A monthly round-up of the latest news, events and topics in integrative healthcare policy from John Weeks.
“May” to “shall”: 2011 revision of CPT a breakthrough for time-intensive, health-focused, integrative practices
A change in Current Procedural Technology (CPT) codes may be excellent news for integrative practices according to a recent article in the December eNews of the American Association of Naturopathic Physicians (AANP). The article by Bruce Milliman, ND and Eva Miller, ND states:
“Effective January 1, 2011, the CPT manual has been revised to state that: ‘When counseling and/or coordination of care dominates (more than 50%) of the physician/patient and/or family encounter, then time shall be considered the key or controlling factor to qualify for a particular level of E/M services. The extent of counseling and/or coordination of care must be documented in the medical record.'”
Milliman serves the AANP on the Health Care Professionals Advisory Committee (HCPAC) for the CPT. He and Miller go on to state the following:
“Until 2011, the bolded and italicized “shall” was “may.” This change is of paramount importance to the naturopathic community because time spent with patients in counseling and/or coordination of care is that for which the profession has wanted to get reimbursed. This recognition of time throughout the healthcare system is a remarkable and important change! This change moves the United States towards a healthcare system which invests in wellness and health promotion. This one word change supports naturopathic physicians and other providers who “treat disease by restoring health” (AANP Definition of Naturopathic Medicine Position Paper 1989).
Comment: If one could put a paradigm shift in a nut-shell, this just might be the holder. The plaintive cry in human life that change takes time appears to finally be reflected in the payment. Time is what it takes to work with patients toward better esteem, to movement up the gradients of readiness to action, to habit change and health. Some evidence of the many positive effects of time well used (defining that is another issue) in whole practice care is here. Coverage of time-well-used can help bring clinical care more deeply into primary prevention and thus into focus as a clinical foundation of a forward-thinking National Prevention Strategy (see Policy, below). Milliman, a long-time member of AMA’s HCPAC, has been like water over stone at the HCPAC-CPT meetings on this issue. Others have supported this direction; Milliman, the son of the founder of the ground-breaking, influential Milliman & Robertson actuarial firm, has been the through line in getting this done. The change is a tremendous accomplishment for the integrative practice community and for the actual movement toward a system that might begin to focus on wellness and health. Now, let’s see how it plays out in the interpretation by insurers.
Acupuncturists at University of Colorado hospital granted privileges in embryo transfer unit
Acupuncturists have been granted privileges to the embryo transfer (IVF) suite in the operating room of the University of Colorado Hospital, according to a notice from Ben Meyerhoff with the Center for Integrative Medicine at the University of Colorado Hospital. “We are now coordinating on-call [Traditional Chinese Medicine] care with the Endocrinologists of Advanced Reproductive Medicine and on the date of embryo transfer we are performing acupuncture before and after that procedure to increase the embryo’s chances to become a baby.”
Comment: Step by step, better care options. This time the progress is, happily, baby steps.
Review shares 25 windows on cost-findings and business models in integrative practices in 2010
A review of 2010 Integrator Blogs News & Reports content found an intriguing array of articles that directly relate to cost and economics issues. (See Cost and Economics of Integrative Healthcare in 2010: 25 Brief Articles.) Subjects include: a Medicare pilot with chiropractors; savings to the system from Duke’s personalized program; cost savings to insurers from patients using CAM practitioners in Washington state; huge benefits from direct access to chiropractors in Blue Cross Blue Shield of Tennessee; a new Medicaid integrative therapies pilot in Colorado; the new federal law on non-discrimination; inclusion of Ornish and Pritikin programs in Medicare; Sebelius’ views of complementary therapies; issues related to the business viability for licensed acupuncturists; savings through the whole practice of naturopathic care for Canada Post employees; trends in supplement and herb sales; savings from Allina’s in-patient integrative care program; massage practice trends in a down economy, and more. The two-dozen plus short articles are gathered here with links to primary sources.
Comment: Cost is king in a capitalist economy. As I noted in my commentary on the mix of articles, the biggest question as the year draws to an end is whether costs will be elevated from its present invisibility in the draft NIH NCCAM 2011-2015 strategic plan’s “strategic objectives” when the final plan is unveiled in February 2011. How else can NCCAM fulfill on the charge in Section C of the mandate to:
” … study the integration of alternative treatment, diagnostic and prevention systems, modalities, and disciplines with the practice of conventional medicine as a complement to such medicine and into health care delivery systems in the United States.”
