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.

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. 

Philanthropy

Hugely influential Bravewell Collaborative announces plans to sunset operations in 2013

In June 1, 2011, the Bravewell Collaborative of philanthropists for integrative medicine sent a letter to donors, friends and supporters to announce that “the timing is appropriate to sunset the organization – as it is structured today – at the end of 2013.” They state that there is yet “more to come” prior to shutting the collaboration down. Below is the letter, in full, in respect for the Bravewell’s contribution.   

“Over the past decade, members of The Bravewell Collaborative have worked together to transform the culture of healthcare by advancing the adoption of integrative medicine. This catalytic effort not only resulted in extraordinary outcomes, it also established a unique and effective model for excellence in collaborative philanthropy.

“As many thoughtful philanthropic organizations have done in the past, The Bravewell Collaborative believes that the ten-year mark is an appropriate and strategic time to review its accomplishments relative to the mission and goals it set when it was created in 2001. A description of our accomplishments is included with this letter and we assure you that there are more to come. 

“Bravewell has always stated that its goal was to not exist, once it had accomplished what it set out to do – an unusual goal for a philanthropic organization, but one that has always been at the foundation of all of Bravewell’s strategies and initiatives.

“After thoughtful deliberations, Bravewell members have concluded that the timing is appropriate to sunset the organization  – as it is structured today – at the end of 2013. 

“We are currently involved in strategic planning to ensure that several of the key programs will be sustainable for many years to come and continue to promote the health and wellbeing of us all.

“The members recognize that Bravewell’s goals were achieved not only from their own collaborative efforts, but also through the enduring partnerships it built with other institutions and individuals.  We cannot thank these partners enough and we want to assure all involved that as soon as we have finalized our planning, we will communicate the strategies for the continuance of the key initiatives.

“We are planning our final Bravewell event for November 7, 2013 in New York City.  The daytime Lectures & Luncheon, moderated by Jon LaPook, will take place at the Grand Hyatt and the evening black-tie dinner, emceed by Mehmet Oz, will be held at Cipriani.

“We look forward to seeing all of you, our strategic partners and our loyal supporters, at both of these very special events.”

Sincerely,

The Bravewell Collaborative Executive Committee

Christy Mack, President
Penny George, Vice President
Ann Lovell, Treasurer
Sherry Lund, Secretary 

Comment: Bravewell’s contributions are hard to overstate. In early January of 2010 I wrote up a piece called A Short History in the Form of a Top 10 for the Decade in Integrative Medicine. Just after #1, the “Publication of the Report of the White House Commission on CAM Policy,” I put: “Founding and Strategic Partnerships of the Bravewell Collaborative of Philanthropists for Integrative Medicine.” In truth, I had mis-remembered, as I began writing this, that I had placed Bravewell as #1. The #1 spot is where it belonged. After all, #3 on my list was the “Founding and Expansion of the Consortium of Academic Health Centers for Integrative Medicine.” Bravewell midwifed that organization’s birth and helped substantially to rear that Consortium through 2012. My #9 was Institute of Medicine National Summit on Integrative Medicine and the Health of the Public, which the Bravewell conceived and wholly funded. Bravewell’s other projects such as mapping the field, funding a clinical network, publishing foundational documents, sponsoring a 2006 PBS feature, are amply displayed on Bravewell’s website.

The impact of the Bravewell on institutional integrative medicine is huge. At the same time, the organization had its biases and areas of closure. Bravewell favored (and favors) medical doctors, and above all medical doctors in academic health centers as agents of change in US health care. As such, the collaborative did not explore some strategic partnerships that may have been useful in advancing its outspoken, transformational mission. Like the passing of any influential, powerful parent, new opportunities will arise with Bravewell, the organization, no longer enthroned in the family system. For now, I’m looking forward to the “more to come” in the next 18 months. We should all be deeply grateful that these individuals, mainly women in the 55-65 range (and the men behind them) have collaborated to accomplish for a healing-oriented health care.  

