Giving Patients Alternatives

Before she was diagnosed with breast cancer in 1996, Penny Pilgram George had been busy running her own psychology

practice, supporting her husband’s lucrative corporate career, and raising her two sons. Health care was a periodic visit to the doctor, a little exercise, and vitamins.

A mastectomy was followed by chemotherapy and then hormonal therapy. But while the treatments attacked the cancer, they did little to ease Ms. George’s exhaustion, sense of anxiety, or confusion over what path her life should take next. With encouragement from a good friend, Ms. George sought out less conventional treatments to complement her care, including acupuncture, Chinese herbs, and “healing touch,” in which a practitioner laid hands over and under Ms. George to, as she describes it, “smooth out my energy fields.”

Today, Ms. George’s cancer is in remission, and she has given up her Minneapolis psychology business to oversee the philanthropy she started with her husband, Bill, retired chairman of the medical-technology giant Medtronic. The George Family Foundation spent $969,116 in 2003 — 58 percent of its total grants budget — to give patients at hospitals and health centers greater choice in treatment options, beyond what is conventionally offered, and make the practice of medicine more attuned to the emotional life of people who are ill. The foundation’s assets stand at $37.7-million today, but the Georges plan to eventually increase that number to $100-million — their current net worth. And they give $2-million or $3-million a year apart from the foundation to a variety of causes.

As president of the George Family Foundation and chair of the Philanthropic Collaborative for Integrative Medicine, Ms. George is orchestrating a national campaign to broaden the definition of traditional health care. A patient is not just a body in search of a cure, she argues, but an interconnected web of emotional, physical, and spiritual needs, all of which require attention.

“It’s about integrating the best of what Western medicine has to offer within a patient-centered, relationship-centered, healing-and-wellness focus,” she says. “You can be healed even if the outcome of your illness is that you will die.”

Nontraditional Paths

The move to pair Western medicine with less traditional approaches has been gaining some traction with doctors and researchers in recent years.

Federal agencies have been increasing spending on research to determine whether nontraditional health care works. For instance, the budget of the National Center for Complementary and Alternative Medicine at the National Institutes of Health has more than doubled since it was created in 1999, to $117.7-million for the 2004 fiscal year. Most of the money is for research into the effectiveness of unconventional treatments for AIDS, severe anxiety disorders, and heart disease.

A handful of big health foundations, including the Robert Wood Johnson Foundation, in Princeton, N.J., also make grants in complementary and alternative medicine.

James S. Gordon, director of the Center for Mind-Body Medicine — an educational group in Washington that has received money from the George fund for a training program known as CancerGuides — says he has started to see doctors become much more receptive to alternative therapies that can treat a person’s mind and spirit, as well as body. “The challenge,” says Dr. Gordon, a clinical professor at the Georgetown University School of Medicine, is to make the integration of such treatments “the heart of all health care, not merely an elective in a medical school or a department in a hospital.”

Some physicians are alarmed by such ambitions, however. They worry that patients can get sidetracked by alternative therapies that have little or no proven ability to cure illnesses, which can be a dangerous loss of time and money.

“People who have real illnesses, like diabetes and heart disease, are not going to be cured by therapeutic touch or guided imagery or reflexology,” says Robert S. Baratz, an internist who runs the National Council Against Health Fraud, an educational and investigative group in Peabody, Mass. In addition, Dr. Baratz says, with the rise in popularity of alternative medicine comes a surge in the number of people who try to profit by suggesting that certain approaches are cures when they only lessen the mental side effects of an illness, like stress.

Ms. George says that while she shares some of Dr. Baratz’s concerns about overselling the advantages of nontraditional therapies, she believes many of them can have real benefits and that patients need more options. She also says that her chief interest is not in advancing specific treatments. Rather, she wants to improve the relationship between patients and medical professionals, making it more of a partnership dedicated to discerning the best care and less about patients surrendering themselves to their doctors.

