Holistic Medicine: Primary Care for the 21st Century–An Interview with Robert S. Ivker, D.O.

by larrytriv

Dr. Robert Ivker is a holistic family physician, a doctor of osteopathic medicine (D.O.), and healer who has been practicing medicine for over thirty years. For more than a decade, he has been in the forefront of those seeking to change the face of our nation’s health care system. Like many other physicians, he recognizes that our current medical paradigm is incapable of addressing the growing incidence of chronic disease conditions. In its place, he advocates the adoption of holistic medicine as the solution to this problem, based on his successful treatment of chronic illness in his holistic medical practice in Littleton, Colorado over the past fifteen years.

Like many healers, Rob’s embrace of holistic medicine is a direct result of a personal healing journey which he began in 1977, when he developed chronic sinusitis. After exhausting conventional medical approaches for his condition to no avail and being told he was “just going to have to live with it,” Rob dedicated himself to heeding the advice of Hippocrates: “Physician, heal thyself.” To that end, he began experimenting with a variety of holistic healing approaches, ultimately creating the “Sinus Survival” program that cured him. Based on his success, Rob went on to write the bestselling bookSinus Survival, which is now in its fourth edition and has brought relief to thousands of sinusitis sufferers worldwide.

In 1996, Rob became the tenth president of the American Holistic Medical Association (AHMA), and co-founded the American Board of Holistic Medicine (ABHM). He also co-created the first board certification examination IN holistic medicine for physicians (M.D.’s and D.O.’s).Beginning in 2002, he will serve as the ABHM’s president. In addition he is an assistant clinical professor in the Department of Family Medicine and a clinical instructor in the Department of Otolaryngology at the University of Colorado School of Medicine.

What is holistic medicine and how is it different from conventional care, and from what is referred to as alternative, complementary, or integrative medicine?

Holistic medicine is the art and science of healing that addresses the whole person body, mind and spirit. Holistic physicians integrate conventional and alternative therapies to prevent and treat disease, but most importantly to create a condition of optimal health. Optimal or holistic health, combines at least six different aspects of health–physical, environmental, mental, emotional, social and spiritual. Rather than thinking of health as simply the absence of illness, we are looking at a state of being that is encompassed by high energy and vitality, harmony with your environment (neither harming nor being harmed), peace of mind, a sense of contentment, high self-esteem and self-acceptance, and greater intimacy with at least one other person and with God. This optimal state of well-being is the primary objective of the practice of holistic medicine. To differentiate it from alternative or complementary, or the more popular term today, integrative medicine — all are encompassed within the scope of holistic medicine. To me, the practice of alternative or complementary medicine is simply an extension of conventional medicine in that it is almost entirely focused on treating disease and physical dysfunction, but instead of using drugs and surgery they might use alternative therapies such as herbs, acupuncture, or homeopathic remedies. Holistic medicine employs both conventional and complementary therapies – whatever is safe and effective for treating chronic illness. It also distinguishes itself by addressing the multiple causes of disease, in addition to treating the symptoms. But first and foremost to me, holistic medicine’s most important characteristic of all is its fundamental belief that unconditional love is life’s most powerful healer. As practitioners of holistic medicine, we believe that every illness is energetically held in the heart, and therefore, to a significant degree, every disease results from a deprivation of love.

How do holistic physicians empower their patients to connect with unconditional love? What approaches do they use?

Holistic physicians attempt to guide their patients in a transformative process that leads them to heal themselves physically, environmentally, mentally, emotionally, spiritually and socially. Patients are inspired to healtheir lives, while repairing their “broken parts.” And they do so by being empowered to love and nurture themselves in body, mind, and spirit. The key to healing is to begin by “loving” the dysfunctional tissue or organ. For example, with chronic sinusitis, America’s most common ailment, the initial focus is on healing the chronically inflamed mucous membranes, through air-cleaning, steaming, spraying, and drinking more water. When someone who has been suffering for a long period of time obtains relatively quick relief from their physical discomfort, they are much more likely to continue with the prescribed treatment program.

