LOUISVILLE For Deborah Ann Ballard, MD, MPH, “Lifestyle is medicine.” With this philosophy in mind, Ballard, who is credentialed in internal medicine and integrative medicine and holds a Master’s in Public Health, opened Holiwell (pronounced wholly well) Health in June of 2017. This integrative medicine practice is located in Louisville, Kentucky in the St. Matthews neighborhood. Among many other holistic features, the practice houses a teaching kitchen where clients can learn how to prepare healthy food from a gourmet chef. The staff of integrative medicine providers at Holiwell Health includes a family and marriage therapist, a wellness chef, an Asian medical practitioner, a massage therapist, a health coach, a dietitian, a Pilates instructor, and a yoga instructor. The collective focus is on healing body, mind, and spirit.
When asked to define integrative medicine and her mission for her practice, Ballard gives the definition offered by the Academic Consortium for Integrative Medicine and Health: “Integrative medicine and health reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic and lifestyle approaches, healthcare professionals and disciplines to achieve optimal health and healing.”
Ballard’s increasing focus on integrative therapies and lifestyle medicine parallels the arc of her career. Initially, Ballard specialized in internal medicine, completing her residency and graduating from the University of Louisville in 1991. Following, she established her own practice in Bardstown, Kentucky as part of Bardstown Primary Care that also included Physicians to Children and Family Medical Center. After 11 years at the Bardstown primary care office, Ballard spent six years practicing endocrinology, exclusively, and doing research for the pharmaceutical industry.
It was there that her interest in integrative medicine was piqued. “I was treating people with chronic diseases that were mostly lifestyle induced, such as diabetes, hypertension, and obesity,” says Ballard. “I became very discouraged at seeing patients who had these great sacks full of drugs and although I could temporarily make the numbers look better with more medications, I did not make them well. I was horrified at the outrageous cost and side effects of the drugs, and the many hoops I had to jump through to get these drugs approved by insurance companies. But the most disappointing reality was the patients were still obese, tired, depressed, and often in pain. I observed that if patients made the lifestyle changes, they got better. I decided then that I wanted to work more on lifestyle medicine and prevention and wellness.”
The Journey to Integrative Medicine
When she left the endocrinology practice in 2006 and went to work for Norton Cancer Institute in their prevention program, Ballard focused more on early detection, prevention, and wellness. According to Ballard, during that time, the Norton cancer prevention program had been undergoing an evolution and moving from cancer prevention only to a broader approach. Concurrently, Ballard obtained her Master’s in Public Health degree from The University of Kentucky.
“There is a huge overlap between public health strategies and integrative medicine because both look at the root causes of chronic disease,” states Ballard. “Most chronic diseases are related to how people live their lives — their diet, physical activity, sleep patterns, exposure to environmental toxins, and the stress accumulated over the course of their lives due to adverse childhood experiences, low socio-economic status, social injustice, lack of sense of purpose, loneliness, and unhappy relationships. It is a huge task to address all those issues for patients, but it is necessary if we want to make people well.”
In 2011, Ballard was invited by members of The Kentuckiana Holistic Nurses Association to attend an integrative medicine Continuing Medical Education (CME) conference in San Diego, where she met Dr. Mimi Guarneri, one of leading physicians in the integrative medicine field. Ballard says, “I remember when I got there I thought, ‘Wow I have found my tribe.’ These doctors were enthusiastic and happy, and didn’t look worn down or discouraged by practicing medicine. They seemed to have a lot of joy in what they were doing.”
When Norton’s prevention department was reconfigured, it was time for Ballard to seek a new venture. Then, she got a call from a recruiter to join the new Healthy Lifestyle Centers that had been created by the KentuckyOne Health system. Ballard worked for KentuckyOne Health as medical director of the healthy lifestyles centers and co-director of the Ornish Reversal program, an advanced cardiac rehabilitation program proven to reverse coronary artery disease.