A Support Coalition

One of the Georges’ favorite projects is to make Abbott Northwestern Hospital — the largest nonprofit medical facility in the Twin Cities — into a national model for integrative medicine. The couple has pledged $2-million to the effort, estimated to cost $20-million over five years.

A new center at the hospital, scheduled to open in June, will test the effectiveness of complementary approaches to Western medicine and train coaches to help patients throughout the hospital receive the best of both conventional and alternative therapies. A wide variety of nontraditional services, including acupuncture, Chinese medicine, hypnosis, and reflexology, will be available on an inpatient and outpatient basis, as will workshops on such topics as how to develop a wellness plan, holistic approaches to pain control, and ways to treat specific illnesses, like cancer or heart disease.

Perhaps more significant than the Georges’ own giving is the philanthropic collaborative that Ms. George started in April 2002 with Diane B. Neimann, executive director of the George Family Foundation. Its 19 members have pooled $6.7-million for integrative medicine, a significant amount in a field that has trouble attracting philanthropic money.

In November, Walter Cronkite, the retired CBS News anchorman, presented the collaborative’s first biennial award, for $100,000. Ralph Snyderman, Duke University’s chancellor for health affairs, was honored for establishing the Duke Center for Integrative Medicine. Dr. Snyderman is a founding member of the Consortium of Academic Health Centers for Integrative Medicine, a group of 22 clinics at some of the country’s most prestigious universities, which are currently developing a shared medical-school curriculum.

Ms. George’s philanthropic collaborative is the academic consortium’s life support. By 2005, its donations to the group of health centers are expected to total nearly $700,000. “They’ve allowed the coalition to be real,” says Dr. Snyderman, pointing out that membership has more than tripled since 2001, when Ms. George assembled a group of donors and academicians at Miraval, a luxury spa in the Arizona desert, for their first meeting. “We needed to create a coalition of academic medical centers to have a vehicle to share best practices and to support each other. That meeting was transforming.”

Learning to Take Charge

For Ms. George, a surgeon’s daughter, the transition from practicing psychologist to lead spokeswoman for alternative therapies has been a challenging journey, one that began with a frightening message about mammogram results that her doctor had left on her home answering machine.

Two years after she learned she had cancer, she traveled to the desert canyons of southwestern Utah on what is called a “vision quest” that included spending four days alone in the wilderness with a sleeping bag and her thoughts.

“I came away from that being clear that my life as a practitioner of psychology was over,” she says, and that her role as a foundation leader was beginning.

When Ms. George announced her desire to devote herself to philanthropy, her husband says he was thrilled. “I didn’t have the time to put into it, and she had a passion,” he says.

The couple had created the George Family Foundation in 1994 as a tax-advantageous way to write checks to some of their favorite causes — the local United Way or the Episcopal school their children attended, for example.

Yet letting go of the foundation’s reins proved hard to do for Mr. George, author of Authentic Leadership: Rediscovering the Secrets to Creating Lasting Value, published last year by Jossey-Bass.

“It was the first time where I was really having more control,” recalls Ms. George. “His head and his heart wanted me to do this, but his habit was to take it for granted that he had the power. It wasn’t easy.”

She adds: “The tone of his early questions implied to me a lack of confidence. I had to earn my stripes with him.”

Ms. Neimann, a philanthropy adviser whose children attended the same preschool as the Georges’ sons, helped Ms. George develop goals for the foundation. Its biggest program would support integrative medicine. But it would also pay for fellowships for international and minority students to attend institutions that George family members were associated with — Mr. George’s personal cause — and support efforts to help women and members of minority groups overcome obstacles to achievement, to enrich the lives of young people, and to enhance people’s spiritual lives.

Collaborative Effort

Remembering the key role her friend played in supporting her explorations into alternative medicine, the first of Ms. George’s new grants paid for a healing coach at Abbott Northwestern’s cancer institute, someone who could help guide and support patients through their recovery.