Another highly effective method for physicians to inspire and empower patients to commit to healing (loving) their lives is by first modeling that condition of optimal health. The training to become a healer or holistic physician is to follow Hippocrates’ advice, “physician heal thyself.” Since holistic physicians are actively engaged in the same healing process as their patients, they can inspire them through their own example. Then within each realm of health there are a number of specific recommendations and therapies that patients can choose from to assist them in their own unique healing process. Since no two of us is exactly alike, each will navigate a somewhat different route towards holistic health.

If we look at the primary objective of our practice in holistic medicine as a condition of optimal health, then we should clearly understand what is meant by that term. The word health, as well as heal and holy, comes from the old English word haelen,which means “to make whole.” If we see health as a state of wholeness rather than the absence of illness, then Idefine holistic health as the unlimited and unimpeded free flow of life force energy through body, mind and spirit. This life force energy is known in Chinese medicine as Qi; the Japanese refer to is as ki; in India it is known as prana, and in Hebrew it is chai. In traditional Chinese medicine and Ayurvedic medicine (the medical system of India), both of which have been in existence for thousands of years, this concept of life force energy is essential and is the foundation to their practice. Although our culture has neither a word nor a concept for this energy, I believe that the feeling of “unconditional love” comes closest. During my thirty years in medicine, I’ve identified certain therapies or practices that seem to have the greatest impact on enhancing this and deepening our connection to life force energy. I call them the “essential eight” for optimal health. They are:

Air, both in terms of quality and quantity. Oxygen is our most critical nutrient, and to obtain a maximal supply we teach patients how to breathe more efficiently through abdominal or belly breathing. We may also provide instruction in breathing exercises, known in the Ayurvedic system as pranayama exercises. We also recommend methods for creating an optimal indoor environment. Air that is clean, warm, moist, and filled with oxygen and negative ions is considered ideal.

Water is the second of the essential eight. Drinking higher quality water in the proper amount is the objective. We usually recommend drinking 1/2 oz. of bottled or filtered water per every pound of body weight on days without exercise, and 2/3 oz per pound on days that you do exercise.

The third of the essential eight is foodand nutritonal supplements. Basically this refers to a healthy diet rich in organic fruits and vegetables, whole grains, fiber, protein, and a good daily regimen of supplements, particularly antioxidants. If patients are being treated for a particular condition, then specific nutritional supplements, dietary recommendations, and medicinal herbs might also be recommended.

Exercise is fourth on the list, especially regular aerobic exercise. All of these first four essentials could be construed as four methods of learning to love, nurture and care for your body and your environment, and encompass physical and environmental health.

The fifth essential relates to what I call play/passion/purpose – identifying and manifesting your heart’s greatest needs and desires. I recommend the use affirmations, visualization, and intuition to facilitate this transformational process. It’s a method that allows the individual to think of a genie coming out of a bottle and granting you your ten greatest wishes. You write them down and then reword each one into the form of an affirmation. And then I suggest a process of writing, reciting, and visualizing each of those desires. To do so on a daily basis can be a very powerful transformational tool. It allows an individual to become much more aware of their feelings as well as their purpose here in this lifetime, to greatly expand their capacity for play and passion, and to simply enjoy being alive.

The sixth essential is the practice of gratitude and prayer. It does seem as if basic human nature allows us to be much more aware of what we don’t have and what’s going wrong with our lives, rather than to be more conscious of their many gifts and blessings. Yet the more a person can focus on what is working well and the many wonderful things they do have, then the greater the abundance they will attract into their lives. Find something on a daily basis to thank god for and to pray in whatever way feels comfortable. It sometimes helps to think of God as your best friend, making it a more personal prayer, or a prayer prefaced by “let thy will be done,” rather than praying for specific material things. For example, if you are praying for money it’s much more effective to pray for what the money will bring you. If it’s a need for greater security, then pray for a sense of greater security rather than praying for more money.

The seventh health essential is intimacy and the cornerstone of a thriving relationship rests on the triad of communication, physical intimacy, and recreation. I hyphenate that word– “re-creation” — recreating the fun and enjoyment that comprised the initial ‟glue” of the relationship.

