Do you have a chronic medical condition? If you do, you probably already know how critical it is to attend your medical appointments and have an ongoing dialogue about your condition with your health care provider. In addition, you know how essential it is to be proactive and learn all you can about how to manage your condition. Many patients have also discovered that it is very helpful to get support from others living with the same condition either through support groups or online programs.

Wouldn't it be nice to get medical care, education and support all in one visit? Many health care providers are starting to offer group medical visits for people with chronic medical conditions so all these important aspects of care can be addressed at one time. I am involved in developing an innovative program for women living with chronic pelvic pain (CPP).  We will be offering group medical visits with an important twist; we will incorporate the Centering model of group care and an integrative medicine approach into the care we provide.

Why is integrative medicine the best approach for the treatment of CPP? Chronic pelvic pain (CPP) is a complex pain syndrome that can involve multiple organ systems (GI, urinary and reproductive tracts), the musculoskeletal and nervous system and psychological health. It is important that we care for women with CPP using a holistic approach so that we can address all aspects of their health. Integrative medicine emphasizes the patient/provider relationship and caring for the whole patient: mind, body and spirit. We offer a wide variety of treatments that encompass nutrition, physical activity, herbs, mind/body techniques and alternative healing systems in addition to conventional medicine. When I take care of patients with CPP using an integrative approach I have so many tools in my toolkit! For more information about CPP see the Newsletter from September 2008 in the Archive.

What is the Centering Model of Care? Some of you may have heard of CenteringPregnancy, a very popular and successful way of providing prenatal care. Centering combines self empowerment, education, peer support and medical care. Here is why we chose this model of care:

It promotes self care. For instance, each group member gets her own blood pressure reading, weight and helps manage the information in her chart. This facilitates the woman's participation in her care.

Essential health education about living with CPP is provided so that women can improve their quality of life. Topics will include: Review of CPP causes and treatments, pain management strategies, therapeutic exercises, communication skills, sexuality issues, mind/body approaches, and nutrition.

Encourages peer support and group problem solving. During each group meeting there is time for sharing and discussion in the circle. Many of the women will have experiences and knowledge to share that is beneficial to other group members.

Each member of the group is valued. The facilitative leadership style used in Centering groups honors each member's contribution to the group. Before coming together as a group, each woman has the opportunity to meet with the provider for an assessment and discussion of any health issues of concern to her.

When will the groups be starting? We hope to start these groups early next year. The first groups will include San Francisco General Hospital patients. (See news item about the Hearts Grant I received.) We will then expand the groups to include UCSF Chronic Pelvic Pain Clinic patients. We hope to conduct research to determine whether the groups improve the quality of life of women living with chronic pelvic pain. Look for updates in future newsletters.

If you suffer from chronic pelvic pain or know of a woman who does, you can learn more about CPP at this UCSF website.