November 2011 John Weeks Integrator Round-up: Policy
The September 2011 “strategic change in direction” by leaders of the Arizona Center for Integrative Medicine to promote recognition of a board-certified integrative medicine specialty prompted significant, sometimes fractious dialogue in the integrative practice community. Some perspectives on the proposed American Board of Integrative Medicine (ABIM) were captured in Integrator Forum: 20 Voices on Weil/University of Arizona and the American Board of Integrative Medicine. This diverse grouping of responses included MDs, DCs, NDs, AOM leaders and others, including two anti-“Quackademic” bloggers. A second set of respondents contributed after reading the dialogue in the first group. These are captured here: Forum #2 on the American Board of Integrative Medicine: Quinn, Redwood, Gmeiner, Anderson and Manahan.
The Arizona’s Center’s change in direction is from promoting “integrative medicine” as the right approach for every branch of medicine to advocating formation of an integrative medicine specialty. The Arizona Center’s executive director Victoria Maizes, MD clarified that the move is part of a “both/and” focus for the Center. They are still promoting an overall transformation toward an integrative model. The 20 Voices also stimulated this follow-up discussion by an anti-CAM/IM blogger who celebrates the apparent divisiveness of the move.
Comment: This is not capital “P” policy but is certainly core policy inside the integrative practice community. The topic is like a natural therapeutic regime that successfully surfaces both entrenched morbidity and abiding hope. My sincere intent is that the perspectives registered in these Integrator postings will lead those establishing ABIM to more deeply embrace the emerging discipline’s most transformational potential. This means an enhanced focus on the interprofessional education that a patient-centered approach requires. This will address the critical interprofessional concerns directly and indirectly note by many. Many who can’t sit for the BCIM are not yet sure that historic and continuing political-economic suppression of other disciplines by medical doctors will not be furthered, again, by the emerging guild of MD-BCIMs.
US Senator Amy Klobuchar(D-MN) and US Representative Erik Paulson (R-MN) have announced the creation of the Congressional Wellness Caucus. The focus is “to put workplace wellness on the national agenda,” according to an article on the June kick-off. Despite well-researched savings associated with wellness programs, “only about 27 percent of employers with 500 or more employees offer wellness programs and about 43 percent with 10,000 or more do” according to the article. The timing of the creation of the Wellness Caucus was within 2 weeks of the publication of the National Prevention Strategy via the National Prevention Council (see article below). The caucus, expected to be fully functional by this fall, was referenced in a November 1, 2011 Congressional briefing that was led by Trust for America’s Health (TfAH). Notably, the executive director of TfAH, Jeffrey Levi, PhD, serves as chair of the Advisory Group on Prevention, Health Promotion and Integrative and Public Health that advises on the above-mentioned National Prevention Strategy. Participants in the Congressional briefing included representatives of the Robert Wood Johnson Foundation, National Business Coalition on Health and the Alliance for a Healthier Minnesota. Joining the Minnesota co-founders in the bi-partisan Caucus are Sen. John Thune (R-SD) and Rep. Ron Kind (D-WI). (Thanks to the Integrated Healthcare Policy Consortium for bringing the November event to my attention.)
In an October 7, 2011 announcement, Barack Obama appointed Janet Kahn, PhD to the Advisory Group on Prevention, Health Promotion and Integrative and Public Health of the National Prevention Council. Kahn has been a leading advocate for integrative practices and a health-focused delivery system through her service as executive director of the Integrated Healthcare Policy Consortium which nominated her for the post. Kahn has served on a number of boards, including that of the National Advisory Council for Complementary and Alternative Medicine at the National Institutes of Health. Kahn is the second individual closely connected to the integrative practice fields to gain appointment to the council. The first is Charlotte Kerr, RSM, BSN, MPH, MAc, an emeritus faculty member at Tai Sophia Institute. The Advisory Group is charged with assisting the Council in developing the nation’s prevention and health promotion strategy. Kahn consults on federal policy with the Consortium of Academic Health Centers for Integrative Medicine.
