June 2012 John Weeks Round-up on Policy

IHPC Congressional Briefing-Where Health Care is Headed: Patient-Centered Medical Homes and Integrated Healthcare 

The Integrated Healthcare Policy Consortium (IHPC) continued its series of Congressional Briefings on June 8. The latest in a series of four focuses on the intersection of what IHPC prefers to call “integrated care” and the emerging patient-centered medical home (PCMH) and accountable care organization (ACO) models. Congress has promoted these via the Affordable Care Act. Topics and speakers are: Introductions to integrated (integrative) healthcare and the Patient-Centered Medical Home (PCMH) model in the Affordable Care Act (Janet Kahn, PhD); Vermont experience with PCMH’s (Craig Jones, MD); experience of HealthPoint, Seattle’s 13-center Federally Qualified Healthcare Center, in the integration of conventional, complementary and alternative health care in a PCMH (Tom Trompeter, MHA); acupuncturist researcher’s perspective on integrated community health teams supporting PCMH’s (Beth Sommers, LAc, MPH, PhD). The briefing, which targets members of Congress and their staff, will be delivered twice, once on the House side, once on the Senate side.

Comment: Much change begins with familiarity and of course education. Chances are, few if any of the members of Congress have ever thought of integrative health and ACOs in the same breath. Notably, however, “doctors of chiropractic and licensed complementary and alternative medicine practitioners” are included in Section 3502 of the Affordable Care Act which is related to PCMH teams. The all-important connective language is not “shall” but “may” however. This has been interpreted by most as will not. This briefing is a very smart move for IHPC, this field’s little (policy) engine that could. Credit IHPC chair Len Wisneski,MD and Kahn. For related Integrator content, see:

Healthpoint’s Tom Trompeter: Opportunities for Integrative Medicine in a Patient-Centered Medical Home   

Ira Zunin, MD & Manakai O Malama: Integrative Medicine Model in a Patient Centered Medical Home 

Bravewell Event: Health System & Military Leaders Say Economic Costs and Pain are Motivating Inclusion of Integrative Medicine 

 

The Need to Change the Nation’s Therapeutic Order: Senate Committee Examines Close Relationships Between Pain Groups and Pharma

News broke May 9, 2012, that US Sens. Max Baucus (D-MT) and Charles Grassley (R-IA), powerful leaders of the US Senate Finance Committee, have begun an investigation of relationships between three major manufacturers of narcotic pain medications and “the medical groups and physicians who advocate the use of these drugs,” according to an article in Modern Healthcare. The three firms are Purdue Pharma, Endo Pharmaceuticals, and Johnson & Johnson. Baucus and Grassley sent letters to seven organizations to begin fact-finding: the American Pain Foundation, the American Academy of Pain Medicine, the American Pain Society, the Center for Practical Bioethics, the Wisconsin Pain & Policy Studies Group, The Joint Commission, and the Federation of State Medical Boards. Notably, the American Pain Foundation announced on May 3, 2012 that it is shutting down due to lack of funding.To explain their investigation, the senators cited statistics from the Centers for Disease Control and Prevention that show more than 40% (or 14,800) of the 36,500 drug poisoning deaths in 2008 were related to opioid-based prescription painkillers. 

Comment: The Senate investigation moved close to home when The Kansas City Star published a follow-up article on that city’s Center for Practical Bioethics (CPB). An organization of educators in integrative health with which I am involved is among the founding organizational members of the CPB’s “Pain Action Alliance to Initiate a National Strategy” (PAINS). CPB, run by a colleague, Myra Christopher, has been substantially supported by Purdue Pharma.

One way for CPB to make lemonade from these lemons is to engage an affirmative exploration of proactive, best practice strategies for first use of natural therapies and practitioners in integrative pain treatment. Typically inclusion is prefaced by a when all else fails caveat. Why not explore elevating integrative strategies to discover how much can be done early on with mind-body, massage, chiropractic, physical therapies, and other approaches that can limit the perceived need for opioid-based prescription drugs? Ms. Christopher, to her credit, actively solicited participation of integrative practitioners in the CPB’s PAINS initiative.

