In­te­gra­tive in­no­va­tor

Raby In­sti­tute founder and leader named Physi­cian En­tre­pre­neur of the Year

Modern Healthcare - - PHYSICIAN AFFAIRS -

When Dr. Theri Griego Raby was grow­ing up in Al­bu­querque, her mother and grand­mother taught her that good health is of­ten con­nected to things like nu­tri­tion and sleep, and that some­times the best cures are found in na­ture.

“We al­ways had gar­dens and shopped in coops,” Raby says. “As ba­bies, my grandma gave us teas and herbal reme­dies. If we had headaches, we’d put a cold nickel on our fore­head, and if you started to wheeze, you’d use a pa­per bag.”

Raby, who is Mod­ern Physi­cian’s 2012 Physi­cian En­tre­pre­neur of the Year, says she al­ways loved sci­ence, but didn’t re­al­ize she wanted to be a doc­tor un­til she was in col­lege at the Univer­sity of New Mex­ico. A few years af­ter com­plet­ing her bach­e­lor’s de­gree in health ed­u­ca­tion, Raby en­tered the Univer­sity of New Mex- ico Med­i­cal School in 1987 where she im­mersed her­self in the study of Western medicine, but never for­got the lessons of her child­hood.

Raby com­pleted her in­tern­ship and res­i­dency at Rush-Pres­by­te­rian-St. Luke’s Med­i­cal Cen­ter in Chicago, now called Rush Univer­sity Med­i­cal Cen­ter. In 1996, she took a job as an in­ternist at North­west­ern Memo­rial Physi­cians Group in Chicago. It was there that Raby says she be­came more acutely aware of how mod­ern medicine some­times misses the mark by treat­ing ill­nesses rather than proac­tively sup­port­ing health and well­ness.

“As I be­came more in­volved in pa­tient care, I saw that things like diet, wa­ter qual­ity and en­vi­ron­ment were hav­ing a huge im­pact on pa­tients,” says Raby, 52. “I saw con­di­tions Western medicine couldn’t do any­thing about—can­cers, neu­ro­log­i­cal con­di­tions, chronic pain and fa­tigue. There was a gap and some­thing I knew was miss­ing.”

From the start of her ca­reer, Raby says she took an in­te­gra­tive ap­proach to prac­tic­ing medicine—treat­ing each pa­tient as a whole per­son rather than a set of symp­toms. When peo­ple came in for rou­tine Pap smears or colono­scopies, she would take the time to talk to them about their di­ets and sleep habits. Or, if a pa­tient whose tests were nor­mal still com­plained of fa­tigue, Raby says she would dig deeper to de­ter­mine the emo­tional, chem­i­cal and phys­i­o­log­i­cally fac­tors that could be con­tribut­ing.

As she be­came more con­vinced that her in­te­gra­tive ap­proach was re­sult­ing in pos­i­tive out­comes for pa­tients, Raby be­gan shar­ing her ideas with her col­leagues. At first, she says some physi­cians were skep­ti­cal, but Raby says she “kept push­ing it.”

“The fact that I did what I did in a teach­ing in­sti­tu­tion was a huge risk for me,” Raby says. “But the fact of the mat­ter was that I was able to have a con­ver­sa­tion with any doc­tor about Western medicine, so I got them to have con­ver­sa­tions with me about how krill oil or fish oil works.”

Raby’s per­sis­tence paid off, and in 1997 she was given the green light to launch the Cen­ter for In­te­gra­tive Medicine at North­west­ern Memo­rial Hospi­tal. As the med­i­cal di­rec­tor of the Cen­ter for In­te­gra­tive Medicine, Raby was able to more fully ex­plore the ways that al­ter­na­tive treat­ments can aug­ment tra­di­tional med­i­cal prac­tices. For ex­am­ple, she would rec­om­mend acupunc­ture be­fore and af­ter a woman un­der­went in vitro fer­til­iza­tion. She also spent time ed­u­cat­ing other doc­tors and res­i­dents about in­te­gra­tive medicine.

Dr. Dil­jeet Singh is a gy­ne­col­o­gist who spe­cial­izes in women’s can­cers. Singh worked at North­west­ern at the same time as Raby, and the two doc­tors would re­fer pa­tients to one an­other. “One of the big things I ap­pre­ci­ated about (Raby) is that she was very hands-on and in­di­vid­u­al­ized with her pa­tients,” Singh says. “Her pa­tients al­ways came to me pre­pared to see a can­cer spe­cial­ist.” Singh de­scribes Raby as hav­ing a “healer at­ti­tude.” She says Raby has a clear vi­sion about how health­care should fo­cus on the whole per­son.

Af­ter ded­i­cat­ing 12 years to build­ing the Cen­ter for In­te­gra­tive Medicine at North­west­ern, Raby de­cided to strike out on her own. In 2008, she founded the Raby In­sti­tute for In­te­gra­tive Medicine at North­west­ern. “I left the hospi­tal be­cause I knew I could do a lot more,” Raby says.

The Raby In­sti­tute be­gan in a small shared space across the street from North­west­ern Memo­rial. Raby was the sole health­care provider and she had just one pa­tient treat­ment room. But de­mand for her in­te­gra­tive style of med­i­cal care grew quickly.

