Gynecology clinic offers new approach

JOHNSON -- A new gynecology clinic has a different approach that health care patients can expect to see more frequently, doctors say.

The Washington Regional Integrative Gynecology Clinic opened this month in Johnson. Dr. Kristin Markell, the clinic's sole gynecologist, recently completed a two-year fellowship in integrative medicine. She said integrative medicine focuses on patients' overall health and well-being and involves a combination of conventional or westernized medicine and alternative medicine.

Patients traditionally go to gynecology clinics for annual exams and specific gynecology-related issues. Markell said new patients may come to the integrative clinic for six appointments over the course of a few months so she and the patients can take an in-depth analysis to evaluate their health and create individualized health plans.

"We're talking about every little tool that we can use to support the patient, and each patient is going to be different because not everyone has the same life and not everyone has the same health goals," she said.

Markell said she and the patients discuss everything from nutrition and exercise habits to lifestyle, sleep and stress levels. She may make nontraditional recommendations such as yoga or meditation and may recommend specific nutrition or exercise plans.

Consultations also typically involve lab work to learn whether hormones are balanced. The goal is to focus on the patients' overall health, not necessarily only their gynecological needs.

Patients sit with the doctor in her office during their first visit, rather than an exam table.

She asks patients questions such as "What's going on with your life? Where do you want to be? What brings you joy?"

Integrative medicine is not specific to gynecology. Markell was a gynecologist at Washington Regional's HerHealth clinic in Fayetteville for about 10 years. She simultaneously completed an online fellowship focusing on integrative health from 2017-2019.

Dr. Jeanne Wei of the University of Arkansas for Medical Sciences said she expects integrative health to become more prevalent as nonconventional methods become more widely accepted and wanted, especially in light of the opioid epidemic.

"It started on both coasts. Because we're in the Midwest, it usually takes a little while to come to us. You're going to see more of it in Fayetteville, Springdale, Bentonville -- that whole area," she said.

Doctors who treat geriatric patients at Northwest Health, which has five hospitals in Northwest Arkansas, particularly take an integrative approach, said Beth Wright, spokeswoman for Northwest Health.

Wei said the approach takes into account that patients' mental, emotional and physical health are connected. What is the difference between physiological health an physical health? A doctor who practices with an integrative approach may focus on nutrition and exercise as preventive health care and recommend alternative therapies such as massage, mindfulness, acupuncture, hypnosis, art, dance or gardening before resorting to prescription medication, she said.

Arkansas had the second-highest rate of opioid prescriptions in the United States in 2018, according to the federal Centers for Disease Control and Prevention. The state had 93.5 opioid prescriptions per 100 people, compared to the national average of 51.8 prescriptions per 100 people.

"We are very ready to have other modalities of therapy," Wei said.

The approach also acknowledges the body's systems are connected and treating one system, such as the cardiovascular system, may affect other parts of the body, Wei said.

Markell said the clinic offers conventional methods of treatment, such as birth control pills, but the integrative approach treats common gynecological issues such as fertility, pregnancy prevention and changes in menstruation in a more holistic manner.

For example, some birth control pills can cause patients to be deficient in certain vitamins. Markell may recommend supplements in that case. Underlying problems, such as stress, can cause changes in menstruation, so she may discuss stress management with patients.