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Dr. Mehta is the Medical Director of the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital (BHI-MGH) and Director of Education at the Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women’s Hospital. He is an Assistant Professor of Medicine at Harvard Medical School. His educational and research interests include curricular development in complementary and integrative medical therapies, mind/body educational interventions in health professions training, and promotion of professionalism in medical trainees. He directs medical student and resident rotational electives at BHI-MGH and the Osher Center.
Zoe Dobuler: I’d love to start off by hearing about your background and how you found your way to the Benson-Henry Institute.
Dr. Mehta: Sure. I’m a general internal medicine physician and when I went into my residency training, my original intent was to finish training, go into private practice and be a primary care provider. Then during my training, sort of a confluence of things happened, a couple of seminal moments for me.
One was I began to notice that a lot of my patients were asking me about the use of complementary and integrative approaches, which included mind body practices. And whenever I would approach those questions that were posed to me to my preceptors, they would really be without words of how to answer, advise, guide or counsel someone. That sort of became disasstifying to me, I was like, “we have to do a little bit better if patients are asking these good questions.”
The second thing was my own personal interest. I always thought of mind body practices as important for my own sense of well being. But I never saw it as medicine until it became the idea of mind body medicine, that this is something actually that can be used to treat individuals with medical conditions. That was the second piece.
And third was I decided I really wanted to be in an academic medical center, and that required me to have a certain amount of vocabulary, so that’s actually what brought me out to Boston. So I ended up coming out to Boston to do a research fellowship in complementary integrated medicine, and subsequently it was a little bit of serendipity and luck, I happened to meet Dr. Benson as part of my fellowship experience. At the time at the clinic, which used to be out at Chestnut Hill, he needed some additional physician support. And for me, I was a research fellow at the time, and I needed additional income to support the high cost of living in Boston, so I started to do a little bit of work on the side as a physician at the clinic. Subsequently I finished my fellowship, and the institute as you may know, a large gift was given by John Henry to bring the institute to Mass General. My current boss, the director Greg Fricchione, invited me to come onboard as a physician to lead some work in medical education. Subsequently about 5 years later, I moved into the role of Medical Director of the institute.
ZD: I’m curious how you define the concept of mind body medicine and how you see it as being a unique approach, as opposed to the more clinical interventions you were familiar with before.
DM: These are approaches that are built on the premise of self care and techniques that are grounded in these approaches around self awareness, self care. And it includes approaches like meditation, imagery, biofeedback, practices that cultivate mindfulness. So yoga, tai chi, these are examples that are really steeped in the notion of self care and self awareness. And they really utilize various approaches that address physical well being, emotional well being, psychological well being, social well being.
Most recently, what makes it medicine is that they have been studied and shown benefit in clinical populations. So again Dr. Benson, the founder of our institute, his original work was where he coined the term “the relaxation response,” the description of a physiology that counteracted the negative effect of the stressor response. And he used the study of hypertension (or high blood pressure) and found that when patients engaged in mind body practices, they were able to reduce their blood pressure by the amount equivalent to medication.
ZD: It’s interesting when you mention the term “self care,” because I feel like that phrase has been so co-opted by pop culture. Especially things with millennials and face masks and these superficial interventions. But it seems like the idea of self care is also a medical term, so I’m curious about the pop culture versus medical use.
DM: We are expected as physicians to somehow counsel/teach our patients about things they can do for themselves to augment/support their own sense of health and well being. But we’re really not taught how to do that. We’re taught in the disease model: that if you are ill, here’s a pill. That’s what it is. So this is really the idea of cultivating health rather than treating disease.
ZD: I was looking at the Benson-Henry Institute’s website and there’s a little quote I found interesting. It talks about “integrating the feel of mind body medicine into MGH’s clinical care programs.” I’m curious what that actually looks like on the ground and what the impacts of bringing these two fields together are in practice for you.
DM: In terms of clinical care, we really believe that the approaches that elicit this physiology of the relaxation response that cultivate mindfulness as a state of being have health implications. And we see it in multiple conditions. As I mentioned, early work began with hypertension. Since then we’ve focused on lots of different conditions that include irritable bowel syndrome, migraines, anxiety, depression. We’ve seen clinically relevant impact, so the more that we can educate our colleagues about this, the more we can educate our patients. The more they become empowered to take care of themselves.
Now it doesn’t substitute; we don’t want to make the claim that this would take away from what modern medicine has to offer. I think this is unfortunately what people sometimes misconstrue. As a general interest, I fully support the advancement of modern medicine, but I don’t think we give enough emphasis to these approaches. And we’re seeing the research has pointed that out. Things like diet, exercise, stress reduction, that’s the core of well being and from a health perspective what cultivates health, so we need to make sure that we are maximizing that.
So the impact that we see obviously are improvements in symptom management, how people experience their symptoms, the severity of their symptoms, the duration of their symptoms, the management of their medical condition. And we even see an impact on healthcare utilization. So people who engage in these practices actually use the healthcare system less, which obviously has economic implications as well.
ZD: I’m wondering what you see as the future of this field: where you think it’s going, what you’re most excited about for the next 5, 10, 50 years of the mind-body medicine field.
DM: I think that this field is not a novelty. It’s as normal as cardiology and gastroenterology. That’s the future. People say “Oh my god, he’s going to the mind body medicine clinic.” We don’t say that about someone going to a cardiology clinic. That’s just how you cultivate health. So I think that’s the future.
I work a lot in the realm of education and we do a lot of projects currently with healthcare providers. You may have heard of the big epidemic of healthcare provider burnout. We feel that what we have to offer provides one important tool in the broad changes that are needed to our healthcare system. Not to say that this would solve everything about healthcare provider burnout, there are obviously system issues as well, but this is also an important way to cultivate awareness, a sense of coping, and being resilient. So that’s one piece of it I’m most excited about.
I’m also working on a curriculum for Harvard Medical School that its required of all students to learn some of these skills, which I could’ve never imagined that and the change there. So that’s another area as well.
This Change Maker interview was originally published July 2019 on the HubWeek blog.
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