In 2011, Denise Millstine completed the Integrative Medicine Fellowship at the University of Arizona Andrew Weil Center for Integrative Medicine. She went on to expand the integrative medicine section at the Mayo Clinic. Now, she returns to her alma mater to move her mission from institutional to systems-change.

What doctor prescribes a book?

Denise Millstine, MD’s patient was facing breast cancer and appeared, outwardly, perfectly healthy. She had come to Millstine for an integrative medicine consultation. Having already undergone endocrine and targeted therapies, her care plan included chemotherapy, oncology acupuncture, a nutrition plan, and a daily guided imagery practice. 

The patient had a great marriage. A wonderful partner. A close friend group. Parents who called every day. The problem was that none of them could talk about the fact that she was dying. In a typical exam room, this might look like a note on a chart. Maybe a referral to a counselor. Millstine attends to both — and then reaches for her bookshelf. She pulls down a copy of Nina Riggs's memoir, The Bright Hour, a beautifully crafted account of living with terminal metastatic breast cancer. Written with wit and unflinching clarity, it is the story of a woman who refused to be reduced to her diagnosis. Millstine hands her patient the book and suggests her loved ones read it.

The patient wrote Millstine soon after. She and her mother had read the book. They had talked —  about breast cancer and about the woman in the book who was dying. Riggs was living something close to what they were both living. The patient and those closest with her were finally able to talk about the possibility of her death. 

Millstine reflects on the distance between what patients experience and what the people around them — including their physicians — know how to name. “When someone is going through a disease, they may want to read a textbook or instructional nonfiction book about it. But reading about someone in a story having a similar experience to yours or someone you care about means understanding better what the whole experience could be like in the context of a person or character’s life.” she says.”

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Millstine, an internal medicine physician, was working at a 607-bed nonprofit hospital when she was named a University of Arizona Integrative Medicine Fellow. The fellowship was not a detour from internal medicine but a deliberate search for tools that conventional training alone had inadequately provided. She completed the fellowship while practicing medicine and training residents. What she learned was not a replacement for what she already knew, but a new lens — one that made patients partners and her own wellbeing a priority.

Millstine, once a Chief Resident, knows all too well what burnout looks like in medicine. It is not something that can be solved with a vacation. The multidimensional fatigue that comes with being a healer in modern healthcare feels like a slow tide, quiet and systemic, with no clear point of origin. Physician wellness is among her professional interests. She credits the Integrative Medicine Fellowship with giving her the toolkit she needed, especially with a rising career in medicine.

In 2013, Millstine joined Mayo Clinic, ranked the world’s best hospital, specializing in women’s health and leading the integrative medicine section. The significance of what she built there is a testimony for the field. Mayo Clinic is one of the country's most evidence-driven medical institutions. Integrative medicine didn't reach Mayo Clinic by sentiment. It arrived because physicians like Millstine built the evidence for it.

She directed some of  Mayo’s continuing medical education programs and was the medical director for  the Mayo Clinic Press Women’s Health channel. She created the Read. Talk. Grow. podcast, which brings authors and medical experts together to examine health through fiction, memoir, and narrative nonfiction — miscarriage through a novel, menopause and through a thriller, benzodiazepine dependency through memoir, racism in medicine through investigative nonfiction. She served as medical director of the Office of Joy and Well-being.

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Millstine says, “We live our lives in stories. As a physician, my job is to make space for patients to share and for me to hear these stories to better understand what they are experiencing.” This may sound like a philosophy, but beneath its warmth lies a structural argument: medicine organized  around the presenting complaint overlooks  details that might determine how well a person recovers.

The power of writing is thematic to Millstine’s medicine journey. She wrote an article about how worried one should be after calcifications are found on mammograms for the Mayo Clinic Press Women’s Health channel that reached more than 29,000 readers in its first year. Millstine was struck by that number. It would take over a career to convey that message to the same number of patients. The reach of this channel extended far beyond the confines of her clinical work one-on-one with patients. 

