Enhancing the Care of Patients Undergoing Complex Medical Evaluation: A Program to Preschedule Integrative Medicine Services

*Elizabeth A Gilman
Division Of General Internal Medicine, Mayo Clinic, Minnesota, United States

*Corresponding Author:
Elizabeth A Gilman
Division Of General Internal Medicine, Mayo Clinic, Minnesota, United States

Published on: 2021-05-29


Objective: In our Consultative Medicine practice, we treat patients with complex conditions, often refractory symptoms, and high levels of stress who likely have been evaluated at multiple institutions. Once at our clinic, many of these patients express an interest in integrative medicine therapies and, anecdotally, many find such services to be helpful. Most of our patients are at our institution for a short time, so scheduling these services can be difficult. We, therefore, decided to evaluate the willingness of patients to access integrative medicine services during their appointment intake. For patients who requested such services during intake and received them as part of their overall evaluation in the Consultative Medicine Clinic, we also evaluated their satisfaction with the consultations provided.
Design and Interventions: From March 1, 2019, until November 19, 2019, we modified the intake form to ask if patients would be interested in stress management or herbal medicine consultations in our Integrative Medicine section during their evaluation. We tracked percentages of patients interested in consultations and their satisfaction with the consultations.
Results: There were 14,690 appointment intake forms completed during the study period. Of 6,063 patients who answered the question regarding stress management, 2,014 (33%) responded “yes” to wanting a stress management consult. Many patients (6,186/14,690; 42%) marked that they were taking herbal dietary supplements, and 1,810 of 5,926 (31%) who answered the question regarding a consult were interested in consulting with a specialist to discuss herbal and/or dietary supplements. During this same timeframe, data indicated a high degree of patient satisfaction with the consultations offered through the Integrative Medicine & Health Clinic.
Conclusion: Patients who travel to receive tertiary care at an academic medical center often have high health care use, persisting symptoms, and stress and may benefit from routinely including integrative medicine consultations in their appointment planning.


Dietary Supplements; Healthcare Delivery; Integrative Medicine; Stress; Whole Practice


Many patients travel to Mayo Clinic for complex medical care, which often requires multiple specialty evaluations and evaluation of complex undifferentiated symptoms. Many patients also come who have received medical diagnoses elsewhere and have been given treatment recommendations they do not find acceptable or want another opinion.
When patients request an appointment in General Internal Medicine, they first complete an appointment request form. The form has 2 purposes:

  • To identify the patient’s main priorities/concerns for seeking an appointment and
  • To determine if Mayo Clinic has appropriate diagnostic and therapeutic offerings to satisfy the patient’s concerns.

The Consultative Medicine Clinic becomes the starting point for many patients in General Internal Medicine and therefore at Mayo Clinic. Many of these individuals have exhausted their local medical resources looking for a diagnosis and cure for their conditions. Many of these patients are emotionally, psychologically, and physically stressed and have markedly impaired lifestyles.

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