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

NCQA to “score” Vermont’s naturopathic doctors in medical homes, according to report from Vermont’s Lorilee Schoenbeck, ND 

The February 2012 issue of the newsletter of the American Association of Naturopathic Physicians includes a synopsis of medical home developments from a naturopathic perspective by Lorilee Schoenbeck, ND, a leader of that profession in Vermont. Of particular note is the effort of Vermont naturopathic doctors to gain recognition through the National Committee for Quality Assurance (NCQA), which accredits medical homes. Schoenbeck writes:

“NCQA: The Medical Home Model is currently being promoted and accredited by a national, private organization called the National Committee for Quality Assurance (NCQA). Prior to the efforts of Vermont, the NCQA did not acknowledge or ‘assess and score’ NDs as Medical Home applicants. However, now through our state’s health reform agency, we have been successful in having NCQA assess our clinics to provide scores. To date the NCQA has not formally certified NDs. The assessment is a major breakthrough and one we continue to use with our state legislature to gain recognition.”

Schoenbeck has led successful efforts in the state of Vermont to include NDs in insurance coverage and  as primary care, Medicaid-covered practitioners. She concludes her article to her naturopathic colleagues this way: “At one time, PA’s and NPs were not recognized by the NCQA. Pressure from the states and state legislation changed this policy. NCQA recognition may be a way ‘in’ through health care reform for NDs wanting to maintain their status as a PCP.”

American Chiropractic Association House of Delegates chastise some chiropractors in effort to position the profession for primary care role 

According to this release on their February 2012 regular meeting, the American Chiropractic Association (ACA) House of Delegates approved a new policy supporting the organization’s efforts “to position DCs as conservative primary care doctors who can help fill the looming primary care workforce gap.” The policy reads: 

“Public Health Concerns Due to Failure to Differentially Diagnose. ACA condemns as a threat to public health the failure by doctors of chiropractic/chiropractic physicians to adequately differentially diagnose and/or to sell treatment packages in the absence of a differential diagnosis. Such practices are contrary to the doctorate level of education inferred by our degree. Furthermore, they are contrary to the universally accepted standards of care and do not represent the customary practices of a member doctor of this organization.”

The meeting also included a discussion among nine chiropractic college presidents about the doctor of chiropractic as a primary care provider.

Comment: The position of chiropractic doctors relative to primary care is a challenge on many fronts. On one hand, some chiropractic colleges train these professionals for the broad scope practice of what they prefer to call “chiropractic medicine.” On the other are those who find any connection of “chiropractic” to “medicine” an utter violation of the profession’s core values. This ACA resolution appears to be a slap to the subset of the latter group who may be adjusting without thorough diagnosis. Then again, the business model of The Joint … the chiropractic place, reported elsewhere in this Round-up, is also likely to be a target. The low costs services will also be likely to stimulate a limited commitment to differential diagnosis.


Notes from the 2010 annual report from the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) 

The most recent Annual Report (2010) from the National Certification Commission for for Acupuncture and Oriental Medicine (NCCAOM) provides a useful glance inside the AOM profession. At the end of 2010, NCCAOM had 16,899 Diplomates worldwide, up 17% since early 2008. Operating revenues of the organization in 2010 were $2.9-million. Total applicants dropped from 1,833 in 2009 to 1481 in 2010. One part of NCCAOM’s mission is to provide “information and testimony” on various state licensing and scope issues to legislators nationwide. NCCAOM was active in 16 separate jurisdictions in 2010. The report concludes with a list of Professional Ethics and Disciplinary Cases that NCCAOM reviewed. NCCAOM chair is David Canzone, Dipl. Ac., DOM, Dipl. NBAO and the chief executive officer is Kory Ward-Cook, MT (ASCP), PhD, CAE.

Effort underway to revitalize National Association of Nurse Massage Therapists 

A January 2012 release from the National Association of Nurse Massage Therapists (NANMT) announces efforts of the organization to revitalize its work under new leadership. According to the release, NANMT was organized in 1992 and “has been recognized as the official organization representing the specialty practice of Nurse Massage Therapy.” NANMT “supports the emerging trend of State Boards of Nursing to incorporate the specialty services provided by Nurse Massage Therapists as a component of the Nursing Process within the Scope of Practice of Professional Nursing.” The group is presently small. A national referral directory lists just 3 nurses massage therapists in Washington, 5 in California and 0 in Massachusetts. The membership standards are certification through the National Certification Board for Therapeutic Massage and Bodywork, licensing in a state as a massage therapist or completion of a 500 hour course.

Comment: As a sometimes patient, my bias is that more nursing professionals would be good at massage. It is pleasing to see that the massage education standard is not less than the already low standard (500 hours) for massage education. This is in contradistinction to the typically 150-300 hour of training typically required for a medical doctor, chiropractor or naturopathic doctor to be allowed to practice acupuncture under their MD, DC, or ND licenses – as compared to 10 times as  many hours for a licensed acupuncture and Oriental medicine professional.


Foot Levelers, major donor to chiropractic PR effort, pledges additional million dollars  

The February 2012 issue of the newsletter of the Foundation for Chiropractic Progress (F4CP) announced that orthotics manufacturer Foot Levelers has pledged an additional million dollars to support the profession’s robust public relations effort. The firm has already granted F4CP over $1.3-million since the organization was founded in 2003. As part of the new million, the firm matched $81,000 of pledges at a recent Parker Seminars meeting. These included, as the F4CP reports:

  • American Chiropractic Association (ACA) increased its annual contribution of $4,000 to $8,000 (prior donations total $31,800)
  • Michigan Association of Chiropractors made its annual pledge of $18,000 (prior donations total $57,000)
  • Northwestern Health Sciences University contributed $14,000 (total contributions equal $102,500)
  • Performance Health contributed $10,000, in addition to its normal $25,000 pledge, in honor of General Halstead’s service to chiropractic (total contributions equal $115,000)
  • ChiroHealth USA contributed $2,500 in addition to its normal monthly pledge for 2012 (total contributions equal $26,205)
  • Hill Laboratories became a contributor with a donation of $6,000 annually

Comment: This campaign is a textbook, profession-wide grassroots fundraising effort. The major contributors – Foot Levelers and Standard Process – are partially drawn in by the significant grassroots support. In this case, over 2000 individuals and organizations are making monthly contributions. In the driver’s seat as COO of F4CP is former ACA executive director Garret Cuneo.