August 2012 John Weeks Integrator Round-up on current Research

Neuroscientist Bushnell appointed scientific director for NCCAM’s Division of Intramural Research

The NIH National Center for Complementary and Alternative Medicine has appointed M. Katherine Bushnell, PhD, as the new scientific director of the Division of Intramural Research. Bushnell will lead an NIH-wide pain initiative. Bushnell is a distinguished, conventional pain researcher with multiple honors. These include Lifetime Achievement Award from the Canadian Pain Society and the Frederick Kerr Basic Science Research Award from the American Pain Society. Her interests are “forebrain mechanisms of pain processing, psychological modulation of pain, and neural alternations in chronic pain patients.”

An examination of Bushnell’s CV finds over 100 publications and numerous awards. Nothing is directly related to complementary, alternative or integrative medicine. In a comment on the appointment, NCCAM director Josephine Briggs, MD states: “Under [Bushnell’s] leadership, this program will continue to work toward the development of better ways to safely and more effectively treat chronic pain, and advance research on the intersection and integration of pharmacological and non-pharmacological approaches.” 

Comment: One positive sign in the NCCAM’s ongoing practice of hiring leaders with no direct experience with the modalities, systems and disciplines NCCAM was charged to explore is Bushnell’s training as a psychologist. That’s better than a straight, bench, mechanism researcher.

Yet think of the missed opportunity here. Imagine the NCCAM research product if We the People had hired a health services researcher whose experience reflected work in integrative pain delivery and the patient-centered and payer interest in outcomes such as satisfaction, functionality, and cost. Why not choose someone squarely experienced in these “non-pharmacological approaches”?

Instead, NCCAM appears to be serving its usual masters: mechanism and the NIH hierarchy that cares about it. NCCAM likely views this appointment as a coup to have this NIH-wide pain initiative inside the NCCAM. That’s probably useful, given the assaults on NCCAM’s worth from within and without. But other than that political move, would someone please share why this clearly top-flight individual belongs in NCCAM rather than somewhere else in the NIH? Bushnell seems to be hardly the best appointment to support either the IOM pain “blueprint” that promotes an integrative pain strategy or the move in research toward patient-centered outcomes. Is it too much to expect that NCCAM might actually advance research into the strengths and uniqueness of multimodality integrative treatment?   

 

Group Health researcher Dan Cherkin, PhD in joint appointment as Bastyr research director

In a joint release on July 16, 2012, Bastyr University and the Group Health Research Institute announced that one of the leading researchers in complementary and alternative medicine, Daniel Cherkin, PhD will become director of Bastyr University Research Institute (BURI). According to the release, Cherkin, who is currently a senior investigator for Group Health Research Institute (GHRI), will continue to have a joint appointment at GHRI. There, he will “continue his current research projects in complementary and alternative approaches to back pain.” Cherkin has strong ties to Bastyr University going back to 1981, when he served as an instructor, and leading up to a co-authored study with Bastyr researchers about the positive effects integrative care can have on diabetes patients. Cherkin, a past program director of the most significant international research conference in complementary and integrative medicine, recently was appointed to a term on the NIH NCCAM. 

Comment: This is an exciting appointment. Cherkin has worked closely with Bastyr’s growing cadre of top quality researchers like Ryan Bradley, ND, MPH and Erica Oberg, ND, MPH.  The move essentially gives Bastyr two NIH NCCAM advisory council appointees, as Bastyr’s dean for naturopathic medicine, Jane Guiltinan, ND, has the one slot held by a naturopathic doctor. The appointment puts Cherkin squarely between one of the top HMO research institutes and one of the two most significant CAM research centers. According to an analysis by the Academic Consortium for Complementary and Alternative Health Care, as of early 2011, Bastyr had received nearly a third of all NCCAM grants to “CAM” institutions. (See ACCAHC reports that CAM schools received just 4.6% of NCCAM’s $1.29-billion between 1999-2010.) Expect good things from this move. 

 

Naturopathic and chiropractic researchers top 2012 awards from Canadian CAM Research Fund (CCRF)

The Canadian network for CAM research has announced winners of the 2012 Canadian CAM Research Funds grants competition. Notably, the 5 winners include 4 who are from the chiropractic and naturopathic medicine professions or institutions linked to them. Two went to researchers associated with the Ottawa Integrative Cancer Center, a project of the Canadian College of Naturopathic Medicine (CCNM): Dugald Seely, ND, MSc and Laura Weeks, PhD. Seely is undertaking an-of-1 study of homeopathic treatment of fatigue in patients receiving chemotherapy and Weeks a “Participatory, Formative Evaluation of Practitioner Integration at the Ottawa Integrative Cancer Centre.” Also at CCNM,Deborah Kennedy, ND, MBA, was an awardee for a study called: The Diagnostic Predictability of Food Allergy Testing in Individuals with Irritable Bowel Syndrome (IBS): A Comparison between various laboratory methods and an elimination diet (The FAST Study).

The fourth awarded study is from chiropractor Jeffrey Scholten, BSc, DC: “Moving towards evidence informed practice: Evaluating the feasibility of using online software to collect patient information for a practice based research network.” Scholten’s work is via the University of Calgary. The fifth award went to Cary Brown, PhD at the University of Alberta for a pilot study of self-shiatsu hand massage “as an intervention to promote sleep efficiency in persons with chronic pain.” 

Comment: These Canadian awards are an interesting juxtaposition to the NIH NCCAM appointment immediately above. The Canadian awards in a nation where the health system has a strong socialized component at is base, are all clinically focused on the kinds of things directly meaningful to people in integrative practice. The NIH appointment into a system hell-bent on protecting its for-profit nature, remains a few orders of magnitude removed from the real world.