October 2012 John Weeks Integrator Round-up covering the topics of:  Policy; Costs, Coverage adn Employers; Integrative Centers; Business; Organizations; Professions; Media and People

by John Weeks, Publisher/Editor of the Integrator Blog News & Reports 

Policy

American College for Preventive Medicine wins $774,000 HRSA grant to create National Coordinating Center for Integrative Medicine

The American College of Preventive Medicine (ACPM) announced on October 3, 2012 that it has received “a cooperative agreement award from the Health Resources and Services Administration (HRSA) to create a National Coordinating Center for Integrative Medicine (NccIM).” The $774,000 award will focus on the preventive medicine specialty and particularly 12 preventive medicine residencies that received smaller awards. But ACPM will also “provide technical support for other preventive medicine residencies and other health professions training programs in integrative medicine. According to the ACPM, the “centerpiece” of ACPM’s approach to the NccIM “is to create, convene, administer and sustain a Community of Learning for integrative medicine (IM) and preventive medicine that includes partners in Preventive Medicine training, primary care, other health professions such as nursing, dentistry, and pharmacy, and complementary and alternative medicine (CAM) practitioners from a wide variety of practice modalities.”

ACPM Executive Director, Michael Barry comments: “With our focus on evidence-based interventions to prevent disease and promote health, healthy lifestyles, and systems-based approaches to health care, and our longstanding relationship with and commitment to Preventive Medicine Residency training programs, I believe ACPM is uniquely qualified to lead this effort.” The award is to cover two years of operations. ACPM has “committed to the sustainability of the NccIM initiative beyond the life of the HRSA funding cycle.”

Comment: The NccIM award caused a special happiness for this writer. The Academic Consortium for Copmplementary and Alternative Health Care (ACCAHC) with which I work was asked to be a partner organization on this grant. ACCAHC wrote a support letter. I was also asked to serve on an advisory panel. The panel is expected to be chaired by Yale integrative medicine leader David Katz, MD, MPH, and also includes his colleague there, Ather Ali, ND, MPH. Other partners include, on the integrative health side, the American Association of Naturopathic Physicians and the Integrative Healthcare Policy Consortium (IHPC). Also on the team with deep background in integrative medicine and health are Len Wisneski, MD, IHPC chair, and Pamela Snider, ND, an AANP leader with strong links to both IHPC and ACCAHC. What was most pleasing in ACPM’s approach was the interprofessional and approach lodged in a deep commitment to primary prevention. Here’s hoping this Community of Learning has tremendous, positive influence in the evolution of education in integrative medicine.

 

Minnesota receives $4-million from HRSA as the first National Coordinating Center for Interprofessional Education and Collaboration

A September 26, 2012 article in the University of Minnesota Daily reports that the University of Minnesota bested 13 other applicants in gaining a $4-million award from the Health Resources Services Administration as the first National Coordinating Center for Interprofessional Collaborative Practice. The HRSA funds, granted over 4 years, will be significantly enhanced via $8.6-million pledged from a consortium of private foundations. The announcement from U Minnesota’s associate vice president and center director Barbara Brandt, PhD notes that the new center will “teach nurses, physicians, pharmacists, social workers and other health professionals to improve communication with each other and to work as a team. Said Brandt: “The endpoint is not how professionals are collaborating. The endpoint is on what are the outcomes of health. So how do we improve the health of people and communities?”

Comment: The University is a terrific site for this award, from the perspective of the integrative health community. First, Mary Jo Kreitzer, RN, PhD, FAAN, integrative health leader at the academic health center, is a long-time colleague of Brandt. Second, Kreitzer’s center for Spirituality and Healing has a history of collaborating with academics in the licensed CAM fields, particularly through Northwestern Health Sciences University but also Bastyr University. Third, Brandt is personally familiar with the integrative health movement. She will key-note the upcoming International Congress for Educators in Complementary and Integrative Medicine. Fourth, the Center will focus on connecting professionals more deeply with the real world needs of the healthcare delivery system. The Twin Cities has perhaps the highest level on integration of integrative health practitioners into mainstream service delivery of any metropolitan area of the country.

