After spending her entire career working in oncology, Dr. Lanie Francis gained a whole new perspective on her field seven years ago, when her mother was diagnosed with cancer.
“I jumped into this very different role of seeing things very much on the front lines,” Francis recalls. “I was feeling all of these overwhelming existential emotions.”
The experience gave her a new understanding of the larger mental and emotional burden of cancer that both patients and their families carry every day.
“After her death, it was like I had this battery pack,” says Francis. “I had to do something that would, at least from my perspective, change the way we supported patients with cancer, and open up this whole other layer of support and healing that could be available to patients and in their own control.”
Even in the earliest days of her study at UPMC, Francis says she always considered larger ideas of holistic health in her treatment plans. In the pre-smartphone era, she printed out information on yoga poses for her patients at Mercy Hospital.
Her first step toward bringing an even more holistic focus to her work was organizing UPMC’s first ever Wellness Fair in 2013. It has since become an annual event.
Given the positive public response, Francis and her team had traction to raise funds for what became The Wellness and Integrative Oncology Program.
Working out of a Wellness Suite at UPMC Shadyside’s Hillman Cancer Center, the program provides guided workshops and therapies based on four themes: nutrition, exercise, meditation and mindfulness. Francis’s team has also trained more than 40 nurses who work throughout the UPMC system.
And they’ve gotten creative about funding: While holistic, integrative medicine is becoming increasingly common, one challenge to use it is cost: the traditional system of insurance payments isn’t designed to embrace this kind of work.
“Insurance coverage fundamentally approaches integrated care in the same way they approach medical care,” explains Francis. “That is, by design, a pretty narrow focus.”
Integrative care, on the other hand, is “systems-based and it has a larger focus on what makes something work or not work,” says Francis. “A lot of it is based on more intangible things, and a lot of it is also based on eventually saving money and values that are hard to quantify on the front end.”
The Wellness Center’s care model is based around patients trying several therapies before deciding which are helpful. “Being able to let everybody try, whether its acupuncture, massage or yoga, before they really commit is a really important part of our model,” says Francis.
But relying on insurance alone to fund that would entail waiting for providers to approve and pay for each individual procedure. “The momentum gets completely slowed down by that bureaucracy,” says Francis. “To the point where I think it would ruin what we’re trying to do.”
So this program pursues treatments that can be easily replicated outside of a clinical setting — even by the patient themselves at no cost. “All of the hands-on things we do in the Wellness Suite, we think really hard about either how to make them affordable,” says Francis, “or how to kind of take our providers out of it so patients are doing these things on their own.”
But to keep the lights on, and to keep up with innovations in the field, Francis and her team also rely on community support. Their next fundraiser will be the two-day Breathing Room event, which includes public wellness classes at parks and yoga studios around the city from May 16-18.
As a long-time expert in holistic care, Francis has watched with some bemusement as nontraditional wellness and mindfulness therapies are finally penetrating the mainstream culture. “It’s so much more accessible because people are seeing images of it,” says Francis. “It’s less weird and hippy. It’s almost been heightened to this more elite status, which I don’t think is good necessarily.”
Still, she says, the main reason holistic treatments are gaining popularity is the fact that they can do a lot of good for a lot of people, no matter what their current state of health.
“It helps people manage complicated and highly stimulating lives and environments,” says Francis. “This desire to simplify, and do less, and get back to the basics, really does come from a place of need.”