December 2012 John Weeks Integrator Round-up covering the topics of:  Policy; Employers & Costs, Integrative Clinics & Services; Education;
Professions and Organizations and People

Yoga therapists publish guidelines for grand-parenting of providers as educational standards advance

The International Association for Yoga Therapists (IAYT) has published Emerging Guidelines for Grandparenting Yoga Therapists. Work on this document has been the primary focus of IAYT’s accreditation committee since IAYT’s adoption of the Educational Standards for the Training of Yoga Therapists earlier this year. The grand-parenting issues were engaged as part of “developing the process for accrediting yoga therapy training programs that meet these standards” according to the document. A cover note states that these presently focus on current students or on recent graduates of courses of 300 or more hours. A separate focus will be on grand-parenting “seasoned yoga therapists.”

Comment: As twin signs of emergence, in the present moment of time, both Yoga therapists and integrative medical doctors, via the American Board of Physician Specialists’ “time-limited eligibility option,” are each engaged in grand-parenting standards.


AHMA executive director Cadwell and the convergence of various integrative and holistic organizations

A November 13, 2012 report from Steve Cadwell, executive director of the American Holistic Medical Association notes that the organization picked up 79 new members during and around the annual course review and exam for the American Board of Integrative and Holistic Medicine (ABIHM). In the past two years, the numbers of new members AHMA gained via the meeting more than doubled that of the last two years. AHMA did not feature an educational conference of its own in 2012 so had its annual meeting at the San Diego gathering. Sixty AHMA members attended. Cadwell notets that past AHMA president Hal Blatman, MD is chair of the Integrative Medical Consortium  of which AHMA is one of six member organizations. Present AHMA president Molly Roberts, MD is slated to be his successor. Writes Cadwell: “The AHMA Board wants to help support ABIHM diplomates and AHMA members keep ‘holistic’ and the established Principles of Holistic Medical Practice in integrative medicine, especially as a new program is developed and transitioned into existence, the American Board of Integrative Medicine (ABOIM).”

Comment: Cadwell’s report offers a collision of the acronyms in integrative medicine: AHMA, ABIHM, IMC and ABOIM. Oh, he didn’t mention CAHCIM, but its with that organizations members that ABIHM is converging to create ABOIM. New alignments are being created as the new American Board of Integrative Medicine takes shape. Meantime, ABIHM is likely to feel a spike in interest in its waning years as the most direct way for medical doctors and osteopaths to meet the “time-limited eligibility optionotherwise known as grand-parenting. ABIHM makes this case on their website. AHMA remains the one membership, professional organization of the group. How will it frame or reframe its role as the field reaches the new level of recognition. Cadwell indicates that a focus will be on maintaining a philosophic grounding in holism.


Academic integrative medicine doctors reach out to support community medical doctors on legal issues

The chair of the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM), Ben Kligler, MD, MPH, has urged his fellow members to consider submitting their names to be on an “Integrative Medicine Expert Witness List.” Via the CAHCIM newsletter list, Kligler directed CAHCIM members to a letter from the multi-organization Integrative Medicine Consortium (IMC). The IMC letter asks interested integrative medicine parties to submit CVs and related materials to become part of a pool of potential consulting witnesses. These will “provide information allowing physicians under investigation and in need of expert review, and their attorneys, to locate these important resources.” The initiative is supported in this editorial from Molly Roberts, MD, president of the American Holistic Medical Association.

Comment: Legal issues have historically been a hot topic for the town-side of the town-and-gown mix that makes up the whole, sometimes acrimonious, integrative MD community. Organizations like the former American Preventive Medical Association, now the Alliance for Natural Health, have promoted legal defense of integrative physicians as a key purpose. In recent years, the townies tend to push the integrative clinical envelope beyond what the gown-side condones as an evidence-based boundary for clinical practice. If an expansive integrative MD in Wilkes-Barre or Sedona finds some local law enforcement after him or her, he or she just might like some ivory tower ju-ju weighing in on their behalf. So then you are a leader of a consortium of 51 medical schools that have programs in the kind of medicine practiced by my client? Here is a piece of timing that is interesting though I would guess utterly coincidental. The request from CAHCIM came shortly after one of the most disputed and lucrative townie therapies, chelation, saw its huge NIH trial come out positive.  


Obstetricians’ challenged on bad science in their effort to deny value of planned home births

The American Association of Obstetricians and Gynecologists has published a recent paper that warns mothers to stay away from home birth. The paper is entitled Planned Homebirth: The Professional Responsibility Response. The authors build a case against recent claims of safety, effectiveness, diminished adverse effects, and cost-effectiveness of planned home birth. They conclude: “We call on obstetricians, other concerned physicians, midwives and other obstetric providers, and their professional associations not to support planned home birth when there are safe and compassionate hospital-based alternatives and to advocate for a safe home-birth-like experience in the hospital.”