 

Foundation consortium in $8.6-million boost for new National Center for Interprofessional Education and Collaborative Practice

The Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation, and The John A. Hartford Foundation have collectively committed up to $8.6 million over five years to support creation of a National Center for Interprofessional Education and Collaborative Practice. The commitment follows an announcement by the Health Resources and Services Administration (HRSA) that the agency would create such a center. The center’s purpose is “to accelerate team work and collaboration among doctors, nurses and other health professionals- as well as patients-and break down the traditional silo-approach to health professions education.” The timing is linked to the implementation of the Affordable Care Act: “The implementation of the Patient Protection and Affordable Care Act along with the evolution of accountable care organizations, medical homes, and other new models of care have injected new energy and enthusiasm in interprofessional models of education and practice to improve quality, safety and access to health care. Sponsors of the new national center hope its creation will accelerate these activities.” The HRSA website includes an RFP on the coordinating center.

Comment: Credit the leadership of both the Obama administration and the Macy-led foundation community for elevating team care in U.S. medicine during the last 18 months. Their work was been focused, multifaceted and and relentless – as it has needed to be given the structural and economic obstacles. George Thibault, MD, president of the Josiah Macy Jr. Foundation states: “We know that health care delivered in teams is better health care. But we will never be able to change the delivery system until we change how health professionals are educated. We are excited to help facilitate a center like this, which we believe will take interprofessional education and practice to a critical new level.”

The Obama administration, for its part, passed the Affordable Care Act. This put some financial incentives behind team care. It has also rolled HRSA director Mary Wakefield, RN, PhD out as a key spokesperson and collaborator for team care. Mainly I credit Thibault. He made it clear in a May 2011 press conference in which Wakefield participated that this time the movement for team care will not be stifled by perverse incentives against what he simply calls “better health care.” Now, its time for the integrative health community to finds its way more deeply into this team care work. 

Employers

WebMD pumps health coaching to employer community

“Integrating Coaching into a Global Wellness Strategy.” So headlined the WebMD invitation for a June 13, 2012 webinar to explore health coaching as a key measure in limiting costs related to health. The webinar will be held 2:00-3:00 ET. In the appeal, WebMD presents coaching as a “foundational” component in US wellness programs. The hour-long webinar is free.

Comment: The webinar targets employers but there is nothing to keep a non-employer from gathering intelligence by listening in. It would be nice if WebMD and some of these employers would see the value in a little corporate contribution to the National Consortium for Credentialing Health & Wellness Coaches (NCCHWC) that is working to rationalize this field by creating education and certification standards.

Integrative Clinics

Briefly noted developments in health system integrative medicine programs

The following is a sampling of developments in various integrative clinics, mainly in health systems, over the past month.

  • The Sylvester Comprehensive Cancer Center of the University of Miami Hospitals and Clinics is boasting its integrative programs led by University of Arizona Fellow Ashwin Mehta MD, MPH.
  • Stephen Schimpff, MD, former CEO of the University of Maryland Center offers a 4-part reflection on integrative medicine.
  • The Fountain Centre, an integrative services unit associated with Guildford, England’s St. Luke’s cancer center, welcomed actor Hayley Mills as a marketing agent and supporter.
  • The Petaluma Health Center promoted its integrative offerings “that includes acupuncture, drug counseling and therapy, alongside traditional medical and dental services.”
  • A fundraiser called Appetite for Life benefited the Middlesex, Connecticut Center for Survivorship and Integrative Medicine.
  • The Ottawa Integrative Cancer Centre, led by Dugald Seely, ND, was the subject of a favorable feature, “An Oasis of Healing,” in the Ottawa Citizen. The model is based on British Columbia’s InspireHealth.
  • The for-profit UCR Health Centers, with two clinics in the Chandler, Arizona area, advertised its integrated services in a June 1, 2012 release its integrated services: “Urgent Care Clinic Announces New Improved Chandler Facility, Integrated Model is America’s Healthcare Future.”
  • The Well Integrative Medicine program, an integrative wellness model, was recognized as a “Social Venture Accelerator” by Propeller: A Force for Social Innovation.
  • The comprehensive pain strategy of Beverly Hospital at Danvers, MA sent this release on their program.
  • Integrative medicine gets as brief mention in this piece on a $50-million expansion of Florida’s Jupiter medical Center.
  • The music therapy program at Northern Westchester Hospital was awarded a Planetree Award
  • A column on integrative medicine insurance coverage in Hawai’i by Ira Zunin, MD, MBA, MPH is here.
  • The CAM Masters program at Georgetown caught a notice via the University of Buffalo’s PreHealth Advisor.
  • The role of UCSF’s Shelley Adler, PhD in the International Congress for Educators in Complementary and Integrative Medicine is featured here.
  • Aurora Healthcare is featuring a June evening discussion on integrative oncology.
  • Michigan’s Oaklawn Hospital is finding some controversy in opening its Holistic Center.
  • Virginia’s Riverside Medical Group has a note sharing why its integrative care services are offered for free, which is connected to a pitch to support them with donations.
  • The University of Wiusconsin is planning a $25 million replacement facility to house the Wingra Family Medical Clinic, integrative medicine physicians.
  • The UCLA student paper features a story on UCLA pre-medical students shadowing acupuncturists at Emperor’s College for an internship.