Colleagues in integrative medicine have shared their excitement with this award. Only time will tell how much “other health professionals” may include these disciplines who are part of a patient-centered interprofessional system. My guess is that it will take some persistent knocking on the doors. But as George Thibault, MD, one of the foundation leaders supporting this initiative said recently, interprofessional education needs to “widen the circle” and not “create a new elite.” (See Widening the Circle: ACCAHC Report from the 1st IOM Global Forum on Interprofessional Education and Care.)

Costs, Coverage and Employers

Key data for policy leaders published in Herman-Eisenberg systematic review of cost-effectiveness in CIM

A critically-needed review of all cost-effectiveness studies on complementary and integrative medicine (CIM) found 28 “high-quality studies,” according to lead author Patricia Herman, MS, ND, PhD. The review was global and covered the years 2000-2010. Herman, an economist and licensed naturopathic doctor, first engaged the project with David Eisenberg, MD with the Harvard School of Public Health, in 2008. The report is entitled “Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations.” In an interview published here Herman states: “I’m tired of this talk that there is no evidence for cost-effectiveness of complementary and integrative medicine. There is evidence. We need to move onto phase two and look at how transferable these findings are. We can take this evidence and run.”

Studies which found frank “cost savings” ranged from acupuncture for breech delivery and for low-back pain, to manual manipulation for neck pain, natural products for various conditions, and a study of the whole practice of naturopathic medicine for chronic low back pain. Those that were found cost-effective based on analysis of changes in quality adjusted life years included treatment in clinics of Oregon chiropractors, massage, Tai chi, Alexander technique, and numerous studies of adjunctive acupuncture treatment. A column on the topic is here: Review Finds Cost Effectiveness of Complementary and Integrative Medicine in More Than Two Dozen High-Quality Studies. 

Comment: First, credit Herman, in particular, for the labor that this survey entailed. She personally read over 13,000 abstracts generated through key words searches. Second, why just 28 studies, globally, in 10 years? heck, this is an era in which many are obsessed with the awful cost situation. In fact, if one looks closely, one finds only 2 that are actually looking at the way whole person practitioners treat patients in the real world. This is a time to truly bemoan the fact that the NIH National Center for Complementary and Alternative Medicine has failed to comply with the real world, outcomes-plus-health services charge Congress gave the agency in 1998.  Will the next decade bring more than this sparse yield. Regardless, as Herman says, those who say there are no cost benefits from CIM services should be muzzled. The comment field here shows, however, that the Polarizing Science Blogger naysayers cannot be convinced by evidence.


Washington Post
touches on state decisions relative to chiropractic and acupuncture in essential benefits

The WonkBlog for the Washington Post included a September 22, 2012 piece called: “Is acupuncture an essential benefit? Weight loss surgery? Under Obamacare, states choose.” In California acupuncture is in. In Michigan chiropractic is in. Yet in Oregon “officials would leave both of those benefits on the cutting-room floor.” The article details other negotiations and decisions in other states: “That nationwide patchwork highlights the difficulty of agreeing on what constitutes good basic health care, as well as the tricky balances that states face in weighing coverage vs. cost.” An Oregon administrator opined: “This being Oregon, where you have a school of chiropractic care, there was a lot of discussion about alternative medicine,” said Jeanene Smith, administrator of the Office for Oregon Health Policy and Research. “We felt that there was some benefit, but we didn’t exactly consider these to be absolutely essential.”

John Falardeau, policy lead for the American Chiropractic Association is quoted this way: “It’s a very big issue for us. We’ve been working hard with our state associations to make sure they’re at these meetings, to even get on the essential benefit advisory board.” All states must cover 10 broad categories, including “ambulatory patient services,” drugs, ER visits, preventive services and lab. A California Medical Association article on acupuncture’s inclusion begins: “The era of acupuncture’s existence as a practice on the margins of medicine appears to be inexorably drawing to a close.”

Comment: What is particularly notable in the Oregon decision is that the state also has a top acupuncture and Oriental medicine school and a top school of naturopathic medicine. Basic patient evaluation and management from members of the latter profession will likely be included under “ambulatory patient services” – after a lawsuit or two – if Section 2706 of the Affordable Care Act stays on the books. The section which requires non-discrimination among different disciplines, stays on the books. A brief below looks at efforts of massage therapists in Washington state to gain inclusion in that state’s plan. (Thanks to Kory Ward-Cook, PhD for the link to the CMA article.)