The Integrated Healthcare Policy Consortium (IHPC- www.ihpc.info) is celebrating the appointment of senior associate and past executive director Janet Kahn, PhD, to the Advisory Group of the National Prevention, Health Promotion and Public Health Council. According to an IHPC release from chair Len Wisneski, MD, Kahn, a researcher and practicing massage therapist, is expected to have a significant role in shaping the nation’s relationship to integrative care from her position on the Advisory Group. Meantime, IHPC has announced new members of its diverse Partners for Health program. The current list includes the following, with those relatively new in italic:
- American Academy of Pain Management
- American Association for Acupuncture and Oriental Medicine
- American Association of Naturopathic Physicians
- American Massage Therapy Association
- Bastyr University
- International Chiropractic Pediatric Association
- National Association of Certified Professional Midwives
- National Center for Homeopathy
- Oregon College of Oriental Medicine
- Palmer College Center for Chiropractic Research
- Sojourners Community Health Clinic
- Tai Sophia Institute
Comment: It is pleasing that Kahn will continue to work with IHPC in her Senior Adviser capacity. She helped IHPC accomplish a good deal as executive director in an environment of great scarcity. Kahn extended herself personally in many ways. She had a key role in placing licensed complementary and alternative healthcare practitioners in the nation’s workforce planning, via her home state connection with US Senator Bernie Sanders. Meantime, this is a nice group of Partners for Health! Here’s a wish that some philanthropist or corporation with skin in this game will realize how much fun and value could come from jumping in and empowering this group with some real cash!
I place the TEDMED conference under Policy because of a decision by the new owner of the brand, Jay Walker. The billionaire TEDMED curator who founded Priceline has announced that this influential gathering of medical innovators will be moving next year. TEDMED will leave its cozy 2009-2011 community-enhancing home at San Diego’s luxury Hotel Del Coronado for the Kennedy Center in Washington, DC. Explains Walker: “Holding TEDMED’s annual conference at the health and medicine capital of the world will amplify the voice of the TEDMED community, bringing TEDMED to a larger stage where the members of our community can provide a much-needed national service.” TEDMED 2012 will be in the heart of the nation’s Beltway and a half-year earlier, April 11-13, 2012.
TEDMED, under Walker’s leadership, saw diminished visibility of integrative medicine. The first two years featured 1-3 presentations from the pantheon of the most visible integrative medical doctors. One or more of the segments each of the first three years were presented by Andrew Weil, MD, Dean Ornish, MD, Deepak Chopra, MD, Mehmet Oz, MD and Mark Hyman, MD. No integrative MD was on the TEDMED 2011 program for the estimated 850 participants. Mycologist and author Paul Stamets was as good as it got for integrative practice.
Comment: The barrier to entry for TEDMED is high, at $4000 per person. I was gifted an opportunity to attend the October 25-28, 2011 meeting. I will report the excitement and sometimes disturbing trend-lines more fully soon. Walker, whose passion for the history of innovation is infectious, noted on closing that some attendees had told him that the 2011 iteration “left out the patient perspective.” Walker said he’d bring it back. Here’s hoping that his concept of innovation is broad enough to include the substantial cultural innovation engaged by the patient population when it co-conspired with diverse practitioners to invent the holistic and complementary and alternative healthcare disciplines. I have heard that Walker is personally supportive of integrative medicine. Hopefully the omission will be righted in the Beltway in 2012.
Lori Knutson, RN, BC-HN, is an integrative care educator and the integrative health leader for the nation’s most significant health system-based integration initiative, Allina Hospitals and Clinics. Knutson sends notice that the US Preventive Service Task Force (USPSTF) is seeking information on what should be considered in its “development of academic curriculum as it relates to prevention.” I asked Knutson for her perspective on why the integrative health community should participate. She wrote:
“This is a cultural imperative. If we are serious about influencing the health of our nation and integrating ‘CAM’ in the tapestry of care then we must not only focus on delivering services and researching outcomes and best practice. We must proactively embed this work in academic institutions so that integrative care/medicine/health is the norm and not the exception for healthcare provider education. The U.S. Preventive Services Task force is asking for feedback on how to improve the academic training of healthcare providers to ensure health promotion and prevention as having equal relevance to the academic focus on treatment of disease and illness. I propose we have an obligation to be active partners in ensuring this.” The link to the USPSTF is here. The link on the curriculum is here.