John Weeks’ August 2012 Round-up to include news headlines on the topic of integrative centers

October 2012 Integrator Google Alerts extracts from academic and health system action in integrative medicine

The 35 short segments in this article, Integrative Medicine in Academic Centers, Hospitals and Health Systems Via Google Alerts: October 2012, were extracted from scores of Google Alerts links in the previous month. The focus on health system-based integrative medicine programs from mid-September through October 6, 2012. Each is noted with a single line and a link. The article is meant to serve as a quick scan of developments in the rapidly evolving medical doctor-focused areas of integrative medicine in hospitals, health systems and academic health centers. Health systems referenced in this article include Duke, LSU Shreveport, 3 new Jersey systems, Sutter Sacramento, East Connecticut Cancer Institute, NY Beth Israel, New Hampshire’s Hospital for Children, Arizona Center for Integrative Medicine, a n eastern Oregon VA, Simms-Mann at UCLA, UC Irvine primary care, Michigan’s Holland Hospital, and over two dozen more. This monthly service will henceforward be a regular feature of the Integrator, with a link in the monthly Round-up. Click here for the October article.

Comment: As a side-note, two areas of significant media attention during the month were stimulated by scientific publications with positive outcomes for integrative approaches. One is the Scripps-based study on mind-body for PTSD in Marines.  The other was the systematic review of patient outcomes in the acupuncture literature noted elsewhere in this Round-up.

 

Chiropractic House of Delegates passes resolutions on a chiropractor’s role in integrative centers

The House of Delegates of the American Chiropractic Association passed a resolution relative to appropriate relationships in integrative centers at their late September 2012 meeting. The policy “offer(s) guidelines on participating in multi-disciplinary practices to help chiropractic physicians evaluate whether such opportunities emphasize financial gain over clinical appropriateness.” It goes on: “The policy touches on the importance of an independent legal consultation before entering into an agreement and also provides specific guidance on hiring personnel, patient supervision, referrals, and coding and billing issues.”

Comment
: The disquieting chiropractic focus on a potentially non-patient-centered motivation leads to a flippant recollection that a great deal of “integration” into hospitals health systems over the past 15 years was stimulated more by financial gain (luring and pleasing customers) rather than medical leadership arguing for “CAM” inclusion as “clinically appropriate.” That said, the chiropractors’ focus on motivation leaps out. This is particularly so since the House also passed a resolution “promoting strict standards of conduct by encouraging members to adhere to not only ACA’s Code of Ethics but all relevant federal and state statutes providing anti-fraud standards.” That the ACA believes that focusing on ethics and motivation is this important evidences an apparent need. Credit the ACA’s willingness to step into what must be a challenging internal issue. No one likes airing dirty laundry in public. Again, credit the ACA’s self-regulatory instinct.

However, perhaps the most interesting statement in the report of the House of Delegates meeting is the quote from ACA president Keith Overland, DC describing the lure of chiropractic to patients. Overland attributes it to the profession’s “collaborative, integrated, distinctive approach to health care that uses conservative, natural approaches first.” The “collaborative, integrated” language is welcome positioning for a profession that has historically been quite isolated. Good also to see the profession making a point of its respect for the therapeutic order that in embodied by putting the least invasive, conservative practices first.