 

IHPC’s Wisneski speaks on integrative medicine to over 400 employers on CFO Magazine webinar

An initiative from CFO Magazine to educate chief financial officers of employers is called CFO Playbook.  The program is described as “a series of educational Best Practice Webcasts, ebooks and events providing you with practical knowledge and insights from your peers.” On October 4, 2012, CFO’s readers had a chance to view a podcast which introduced a new idea. Perhaps “a pragmatic framework for implementing the solution” to the employer’s cost crisis in health care may be by looking at “how including integrative medicine treatment options in healthcare plans can give companies more control over their spending.” Long-time integrative medicine clinician, educator and policy leader Len Wisneski, MD, FACP, chair of the Integrative Healthcare Policy Consortium, was the featured guest. The session was organized by Wayne Miller of Nura Life Sciences and entitled The CFO Playbook on Health Care Cost Management.
 
Comment: Good for Miller to pull this together and get this audience thinking more deeply about how to create sustainable solutions through integrative approaches.

Employer group IHPM takes over global wellness initiative from World Economic Forum

The World Economic Forum, famous for its exclusive and pricey meetings at Davos, Switzerland, has handed off it’s health and wellness initiative to the Institute for Health and Productivity Management (IHPM). The IHPM sent a September 28, 2012 release entitled “Accelerating and Expanding Wellness Around the World: Transition of the Workplace Wellness Alliance from the World Economic Forum to IHPM.” The Forum’s initiative was led through their Workplace Wellness Alliance which provides “a platform for sharing best practices in workplace wellness.” IHPM, led by former National Business Coalition on Health CEO Sean Sullivan and vice president Deborah Love, has been a leading employer group in exploring complementary and integrative medicine as a means of enhancing health and productivity. IHPM is a former Integrator sponsor.

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. 


Businesses

Data collected by Jill’s List available free for academic research; firm moves into employer market

A recent report from Jill’s List, the Boston-based business, has shared recent developments of interest to integrative health practitioners and researchers. The firm, founded by Jill Shah and boasting an advisory board that includes notables such as David Riley, MD, Mark Hyman, MD and Michele Mittelman, RN, MPH, is dedicated to “deliver solutions that help doctors, patients, CAM practitioners and companies collaborate in order to deliver more effective and less costly healthcare.” Shah notes that the firm has launched it’s Referral Tool for health professionals: “All professional members of Jill’s List can use the tool to send and track referrals to CAM and Integrative Health practitioners who are listed on Jill’s List.” Shah adds that “the tool tracks patient information including geography, age and gender, conditions related to the referral, and modalities of the practitioners sending and receiving the referral.” The referral tool also “collects feedback related to each referral from both the practitioner accepting the referral and the patient involved in the referral.” Shah states that the data gathered can be mined for academic research.
 
The Jill’s List referral process, described in this video, takes less that 30 seconds. All professional members on the site can access it for free. The firm uses either a subscription model or charges a per referral “only when a practitioner accepts a referral to a new patient.” In other news, the firm has recently begun a push into the employee benefits realm. Shah expects that by the end of teh year, 20,000 employees will be using the firm’s “vetted, reviewed

list of practitioners and incentivizing employees to get, be and stay healthy.”

Comment: Since the “integration” era began some 15-20 years ago, many businesses started to link consumers and other stakeholders to vetted lists of providers have come along. Many have long since departed, with their business models. Jill’s List intrigues for reasons like this referral list, and the openness to partnership with academic researchers, and a project in which Shah has had a lead role in convening integrative medical doctors in the Boston area. Jill’s List is presently in a league of its own for its commitment to actual integration, both in its modeling and its products. This business is worth looking into. 

 

Canadian business launches national directory of integrative health clinics

Heidi Rasmussen, co-founder of the Integrative Health Care (IHC) Directory of Canada writes that “after 2 years of searching and designing our website, we have located 50 IHC clinics in Canada who meet the criteria” the business has established for IHCs. The firm’s site has been launched. The criteria are: 1) follow an integrative health care (IHC) philosophy; 2) provide care by a multi-disciplinary team of health professionals; 3) include both traditional Western, complementary and alternative medicine (CAM); and 4) offer clinic information through an online presence. The Integrative Health Care (IHC) Directory of Canada is a free, business listing of selected health and wellness centers in Canada. The firm’s business model appears to be through a “Premium Listing” which is available by subscription. 