Draft National Prevention Strategy nearly mum on “integrative care” despite significant inclusion in enabling law: Comments close 01/13/11
A comment period closes/closed January 13, 2011 on the draft National Prevention Strategy. The law behind this strategy represents the most significant inclusion of “integrative care” in federal policy. Three of the top 4 purposes of the National Prevention, Health Promotion and Public Health Council, through which the strategy is being developed, reference “integrative care.” The short-comings of the draft strategy are pointed out in a filing on the strategy’s framework from the Samueli Institute, led by Wayne Jonas, MD. The Samueli Institute, a strong backer and conceptualizing influence for the law that established the Council, points out that the strategy is being determined without the Council first establishing an Advisory Group of community leaders from outside government that the law requires. Notably, this group was to include at least one integrative care practitioner. (See Section 4001 here.) Evidence of the kinds of value in prevention and health promotion that might come from adhering to a progressive inclusion of integrative health care practitioners is present in this position statement filed by the Associated Bodywork and Massage Professionals. Readers can respond here to the draft National Prevention Strategy until January 13, 2011.
Comment: I mailed an “alert” to Integrator readers to stimulate response from the integrative practice community to the draft framework for the strategy (comment period closed December 5, 2010) and then the draft strategy itself (comments closing/closed January 13, 2011). The draft plan teases one with its language. The opening salvo is that the strategy:
” … provides an unprecedented opportunity to shift the nation from a focus on sickness and disease to one based on wellness and prevention.”
Nice. Yet it seems to be doing so without embracing the challenges of bridging the chasm between reactive, sickness-focused clinical care and a wellness focus. This is precisely the promise that “integrative practice” represents. Wouldn’t it be nice if clinical care was shifted to integrative, health-oriented principles and practices that create the kinds of prevention and wellness outcomes as side effects that were found in this report:
” … (self reports) found improvement in multiple areas: fatigue, sleep, weight, stress, allergic symptoms, hypertension, coffee consumption and muscoloskeletal problems …”
The so-far meager participation of the integrative practice community in this dialogue suggests that the community is not yet adept at either making its case or gathering the resources to show up. This is sad-making, particularly since the law gives “integrative care” significant standing. Hopefully, the community will increasingly seize opportunities as they arise.
Chiropractors organize strong response urging re-consideration of included provider types in Accountable Care Organizations (ACOs)
When the Centers for Medicare and Medicaid Services requested comments on preliminary standards for Accountable Care Organizations (ACOs), the chiropractic profession responded with strength. Over 30 DC organizations filed responses. John Falardeau, vice president for government relations with the American Chiropractic Association (ACA) shared the organization’s response, printed here in full. The ACA’s core argument is one that if chiropractic physicians are not included in ACO teams “but treat beneficiaries attributed to ACOs and achieve cost savings, it would be inappropriate to reward only those providers who are delineated within the legal structure of the ACO, rather than those providers responsible for the cost savings.” They note recent studies that have shown savings. The chiropractors began tracking the ACO issue closely when the National Committee for Quality Assurance, requested comments on their Draft Accountable Care Organization Criteria, the end-date for which was November 19, 2010.
Comment: The ACA’s point is well made that those who may be responsible for savings should share in benefits. My guess is that the ACA speaks for more than one profession in calling for a “reconsideration of the practitioners that are needed in an ACO and to expand this list to include … [your non-included profession here].” The ACA also spoke indirectly for other non-included or limited professions in its response to the NCQA:
“The limited nature of the practitioners who will be considered primary and specialty care practitioners in NCQA’s definition of an ACO will seriously limit the ability to reduce per capita costs.”
Note, for instance, the cost-savings in this report on the whole practice of naturopathic physicians. Given public use of chiropractors and other “CAM” practitioners, broad inclusion would also seem to be required if an entity is to meet the NCQA definition of an ACO as an organization in which “providers will need to be clinically integrated and work together to seamlessly coordinate care for assigned patients.”