Education

Consortiums of medical schools (CAHCIM) and CAM educators (ACCAHC) jointly sponsor International Congress for Educators in Complementary and Integrative Medicine, Georgetown, October 24-26

On October 24-26, 2012, Georgetown University will host a historic collaboration: the International Congress for Educators in Complementary and Integrative Medicine (ICECIM). Jointly sponsoring are the 51 medical schools of the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM) and the 16 complementary health organizations of the Academic Consortium for Complementary and Alternative Health Care (ACCAHC). The principal organizer is Aviad Haramati, PhD, integrative medicine leader at Georgetown and a long-time leader in cross-fertilizing the conventional and CAM educational institutions and organizations. ICECIM is EXPECTEDto draw a multidisciplinary group of 200-300 educators. ICECIM’s program committee and planning committee (on which I serve) are thoroughly integrated.

Comment: In 2004-2005. I had a chance to work with Haramati and a mixed group of 25 educators in integrative practice fields to create the National Education Dialogue (NED) to Advance Integrated Health Care: Creating Common Ground. At that time, CAHCIM was not willing to formally co-sponsor with ACCAHC. The reluctance made sense: CAHCIM was young, and ACCAHC was just emerging, under the leadership of Pamela Snider, ND, in that NED process. The open alliance on this project is terrific. As Integrator adviser Clyde Jensen, PhD, taught me to consider in 2000: “Those who are educated together practice together.”

 

University of Calgary medical acupuncture program for MDs enters 22nd year

The University of Alberta has just begun the 22nd year of what it calls “one of the few academic university-based medical acupuncture programs in North America.” The Medical Acupuncture Program is described as: “Over 200 credit hours of intensive graduate-level instruction in Traditional Chinese Medicine theory and clinical practices as it relates to medical acupuncture and modern biomedicine. Instruction is provided through lectures, workshops, demonstrations, clinical practice, and examinations. The program is designed to be taken on a part-time basis and to be completed in nine months. It is presented in four modules (levels), each worth 50 credit hours. Each module consists of two 3-day weekend sessions, (Friday through Sunday) held approximately one month apart.”

Comment: The main such short course in the US for educating medical doctors is the so-called Helms program. Like the Calgary program, the Helms course was originally linked to the UCLA and later Stanford from 1982-2008 via continuing education. I had not been aware of the durability of the Calgary program as a part of a medical school. Notably, in the less rigid guild environment of Canada, the course is open to MDs, dentists, physiotherapists, occupational therapists and chiropractors.

 

Organization called “the official voice of CAM in the United States” featured in Redwood’s Healthy Insights Today

The name of the feature by Dan Redwood, DC is “Developing Collaboration Among CAM Professions, Forging Integration with Conventional Health Professions.” Redwood examines, via interview, what he calls “the only organization in the United States with full participation of the councils of colleges and accrediting agencies from all the licensed professions defined as complementary and alternative medicine (CAM) by the National Institutes of Health—chiropractic, naturopathic medicine, acupuncture and Oriental medicine, and massage therapy.” Redwood adds: “As such, ACCAHC comes closer than any other group to being the official voice of CAM in the United States. The organization is the Academic Consortium for Complementary and Alternative Health Care (ACCAHC). Redwood chooses to portray the organization through the comments of its executive director, John Weeks, the very same character, re-hatted, who is writing this Round-up.

