512 Historical Summit on Integrative Medicine planning committee for the conference was the eminent Ralph Snyderman, Chancellor Emeritus, Duke University. Perhaps most impressive of all was the audience itself who consisted of many health and medical experts who often serve as keynoters at health conferences, including Jeffrey Bland, Jon Kabat-Zinn, Larry Dossey, Woodson Merrill and Wayne Jonas, as well as dozens of professors of medicines who teach at leading medical schools, nat- uropathic, nursing, acupuncture and chiropractic colleges. The Presentations Harvey Fineberg, the president of the IOM, welcomed attendees and acknowledged that integrative medicine is a bit like a Rorschach blot test because it meaning seems so varied. Ralph Snyderman gave the opening address expressed concern about the state of medicine today. He asserted, ‘no other industry holds its customers in such high dis- regard, except perhaps the airline industry’. He described health care today as uncoordinated, disease-oriented, reactive, physician-directed, not personalized or safe, and extremely expensive. Snyderman expressed his strong appreciation for modern medical science, but he humbly acknowledged that most drugs and technologies have not been proven efficacious and that at best it may only impact 25% of modern health concerns. Reed Tuckson, who represents one of the large HMOs, warned attendees that we all may want health care reform, but whatever changes we want must have evi- dence of benefit. He urged scientific inquiry as well as evaluation of demonstration projects. He, however, also noted that ‘the enemy of the good is the perfect’, and we cannot wait until all of the evidence is in or that there is wide consensus before we begin to make serious changes. Tuckson also reminded the audience that virtually every patient wants every treatment that they receive to be covered by their insurance, and yet, third party payers will always insist upon seeing ‘evidence’ of benefit before allowing coverage. This requirement is not only reasonable but also necessary, and yet, later discussion noted the great number of conventional medical interven- tions that are both very expensive and do not have adequate evidence of benefit. Kenneth Pelletier echoed a similar viewpoint by assert- ing, ‘trust in God, but everyone else must present data’. Pelletier noted that we may not necessarily need new monies in health care but just better allocation of present resources. Because so many high-tech methods presently used have not yet been proven efficacious, there are great savings to be obtained by no longer providing reimburse- ment for questionably effective (and expensive) health interventions. Pelletier has served as a consultant to many major American corporations who have developed various disease prevention and health promotion programs for their employees. He noted that 62 of 63 studies of cost-effectiveness, cost benefit and return on investment have shown positive results (1). According to his review of this research, a return on investment for health programs usually takes only 3.25 years. Furthermore, evidence-based return on investment ranges from $3.50 to $4.90 for every $1.00 invested. Bill George, a professor of Business Management at Harvard Business School, was the CEO, President and Chairman of the Board at Medtronic, Inc., the largest medical technology company in the world that began by creating heart pacemakers. His wife, Penny George, was past President of the Bravewell Collaboration, co-sponsor of this Summit, and the George Family Foundation has been a leading supporter of many Bravewell efforts. Bill George spoke about his personal experience at Medtronic during his presentation. He insisted that it was important for employers to reward good healthy behaviors rather than punish bad ones. He noted that his company gave employees $50/month ($600/year) for complying with some healthy behaviours. He also noted that a gym is not a perk of an office but is a necessary component of it. The Most Powerful Presentation Dean Ornish made what many attendees considered to be the most powerful presentation of the summit, as was evidenced by the largest number of people in attendance giving him a standing ovation for a prolonged period of time. He described his and many others research that showed significant changes in the health status of people suffering from many of the leading causes of mor- tality in the USA. Ornish’s own research has shown that significant changes in dietary and exercise were sub- stantially effective in improving health status in people suffering from cardiovascular disease and prostate cancer. Furthermore, he noted that the minor dietary and exercise recommendations of the American Heart Association and the National Cancer Society were simply inadequate to create significant positive results, thereby leading to poor compliance due to the small health improvements. Ornish noted that the World Health Organization ranked the US health care system in 2000 first in both responsiveness and expenditure, but 37th in overall per- formance (2). This ranking suggests that simply spending more money on what we are doing now or making minor changes in health reform will not provide the real improvements that Americans want and need today. Ornish also made reference to one study in which curcu- min (an active ingredient in the herb, turmeric) was found to have 2000% increase in bioavailability and therefore significant better health benefits when used with a type of pepper used in curries. Ornish sought to