Last on the list is forgiveness. I am not recommending that the individual forgive the action or the behavior that caused them pain, but forgive the actor, who through their own fear, insensitivity, or confusion caused this person who is practicing forgiveness to feel a great deal of pain. It’s very depleting of life force energy to lock a loved one out of your heart. In my experience, the pain of a broken heart, or the depletion of life force energy from not forgiving, or holding on to anger and hostility, is probably the most critical factor in causing chronic disease.

The forgiveness process does not have to be done in person. It can be practiced through meditation, by writing a letter that’s not sent, through journaling, or a number of other methods. I recently came across the following quote, “forgiving is not forgetting; it is remembering without pain.” for me, forgiveness is the ultimate form of preventive medicine.

It’s important to note that every aspect of holistic medicine is now scientifically supported. Many well documented studies support the use of each of these essential eight practices, as well. Most exciting to me has been the proliferation of evidence reinforcing our intuitive belief that love is a potent healer. If we focus on these eight practices, they will do more to enhance life force energy than anything else I’ve experienced in more than thirty years of practicing medicine as a family physician.

Obviously what you are talking about is a very different paradigm than the type of health care, or you might actually call it disease care, that the majority of people receive in this country. So I’d you to talk a little bit about the mission of the American Holistic Medical Association (AHMA) and the American Board of Holistic Medicine (ABHM) in terms of what they are doing in the near future and long-term in order to make this holistic approach to health and healing more readily available to the public at large.

As I previously said, a primary difference of holistic medicine is our focus on optimal health, and as a by-product of that healing process, we are highly effective in treating almost any chronic illness. It is estimated that nearly half of our nation’s 280 million citizens suffers from a wide variety of chronic conditions – from obesity and depression to arthritis and heart disease. We strongly believe that because holistic medicine is such a highly therapeutic and cost-effective approach to treating any disease, it will become the foundation for primary care medicine in the 21st century. To carry out this mission, the American Board of Holistic Medicine was established in 1996 as a non-profit organization, created by a small group of members of the American Holistic Medical Association. The latter was founded in 1978 as an educational and professional support group for holistic physicians by C. Norman Shealy, M.D., a board-certified neurosurgeon and first president, along with about two hundred physicians and fellow kindred spirits. One of the founding members and fifth president of the AHMA, Bob Anderson, M.D., has been gently guiding the organization throughout her twenty-three year history. He was a trustee on the AHMA board until 2000 and is the founding President of the ABHM.

During the past two decades, Bob has been compiling a database, The Scientific Basis for Holistic Medicine, a compendium of nearly 500 pages of scientific references that support the entire curriculum of holistic medicine. These topics include the six core subjects of: nutritional, environmental, exercise, behavioral, spiritual, and social medicine; and the specialized areas of biomolecular diagnosis and therapy, botanical or herbal medicine, energy medicine, ethnomedicine (including traditional chinese medicine, ayurveda, and native american medicine), homeopathy, and manual medicine. In December 2000, the ABHM held the first board certification examination in holistic medicine, preceded by a four-day board review course attended by 425 holistic practitioners. The course was co-sponsored by the ABHM and the Department of Family Medicine at the University of Colorado School of Medicine. Following the second certification exam in 2001, which was co-sponsored by the university of minnesota school of medicine, there are currently just over 400 board-certified holistic physicians (MDs and DOs) in the United States. We believe this is an historic event. The ABHM’S board-certification is creating a new standard of quality health care that will rapidly be embraced by the medical community, by the public, and especially by the insurance industry. We know that the medical insurance companies have been desperate to see a standard of care within the whole field of alternative medicine and we’ve now provided them with one. Their interest lies especially in the cost effectiveness, as well as the therapeutic value of holistic medicine in treating chronic illness. When you consider the fact that America spends nearly 85 percent of our $l.4 trillion health care budget treating chronic conditions, that’s an unimaginable sum of money. We see holistic medicine as the model for primary care in the 21st century, with the holistic physician as the prototypical family doctor — both healer and teacher — and patients as students eager to learn how to take better care of themselsves. As self-care becomes the catalyst for the shift to a true health care system (from the current system of disease care), we’ll be saving billions of dollars while we’re collectively training as practioners of preventive medicine.