Comment: Okay, that was a a bit of a round-about set up. In the interview, Redwood gave me time to speak about the accomplishments made over the past 8 years via the commitments of leaders of 16 national organizations and literally scores of deans, presidents, CEOs, executive directors and faculty members. I am proud to be a part of what is arguably the broadest, deepest, most accomplished interprofessional initiative in North America. (Let me know if I am unaware of some organization or initiative!) Pamela Snider, ND first organized and directed ACCAHC in 2004-2006 via a support from Lucy Gonda. Snider wrestled the first participants into declaring a shared vision and mission. Anyone wondering why I have shifted more of my work from writing to organizing will understand fully through reading this interview. We’ve created an exceptional platform through which we are fostering health-focused change.

 

Input invited on core competencies in integrative pain management for primary care physicians

The director of a new integrative medicine program at the University of Washington, Heather Tick, MD, has initiated a process to develop core competencies for integrative pain management for primary care physicians. Tick led two sessions on the topic at the International Research Congress for Integrative Medicine and Health in Portland in May 2012. Tick sent a note to attendees after the meeting in which she invited broad input on “an initial draft of core competencies in Integrative Pain Care (IPC) recently completed by a broadly representative task force of health care professionals.” She writes: “For an initial investigation, we are seeking your input regarding the extent to which each of the draft competency statements is necessary for primary care physicians (i.e., family medicine, internal medicine, pediatrics, and combined internal medicine-pediatrics specialties). A web-based questionnaire is now available to provide your input. In addition, we welcome your suggestions for refinements in the wording of the statements and any other IPM core competencies that you think should be included.  Your responses to this questionnaire are anonymous and will provide important input for further development of these competency statements.” The Survey Monkey link is here.

Comment: I asked Tick if I might forward her message to the Integrator list and she said yes. Comment away! While I am assuming that her definition of primary care physicians includes osteopaths but does not extend to naturopathic physicians or others who believe they work in a primary care capacity, there is no restriction on who can comment on the proposed standards.


Natural Products

Council of Colleges of Acupuncture and Oriental Medicine Endorses American Herbal Products Association’s Botanical Authentication Program

On May 22, 2010, the American Herbal Products Association (AHPA) announced that the Council of Colleges of Acupuncture and Oriental Medicine (CCAOM) has formally endorsed AHPA’s Botanical Authentication Program. CCAOM reportedly considers the AHPA initiative “a valuable program supporting ongoing quality assurance in the herbal products industry.” The AHPA program consists of two components: identification of known adulterants and information on analytical methods that can be used to ensure botanical identity. The mission of CCAOM is to advance acupuncture and Oriental medicine by promoting educational excellence. Fifty-four U.S. schools and colleges are currently members of CCAOM. Michael McGuffin, AHPA president states: “This endorsement confirms AHPA’s belief that its efforts over the last 15 years to ensure that manufacturers of herbal products have the tools they need to address adulteration issues when they arise is of value to acupuncturists who use herbal products.” AHPA is the national trade association for the herbal products industry. 

Comment: Just as there are places where practitioner-industry relationships are suspect and likely harmful, there are others where such alliances can be useful and valuable. Quality control in natural products is one. Credit CCAOM for recognizing this. I am not aware if chiropractors, naturopathic doctors, or for that matter holistic, functional and integrative medical doctors and nurses who use herbs have gotten involved. I am betting they would be serving their missions by taking a look at this. 


Research

NCCAM begins research blog: Briggs’ early offering explores meaning of “integrative”

The NIH National Center for Complementary and Alternative Medicine (NCCAM) has announced a new ResearchBlog. The goal is “to facilitate dialogue regarding research on complementary health practices and the Center’s strategic directions and funding opportunities.” Readers are invited to provide comments. An early offering from NCCAM director Josephine Briggs, MD is entitled “Integrative – What Is in a Word?” Briggs’ cites NCCAM’s mandate and lays down a real world view: “We are focusing our resources on building better evidence to clarify whether interventions that are already being widely integrated into the real world of health care and health care systems-and for which there exists a reasonable scientific case for investment of valuable resources-are safe and have efficacy.” (Bolding is in the original.) All 4 comments at the time of this writing were from acupuncturists.

Comment: It will be interested to see if NCCAM’s antagonists decide to start participating in this blog. So will it be interesting to see whether those who have been funded or seek funding will choose to respond. I like this idea from NCCAM. I hope that the refereeing of comments includes requiring those submitting to use their real names. Meantime, I am reflecting on why I have not left on the NCCAM site my own pleasure in seeing this real world focus, and my (serious) quibble: Isn’t it “effectiveness” rather than “efficacy” we in the real world care about? 