LEAPS into IM” program for MD/DO students benefits from additional Weil Foundation grant
Medical and osteopathic students interested in participating in the Leadership and Education Program for Students in Integrative Medicine (LEAPs into IM) will benefit from roughly $20,000 in additional grant support from the Weil Foundation, according to a recent notice from the Consortium of Academic Health Centers for Integrative Medicine. The program, which grew out of an American Medical Student Association NIH-funded initiative, is presently led by Wendy Kohatsu, MD and Integrator adviser Bill Manahan, MD. Students pay $250 each for the week-long experiential, introductory program. The funds from the Weil Foundation, founded by Andrew Weil, MD, will allow the program to expand from 20 students to 30 students. Weil, contacted by the Integrator, offered this comment on the grant:
“This seems like a logical step for the Foundation. We like to target our grants, to get maximum bang for the buck, and training medical students in IM is a great investment in the future of medicine.”
Applications are due by March 21, 2011 here.
Comment: I recently attended a memorial service for an early educator-developer of the AMSA program, Pali Delevitt, at which I was reminded repeatedly, via open sharing from beneficiaries, of how utterly life-changing these short programs can be for medical students who are in search of something else in their medical training. Good for the Weil Foundation to open the doors for another 10 students to participate. It’s a pleasure to think of the nascent care-givers and leaders who will walk through this year.
Bastyr University’ Simkin Center trains doulas and allied birth providers
A November 30, 2010 newsletter from Bastyr University focuses on the University’s Simkin Center for Allied Birth Vocations for “social, practical and clinical care providers for pregnant and new families.” The Center is a department of Bastyr’s School of Natural Health Arts and Sciences. Named for internationally-known educator and author Penny Simkin, the Center includes programs for birth doulas, postpartum doulas, lactation consultants and educators and childbirth educators. The Simkin Center also sponsors workshops that focus on essential maternity care issues, as well as pregnancy and infant massage educator certification courses. Check for upcoming workshops and courses.
Comment: The integrative practice movement is inextricably connected to the natural childbirth and homebirth movement. My view comes to me in part through the immense experience of the home births of our two children. I may also be influenced to write this story as my spouse Jeana and I had the opportunity to take birthing classes with Penny. Great to see Bastyr housing these programs and affirming this connection between natural childbirth and our broader mission. This comes at time when doulas are organizing as a profession for 3rd party payment.
UCSF Osher Center moves into large new facility
Margaret Chesney, PhD, shares that the Osher Center for Integrative Medicine program at UCSF is moving to a new UCSF Osher Building. The 5 story, 48,000 square foot building will also house the UCSF Division of General Internal Medicine. Chesney views this co-habitation as a “visible sign that Integrative Medicine at UCSF is integrated into other clinical, research and teaching endeavors of the School of Medicine and Medical Center … It is wonderful step forward.” The new building has the Takahashi Healing Garden on the top of the third floor where patients can walk out into the garden. The buildout was possible through support of the Bernard Osher Foundation which also made a 1:1 match grant for up to $2.5-million to support a $25-million endowment fund goal.
Comment: Even close observers of developments in this field often miss that, inside of conventional academic medicine, we see layers and depths of integration. Often so-called “integrative medicine programs” start as satellite, arms-length or even quarantined initiatives. Chesney rightly is excited about this important step in actual integration inside of the medical center. Kudos, of course, to the Oshers.
Naturopathic accrediting agency gets 5 year approval
Dan Seitz, JD, EdD, executive director of the Council for Naturopathic Medical Education (CNME), reports that the National Advisory Committee for Institutional Quality and Integrity (NACIQI) “voted unanimously to recommend that the US Department of Education (USDE) renew CNME’s recognition for 5 years-the longest time allowed; also, they determined that CNME is in full compliance with their regulations. The whole hearing process took about five minutes and CNMR stood out as the only accreditin agency among 8 being reviewed for renewed recognition that had no adverse findings.” Seitz anticipates that approval of the recommendation by the assistant secretary “will go smoothly.” He noted the important contributions of CNME president Rita Bettenburg, ND, and two leaders of the Association of Accredited Naturopathic Medical Colleges, Karen Howard and David Matteson.
Comment: The latest renewal of recognition is newsworthy given the wild ride for the CNME with the US Department of Education since the agency was first recognized by hte USDE in 1987 when there were just 2 CNME-recognized on several occasions since. The first was for trumped up and ultimately bogus charges from mail-order NDs with what Seitz calls “online or abbreviated training” that don’t meet the CNME standards. In one other instance, internal issues with CNME resulted in a hiatus in the agency’s recognition. Happily for the NDs, and for quality, doctoral-level natural health education, the engine of opposition to the CNME, the former for-profit mail order business known as the Clayton College of Natural Health, shut its doors in 2010. (See HuffPo piece here and Integrator short here.) Twenty-three years later, there are now 7 CNME-recognized programs in North America. The latest review marks a new level of security for the naturopathic profession whose credibility is very much dependent on CNME’s status with the USDE. Now to insure there is work for all those educationally-mortgaged graduates!