Such a natural health measures first focus by CPB would boost our necessary work to, as my colleague Pamela Snider, ND, likes to put it, change the therapeutic order of the nation. Using the least invasive first should be attractive to any practitioner who recalls their oath to first do no harm.

 

Rand Corporation holds policy forum’ on integrative medicine

The Rand Corporation has announced that on July 19, 2011 it will hold an evening event entitled “Policy Forum: Integrative Medicine.” Rand is a not-for-profit organization that is respected as a top purveyor of research and analysis to support policy decisions. The organization has been directly linked to integrative medicine via the generosity of Henry and Susan Samueli who established the Rand-Samueli Institute Chair in Policy for Integrative Medicine at Rand. The position is held by Ian Coulter, PhD, a top health services researcher. Coulter is among the speakers. The others are Samueli Institute CEO Wayne Jonas, MD and David Eisenberg, MD the Bernard Osher Distinguished Associate Professor of Medicine, Harvard Medical School. 

Comment: The Rand brand is about at good as it gets in the real world of policy research, in both government and private contexts. It will be interesting to hear the integrative medicine spin in that environment, from those three speakers. Thanks to Integrator adviser Glenn Sabin for bringing this to my attention. 

 

W.H.O. Invites ACCAHC Executive Director as Outside Adviser for 2014-2023 TM/CAM Strategic Plan  

The World Health Organization (W.H.O.) invited Integrator publisher-editor and Academic Consortium for Complementary and Alternative Health Care (ACCAHC) executive director John Weeks to serve as an outside adviser to the development of the W.H.O. 2014-2023 Strategic Plan for Traditional Medicines (TM/CAM). Weeks participated in a May 9-11, 2012 planning meeting in Hong Kong. The work will update W.H.O.’s 2002-2005 TM Strategy. A major shift in the current work is that TM/CAM was moved inside W.H.O.  During the first plan process, TM/CAM was in a division related only to medicines. Now it resides in a division with a charge related to health systems, delivery and primary care. Weeks participated with 17-18 other individuals in the 3 days of concept development, brainstorming on specific recommendations, and strategies to guarantee measurable outcomes of the strategy. Involved were formal representatives from W.H.O. regions and W.H.O headquarters, selected traditional medicine leaders from other countries, and representatives from the Hong Kong Department of Health, which sponsored the working session. Among national backgrounds of those at the table were India, China, South Africa, Brazil, Belgium, Canada, Mongolia, Norway, Tanzania, Australia, United States (Weeks), England and Egypt. 

In an June ACCAHC newsletter, Weeks is quoted as stating: “Participation was a tremendous honor and a professional highpoint of my 28 years in these fields. While the invitation was to me, it very much affirmed the work that all of us in ACCAHC and in integrative medicine in the United States are doing to develop quality relationships between TM/CAM practitioners and conventional practitioners.” The 2014-2023 version of the plan is expected to focus more on the role of TM/CAM providers Weeks gifted each of his fellow participants with copies of the ACCAHC Clinicians’ and Educators’ Desk Reference on the Licensed Complementary and Alternative Healthcare Professions and of the ACCAHC Competencies for Optimal Practice in Integrated Environments. The W.H.O. TM/CAM strategic plan has a number of steps prior to going before the General Assembly for approval in 2014.

Videos of CAM/IM Policy Presentations Posted by Life University’s Octagon Institute 

Presentations at the April policy conference of Life University, via its Octagon Institute, are available on line here on video. The line-up includes: top employer leaders Dee Edington, PhD with the U Michigan Health Management Research Center and Andy Webber, CEO of the National Business Coalition on Health whose Top 10 foir integrative health and employers was featured in the May 2012 Round-up; lobbyist John Falardeau of the American Chiropractic Association and former Washington State insurance commissioner Deborah Senn, JD, now a lobbyist in Washington, DC for the American Association of Naturopathic Physicians; futurist and principal author of Primary Care 2025 Clem Bezold; and David O’Bryon, JD, CAE on the Supreme Court and health reform; and Integrator publish-editor John Weeks on CAM/IM in the Affordable Care Act and multidisciplinary collaboration as a policy strategy. The videos are typically 30-60 minutes. The policy conference was organized by Gerard Clum, DC, director of the Octagon Institute.