 

IN-CAM Research Conference November 2-4, 2012: Abstract submissions close June 29, 2012 

The Canadian network IN-CAM will be holding its 7th research conference November 2-4, 2012, in Toronto, Ontario. Abstract submissions are due June 29, 2012. The note from IN-CAM co-founders Heather Boon, BScPhm, PhD and Marja Verhoef, PhD states: “The goal of the 2012 Symposium is to continue supporting the advancement of the field of complementary and integrative healthcare through research. The Symposium has also been recognized as an excellent networking opportunity as it brings together researchers, research trainees and practitioners from across Canada and internationally. It is an excellent opportunity to share new knowledge and information, strengthen existing relationships, and develop new collaborations.” 

Comment: As a sometimes participant in integrative activities across the northern border of the U.S., I must say that I find the Canadian context of multidisciplinary thinking and practice refreshing. My assumption is that this relative openness may be linked to the single payer context. Capitalism-in-medicine is hell on team care. The felt openness may also just be that Canadians are nicer than we are on the States. Then again, their having a better healthcare safety net may be a function of them being nicer. Or, well, their being nicer may because they feel safer due to having a better healthcare safety net.

 

Massage Therapy Research Conference

The Massage Therapy Foundation (MTF) has announce conference themes and a call for abstracts for the 2013 International Massage Therapy Research Conference. Abstracts are due on September 15 for the April 25-27, 2013 conference, to be held in Boston. Submissions are welcome of original research, reviews, basic and applied research, translational, participatory and community-based research, case reports and quantitative, qualitative and mixed methodologies.This is the third research conference hosted by the MTF, bringing together massage and manual therapy practitioners, educators, CIM researchers, allied health professionals, and others interested in massage research.

Professions

IAYT board of directors approves education standards for Yoga therapy 

Executive director John Kepner of the International Association of Yoga Therapists reports that “the IAYT board of directors approved the recommended standards for the training of yoga therapists yesterday (May 16, 2012) at our board meeting.” The standards are here. IAYT has set up and an Accreditation Committee to take on the job of reviewing programs and certifying individuals. IAYT worked closely with accreditation expert Dan Seitz, JD, EdD on development of the standards. Kepner thanked leaders of the Academic Consortium for Complementary and Alternative Health Care (ACCAHC) “for support and faith in us way back when,” adding: “Of course we still have a long way to go, developing an implementation plan, peer review process, etc. but this itself is a landmark event in our field.”  IAYT is a Traditional World Medicines member of ACCAHC.


Massage group engages Entry Level Analysis Project (ELAP) to clarify appropriate length of massage education

A cadre of massage leaders has engaged anew the challenge of answering key questions: “What is entry-level massage therapy education? What should core content encompass? How many hours of education are necessary for learners to obtain the basic knowledge, skills, and abilities (KSAs) needed to enter the massage profession and build a viable practice or work successfully as an employee?” The group acknowledges in a May 30, 2012 release that the present 500 hour requirement may not be appropriate. The ad hoc team plans to work with information from job task analyses and consumer and employer surveys. IThe group’s tight time-frame includes releasing a draft report for public comment during the first quarter of 2013. The ELAP work group includes: Pat Archer, Clint Chandler, Rick Garbowski, Tom Lochhaas, Jim O’Hara, Cynthia Ribeiro, Elan Schacter, and Anne Williams. Their goal: “We work group members also understand that our group has no permanent standing. Our job is to produce a thorough, defensible final report that is sufficiently compelling to motivate diverse national and local massage therapy organizations to rise to the challenge to ensure the massage profession embraces and implements the report’s recommendations.”

Comment: This initiative is surprising to me. The massage field already has a single purpose, US Department of Education-recognized accreditation agency, the Commission on Massage Therapy Accreditation (COMTA). COMTA of necessity has set standards. None of the COMTA Commissioners are part of this group. It would seem smart to start with COMTA’s work. I hope this is not another divisive move in the massage community. 