Always very dedicated to learning, Ballard took the next step by participating in an intensive, year-long Leadership in Integrative Medicine training program through Duke University as one of the inaugural class of 36 students. Upon its completion, she decided the time had come to realize her dream and build her own clinic. So, when KentuckyOne Health made the decision to sell its properties and leave the Louisville market, Ballard was ready. She founded Holiwell Health and DABIM (Deborah Ann Ballard Integrative Medicine), which now offers a full slate of services combining the best of evidence-informed medicine from allopathic (traditional western medicine), integrative medicine, and functional medicine.
The Solo Practice
Ballard’s mission for the clinic is to give patients the tools to help them create a healthy lifestyle for themselves. “The questions are always the same. How are you eating? Are you getting exercise? Are you controlling stress? Do you have a sense of purpose or meaning in your life? Are you avoiding toxins like tobacco, excessive alcohol or drugs?
Sometimes, I call myself Dr. Obvious. For example, patients routinely come in with a complaint of chronic fatigue or pain. I find out they persistently sleep only 4-5 hours per night, or they are under huge amounts of stress from a miserable marriage or overwork. No wonder they are tired and in pain. Of course, I order the appropriate diagnostic studies, but many times, the cause is an inherently unhealthy and unhappy lifestyle. I empower my patients with strategies to change that lifestyle and feel well,” Ballard says.
Ballard encourages patients to review the ample evidence that integrative medicine and lifestyle factors are the key to wellness. Research has consistently shown that common chronic conditions such as type 2 diabetes, hypertension, coronary artery disease, and many others, can be reversed with proper diet and nutritional support, physical activity, stress reduction, and toxin avoidance. “Type 2 diabetes is an epidemic in our country and a classic example of a disease that is mostly lifestyle-induced. Helping people understand that—that you can change the way you eat and move and lower stress— and you can reverse an expensive, serious chronic disease. It’s a very hopeful message.”
As both an internal medicine physician and integrative medicine specialist, Ballard’s feet rest in both worlds. “Traditional Western medicine has its role and can be helpful and lifesaving,” she says. “But integrative medicine is about answering those needs for people with chronic conditions that traditional medicine just doesn’t address very well.”
She points to chronic pain, and the recent epidemic of narcotic addiction as a classic example. “The fact is we’ve prescribed medications to people and they don’t work very well, and now we have a lot of people addicted to pain medicine and not functioning well. It’s about learning how to thrive despite having a chronic condition. That is what we try to give people in integrative medicine.”
A major flaw with traditional Western medicine is that there’s a ‘pill for every ill,’ says Ballard. “Look at the outcomes for traditional Western medicine, for example, hypertension. It’s well known that very few patients get to gain control of their high blood pressure with traditional drugs. With holistic care, we’re doing as well or better in those realms and the patients feel better.”
As an integrative medicine specialist, Ballard believes it’s a false paradigm to try to treat the body without treating the mind and spirit, too. “The idea of holistic care is about a whole lot more than ‘Oh, you offer some acupuncture,’ it’s really about the whole health care system, the way we live our lives, the choices we make about everything from food to activity to how we think.” Ballard recommends healing practices such as acupuncture, massage therapy, and herbal medicine as non-pharmaceutical, non-surgical approaches to chronic pain, fatigue, and other common ailments.
According to Ballard, emotional health is a vital facet of holistic health. “It goes back to, ‘Do you have a sense of purpose in your life? Why are you here?’ That’s why we have a mental health practitioner and a health coach here. Attitude is key to getting well.”
Since, as in most medical practices, Ballard’s patients are predominantly women, she hopes to launch a new comprehensive program, “Healing Her,” in late January or early February 2018.
Ballard explains, “Many women reach their 40s or 50s with broken bodies and spirits because of the stress they’ve endured over the course of their lives. By addressing the components holistically, we can help them heal. Optimizing nutrition, getting them moving in a way that suits their own body, avoiding toxins like smoking and junk food, sleeping well, and reconnecting with people who love them and with their purpose in life. All this reduces stress, supports the immune system, and promotes healing. I often tell my patients that I want them to have an MPH, a Master of Personal Health. ‘Healing Her’ is a program to help them become masters of their personal health and thrive with joy and renewed sense of purpose and meaning. Empowering patients to thrive is my mission at Holiwell Health.”