Although our primary objective is the creation of optimal health and disease prevention, the vast majority of our patients today are coming to us as a last resort. They have been to multiple physicians while suffering with a chronic ailment that is either making their lives miserable or killing them. And most of our Patients have been paying for the care they receive out of their own pockets. Recent studies have shown that nearly 50 percent of the American public — in Colorado it’s 75 percent — is regularly using some form of alternative medicine and nationally they are spending nearly $30 billion doing so. Most of that has not been reimbursed by insurance. Board certification will give the insurance industry a standard of care upon which to base their reimbursment to physicians for their holistic medical services. This is already beginning to happen and will open the door to a rapidly increasing number of Americans seeking care from holistic physicians.

Basically you’re talking about a paradigm shift where you’re going to go from being physicians of last resort to physicians of first resort.

That’s precisely our vision. Bob Anderson and I have been family physicians for more than forty and thirty years, respectively, and we believe that holistic medicine represents the evolution of the specialty of family practice. The holistic physician will soon become the family doctor of the 21st century. Since the 1970s, the standard family practice textbook has been replete with references to caring for the whole person. And as an osteopathic physician, during my first year at the Philadelphia College of Osteopathic Medicine, I was taught that osteopathy is in fact holistic medicine. We were taught a concept entitled “the totality of man,” which states that when you evaluate a new patient you should take into account their mental, emotional, spiritual and social status to help determine why that patient has become ill. At the time, this just seemed like good common sense to me. My initial reaction was, “Wouldn’t any good doctor do that?” It just seems like that’s the most effective way to treat a patient. I began my family practice residency training program with this same concept of caring for the whole person. However, the problem has been that, even though we’ve been told that this is what you’re supposed to do, we’ve never actually been trained or given the tools to treat the whole person. This is where the new specialty of holistic medicine will distinguish itself. It provides physicians with an opportunity for training as healers – both to heal themselves and their patients. They’re learning that this body, mind, spirit approach is based on energy medicine – the energy of love. Holistic medicine brings a heightened sense of balance to the practice of medicine – a balance of art and science, heart and mind. As it becomes assimilated into the mainstream,the word “holistic” will be unnecessary. It will be thought of as simply good medicine.

Is the board-certification provided by the ABHM available only to M.D.’s and D.O.’s?

Initially, yes, the certification process will be available only to M.D.’s and D.O.’s. But I expect that within a relatively short period of time, N.D.’s, naturopathic physicians, will be included, since their four-year training program includes most of the ABHM curriculum. They are in fact trained as holistic physicians, but since they are only licensed in about fifteen states there has been some resistance to include them in the certification process. We also believe that in order to be officially sanctioned by the American Board of Medical Specialties (ABMS), we need to initially certify only M.D.’s and D.O.’s. And we do expect that approval to come within the next few years. We’ve been informed that the ABMS will seriously consider sanctioning a new specialty when there are residency training programs in that specialty. In that regard we have begun discussions with the Department of Family Medicine at the University of Colorado, which co-sponsored the first board certification review course, about the possibility of establishing a holistic family practice residency at the University. Similar proposals will be made to several other family medicine residency programs in the near future. Also under serious consideration is a fourth year added to the already existing three year family practice residency. The ABHM curriculum would be integrated throughout the four years. This training program would be the most comprehensive preparation for physicians (M.D.’S AND D.O.’S) to attain certification in holistic medicine.

Ultimately this would spread to other medical schools I would hope.

It will spread very quickly. All it takes is one highly regarded university family practice program like this to open the door and many others will soon follow.

What are your projections for total number of M.D.’s and D.O.’s who will have board certification in holistic medicine in the next three to five years?

We now have just over four hundred physicians who are board certified, and we expect that number to grow ten-fold within the next five years. The enthusiasm and energy generated by the practitioners who attended the first two board review courses has strongly confirmed that we’ve struck a highly responsive cord. Physicians recognize that the practice of holistic medicine provides them with the opportunity to become the healer that most envisioned becoming when they first decided to attend medical school. In a world of high-tech hand low touch medicine, The ABHM certificaton is helping to restore the balance of art and science to the business of caring. That’s why we believe that three to five thousand certified physicians within five years is a reasonable estimate.

That’s a significant number.