 

NY Beth Israel Integrative Medicine Leader Kligler Offers Strong Support for Naturopathic Licensing

Comment: Under another of my hats I learned that Ben Kligler, MD, MPH, the vice chair for the department of integrative medicine at New York’s Beth Israel Hospital, had submitted a strong letter of support for licensing of naturopathic physicians to the New York legislature. The letter was requested by Doni Wilson, ND, who heads the now 8-year campaign of the New York Association of Naturopathic Physicians. In his letter, Kligler first underscored the importance of team care for chronic conditions, then stated, in part: “Naturopathic physicians have a set of skills and specific approach which is unique and which can make a very important contribution to this type of interdisciplinary approach.”

Learning of Kligler’s letter reminded me of how many naturopathic doctors continue to have a polarized, polarizing and competitive feeling toward integrative medical doctors like. I have previously surprised these biases many times by asking naturopathic doctors to view the video of Andrew Weil, MD which for many years graced the NYANP site as a powerful endorsement of naturopathic licensing. The naturopathic medical and integrative MD fields are, to use a phrase my wife has used with me from time to time when I have needed to hear it, “on the same side” when it comes to shaping the health care of the future. It’s a pleasure to observe this action by Kligler.


Media

Economist poll 2-1 in favor of “alternative medicine” being taught in medical schools

In early May, The Economist asked its online readers: Should alternative medicine be taught in medical schools? Your guess for the answer? The response has bounced around. On May 12, 52% were in favor. By June 4, the pro-factor had surged to 66%. Where is it now. 

Comment: The Economist has not typically been friendly toward complementary and alternative medicine. When International Association of Yoga Therapists executive director and economist John Kepner, sent the notice of the poll, he asked me to guess. I was expecting it to be going down at a margin of 45%-55% or so. It was barely ahead. At this writing, the pro-vote was up to 66%. My guess is that many who don’t typically come to the site were steered to it and have voted late. They may have also followed the Chicago political adage to “vote early and vote often.” Still, it’s nice to see. I wonder how the poll would have been had the question been phrased like this: Should medical schools stick their heads in the sand, deny consumer use of alternatives to what their doctors typically recommend, and refuse to allow education in alternative practices inside their hallowed halls that have steered us toward a healthcare system in which half of what we do is waste and much of that harmful? Oops, I think I was allowing full knowledge of the insanity of our practice to emerge. (See reference immediately below.)

 

New York Times writer excoriates the annual physical and routine testing as sources of over-performance of waste and harm

Medical doctor and New York Times writer Elizabeth Rosenthal takes apart the testing and so-called prevention infrastructure of US medicine in a June 2, 2012 piece entitled “Let (Not) Get Physicals.” Rosenthal focuses on the over-use of the lowly physical as the tip of a cascade toward unneeded and unnecessarily-performed surgeries and procedures. 

Comment: Great and perturbing piece. I have many times quoted a statement from an IOM leader in a JAMA editorial (2008) saying nearly half of what we do is waste and most of it harmful. I quibble with Rosenthal’s statement that the contribution to over-testing and overuse of procedures by our high supply of specialists is “sociological.” We are better off calling it by its more naked appellation: economic. This allows us to think more clearly about what the solution might be. Clearly a part of it is to take the lion’s share of responsibility for our payment priorities away from the AMA’s specialist-dominant Relative Value Scale Update Committee (RUC) committee that are followed by Medicare 90% of the time. Such advice should be in some vehicle that leans towards community medicine, true prevention (lifestyle change, self-efficacy outcomes versus early diagnosis) and outpatient services.

Our reality is political-economic. We need to be able to count the votes to make the change. A specialist-dominated committee will likely produce specialist-dominated outcomes. Rosenthal does mention a terrific, countervailing campaign that underscores that some change can be fostered against prevailing economic self-interest. This is the Choosing Wisely initiative from the American Board of Integrative Medicine Foundation. In the campaign, engaged with Consumer Reports, each specialty chooses five tests or procedures commonly used in their field, whose necessity should be questioned and discussed. This campaign has now attracted nearly 20 specialty societies..  

 

Nominations open for IMCJ’s new “Award of Excellence” in Integrative Medicine

Integrative Medicine: A Clinician’s Journal has announced that it has a new Award of Excellence to “honor those leaders who contribute to CAM Medicine without expecting any recognition.” The nomination form states that IMCJ is “allowing you, our readers to assist in selecting a practitioner who has had an impact on how integrative healthcare is applied in practice.” A winner will be announced in November.

