American Board of Integrative Medicine® (ABOIM®) Diplomate Vivian A. Kominos, MD, Explains Integrative Cardiology

Vivian A. Kominos, MDIn simple terms, integrative cardiology is good cardiology. It applies the tenets of integrative medicine to pick the most appropriate treatments for a person’s individual health benefits and disease risks. It employs conventional therapies such as percutaneous coronary interventions and pharmacotherapy when necessary, while including the less conventional treatments such as mind-body medicine, acupuncture, nutrition, exercise and spirituality. It looks for less costly and less risky treatments where appropriate and emphasizes healing and prevention.

Conventional cardiology is wonderful at treating acute cardiac problems such as myocardial infarctions or heart failure. But it falls short when it comes to preventing and healing heart disease. According to the CDC, approximately 80% of premature heart attacks and strokes can be prevented with appropriate lifestyle changes. Although the American Heart Association and the American College of Cardiology have many well researched and evidence proven lifestyle guidelines in place, most cardiologists have little, if any, training in this modality of medicine. As an example, cardiologists agree that nutrition is one of the backbones of prevention and treatment for atherosclerosis. Yet in a survey of 930 cardiologists who were asked about nutrition training:

  • 90% received little or no training during fellowship
  • 59% had little or none during residency
  • One third little or none during medical school
  • Only 8% described themselves as experts in nutrition
  • But most believed that they need to provide recommendations to their patients.

AM J Med. 201; 130 (11): 1298-1305

This survey indicates that most cardiologist feel ill-equipped to provide adequate care for their patients. It is therefore time for cardiology, and for all medicine, to delve into the root causes of disease rather than treating the downstream effects of sedentary lifestyle, high stress, poor nutrition, lack of safe environments and inadequate sleep. Integrative medicine training provides the tools that prevent heart disease, mitigate cardiovascular risk factors, and allow for healing from heart disease.

Integrative medicine understands the innate healing power of the human body and spirit. Studies of heart disease prove that it is never too late to heal. Physical activity, for instance, is a recommendation that can be given to almost anyone. In a worldwide study of coronary artery disease that looked at over 15,000 participants who were followed for 3.7 years, walking just 10 minutes a day was associated with a 30% reduction in all-cause mortality in those who were sickest (JACC. 2017;70(14):1689-1700). Exercise has far reaching benefits that exceed those from statins and aspirin, yet most cardiologists readily offer the latter and often forget to talk to the patient about physical activity.

Cardiology is therefore ripe for integrative medicine. The first Chinese medical textbook was written approximately 5000 years ago. A translation reads: superior doctors prevent disease; mediocre doctors treat the disease before evident; inferior doctors treat the full blown disease. Integrative medicine fellowships are now educating physicians from all primary care and specialty areas and can provide physicians with the tools they need to become superior healers.

— Dr. Vivian A. Kominos has practiced cardiology for 30 years and has concentrated on integrative medicine and integrative cardiology for the past 12. She is Clinical Assistant Professor of Medicine at the Dr. Andrew Weil Center for Integrative Medicine and is a practicing cardiologist in West Long Branch, New Jersey.

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On October 18, 2007, President George W. Bush released Homeland Security Presidential Directive 21 (HSPD-21), calling on our nation, among other initiatives, to “collectively support and facilitate the establishment of a discipline of disaster health”. It is a great testament to the wisdom and foresight of the American Board of Physician Specialties that it immediately set to work and created, within the short span of only one year, an educational blueprint and set of certification examinations, both written and oral, for a new subspecialty of disaster medicine—and it is why I chose to be part this vital initiative and this wonderful organization. This is but one of the many innovative programs initiated by the American Board of Physician Specialties over the years, and why I am proud to support its work on behalf of our nation’s public health.

Art Cooper, MD
Disaster Medicine
When the American Board of Physician Specialties offered to host the American Board of Integrative Medicine, ABPS became a landmark organization working to move medicine into the twenty first century. Certifying physicians who have completed rigorous academic training in Integrative Medicine ensures that the field of Integrative Medicine will continue to develop academically, clinically, and professionally. The leadership of ABPS continues to impress me - they are diligent in constantly innovating to provide certifications for physicians who want to advance their careers and their areas of expertise. I am honored to be a part of this organization.

Ann Marie Chiasson, MD
Integrative Medicine
There are many ways board certification advances a physician career. ABPS Board examination verifies your accuracy, precision, and reflects your mastery of your residency training verifying your expertise. ABPS Board certification demonstrates your level of expertise beyond your practice experience, primary education degrees, and training which are necessary for insurance reimbursement and practice privilege requirements. Attaining your ABPS Board Certification will clarify your purpose, secure your practice growth, and expand into leadership positions. Board certification can serve as an indication of a physician’s commitment to medicine, beyond the minimal standards and competency of training, their measurement to quality of care, and attaining an award for excellence.

Chris Kunis MD
Internal Medicine
When I think historically, advancement in medicine and patient safety and care has been driven by the diversity of people and scientific thought. That’s what I found at the ABPS and more. For over 60 years that is just who we are. I found a physician certifying body that provides a choice and voice to all physicians ensuring that patients are always placed first.

Jerry Allison, MD
Emergency Medicine
When I decided to pursue a full time role as a physician executive it was important to me to obtain additional professional training, education and work experience. Board certification through the ABPS in Administrative Medicine is validation of my efforts and a demonstration of dedication to professional development. We need more physicians to become full time health care executives, knowing there is a board certification option in Administrative Medicine encourages physicians to take the leap from full time clinical practice to healthcare organizational leadership.

Richard Paula, MD
Administrative Medicine
The American Board of Physician Specialties has provided me with the opportunity to demonstrate mastery of internal medicine through board certification. As a hospitalist, board certification is an expected credential, and hospitals recognize the American Board of Physician Specialties (ABPS) as one of the three standard credentialling bodies for Internal Medicine. Additionally, the ABPS has helped me develop leadership skills as a Board member and Committee Chairperson. ABPS has also helped me sharpen critical thinking skills as a test question developer and reviewer. The Allopathic (MD) and Osteopathic (DO) physicians in the ABPS are lifelong learners and frequently pursue multiple board certifications. I enjoy the camaraderie of my peers in ABPS.

Loren Jay Chassels, DO
Internal Medicine