In four years, Raby has turned her one-woman show into a thriv­ing med­i­cal prac­tice, which pro­vides pri­mary care, pe­di­atric and gy­ne­co­log­i­cal ser­vices. The Raby In­sti­tute now has 22 em­ploy­ees, in­clud­ing a natur­opath, acupunc­tur­ist, psy­chol­o­gist, en­ergy healer, mas­sage ther­a­pist, med­i­cal as­sis­tant, lab tech­ni­cian and three pa­tient ad­vo­cates. The in­sti­tute’s an­nual rev­enue has grown by more than 120 times as much as was made in its first year and is expected to ex­ceed $4 mil­lion this year.

The group prac­tices in a well-ap­pointed of­fice on Michi­gan Av­enue in Chicago, which fea­tures 14 pa­tient treat­ment rooms, a full lab, a con­fer­ence and teach­ing cen­ter and a re­tail store. In con­trast to the steril­ity of many med­i­cal of­fices, the Raby In­sti­tute is dec­o­rated in calm­ing col­ors, with soft lighting and sooth­ing mu­sic play­ing in the back­ground.

At the time Raby left the Cen­ter for In­te­gra­tive Medicine at North­west­ern, she had about 4,000 pa­tients. She says be­tween 70% and 80% of those pa­tients fol­lowed her to the Raby In­sti­tute, and at the be­gin­ning she was adding nearly 100 new pa­tients per month. Cur­rently, the Raby In­sti­tute has about 5,000 pa­tients. De­mand is so high that in June there was a three-month wait for new pa­tients to make ap­point­ments at the in­sti­tute.

At the cen­ter of her prac­tice is what Raby calls the “Raby In­te­gra­tive Med­i­cal Model.” Re­gard- less of the type of med­i­cal care they are seek­ing, ev­ery new pa­tient first spends an hour with Raby. “I re­view some stan­dard Western medicine mod­els, but I also fo­cus on herbs they might be tak­ing, who pre­scribed their med­i­ca­tions, al­ler­gies and surg­eries, fam­ily his­tory and so­cial his­tory,” Raby says.

Raby’s in­te­gra­tive ap­proach com­bines stan­dard med­i­cal test­ing with holis­tic eval­u­a­tions. For ex­am­ple, she says, if a pa­tient com­plains of chest pain, Raby or­ders an EKG, but also talks to the pa­tient about his or her en­ergy level, spir­i­tu­al­ity, ex­er­cise and emo­tional well-be­ing. Based on her ini­tial meet­ing with the pa­tient, Raby makes rec­om­men­da­tions for treat­ment. That could mean an ap­point­ment with one of her natur­opath doc­tors, a ses­sion with a clin­i­cal psy­chol­o­gist or a few rounds of acupunc­ture.

Af­ter Raby refers pa­tients to one of her col­leagues for treat­ment, she re­mains in­volved. She says all of her prac­ti­tion­ers are re­quired af­ter each ap­point­ment to make notes in pa­tients’ files, which Raby re­views and signs off on.

As peo­ple have em­braced Raby’s style of in­te­gra­tive medicine, her prac­tice’s prof­its have sky­rock­eted. Be­tween 2008 and 2011, net in­come in­creased more than sev­en­fold. The growth of Raby’s prac­tice has nat­u­rally brought with it some busi­ness chal­lenges, such as fig­ur­ing out the best ways to han­dle things like mar­ket­ing and billing. Raby says she man­ages her busi­ness by hir­ing highly qual­i­fied em­ploy­ees whose strengths com­ple­ment her own. “It’s about know­ing what I need and how it will bring pa­tients to the cen­ter and make the num­bers turn,” Raby says. “But I’m not here to make a whole bunch of money for me. I am bring­ing in peo­ple who are smart, the cream of crop, and they have to be prop­erly com­pen­sated.”

John Ruhl, a health­care mar­ket­ing vet­eran, joined the in­sti­tute in 2010 as the prac­tice man­ager. Ruhl says Raby has a clear vi­sion of what she wants her prac­tice to be and has hand­picked ev­ery­one who works for her—two fac­tors he be­lieves have con­trib­uted to her suc­cess. “Dr. Raby is an amaz­ing clin­i­cian, but she is also a very smart busi­ness­woman,” Ruhl says.

Hav­ing es­tab­lished a suc­cess­ful prac­tice based on her val­ues, Raby says her goal is to continue to in­crease aware­ness of in­te­gra­tive medicine—in Chicago and be­yond. “My whole phi­los­o­phy is that it would be won­der­ful if we got rid of term ‘in­te­gra­tive medicine’ and we just prac­ticed in­te­gra­tively in ev­ery hospi­tal and doc­tor’s of­fice,” she says. Meghan Streit is a free­lance writer in Chicago. Reach her at meghanstreit@gmail.com.

Dr. Theri Griego Raby founded the Chicagob­ased in­te­gra­tive-medicine in­sti­tute that bears her name in 2008.

Treat­ment ar­eas at the in­sti­tute in­clude rooms for acupunc­ture ther­apy.

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