Yes it is, but I think that now that it’s begun and more physicians are aware of the growing acceptance and recognition of holistic medicine by the medical establishment, it’s going to pick up tremendous momentum. Bob Anderson and I reflect the feelings of many of the more than one hundred thousand family doctors and primary care practitioners in this country. And most of the physicians who elect to become board-certified in holistic medicine are coming from primary care specialties – family practice, internal medicine, pediatrics, and obstetrics/gynecology. There is also considerable interest from psychiatrists. In fact, among the four hundred certified physicians, nearly every specialty is already represented. Another major source of diplomates in holistic medicine will come from the over forty thousand osteopathic physicians in the U.S., many of whom are anxious to reclaim their holistic roots. This interest among the D.O.’s will grow quickly as several of the nineteen osteopathic schools begin to sponsor holistic medicine courses. For example, the Philadelphia College of Osteopathic Medicine (PCOM)– my alma mater — will be teaching a series of continuing medical education (cme) courses to physicians and health care practitoners on many of the topics included in the ABHM curriculum. They will also be offering many of these same subjects to their students ,as well as co-sponsoring with the ABHM the fourth annual Board Review Course and Certification Exam in 2003. In a very real sense, PCOM has begun the process of becoming our first holistic medical school. SINCE holism is essentially the philosophical basis of osteopathy, it will not be a difficult transition. Given the level of interest among students in receiving a more holistic medical education, I expect the majority of the osteopathic schools to soon follow PCOM’S lead. And judging from the numbers of medical students seeking a more holistic family practice residency, I expect to see those programs proliferate as well. It’s entirely possible that our estimate of five thousand ABHM diplomates within five years may be overly conservative. When an new idea gains widespread acceptance, in this case from the public, medical community, and insurors, and consistently positive therapeutic outcomes become widespread, the growth of holistic medicine may be meteoric. It will eventually find its way into every specialty, e.g. holistic surgeons, holistic cardiologists, etc. Caring for the whole person, rather than treating a disease, will become the standard for practicing good medicine regardless of the specialty or type of health care practitioner or degree — M.D., D.O., N.D., D.C., R.N. This is what I expect to see happening within the next decade.

What role can the public play to help fast track this and what responsibility, if any, does the public have in seeing this vision unfold?

The public has already done its job. This dramatic transformation, the paradigm shift that we’re seeing in health care, has all been driven by the public interest, which has been demonstrated through the two landmark studies of Harvard’s David Eisenberg, M.D., that were published in the New England Journal of Medicine. The first one was published in 1993 and the second in 1998. In each study, Dr. Eisenberg documented the use of alternative medicine by the public and how much money they were spending to receive it. The public has already done its job and as a result of their tremendous level of interest, the highly competitive insurance industry is looking to provide those services for their subscribers. In demanding higher quality health care, it certainly appears as if the public has been the catalyst for this profound change. Until recently, the medical community has been very resistant to change, but what I’ve seen during the past two years from my medical colleagues has been extremely encouraging . As a result of being president of the AHMA and my books, The Self-Care Guide to Holistic Medicine and the fourth edition Sinus Survival: The Holistic Medical Treatment for Sinusitis, Allergies and COLDS, I have been asked to speak at several medical schools, including Harvard, Tufts, and the University of Michigan, and at the annual scientific meetings of the American Academy of Otolaryngology and The American College of Allergy, Asthma and Immunology.The level of interest, enthusiasm, and acceptance of holistic medicine from both the medical students and the ear, nose and throat physicians, allergists, and other physicians, has been so encouraging to me that it really feels like the building of the bridge connecting conventional and holistic medicine is nearing completion.

Based on that and the vision that you have for the ABHM itself, as that vision starts to become reality, what do you foresee health clinics and hospitals looking like in the 21st century?