The work is countered by Bastyr University adjunct faculty member in the Department of Midwifery, Wendy Gordon, CPM, LM, MPH, in this blog posting at Science and Sensibility: A Research Blog on Healthy Pregnancy, Birth and Beyond.  Gordon argues that the AJOG article rests on an analysis that confounds planned home birth with unplanned out-of-hospital birth. She argues that the OBGYn team also use “several more poor-quality studies, as well as 52 citations of commentaries, opinions and anecdotes (some even pulled from the popular media) to build their ‘evidence’ basis.” Gordon ticks off 8 studies she views as high quality that the authors did not cite. Gordon refers back to the title the AJOG team gave to their piece in her conclusion: “’Professional responsibility’ demands that we examine and disclose our own personal, religious or anecdotal beliefs that may bias our interpretation and presentation of the research.” 

Comment: The obstetricians are behaving with the paranoia of Richard Nixon when he caused the Watergate break-in. Up more than 60% in the polls, Nixon urged his team to engage illegal activity to secure his re-election. The abuse of evidence by the obstetricians, and the sanction from their journal, in the pious name of professionalism, against this band of less than 2000 Certified Professional Midwives, should merit time in science’s slammer. Or at least time, to recall Nixon in the White House corridors at that time, on their knees pleading to the fore-parents of evidence-informed medicine to forgive them for their abuse of their office. Never mind that the OBs, through nurse midwives, had the same position before they were providing “safe and compassionate hospital-based alternatives.” Another look at the evidence, and the politics, is here: Homebirth Midwives and the Hospital Goliath: Evidence Builds for Disruptive Innovation. Nice work Ms. Gordon. 


Society for Integrative Oncology seeks new executive director

The first executive director of the Society for Integrative Oncology (SIO), Sarah Rausch, PhD, is stepping down after two years. The not-for-profit SIO’s mission is “to advance evidence-based, comprehensive, integrative healthcare to improve the lives of people affected by cancer. The organization was established in 2003 and currently has approximately 300 members from 40 states and 21 countries. Information about the position is available through clicking this link.


American Chiropractic Association “retracts” challenge to International Chiropractic Association on pediatrics program

The November 2012 Integrator Round-up reported a skirmish between the two feuding national chiropractic associations over a pediatrics specialty program. On November 27, 2012, the ACA published this statement: ACA Retracts Earlier Statement About the Safety of ICA Council on Pediatrics Certification Program. Said ACA president Keith Overland, DC: “We apologize that our Nov. 1 statement has been misunderstood by some, particularly on the important issue of public safety. It was not intended as a commentary on the quality of that program’s training or the level of competence of its diplomates who provide wonderful care to children. We also regret any inconvenience our earlier statement might have caused ICA leaders or diplomates in the ICACCP’s diplomate program.” Meetings between ACA and ICA leaders clarified two key points: membership in the ICA Pediatrics Council is not required to sit for the examination or to become re-certified, and ICA Pediatrics Council membership will continue to be required to participate in educational programs of the ICA Pediatrics Council. Bill O’Connell, ACA executive vice president commented: “We appreciate the ICA’s patience with ACA as we discuss this matter.”

Comment: Good to see this misunderstanding resolved and the cooperation between the two organizations continue in this area. In similar good news for those who would rather see this rift mended, ACA’s Overland made history in mid-November as the first ACA president to speak at Life University. Life is at the engine of the ICA branch of the profession. Overland reportedly pulled for unity, saying that the two organizations are aligned on 90% of issues. In a separate e-mail communication, the ICA’s Steve Welsh, DC notes: “Please be aware that the ICA has been working closely with the ACA through the Chiropractic Summit, along with about 35 other chiropractic organizations, in order to present a common message to federal policymakers.”


American Holistic Nurses Credentialing Corporation to provides two new certifications in 2013

Mary Brekke, PhD, RN, AHNC shares that the American Holistic Nurses Credentialing Corporation (AHNCC) will be offering two new certifications related to holistic nursing in 2013. One is a certification exam in nurse coaching. Those who are successful are awarded Nurse Coach, Board Certified (NC-BC) status if they are nurses with a minimum of a bachelors in nursing. Others currently certified by AHNCC who successfully pass the exam may be awarded the Health and Wellness Nurse Coach, Board Certified (HWNC-BC). Brekke notes that the “eligibility criteria during the phase-in period, which lasts until March 31, 2013, differ from those required effective April 1, 2013.” In addition, following requests, AHNCC will begin offering a new Advanced Practice Holistic Nurse Certification Exam for nurses who are licensed as APRN and wish to be certified as an APHN-BC, APRN.  The latter is “designed to test knowledge and skills in Advanced Holistic Nursing including the APRN Prescriptive Authority competencies surveyed in the 2012 Role-Delineation study.  

Comment: The nurses may get the award for the most contributions to the hieroglyphics of acronyms that mark the pathway of integrative health maturation.