 

Massage Envy, with now 800 locations, (re)sold to Roark Capital Partners

Fortune reports that private equity firm Roark Capital Partners has agreed to purchase massage and spa chain Massage Envy from Sentinel Capital Partners. The information about the sale was available through an FTC notice. No financial terms were disclosed. The Scottsdale, Arizona-based Massage Envy has nearly 800 locations throughout the US. An independent association of Massage Envy franchisees, reports that average location revenue rose from around $815,000 in 2009 to nearly $1.25 million in 2011. This suggests the 800 sites create a $1-billion operation. Sentinel acquired Massage Envy in late 2009 for an undisclosed amount from Natural Wellness USA.

Comment: A massage leader who sent this on commented wryly: “What a quaint, personal craft/cottage industry!” In May 2008, Veria, a wellness conglomerate, acquired Massage Envy. Veria, which described itself in their release as “a growing natural health and wellness company,” is part of the Essel Group of companies, a multi-billion dollar consortium encompassing television networks, cable systems, satellite communications, entertainment enterprises, and one of the world’s largest packaging companies. At that time, Massage Envy, founded in 2002, had 420 clinics nationwide. This was up from 265 when the Integrator covered its exploding business in September 2007. The Integrator article was called $90-Million Massage Envy Turns to Employee Benefits Market. 

 

 

Organizations

Samueli Institute’s “Patients at the Crossroads” to explore intersection of integrative, evidence-based and patient-centered health

The subtitle of the conference intrigues: “How can patient-centered care, evidence-based medicine and integrative health care be reconciled?” On November 8-9, 2012, the Samueli Institute will be convening a conference in Alexandria, Virginia entitled Patients at the Crossroads. The organizers promise a “solutions-based dialogue with thought leaders from across the health care community and the patients they serve-with a focus on patient-centered education, research, practices and health systems.” Carolyn Clancy, MD, Director of the Agency for Healthcare Research and Quality keynotes the two-day event. Author and futurist Ian Morrison, PhD moderates. The structure is meant to be interactive and focus on patient experience.

Comment: Morrison may prove a terrific choice for this role, particularly in drawing the health system audience Samueli is targeting. Given the question Samueli Institute is posing, Merlin may have been a better moderator. The research community has not thus far been much interested in asking the kinds of health services and outcomes questions that will help us provide the qualitative and quantitative evidence to guide a less magical resolution to the issues that will be on the table at this conference. I picture the patient advocate for integrative practices and practitioners facing off with an evidence curmudgeon. These typically fail to see the evidence holes in conventional practice. One hand over the other, each ascends the length of a bat, to determine who gets to be first. Patient-centered is not synonymous with evidence-centered. There is a winner here.

 

Pathways to Wellness begins drive to support move to new location for serving the under-served in Boston

One of the nation’s most significant providers of free and low-cost acupuncture and other so-called “CAM” services to the underserved, Boston’s Pathways to Wellness, has begun a $380,000 fund drive to support a forced move. According to a message to Pathways supporters from director Demi Stathoplos, MSW, MBA, the Southend Community Health Center, Pathways’ landlord for 6 years, needs the space while also wishing to maintain the collaborative relationship. Pathways, which delivers over 10,000 free and low cost acupuncture, massage and Traditional Chinese Medicine treatments annually, has found space nearby. Details of the plan for the move are here.

 

Detailed plans for November 2-4 IN-CAM Symposium in Toronto include massage summit, exploration of optimal benefits

The Canadian research organization IN-CAM has published a detailed schedule for its annual research symposium, to be held in Toronto November 2-4, 2012. Various pre-conference events are scheduled for November 2. These include an invitational National Massage Research Priority-Setting Summit which was organized by Trish Dryden, MEd, RMT and Bryn Sumpton, BSN and will be facilitated by Barbara Reece, RN, BS. Reece,a former vice president for Optimal Healing Environments with the Samueli Institute is also offering a keynote entitled: “Cultivating Leaders: The Next Priority for Integrative Health Care?” Keynoter Herbert Emery, PhD will ask: “Should complementary and integrative health services be included in Canada’s “Medicare Basket” of publicly funded services?” IN-CAM co-founders Marja Verhoef, PhD and Heather Boon, BscPhm, PhD also offer keynotes, as does Claudia Witt, MD, MBA.