The health clinics will be integrated facilities where you’ll have licensed physicians, M.D.’s and D.O.’s, working side-by-side with naturopathic physicians, chiropractors, psychotherapists, acupuncturists, herbalists, bodyworkers, and other health care providers, all under one roof. They will function as a team of healers, each working in partnership with their patients and with the other practitioners who might be participating in the care of the same patient. Together they will address the specific needs of each individual patient, practicing a variety of modalities, with optimal health as their primary objective. These will be State-of-the-art holistic medical centers. There are currently a number of complementary, alternative, or integrative clinics with several practitioners using different therapies, but most are not treating the whole person. The focus is usually on treating disease with unconventional therapies, i.e., anything other than drugs and surgery, and there typically isn’t a team approach where one physician is coordinating the holistic care of the patient. In the very near future, there will be a profound change that to the casual observer might go unnoticed. But the quality of care will be greatly enhanced, and as a result they will attract the majority of those people suffering with the most common chronic diseases. Those who are not sick but are seeking to enhance their quality of life will also be very interested. These holistic medical centers will be Staffed by board-certified holistic physicians and holistic practitioners who care for patients based upon the fundamental principles of holistic medical practice. They will be both disease treatment (chronic illness) and health educational (including disease prevention) facilities with a comprehensive array of classes and support groups to help guide the patients in a process of learning to care for themselves. Preventive medicine and self-care will soon become the basis and chief objectives in the education-oriented medicine of the 21st century. Within that context, I envision the doctorof the 21st century as a teacher of wholeness rather than merely a fixerof broken parts.

How will hospitals change?

Hospitals will become truly healing environments, which they are not presently. Here too you will see a more holistic paradigm in operation. The holistic medical centers/health clinics will be will primarily serve those people who have made some degree of commitment to treating and/or preventing a chronic illness. The hospitals, however, will treat the seriously acute or life-threatening illnesses. They might serve as a Safety net for those people who have already been to a health clinic and are engaged in their healing process, but are Experiencing an acute or life-threatening flare-ups of their condition. This could include an asthmatic having an acute attack, a person with cancer experiencing a recurrence, or someone with heart disease who’s having a heart attack. For these patients the hospital will offer state-of-the-art medical and surgical treatment while also reinforcing the educational/preventive aspect of their treatment program. During their recovery, patients might be asked to reflect on the following questions: “What do you think caused the attack or the recurrence of your illness?” “How might it have been prevented?” “what lessons have you learned as a result?’ “how will you live differently after you leave the hospital?”

For those hospitalized patients who had not been familiar with holistic medicine, they will be exposed to a more comprehensive approach to treating their disease. In addition to being provided with all of the modern medical innovations offered by conventional medicine, both therapeutic and diagnostic, patients will receive the most appropriate complementary modalities that can benefit their condition. They too will be encouraged to better understand the factors that may have caused their illness, and to use it as an opportunity to further their spiritual growth — to heal, rather than simply relieving the pain or eliminating the crisis.

Whether an individual will be cured is not the primary question that needs to be asked. What really matters is whether they feel more whole, which is what healing is all about. As Bernie Siegel points out, healing can occur even when a cure is not possible, such as when someone has terminal cancer. If patients are dying there will be counseling available to them and their loved ones, and in fact holistic physicians will be much better trained to work with the terminally ill and helping people “heal into death.” That’s a concept that is not understood by most physicians today and it really speaks to the difference between healing and curing. Curing refers to a physical condition and healing refers to the quality of one’s life.

Death is one of the most important stages of life, and that transition will be honored and respected in the holistic health care system of the 21st century. We’ll recognize that all of us are spiritual beings and that we are here on this planet for the primary purpose of learning to love ourselves and others. We’ve been taught by Elisabeth Kubler-Ross and Stephen Levine and other healers who have for many years worked with terminally ill patients that the most often expressed regret from a person’s death bed is “unfinished business in relationships.” No one is bemoaning the fact that they could have worked harder or made more money. We are not here to make as much money as possible, or to die with the most toys. Life on earth is about learning to love, and unfortunately most of us don’t come to that realization until we’re dying. So why not practice a little preventive medicine along with a strong dose of forgiveness while we’re still alive and well, rather than waiting until we’re at death’s door?

So this is another area that holistic physicians can help their patients with.

