James Maskell’s “The Community Cure” – A Terrific Contribution re: Loneliness, Group Services, and Fundamental Transformation

Health creation. Transformation. From reactivity to well-being. Empowerment. From system-centered to person-centered. Using the least force. Changing the therapeutic order of the nation. These aspirations warm and power the integrative health movement, dreams on the long march for radical re-direction of a $3.5-trillion industry. Yet how often do change prescriptions meet the radical requirements of the dreams? Acupuncture in Medicare doesn’t do it. Nor non-pharma into chronic pain guidelines. In The Community Cure: Transforming Health Outcomes Together, Evolution of Medicine impresario James Maskell offers a re-framework that seeks to rise to the task. Maskell grounds his “cure” in group services models through which the medium is the message for a population crippled by loneliness.

Maskell begins the book with six quotes of advanced praise for the book. After dialoguing on groups with him and downloading 25 years of accumulated evidence and excitement about their fit with integrative values, Maskell gave me an opportunity to write one. I honored smart directions he has taken his robust, international, functional medicine-promoting The Evolution of Medicine. (Early on I joined him for a short-lived news show with his now-deceased co-founder Gabe Hoffman.) I shared how Maskell has “shown a penchant for focusing the integrative and functional medicine communities on the most important work ahead. He’s taken on issues related to necessary efficiencies in care delivery—to keep integrative and functional practice costs down— and to blue zones and the massive influence of determinants of health.”

The integrative field benefits from focusing on the of these themes Maskell continues to highlight. I then shared my view that with The Community Cure and his elevation of the epidemic of loneliness and the multiform group services solution he has made it a trifecta:

Groups make the most sense for delivering the mind-and-body integrative interventions for lifestyle change. They are a goldmine for cost saving in an industry that has been wanton in its consumption of resources. And they go straight to resolving the critical access issues that keep less resourced people from the benefits of integrative care. It helps too, that the evidence on how adults like to learn, change, and transform is in interactive, group environments.

Maskell takes the exploration of the potential roles for group services in the Community Cure into into intriguing directions. He begins with the horrible loneliness and isolation that is associated with so much morbidity and mortality. Group is medicine. The reader-friendly journey — large type, argument pearled with stories – continues with addressing doubters. He makes the case via short profiles of pioneers in various ways in this model of delivery: integrative group leaders like clinician Jeffrey Geller, MD, PCORI-funded researcher Paula Gardiner, MD, MPH, Cleveland Clinic’s Tawny Jones and the underserved focus of Mikhail Kogan, MD.  Maskell moves back in time to share the group basis of the work of Dean Ornish, MD‘s heart disease reversal program and the addressing of trauma in international hot-spots by James Gordon, MD. Among others are Shilpa Saxena, MD who developed the Lifestyle Matrix Resource that supported Maskell’s excellent ongoing series of now 12 group visit interviews that informed the book.

The Community Cure moves from the sublime to the useful and mundane. Maskell’s interest in providing models for practice success that shaped Evolution of Medicine’s kick-off is in evidence here as a step-wise plan for clinicians to build group in their practices in ways that fit their unique circumstances and payment models. The book is an unusual mix of education, motivation, and how-to. At times it is thin yet still a comfortable, breezy and inspiring read. He quietly leads the reader across the whole translational mix, from research to implementation and payment. I was pleased to see his reference to the work with which I was engaged with Gardiner, Geller and others for the July 2019 JACM Special Focus Issue on Innovation in Group-Delivered Services.

I find myself with one gripe that diminishes the book. At times the narrative moves abruptly into promotion of one or more of the initiatives with which Maskell is involved with Evolution of Medicine, either as a direct money-maker – notably his business’s Practice Accelerator –  or indirectly, a product or service of a present or past sponsors that fueled EvoMed’s business model (such as Lifestyle Matrix Resource). Perhaps my recent work examining conflict of interest concerns for integrative and functional medicine via the Accreditation Council for Continuing Medical Education has heightened my consciousness of blurring the lines. A part of Maskell’s work is as promoter and business developer. While no rules prohibit mashing together of business with educational content in a book such as this, I would have preferred that the lines and interests were more transparently acknowledged.

That stated, this is a book that wants to make a difference and I hope it does. Starting with loneliness was just right. Where is meaning and motivation in isolation? The arc of separation that needs addressing runs from the breakdown of connection via church, political party, and unions a half century ago to the force forces of faux communities in virtual life of gaming or social media. One might say the arc goes back to Descartes or earlier, in concepts of human against nature. Desire to live, and to live a healthy life, motivates change processes. Nothing connects to such desires and motivation more than the love, affection, and satisfying connection with others. Maskell concludes by exploring groups in the context of the naturopathic therapeutic order, a pyramid that he reframes into a “5 Cs” series of overlapping circles.

Given opportunities last year to address the mainly medical doctor leaders of the Academic Consortium for Integrative Medicine and Health and later a “Conversation for the Future of Naturopathic Medicine”, I urged each to lead in putting group at the center of care. Hard work, while absolutely on mission. The alignment with integrative values is profound. Why would a move from reaction to disease toward creation of health not look under every clinical and community stone for ways to interlink people on our collective journeys to health, for ourselves and the planet? The Community Cure is a fine and important contribution.

Note: Kindle version of The Community Cure is available for $0.99 and the book for $15.99 via Mr. Bezos.


John Weeks
In May 2016, he accepted an invitation to serve as the editor-in-chief of the Journal of Alternative and Complementary Medicine. Since mid-2015, John has re-focused his work on presenting, teaching and mentoring. He has keynoted, led plenary sessions, breakouts and offered guest lectures for dozens of organizations. These range from the Association of American Medical Colleges and Harvard University to Bastyr University and American College of Traditional Chinese Medicine; the UCLA School of Medicine to the Institute for Health and Productivity Management and Palmer College of Chiropractic; from the International Congress for Research on Integrative Medicine and Health to the American Hospital Association and the Midwives Alliance of North America. He has consulted with insurers, employers, professional organizations, universities, and government agencies at all levels. As an organizer, Weeks convened the Integrative Medicine Industry Leadership Summits (2000-2002), directed the National Education Dialogue to Advance Integrated Care (2004-2006), fund-raised the start-up and was on the founding steering committee of the Integrated Healthcare Policy Consortium (2002-). He co-founded the Academic Collaborative for Integrative Health, which he directed 2007-2015, and was on the founding board of the Academy of Integrative Health and Medicine. In 2014, three consortia and others combined to grant him a Lifetime Achievement Living Tribute Award. Four academic institutions have granted Weeks honorary doctorates for his work. Seattle-based, he considers himself a particularly lucky soul to have worked remotely while living with his spouse Jeana Kimball, ND, MPH, and their children in Costa Rica, Nicaragua and Puerto Rico for 6 of the last 15 years. For more with John Weeks, follow his Integrator Blog.