Comment: The border with Canada appears all the more porous as I read this agenda and the keynotes. Substitute “essential benefits” for “Medicare package.” Leadership is indeed a major issue for integrative health organizations south of the border. Rumors are afloat of a leadership program in development associated with the Consortium of Academic Health Centers for Integrative Medicine. Reece herself has a key role in developing and facilitating an “ambassadors” program for integrative health for the Academic Consortium for Complementary and Alternative Health Care. In addition, Dr. Roger’s Prize winner Verhoef is asking a question that crossed over into the Patients at the Crossroads theme of the Samueli Institute conference. Her title: “Evidence-based CAM: Can We Get it and Do We Need It?” Hate to miss this conference.

 

 

Academics

Consortium of Academic Health Centers for Integrative Medicine begins forum for residents interested in integrative medicine

The co-chair of the Education Working Group of the 51 medical school member Consortium of Academic Health Centers for Integrative Medicine (CAHCIM) announced in the organization’s newsletter a new initiative to network residents from CAHCIM schools with an interest in integrative medicine. According to an open letter to such residents, the group will share best practices, engage a quarterly conference call, and support other such networking opportunities,. One feature is a Facebook site entitled Resident Doctors for Integrative Medicine. The leaders on the effort are residents Ashley Salomon, MD (PGY-2 University of Arizona Family Medicine) and Stephanie Cheng, MD (PGY-1 Contra Costa Family Medicine).

Comment: The initiative might eventually be smartly linked with the National Coordinating Center for Integrative Medicine, reported above, given its close relationship to the dozen preventive medicine residencies in integrative medicine.

 

Portrait of growth in an AOM school: Five Branches University

The Santa Cruz Sentinel ran a focus on a local business on September 1, 2012: “Profile – Five Branches University grows to faculty of 100.” The for-profit acupuncture and Oriental medicine institution was founded in 1984 with five faculty members and 18 students, according to founder and  current president Ron Zaidman, MAOM, MBA. The school now has 200 students in Santa Cruz and 240 students in a second campus in San Jose, California. Classes are taught in English in Santa Cruz, and in English, Korean and Chinese in San Jose, according to the article. The teaching clinics treat over 100 patients a day, and as noted in the title, total faculty members has hit 100. Zaidman said the economic downturn in 2008 kept the school from opening a third campus in 2010.

Comment: The story exemplifies the type of vision and leadership many of those responsible for the development of integrative care options in the 1980s. In an era of virtually no “cultural authority,” and even less access to any public, private or foundation financial investment, individuals like Zaidman pulled together a handful of colleagues and started schools. These provided infrastructure that led to expanded availability of practitioners and services. The Five Branches story is multiplied across disciplines like massage, naturopathic medicine, yoga therapy and direct-entry (home-birth) midwifery, its growth and success a marker of the changes in the US culture, and a reminder of the gutsy, passion-driven work of those who pioneered. 

 

Historic International Congress for Educators in Complementary and Integrative Medicine close to selling out

A near capacity crowd of close to 300 educators, researchers and leaders are signed up for the first ever International Congress for Educators in Complementary and Integrative Medicine (ICECIM). ICECIM  is co-sponsored by the Consortium of Academic Health Centers for Integrative Medicine, the Academic Consortium for Complementary and Alternative Health Care and Georgetown University, where it will be held. The Congress is international. Among the initial 271 registrants, 35 are from 10 countries outside the US: Canada-12, Korea-6, Germany-5, China, Italy, Jamaica and Thailand with 2 each, Iran, Israel, Spain and Switzerland with 1 each. 

Comment: This is the most significant event ever developed from the ground up via a direct, horizontal collaboration between academics in integrative medicine and academics from the licensed complementary and alternative healthcare disciplines. The collaboration is apparent in planning teams, program teams, content and sponsorship. 