That’s right. We’ve been given the same message repeatedly from every spiritual teacher throughout recorded history: love thy neighbor as thyself. And after more than a million years on this planet, our species still hasn’t learned to live together happily, peacefully, or lovingly. From Kubler-Ross, Levine, and a burgeoning body of scientific evidence, the conclusion is always the same – the healing power of love and intimacy surpasses that of any drug, surgical procedure, diet, exercise, supplement, or herb. Yet as we begin the new millenium with our global population at 6.5 billion, our greatest health hazard is our growing sense of isolation. We have become disconnected from the earth, from one another, from ourselves, and from god. The primary job of the holistic healer is to help us to awaken to the limitless possibilities and the joy of being fully alive. This is my vision for the future.


How Healthy Are You?: Dr. Ivker’s Wellness Self-Test

The following questionnaire was designed by Dr. Ivker to help patients discover their health status in each of the six areas addressed by holistic medical physicians — physical and environmental health; mental and emotional health; and spiritual and social health. Completing it will provide you with a blueprint for restructuring your life, according to the areas which most need your attention. You can also measure your progress by taking the test again every few months.

Answer the questions in each section and total your score. Each response will be a number from zero to 5. When answering questions about an activity refer to the frequency within the parenthesis (e.g., “2 to 3x/week”). The questions that are not about activities (e.g., “Do you have a sense of humor?” or “Do you have specific goals in your personal and professional life?”) are more subjective. Score them according to their frequency, such as “often” or “daily,” or how accurately you feel the trait described is part of your life. For example, if a sense of humor is a strong part of your personality, your score would be 5, whereas if you feel you usually fail to see humor in your daily life, you would score zero.

0 = Never or almost never (once a year or less)

1 = Seldom (2 to 12x/year)

2 = Occasionally (2 to 4x/month)

3 = Often (2 to 3x/week)

4 = Regularly (4 to 6x/week)