Comment: From the looks of the IMCJ notice, the award will not, alas, be a big fat check, which is what most in the integrative practice world would probably like, if not need, as pay-off for laboring without recognition.

 

Taylor Walsh makes case for integrative medicine as

Integrator adviser and frequent contributor Taylor Walsh sometimes writes for other medical blogs, including the Altarum Institute Health Policy Forum. Walsh begins his most recent offering, Health Care Transformation: Still a Work in Progress with: “Five years ago I slid serendipitously onto the outer edges of health care, landing in the highlands of integrative medicine.” Walsh, a skilled writer with a marketing mind, artfully weaves a story that allows the values in integrative care to sneak up on the reader. The might be useful to one or more of you who is working to open the heart and mind of a colleague or friend.


People

David Mercier’s A Beautiful Medicine a finalist in the International Book Awards

A gem of a book written by David Mercier, an acupuncturist with substantial health system experience in integrative care, A Beautiful Medicine, was honored as a finalist in the International Book Awards. Mercier’s health system work has been featured here and here in the Integrator. Mercier will b e delivering his two-part workshop “A Life of Vitality-Awakening the Energies of Mind, Body, and Soul The two-part workshop at the Studio in St. Michaels, Maryland on Saturday June 9th and Saturday June 23rd.  

Comment: Mercier’s book is a gem. I took it on a family reunion vacation and ended up in a depth, ongoing discussion over as period of 6 days with a brother-in-law who practices as a healer. We alternatively laid claim to the book and shared favorite sections. Nice to see Mercier’s labor achieving recognition. One day I hope to get around to writing a proper review. This book re-evokes all of why we got into this work together. A Beautiful Medicine is a beautiful book.

 

Prevention leader Jud Richland named CEO of American Association of Naturopathic Physicians

On March 23, 2012 the AANP announced a new executive director: Jud Richland. The release notes that Richland “comes to AANP from Partnership for Prevention, a national health policy organization, where he served as President and CEO.” Richland previously served for seven years as executive director of the American College of Preventive Medicine, the national medical specialty society representing preventive medicine physicians. He also served for seven years as deputy director and acting executive director of the Public Health Foundation. In welcoming Richland, AANP president Michael Cronin, ND, stated: “AANP was determined to find a CEO who is passionate about improving health and who is experienced in driving policy change.”

Patricia Herman, MS, ND, PhD takes research position at RAND Health division

Economist, naturopathic physician and leading cost researcher Patricia Herman, ND, PhD has just accepted the position of Senior Behavioral Scientist in the RAND Health division of the RAND Corporation. Herman shares that in this position she plans to help build RAND’s complementary and integrative medicine research and to participate in broader health services research initiatives. Herman has been an economist for 30 year. She was previously invited to co-author a commissioned paper on the economics of integrative medicine for the Institute of Medicine’s Summit on Integrative Medicine and the Health of the Public. She has served on National Institute of Health review panels, and was an invited speaker at the Office of Dietary Supplement’s workshop on the Economic Analysis of Nutrition Interventions: Methods, Research and Policy.

Moira Fitzpatrick, PhD, ND selected to head of Bastyr Sand Diego campus

In a May 23, 2012 release, Bastyr University named Moira Fitzpatrick, PhD, ND, FICPP, CHT  as named Bastyr University California’s new vice president. Fitzpatrick has a BA in developmental psychology from UC Davis, an MA and PhD in clinical psychology from California School of Professional Psychology and a Doctor of Naturopathic Medicine degree from Bastyr University.  She is currently the principal at Emerald Center for Integrative Medicine in the Seattle area. Fitzpatrick will serve as both chief administrative and academic officer.

Dana Ullman’s Homeopathic Family Medicine

Dana Ullman, MPH, considered by many the foremost writer on homeopathy sent notice that his main writing project currently is an e-book entitled Homeopathic Family Medicine: Evidence Based Nanopharmacology. Ullman views the project as the “most comprehensive and up-to-date body of clinical research published in peer-review journals” on homeopathy. Ullman says adds new information monthly for subscribers. Todd Rowe, MD, the founder of the American Medical College of Homeopathy, celebrates the value of Ullman’s resource here.