She also provided money for the CancerGuides program at the Center for Mind-Body Medicine, which trains health-care professionals in nontraditional techniques for treating their patients. In addition, she supported research that the nutrition specialist Dean Ornish was doing on the impact of alternative therapies on patients with prostate cancer.

“We were making grants here and there basically,” says Ms. George, “and then we began to realize that other people were funding these things as well.” In April 2001, Ms. George gathered the group at Miraval to strategize with scientists and other donors about the future of integrative medicine.

One of those present at what was to evolve into the Philanthropic Collaborative for Integrative Medicine was Christy K. Mack. Ms. Mack is a “reiki master” — someone who tries to transmit energy forces to patients through touch — and the wife of John J. Mack, a chief executive officer of Credit Suisse Group. Ms. Mack did not know Ms. George at the time, but the two have since become close working partners.

“Everything that this collaborative and the consortium have done we all owe to Penny and her vision, and her determination to light a fire under a lot of people,” Ms. Mack says. “I was delving into it on the periphery when Penny called.”

To join the collaborative, donors must agree to give a minimum of $100,000 over three years. In 2002, the Georges promised to donate $1-million over five years, and members believe they will raise $10-million among themselves during that time.

In addition to supporting the consortium of academic health centers, the collaborative provides financial help to seven centers for integrative medicine, paying for meetings and a consultant to help them strengthen their business plans. It also sponsors research, including a study on the success of six of those clinics and their prospects for long-term survival. Members of the collaborative have met with officials at the National Institutes of Health and the National Cancer Institute to win more support for integrative medicine, and the cancer institute agreed to hold a meeting to share information about research in clinical settings with the centers in the network.

Public Education

Ms. George says the organization is a long way from making alternative therapies broadly available, especially since such treatments are often not covered by insurance plans. But greater acceptance by the public and the medical world could bring changes in coverage, and the collaborative’s newest endeavor is in public education.

The organization has proposed a follow-up to Bill Moyers’s popular public-television series on alternative medicine, Healing and the Mind, which was first broadcast in 1993. And it plans to put together $150,000 to help get the project started. It is working closely with Mr. Moyers’s wife, Judith Davidson Moyers, another television producer. The production could cost as much as $2.5-million, so members are gearing up to raise money from other wealthy people and large foundations.

Ms. George is uncomfortable asking for money, but she does it a lot these days, by inviting people to join the collaborative or to sign on to projects personally important to her, like the new center for integrative medicine at Abbott Northwestern.

Rather than dismiss her cause as the domain of crystal gazers, Ms. George has found that most potential donors are eager to learn more about ways to pair alternative medicine with more conventional Western treatments. Many people she talks to have had negative experiences with the health-care establishment, she says. “People feel that the time for change in medicine is overdue,” she says, “and if we can make that happen, they are very happy.”

Ms. George’s husband says he is impressed that a woman whose mother taught her not to stick her neck out has ended up out in front of a national movement. “She has a very empowering style. Everyone has the chance to lead,” he says, but “she is clearly the leader.”

THE GEORGE FAMILY FOUNDATION

History: Created in 1994 by Penny Pilgram George and her husband, William W. George, to support local causes. In 1999, the couple gave the foundation a new focus on promoting the integration of alternative therapies into mainstream health care, a move inspired by Ms. George’s experiences fighting breast cancer.

Mission: To foster intellectual, physical, psychological, and spiritual growth, and to enhance the work of people and organizations devoted to “exemplary service.”

Assets: About $37.7-million

Grants: $1.7-million last year; $1.2-million in 2002

Application procedures: The foundation does not accept unsolicited proposals.

Key officials: Ms. George, president; Diane B. Neimann, executive director

Address: 1818 Oliver Avenue South, Minneapolis, Minn. 55405; (612) 377-8400

Web site: http://www.fpadvisors.com