ALLEGRA Learning Solutions gains traction with AHNA for integrative health CE courses
A note from reader Cyndie Koopsen, RN, MBA, HNB-BC, co-CEO of ALLEGRA Learning Solutions shares that 2 of the firm’s 10 certificate programs are “nationally accredited for continuing nursing education and they have just been nationally endorsed by the American Holistic Nurses Association.” One is a new Certificate in Integrative Health, advertised as including “holistic stress management, humor, energy healing, meditation, spirituality, Traditional Chinese Medicine, Ayurvedic Medicine, bodywork healing therapies, healing environments, music and sound healing, nutrition, and the healing effects of physical activity and movement. (67 hours; $469) The second program, which was recently endorsed by the AHNA for the 2nd time, is a Certificate in Spirituality, Health, and Healing. (25 hours; $180) Allegra has 8 other programs, including one in Complementary and Alternative Medicine (28 credit hours; $196).
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UCLArts & Healing in Time Magazine article
“How Group Drumming May Improve Low Income Student Behavior” is the title of a December 9, 2010 article in Time magazine. The article focuses on a drumming-based behavior program for at-risk youth developed by Ping Ho, MPH, director of UCLArts & Healing. The projects was engaged in collaboration with the National Association of Music Merchants and drum-maker Remo Belli. The team offered and studied a 12 week, post-lunchtime, 45 minute, counselor-led drumming experience that created an array of positive outcomes in the group of 101 “mostly Latino” children. An analysis of the program found that “across all types of problems, each drumming lesson was associated with significantly more improvement than a control lesson.” Said Ho: “We would have been happy with one [positive] outcome, so when the statistician kept reporting ‘withdrawal improved’ and then ‘depression improved’ and so on, it validated everything we believed,” Ho says. (Alignment of interest note: I serve on Ho’s board.)
Comment: Interesting to note the parallel health-creating outcomes in this program as those noted above in the piece on the National Prevention Strategy and found in this report of integrative medicine practices. Unfortunately, these kinds of progressive programs Ho is creating appear to be as little part of the thinking in the draft National Prevention Strategy as are whole person integrative clinical practices. What a great, healing tool such a program may be for our schools and at risk kids.
Council for Responsible Nutrition in joint education/promotion effort with nurse practitioners
On December 20, 2010, the Council for Responsible Nutrition (CRN) announced that it is working on a “joint education effort” with the American Academy of Nurse Practitioners and the American Academy of Nurse Practitioners Foundation (AANPF) “to help raise the level of awareness within the supplement industry and with consumers about the valuable role of nurse practitioners in the quest for good health.” The release notes evidence from a survey that nurse practitioners both use and recommend supplements.” Said Steve Mister, president and CEO, CRN: “These factors make it important for our industry to support the professional organization for nurse practitioners and for us to work with them to further educate the public about nurse practitioners.” CRN is now a contributing sponsor of the American Academy of Nurse Practitioners Foundation and is encouraging its members to also contribute. Elements of the partnership include CRN promoting the role of nurse practitioenrs to the general public. Said Mister: “We want consumers to know nurse practitioners can be a trusted source of health information.” The Academy represents the nation’s 140,000 nurse practitioners. CRN, founded in 1973, represents 75 of the largest suppliers of supplements in the US.
Comment: Here is the integrative medicine trivia question of the day: What do the nation’s most powerful supplement industry group (CRN) and most significant health-care related foundation (Robert Wood Johnson Foundation) have in common? Answer: Both are actively promoting a growing role for nurse practitioners in US health care. (See #3 here regarding RWJF and NPs.) Fascinating, and smart, strategic move for CRN, to find in this rising set of primary care practitioners a more friendly partner, then pursue the partnership. It fits one of my favorite rules: Life is short. Play with those who want to play with you. The nurse practitioners are likely to be both more welcoming and a better use of energy and resources than concocting something similar with, say, the AMA.