5 = Daily

BODY: Physical and Environmental Health

__ 1. Do you maintain a healthy diet (low fat, low sugar, fresh fruits, grains, vegetables)?

__ 2. Is your water intake adequate (at least 1/2 ounce per pound of body weight)?

__ 3 Are you within 20 percent of your ideal body weight?

__ 4 Do you feel physically attractive?

__ 5 Do you fall asleep easily and sleep soundly?

__ 6 Do you awaken in the morning feeling well rested?

__ 7 Do you have more than enough energy to meet your daily responsibilities?

__ 8 Are your five senses acute?

__ 9 Do you have time to experience sensual pleasures?

__ 10 Do you schedule regular massage or deep-tissue body work?

__ 11 Does your sexual relationship feel gratifying?

__ 12 Do you engage in regular physical workouts (lasting at each 20 minutes)?

__ 13 Do you have good endurance or aerobic capacity?

__ 14 Do you breathe abdominally for at least a few minutes?

__ 15 Do you maintain physically challenging goals?

__ 16 Are you physically strong?

__ 17 Do you do some stretching exercises?

__ 18 Are you free of chronic aches, pains, ailments, and diseases?

__ 19 Do you have regular bowel movements?

__ 20 Do you understand the causes of your physical health problems?

__ 21 Are you free of any drug or alcohol dependency?

__ 22 Do you live and work in a healthy environment with respect to clean air, water, and indoor pollution?

__ 23 Do you become energized by spending time in nature?

__ 24 Do you feel a strong connection with and appreciation for your body, your home, and your environment?

__ 25 Do you have an awareness of life force energy or Qi?

Total BODY score :____

MIND: Mental and Emotional Health

__ 1 Do you have specific goals in your personal and professional life?

__ 2 Do you have the ability to concentrate for extended periods of time?

__ 3 Do you use visualization or mental imagery to help you attain your goals or enhance your performance?

__ 4 Do you believe it is possible to change?

__ 5 Can you meet your financial needs and desires?

__ 6 Is your outlook basically optimistic?

__ 7 Do you give yourself more supportive messages than critical messages?

__ 8 Does your job utilize your greatest talents?

__ 9 Is your job enjoyable and fulfilling?

__ 10 Are you willing to take risks or make mistakes in order to succeed?

__ 11 Are you able to adjust beliefs and attitudes as a result of learning from painful experiences?

__ 12 Do you have a sense of humor?

__ 13 Do you maintain peace of mind and tranquility?

__ 14 Are you free from a strong need for control or the need to be right?

__ 15 Are you able to fully experience (feel) your painful feelings such as fear, anger, sadness, and hopelessness?

__ 16 Are you aware of and able to safely express fear?

__ 17 Are you aware of and able to safely express anger?

__ 18 Are you aware of and able to safely express sadness (cry)?

__ 19 Are you accepting of all your feelings?

__ 20 Do you engage in meditation, contemplation, or psychotherapy to better understand your feelings?

__ 21 Is your sleep free of disturbing dreams?

__ 22 Do you explore the symbolism and emotional content of your dreams?

__ 23 Do you take time to relax, or make time for activities pf play that constitute abandon of your cares?

__ 24 Do you experience feelings of exhilaration?

__ 25 Do you enjoy high self-esteem?

Total MIND score: ___

SPIRIT: Spiritual and Social Health

__ 1 Do you actively commit time to your spiritual life?

__ 2 Do you take time for prayer, meditation, or reflection?

__ 3 Do you listen to and act on your intuition?

__ 4 Are creative activities a part of your work or leisure time?

__ 5 Do you take risks?

__ 6 Do you have faith in God or Spirit?

__ 7 Are you free from anger toward God?

__ 8 Are you grateful for the blessings in your life?

__ 9 Do you take walks, garden, or have contact with nature?

__ 10 Are you able to let go of your attachment to specific outcomes and embrace uncertainty?

__ 11 Do you observe a day of rest completely away from work, dedicated to nurturing yourself and your family?

__ 12 Can you let go of self-interest in deciding the best course of action for a given situation?

__ 13 Do you feel a sense of purpose?

__ 14 Do you make time to connect with young children, either your own or someone else’s?

__ 15 Are playfulness and humor important to you in your daily life?

__ 16 Do you have the ability to forgive yourself and others?

__ 17 Have you demonstrated the willingness to commit to a marriage or comparable long-term relationship?

__ 18 Do you experience intimacy, besides sex, in your committed relationships?

__ 19 Do you confide in or speak openly with one or more close friends?

__ 20 Do you or did you feel close to your parents?

__ 21 If you have experienced the loss of a loved one, have you fully grieved that loss?

__ 22 Has your experience of pain enabled you to grow spiritually?

__ 23 Do you go out of your way or give time to help others?

__ 24 Do you feel a sense of belonging to a group or community?

__ 25 Do you experience unconditional love?

Total SPIRIT score: ___

Total BODY, MIND, SPIRIT Score: ___

Health Scale:

325-375 Optimal Health: THRIVING

275-324 Excellent Health

225-274 Good Health

175-224 Fair Health

125-174 Below Average Health

75-124 Poor Health

Less than 75 Extremely Unhealthy: SURVIVING



Dr. Ivker’s website provide information about his acclaimed holistic treatment protocol for treating sinusitis, allergies, colds, asthma, arthritis, headache, and backache; a Q&A with Dr. Ivker; online forums; and online ordering of Dr. Ivker’s books and recommended health care products.

American Holistic Medical Association (AHMA)


American Board of Holistic Medicine (ABHM)


Both the AHMA and ABHM offer nationwide referrals to physician (M.D.’s and D.O’s) competent in the practice of holistic medicine.

By Robert S. Ivker, D.O.

Dr. Ivker’s Survival Guide Lifelong Wellness Series (Tarcher/Putnam):

Sinus Survival: The Holistic Medical Treatment for Sinusitis, Allergies, and Colds; 4th edition, 2000

Arthritis Survival: The Holistic Medical Treatment Program for Osteoarthritis (with Todd Nelson, N.D.) 2001

Asthma Survival: The Holistic Medical Treatment Program for Asthma (with Todd Nelson, N.D.) 2001

Headache Survival: The Holistic Medical Treatment Program for Migraine, Tension, and Cluster Headaches (with Todd Nelson, N.D.) 2002

Backache Survival: The Holistic Medical Treatment Program for Low Back Pain, 2002

The Self-Care Guide to Holistic Medicine: Creating Optimal Health (with Robert A. Anderson, M.D., and Larry Trivieri, Jr.) (Tarcher/Putnam) 2001

Thriving: The Holistic Guide to Optimal Health for Men (with Edward Zorensky) (Crown), 1997