Healthcare professional resource featuring the most recent developments in Integrative Healthcare policy, research, education and news, courtesy of John Weeks and the Integrator Blog, March 2012 Academic Health edition

Six profession organization enters the team care/interprofessional education space: from dictatorship to oligarchy? 

The movement toward interprofessional education (IPE) and team care took a curious organizational step in February 2012. Academic organizations representing the six most significant health professions (medicine, pharmacy, nursing, public health, dentistry and osteopathy) announced that they have formed a new organization, the Interprofessional Education Collaborative (IPEC). The release notes that “as a stand-alone entity, the new IPEC will provide leadership around national initiatives to advance interprofessional education (IPE) and share information on IPE best practices and collaborative practice innovations.” The academic organizations for these six disciplines first came together under the IPEC name in 2009 to develop a document published in May 2011 called Core Competencies for Interprofessional Collaborative Practice

Comment: Normally I would greet news of collaboration between medical disciplines with unrestricted positivity. It furthers us to cross the great water out of our guilds. But the timing of this announcement looks like a power-play by a subset of professions to control what was shaping up as a broadly inclusive movement. The image is of a transition from the historic dictatorship of care by MDs to a six family, biomedical oligarchy that may make second class citizens of other professions in the whole body-mind-spirit of quality care.

Here is context. Just last year, a project that has carried the IPE torch in the U.S., American Interprofessional Healthcare Collaborative, formally incorporated as a stand-alone entity. This group, closely connected with the pioneering (and Canadian government funded) Canadian Interprofessional Health Collaborative, has pushed IPE/C for years as an important shift in U.S. health care. The group, headed by Barbara Brandt, PhD, is inclusive. Among the board members, for instance, is CIHC leader, John Gilbert, PhD, a speech therapist by training. The work in Canada, which Gilbert leads, has included chiropractors and midwives. The AIHC and CIHC organizations jointly promote the biennial Collaboration Across Borders conference. The conference surged in attendance in 2011 to roughly 700 from half that size two years earlier. The felt sense among the long-time laborers in this fields was that the movement had finally arrived.

As a participant in that meeting on behalf of educators in integrative health care, I experienced the openness and receptivity to the integrative health disciplines participating in this nominally patient-centered movement. As one who has known what it is to labor in obscurity and without two dimes to rub together, I had hoped that the foundation community would finally bless and empower the AIHC work in a significant way. The work is important.

Yet it appears that the “Big Six” professions comprising IPEC are taking that wind and inserting their professions in the movement’s driver’s seat. With announcement of the founding of IPEC organization came word of a May 2012 meeting. I clicked in: the May 2012 IPEC Institute was already announced as Sold Out!  

The problem with this limited set of disciplines is that the whole person is poorly represented. Will this group insure there is space at the table for psychologists? Social workers? Physical therapists? Chiropractors? Mental health counselors? Naturopathic doctors? Functional medicine educators? Will members of other disciplines have any say over programs and organizational directions? Or have they decided that, for now, IPE is a 6 discipline game.

A colleague who is a seasoned academic veteran urged time and patience. She shared her willingness to accept this as a step in the right direction for these typically silo-ed guilds. Yes, this is good. But why begin without the mind, spirit, treatment of the body and access to community services fully included– via psychology/mental health, PT/chiropractic/massage and social work — not to mention the other licensed integrative practice fields. I will learn more about this soon and report back whether my concern is valid that this was less a “patient-centered” move than a “profession-centered” power play to limit and control the emergence of democracy among professions. In place of dictatorship, oligarchy. I hope I am wrong. 


Consortium of academics in chiropractic, AOM, naturopathic medicine, massage and midwifery receive a breakthrough $100,000 grant from the Westreich Foundation 

The Westreich Foundation “broke the glass ceiling” that has kept significant philanthropic support for  integrative health initiatives that are not run by medical doctors. So asserts a February 29, 2012 release from the Academic Consortium for Complementary and Alternative Health Care (ACCAHC). The foundation, led by Ruth Westreich, chose to give ACCAHC $100,000 over three years to support “the bridging and collaboration [ACCAHC is] striving to accomplish across all fields of quality care.” Ruth Westreich, the foundation’s president, states that the grant was made because: “I believe that [ACCAHC] is playing a significant role in breaking down the dreaded silos of individual groups and are able to envision the greater, larger picture of a preferred patient-centered care model. I am hoping that this grant will allow you even more time to create collaborations between CAM [complementary and alternative medicine], integrative medicine and palliative medicine.”   

The funds will provide staff support for ACCAHC initiatives which include, according to the release, “expanding evidence-informed education, enhancing competencies for optimal practice in integrated environments, and preparing leaders in whole person health.”

Comment: As a part of the ACCAHC team, I found the Westreich Foundation’s grant to be particularly good news. I will personally be allowed more time to work through ACCAHC on networking and program development to help knit new relationships between the disciplines. It remains a curious thing that long-time builders of the movement for whole person, human-intensive, natural health approaches have substantially been passed over since significant philanthropy entered the integrative medicine picture 15 years ago. Money has instead gone to the last players to arrive in the game; namely, the academically-based integrative MDs. There is much good that has come of that priority. Witness the Bravewell study reported in this Round-up as an example.

But what are the optimal strategies to effect the transformation toward a wellness model of care? Change can certainly come from the top down and often does. Yet strategies for leveraging transformation may also come bottom-up, through empowering the already committed grassroots. In the integrative practice movement, the most organizable grassroots are the 350,000 plus licensed CAM practitioners who are delivering high-touch, integrative care daily. What might be accomplished through better empowering these professionals? Doesn’t a kind of pincer movement for integrative health make sense, enabling both top-down and bottom-up strategies? The Westreich Foundation grant represents a visionary breakthrough as a philanthropic contribution toward potentiating pent-up collaborative interest in these disciplines.