British Columbia government backs 5 clinics for integrated cancer care “Integrated cancer care is part of our commitment to support British Columbians make the healthier choice, the easier choice. Integrated cancer care provides cancer patients with access to improved physical,

British Columbia government backs 5 clinics for integrated cancer care   

“Integrated cancer care is part of our commitment to support British Columbians make the healthier choice, the easier choice. Integrated cancer care provides cancer patients with access to improved physical, emotional and nutritional health as well as new opportunities for patients to engage with practitioners about natural therapy interventions and healthy lifestyles.” So states British Columbia Minister of Health Michael de Jong in a June 3, 2011 release that announced a partnership with not-for-profit InspireHealth to establish 5 integrated cancer centers throughout the province. The centers will open in Victoria, Kelowna, Abbotsford and Prince George and additionally include “a virtual one in Vancouver to serve rural and remote parts of British Columbia.” The new InspireHealth centers are scheduled to open in a phased approach beginning in September 2011. Full implementation is expected by September 2012. The centers will open as part of Healthy Families BC. InspireHealth, began operating its anchor Vancouver center in 1997.  

“Integrated cancer care is part of our commitment to support British Columbians make the healthier choice, the easier choice. Integrated cancer care provides cancer patients with access to improved physical, emotional and nutritional health as well as new opportunities for patients to engage with practitioners about natural therapy interventions and healthy lifestyles.” So states in a that announced a partnership with not-for-profit to establish 5 integrated cancer centers throughout the province. The centers will open in Victoria, Kelowna, Abbotsford and Prince George and additionally include “a virtual one in Vancouver to serve rural and remote parts of British Columbia.” The new InspireHealth centers are scheduled to open in a phased approach beginning in September 2011. Full implementation is expected by September 2012. The centers will open as part of . InspireHealth, began operating its anchor Vancouver center in 1997. 

In the release, the BC agency portrays integrated cancer care as “combin(ing) nutrition, exercise, and stress management programs with standard cancer treatments to promote an overall healthier lifestyle, which is proven to lead to better patient outcomes and cancer survival rates.” According to the release:

“Core health classes, dedicated to supporting health and healthful lifestyle changes such as healthy nutrition and cooking classes, exercise, medication, yoga, shared learning groups and stress reduction classes will be offered at all integrated cancer care centres … Access to InspireHealth’s physicians and nurse practitioners is free. InspireHealth has a number of other programs including core health classes, as well as a two-day LIFE Program that costs $445 for the first year of membership and $95 for annual renewals. The fee is waived for patients on Medical Service Plan Premium Assistance. In-house therapy practitioners -such as massage therapists, acupuncturists and naturopathic doctors – have patient-pay-fees.”

InspireHealth, co-founded by Roger Rogers, MD, now retired, and current CEO Hal Gunn, MD, is funded through a mix of physician salary support, patient fees and private donations. According to the release, the Ministry of Health is providing one-time, start-up funding of $2.5 million for the five centers. Additional annual funding of $2.5 million from the Provincial Health Services Authority will provide up to 12 additional medical doctors. The investment is portrayed as “directly complementary to the work of the BC Cancer Agency.” 

Comment: This is a truly remarkable governmental investment. Can US policy-makers allow themselves to be led by their Northern neighbor? That InspireHealth co-founder Rogers had left a tremendous legacy is evident via the Dr. Rogers Prize, named in his honor. Funded through the John & Lotte Hecht Memorial Foundation, the prize awards $200,000 every second year to an integrative medicine leader. (See notice of September 2011 event under Awards, below.) This expansion of InspireHealth as official provincial policy is phenomenal testament to the enduring value of Rogers’ work and that of InspireHealth co-founder Gunn.

 

 Complementary and integrative language in recommendations of Advisory Group to National Prevention and health promotion Council   

On May 24, 2011, the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health met for its second time. Two integrative practitioners were appointed to the Advisory Group to reflect the nominal importance of “integrative health” in the new federal initiative: licensed acupuncturist Charlotte Kerr, RSM, BSN, MPH, LAc and integrative medical doctor Sharon Van Horn, MD, MPH. A slide presentation that kicked off the meeting announced the Advisory Group’s recommendations. The first was entitled “Clinical and Community Preventive Services.” It reads: “Enhance coordination and integration of clinical, behavioral, and complementary health strategies.” Also described were 2 Advisory Group working groups established to move key areas of identified interest. The first is on co-benefit design. The second is entitled “Working Group on Prevention (Clinical and charge:

  • Gather background information and evidence that can be used to effectively describe a continuum of services that includes clinical, community, and integrative approaches to prevention.

The working group will develop the basis for a full Advisory Group discussion “of how the new health care delivery and financing system envisioned in the Affordable Care Act can best support this continuum.” The group will also “collect additional background and engage experts from agencies involved in the design of the reformed system (HHS/CMS), as well as other agencies that provide for health care (e.g., DOD and VA).” Section 4101 of the healthcare overhaul law which created the Council, described here, includes 3 references to “integrative health” in the Council’s top 4 “purposes and duties.” 

Comment: New here is the inclusion of the word “complementary.” In this era of integration, if “CAM” (or complementary) is not explicitly mentioned, one can still bet that these therapies and providers will be excluded. So this language is important. More exciting is the focus on clinical preventive services. Clinical prevention in “integrative health” goes beyond immunizations and screening to true primary prevention. The naturopathic doctors sublimely call this treating disease by restoring health. Now that would transform health care. Here’s hoping Van Horn and Kerr and those working with them make some noise about a health-creating way of practicing primary care. Might they suggest that the government of British Columbia (see story immediately above) is providing a model of secondary clinical prevention and health promotion which we might embrace here?

 

 HRSA, foundations and academic organizations make historic push for team care; possible value for CAM/IM 

On May 10, 2011, a powerful consortium of healthcare leaders joined to promote team care at an event at the National Press Club. This column in the Integrator suggests the initiative may be an exceptional opportunity for “CAM” practitioners and integrative medicine. Joined on the stage were Mary Wakefield, RN, PhD, administrator of the Health Resource Services Administration, and leaders of the powerful Robert Wood Johnson Foundation and Josiah Macy Jr. Foundation. With them were representatives of national academic organizations representing conventional medicine, nursing, public health, pharmacy, osteopathy and dentistry. The group officially released two collaboratively-developed documents: Core Competencies for Interprofessional Collaborative Practice and Team-based Competencies: Building a Shared Foundation for Education and Clinical Practice. George Thibault, MD, president of the Macy Foundation made the case: “We have good evidence that health care delivered in teams is more efficient and more effective, yet we continue to educate our health professionals in silos. We will not have health reform unless we change the way we imprint our students. We cannot change healthcare unless we change education.” 

 Comment: One intriguing political outcome of these initiatives is the language with which the American Medical Association greeted the members of the Coalition for Patient Rights (CPR) in a recent meeting. CPR’s leaders were protesting the AMA’s organized efforts to squash their scope expansions. The AMA greeted the nurses, psychologists and naturopathic doctors and others with strong expressions of the importance of team care and multidisciplinary collaboration. (See “AMA meets with representatives of the Coalition for Patients Rights,” below.) Wouldn’t it be nice if the AMA actually let go of its need to dominate? Actual competence in the “interprofessional collaborative practices” will require they AMA to do so. And the patient-centered focus of these competencies will require them, if they act in integrity, to include “CAM” practitioners. Note however that it was the American Association of Medical Colleges, not the AMA, from which the MD leaders who endorsed the competencies were selected. Still, these interprofessional efforts are tremendous steps, if remedial, for healthcare.