medicare or any commercial insurers. It is an annual membership, not a fee for service office.
The University of Arizona Center for Integrative Medicine is leading the transformation of health care by training a new generation of health professionals and by empowering individuals and communities to optimize health and well being through evidence-based, sustainable, integrative approaches.
Dr. Weil is a world-renowned leader and pioneer in the field of integrative medicine, a healing oriented approach to health care which encompasses body, mind, and spirit.
Krista Tippett is a Peabody Award-winning broadcaster and New York Times best-selling author. In 2014, she received the National Humanities Medal at the White House for “thoughtfully delving into the mysteries of human existence. On the air and in print, Ms. Tippett avoids easy answers, embracing complexity and inviting people of every background to join her conversation about faith, ethics, and moral wisdom."
Tieraona is recognized as one of the leading experts in integrative medicine, particularly in the area of women’s health. She has studied and practiced massage therapy, martial arts, midwifery, and herbal medicine before going on to receive her medical degree. Tieraona has long been an advocate for health care that is compassionate, effective, equitable, and environmentally conscious.
The Environmental Working Group’s mission is to empower people to live healthier lives in a healthier environment. With breakthrough research and education, they drive consumer choice and civic action.
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