Controversy stirred by Institute of Medicine recommendations on Vitamin D
The recommendations in the Institute of Medicine report on Vitamin D stirred an outcry from many nutritional medicine interests. Natural Medicine Journal seized the moment and published responses from researcher Alexander Schauss, PhD; from New York University’s Geovanni Espinosa, ND; and osteopathic clinician Susan Ryan, DO. Ryan decries the way “the media further confounds” the recommendations. Eric Goldman, editor of Holistic Primary Care, explores apparent conflicts of interests on the IOM panel in Who’s in Bed with the IOM: Vitamin D Report Supports Conflict on Interest Suspicion. One member has an interest in a synthetic Vitamin D product, for instance.
Goldman credits the Alliance for Natural Health USA (ANH) for raising the conflicts issue. ANH upped the ante by promoting a letter-writing campaign to Ask Congress to Investigate the Vitamin D Report. One key issue, according to ANH, was the IOM decision to only focus on evidence from randomized controlled trials. The title of an ANH November 30, 2010 blog post positions the report as ” … Wrong, Wrong Wrong.” The Council for Responsible Nutrition published a “reaction” to the report in which it argues that the IOM’s recommendation of increased daily recommended intake is a “step in the right direction [but] still falls far short.” While the IOM doesn’t recommend higher than 800 IU’s a day, and finds evidence of safety at only 2,000-4,000 IUs, CRN states that its affiliated scientists “have demonstrated the science would allow for raising the UL for vitamin D to 10,000 IU/day.”
Comment: Fearing that anything I might add would only be more of the “media further confounding” the subject, as decried by Ryan, I turned to integrative nutritional pioneer pioneer Alan Gaby, MD, who I recently interviewed here on the publication of his 1374 page Nutritional Medicine textbook. I asked Gaby for a sentence or two. He wrote:
“While the IOM has often been excessively conservative, their recommendations regarding vitamin D appear to be reasonable. The evidence supporting the necessity and the safety of high-dose vitamin D for the general population (i.e., more than 2,000 IU per day indefinitely) is weak.”
Donna Karan’s Urban Zen partnerships for 2011
The new year’s notice on January 3, 2011 from Donna Karan, founder of Urban Zen, found plenty to trumpet. Via a partnership with the David Lynch Foundation, the Urban Zen Integrative Therapy Program “will be offering integrative therapies to veterans and their loved ones suffering from post-traumatic stress disorder” in a project called Operation Warrior Wellness. Karan notes that “our partnerships continue with Beth Israel Medical Center, Montefiore Children’s Hospital, Southampton Hospital and Hope Lodge as clinical rotation sites” for Urban Zen’s in-patient integrative services. Karan adds that she is “thrilled to share that we will be offering a second semester of self-care to nursing students at Kent State University.” Urban Zen also partners with other organizations for 3 programs for school age children: Bent on Learning (yoga in schools), Partners in Health (healthy organic school lunches), and Success For Kids (life skills). Urban Zen will also continue its programs to support relief efforts in Haiti.
Comment: I hope Ms. Karan and her team weigh in with the new National Prevention Strategy on some of these programs, particularly the 3 for school age kids. They might be interested in the UCLArts and Healing drumming program, too! Quite an agenda!
Homeopathy meets NASDAQ, December 29, 2010
Todd Rowe, MD, founder of the American Medical College of Homeopathy (AMCH) sent this note on January 4, 2011: “Greetings to you and Happy New Year. The American Medical College of Homeopathy just rang the closing bell on NASDAQ on December 29th. I thought this might be of interest to you.”
Comment: I asked Rowe for perspective on why this event took place. I didn’t hear back at the time of publishing this. The only thing I could make out is that the homeopathic presence among the money lenders had no direct relationship to Wall Street bonuses, which were quite comfortably in their whole form, though even at the worst of the economy never did appear as infinitesimal doses.
A few Top 10 Lists from 2010: Integrator, AANMC, Community Acupuncture, plus …?
Each year since 2006 the Integrator Blog News & Reports has published a Top 10 list of events and action from the prior year. The 2010 list is here. In 2009 I added a Top 10 People in Integrative Practice. The 2010 “people” list is here. (Most of you won’t be surprised that the people list has has more readers than the events list. Shows that at this level we are all well integrated with our culture.) Meantime, reader Lisa Rohleder, LAc, co-founder of the Community Acupuncture Network (on the 2006 list), sent a note on December 28th that she “took a lesson from you and started an end of year summary for the [Community Acupuncture Network]. Rohleder’s posting is here. In addition, I also discovered while googling around regarding Huffington Post and integrative medicine (my #8 for 2010) that Coquina Deger of the Association of Accredited Naturopathic Medical Colleges, who also honored Arianna Huffington, is about to publish a Milestones 2010. Any other end of year lists from these fields out there?
