John Weeks June 2013 Integrator Round-up covering the topic of Integratve Health care professions.

American Association of Acupuncture and Oriental Medicine (AAAOM) calls for comments on its position statement on “dry needling”

The American Association of Acupuncture and Oriental Medicine (AAAOM) convened a Blue Ribbon Panel on Interprofessional Standards that has taken a strong stand against other professions renaming acupuncture to put therapeutic use of needling in their practices. In a draft document sent to members for review, the panel asserts that “dry needling and any of its alternate designations, including intramuscular manual therapy, trigger point needling, functional dry needling, intramuscular stimulation or any other method by which a needle is inserted to effect therapeutic change, is, by definition, the practice of acupuncture.” The four page document reviews historic precedents, educational standards and concerns. It closes with this recommendation: “The AAAOM strongly urges legislators, regulators, advisory boards, advocates of public safety, and medical professional associations to carefully consider the impact of trends in scope of practice expansion issues.” The document does not share who served on the Blue Ribbon Panel. AAAOM is led by Michael Jabbour, CSP, MS, LAc.

: Many leaders of the AOM profession are deeply concerned about the future of their own field, especially as the rapidly-growing allied health profession of physical therapy is moving both toward doctoral status and into adding dry needling.


Naturopathic doctors celebrate breakthrough with state regulation in Colorado

The American Association of Naturopathic Physicians announced June 5, 2013 that Colorado Governor John Hickenlooper “signed into law a measure to allow naturopathic doctors to register with the state to legally practice naturopathic medicine.”  Colorado became the 17th state with regulation, along with the District of Columbia. State Senator Linda Newell (D-Littleton), the bill’s leading backer, is quoted as saying that “naturopathic doctors are going to be a key component in health care, saving the state millions of dollars through their focus on disease prevention and natural treatment, such as nutrition, lifestyle counseling and botanical medicine.” The action followed 20 years of legislative campaigns in Colorado be a succession of leaders. Denise Clark, ND, was the most recent leader of the effort. She followed Jacob Schor, ND and Rena Bloom, ND, and Louse Edwards, ND, LAc, and others.

Comment: The sick joke about the barrier to licensing for naturopathic doctors is they have clowns to the left of them, jokers to the right. Meaning: opposition from self-described “naturopaths” on the one hand who cannot meet regulatory standards, and from guild-protecting medical doctors on the other. Nowhere have the clowns been more effective than in Colorado.

Perhaps this will be a breakthrough year for the naturopathic profession. Under-handed, guild-based opposition from the the AMA’s Scope of Practice Partnership have kept the field from adding regulated terrain in recent years. But in recent months, the field was a governor’s signature away from a bill in Massachusetts last December and saw bills pass out of committees in Pennsylvania and New York the week Hickenlooper signed. For the NDs, those 3 states would bring them to 20 states and give them their first, major, East Coast presence. This would be transformational. Then, of course, the profession will have to deal with having settled for registration rather than licensing, in Colorado as in Minnesota, the most recent new state.


U.S. MERA conference brings nurse-midwives and certified professional midwives closer to a single voice

On April 19-21, 2013, a historic meeting took place of US MERA (Midwifery Education, Regulation and Association) in Arlie, Virginia. According to this release, the member organizations included three associated with nurse-midwifery [American College of Nurse-Midwives (ACNM), Accreditation Council for Midwifery Education (ACME), American Midwifery Certification Board (AMCB)]. Also involved were four associated with direct-entry midwifery [Midwives Alliance of North America (MANA), Midwifery Education Accreditation Council (MEAC), North American Registry of Midwives (NARM), and National Association of Certified Professional Midwives (NACPM)]. Those present recommended the establishment of the US MERA Work Group as an ongoing entity with the purpose to “create a shared vision for U.S. midwifery within a global context, generate an action plan for collaboration to strengthen and promote the profession of midwifery in the United States, thereby engendering a positive impact on U.S. maternity care that will improve the health of women and infants.”   

Comment: Excellent to see this move toward ongoing collaboration between two branches of a field that has been the subject of a great deal of misleading, self-protective assaults from obstetricians. I had a chance last year to participate in an Arlie meeting of the non-nurse midwives. A nurse midwife leader was present, and celebrated for promoting dialogue. My learning birthed the following piece which produced a good deal of controversy and 3500+ likes on Huffington Post: Homebirth Midwives and the Hospital Goliath: Evidence Builds for Disruptive Innovation. No question: midwifery care and home birth fit with the Triple Aim.


American Chiropractic Association boasts “cultural authority” with a Vermont Blues plan

In a June 6, 2013 notice to members, the American Chiropractic Association announced that their “credibility is growing among payers.” The evidence: Blue Cross Blue Shield of Vermont (BCBSVT) “reached out to ACA’s Vermont Local Liaison, Eric Hemmett, DC, requesting information about chiropractic services that it could share with its membership.” The Local Liaison program is an ACA initiative. The organization supported Hemmet and BCBSVT by “design(ing) a new patient handout providing an overview of the profession. The ACA release spoke of the BCBCVT request as a sign of “growing cultural authority among payers.”

Comment: This is a good sign for chiropractors. I am sure they would like to see a large state like New York doing the same. The handout, notably, informed patients that treatment takes “a certain number of visits,” which is less specific than some payers might like. The association’s flier adds, however, that it is the provider’s responsibility to share an estimate of visits up front.