Now, as associate director of the Fellowship, she returns to the place where she deepened her understanding that caring for a patient means recognizing both the science of disease and their story.

For Stephen Dahmer, MD, AWCIM’s director, the appointment carries real significance. “Dr. Millstine consistently sees the unique person within each patient.  In modern clinical care this is a true challenge to sustain,” Dahmer said. “She brings depth, rigor, and connection to every aspect of integrative practice, and has been able to translate that intro training others. We’re very  fortunate to have her as part of our core faculty.

Beyond Dahmer's endorsement, her appointment signals something about the fellowship's purpose. The AWCIM Fellowship was built on a hypothesis: that physicians trained in whole-person care, with sufficient depth and rigor, at any stage of their career, would carry integrative medicine back to their institutions and communities — and, over time, change the system from within. A tough sell in 1994 when the fellowship launched, it remained a leap of faith when Millstine enrolled in 2009. Today, though there are still misconceptions about the field of integrative medicine to overcome, the fellowship she now co-leads is growing.

Millstine stands as one of the most visible proofs of this concept — a practicing internal medicine physician who completed the training, brought it to one of the most exacting environments in American medicine, and demonstrated its effect on patient outcomes. Now she stands on the other side of the equation. No longer the fellow, but the faculty. No longer the one receiving instruction, but the one designing direction.

“When I trained in integrative medicine, it seemed different from the more typical medicine I was seeing practiced around me. Over the years, we’ve realized that a whole person, integrative approach to patients is simply good medicine. The system, however, doesn’t always make space for this holistic approach, so my hope is that training fellows to be efficient and effective in this type of care will broaden its reach and impact.”

Alumni of the program tend to agree.

The integrative practitioner is a catalyst. Colleagues notice a shift, not only in patients but also in practice. Like Millstine, integrative medicine training may change the way clinicians view and prioritize their own wellbeing. When asked the cause, many say, 'It all started with the Fellowship,' leading into tales of online module intensives, a clinical mentorship, a cross-country collective of likeminded colleagues, and the unforgettable week-long educational retreats in the Arizona desert.

The University of Arizona's online Integrative Medicine Fellowship behaves almost like a positive social contagion. One physician changes, then their practice, then the system.

A practitioner's transformation begins in the first month of the Integrative Medicine Fellowship. Fellows report what feels like a two-year metamorphosis. Less burnout, more joy. A sense of community. A renewed connection to their profession.

The fellowship builds on what physicians already know. Medical school, residency, specialty training — all of it remains. What changes is the frame around it: a whole-person approach that positions patients not as a disease to be treated or a set of symptoms to be managed, but as a person with a life that medicine needs to understand and can help heal. 

The integrative practitioner uses a technique called motivational interviewing to go beyond what’s the matter with their patient, to discover what matters to them, using that information to put together a personalized care plan. They get curious. Ask open-ended questions. Create space for story. They pull patients in, for their opinions much like they would colleagues, “What do you think of this plan?”

They start to identify less with desktop medicine and more so as healers. They work within a continuum of care, referring patients to acupuncturists, nutritionists, dieticians, tai chi videos on YouTube, guided imagery playlists on Spotify, or the farmers' market armed with a shopping list and a strategy. 

The integrative medicine fellowship is a return to healing. 

Millstine has already completed this arc. Now she returns to work at the level of the training itself, shaping what the next generation of integrative medicine practitioners will learn, how they will learn it, and what they will carry back into the communities that await them. 

Somewhere, a patient with an unfathomable diagnosis sits across from a physician who has not yet learned which questions to ask, which complementary practice will empower, which words will heal, which book to offer. Millstine’s purpose is to help train that physician. In the end, that is what she has come home to do.

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Denise Millstine, MD, is associate director of the Fellowship at the University of Arizona Andrew Weil Center for Integrative Medicine. Learn more at https://awcim.arizona.edu/healthhub/news.html