Bottom Feeder of the Year: Edzard Ernst for his pro-active polarizing
Comment: In the midst of the year end reflection, Italian integrative medicine leader Paolo Roberti di Sarsina, MD forwarded notice of an article entitled “Edzard Ernest holds forth again.” Apparently Ernst, a well-known CAM writer adn conventional mouthpiece in England, published an article entitled “Acupuncture – a treatment to die for?” In a review of 20 years of acupuncture publications, Ernst found 469 adverse events (including, reportedly, “fainting”). That’s 22 a year. A critical reading finds “the data are partial and his conclusions limited.” Chiropractors will know that the same Edzard Ernst also published Deaths After Chiropractic in 2010, another literature review. Family physicians loved this study. Integrator reader Tom Ballard, RN, ND, sent notice that Medscape listed Ernst’s work as the 4th most read article by family physicians. Chiropractic researcher Anthony Rosner, PhD writes of Ernst in “another misbegotten review” that Ernst’ work is “discredited” and “in many cases blatantly misleading.” No one likes to see any adverse events, especially deaths. As one analyst of Ernst’ work states: “A single injury – let alone a fatality – caused by acupuncture is one too many, but we have to wonder why Dr. Edzard Ernst, Chair in Complementary Medicine at the University of Exeter, keeps emphasizing the risks.” It is not as though the conventional culture is not already biased toward seeing risk from what it doesn’t know. Ernst gets an award for choosing the rut most traveling by, and digging it deeper.
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Molly Roberts, MD chosen as president-elect of AHMA
Clinician and author Molly Roberts, MD, MS has been selected as the president-elect of the American Holistic Medical Association. She will begin her term in November 2011. Roberts is an integrative holistic physician with the Institute for Health & Healing, in Marin County and San Francisco. She is triply board-certified in family medicine, nutritional medicine and integrative holistic medicine. Her first health care career was as a psychotherapist. Her published books include Blackwell’s Complementary and Alternative Medicine: Fast Facts for Medical Practice, and The Individual Optimal Nutrition Handbook.
Kathi Kemper, MD authors Addressing ADD Naturally
Word arrives that Kathi Kemper, MD, MPH, FAAP, the integrative medicine leader at Wake Forest University has recently published Addressing ADD, Naturally – Improving Attention, Focus, and Self-Discipline with Healthy Habits in a Healthy Habitat. Kemper is a leading integrative pedfiatrician and researcher with over 100 scientific publications. The book is viewed as a practical guide for parents of children with attention deficit disorder.
Mind-Body Researcher Elizabeth “Lisa” Kimbrough Pradhan, MPH, PhD
UCSF Osher Center director Margaret Chesney, PhD writes with news that Elizabeth “Lisa” Kimbrough Pradhan, MPH, PhD, “a precious friend to Integrative Medicine, mindfulness and CAM” died on January 3, 2011 in Nepal. Chesney attached a remembrance from Brian Berman, MD, director of the integrative medicine program at the University of Maryland where Pradhan worked from 2005-2010. Writes Berman:
“Lisa dedicated her career with us to investigating Mindfulness-based Stress Reductions (MBSR), meditation, and traditional Chinese medicine. A gifted researcher and writer, she authored or co-authored over 75 publications beginning in 1991 and was on the review board of five peer-reviewed journals in 2008-2009. Lisa also won many well-deserved awards and honors during her career, such as the Francisco J. Varela Memorial Grant Award from the Mind and Life Institute and the George Family Foundation New Researcher Award. Lisa balanced a rich career with her family life, including her 2 lovely children, Asha and Rajen, her husband, Ravi, and a large circle of friends who span the globe … A devotee of healthy habits, Lisa could often be found running through a nearby park, skiing down a mountain, or deep in restorative meditation. Above all, Lisa brought to everything she did compassion, caring, and a great sense of humor. I will always treasure the memory of our morning chats that ranged from debriefing on the weekend’s Ravens game, laughing about the politicians we wished weren’t in office, to checking in on the research studies she ran with such ease and competence. Lisa will be sorely missed, but her work will go on unceasingly, as she would want it to.”
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