 

 

Professions

Battle in New Mexico over advanced practice certification program for chiropractors deepens division between two forces in chiropractic

On September 13, 2012, the American Chiropractic Association (ACA) filed an amicus curae (friend of the court) brief on behalf of the New Mexico Chiropractic Association. The ACA’s took a position in favor of the right of that state association to set its own scope of practice. The issue is a 2011 law passed by the New Mexico legislature, with support of the state association, that creates a structure through which those chiropractors who choose to add prescriptive authority to their scope can do so. Under the law, they must follow a defined educational path to support the new competencies. An ACA release on the brief states that the ACA felt “compelled” to weigh in after “the International Chiropractors Association (ICA) joined forces with the New Mexico Board of Pharmacy and the New Mexico Medical Board in a December 2011 memorandum to the court. The ICA requested a halt to efforts by the New Mexico Board to create the advanced practice training and certification program. Representatives of the ICA and LIFE University had testified before the New Mexico legislature against the advanced practice direction for the profession. 

Comment: In a moment in which the documentary Doctored celebrates the contributions of chiropractic, the long simmering fight between what used to be called the “straights” (ICA) and “mixers” (ACA) comes curdling to the surface. A commentary in the Integrator by Stephen Bolles, DC, explores the issues. (See Stephen Bolles: Regarding a Trojan Horse with Chiropractic/Chiropractic Medicine at a Cross Roads.) Bolles, presently a consultant to LIFE, opposes New Mexico move toward advanced practice. He finds the association of chiropractic with “medicine” damaging to the field. In my commentary, I consider perspectives and come down in favor of the ACA’s stance in favor of the right to self-determination. 

 

Washington state massage organization pushes inclusion in essential benefits package

Washington massage therapist Marissa Brooks, LMP, MPH, reports action from her state association to gain inclusion in that states essential benefits. Brooks shares that her state chose the Regence Innova plan as its “benchmark plan.” Brooks noted that while “the plan covers many services including massage therapy (MT),” the document from the Office of the Insurance Commissioner (OIC) on essential benefits “does not explicitly mention massage therapy anywhere.” She notes that acupuncture, occupational therapy, and physical therapy are among those specifically included. American Massage Therapy Association-WA took a position that non-inclusion was illegal under a prior state law that required all plans to include “every category of (licensed) provider.” The state organization hired a law firm. According to Brooks, the OIC then asked that AMTA-WA submit research evidence that MT is a therapeutic intervention option. AMTA-WA responded by commissioning a responsive document from a team led by Diana Thompson, LMP. Brooks served on the team. At press time there was no resolution.

Comment: Since the 1995 every category of provider law, Washington has been an insurance leader for AMTA and the massage field. Are other states were so-engaged. Brooks responded: “I do not know of any other states in this same fight. My assumption is that we are leaders or rather in front, in that we have the every category provider rule backing and grounding our position. I am not totally in the know though. I do know that AMTA-WA is assuming that national will be using the document.”

Media

Meta-analysis of individual patient data on acupuncture for chronic pain drives significant positive media

On September 10, 2012 the Archives of Internal Medicine included a study that may have locked in the value of acupuncture for chronic pain. The study, entitled Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis, included a sterling the international team led by AJ Vickers with Claudia Witt, Karen Sherman, George Lewith and others. The team concluded: “Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo. However, these differences are relatively modest, suggesting that factors in addition to the specific effects of needling are important contributors to the therapeutic effects of acupuncture.” The flurry of coverage, also international, included such sites a WEB MD and Medical News Today.  

 


Escape Fire
opens across country, highlights Weil, Berwick, integrative medicine

The trailer to the documentary on the failing US healthcare system and what can be done about it opens with a face and voice quite familiar to the integrative medicine movement: Andrew Weil, MD. The movie, from top notch, award-winning documentary makers, is called Escape Fire: The Fight to Rescue American Healthcare. The documentary opened October 5, 2012. The next well-known face on the screen is former Center for Medicare and Medicaid Services director Donald Berwick, MD. A newsletter from the Samueli Institute notes that CEO Wayne Jonas, MD is also featured. The list of characters on the movies’ website also includes Dean Ornish, MD. Influential author Shannon Brownlee, who has written on over-treatment and the perverse incentives in the system, is also highlighted. 

 

The on the failing US healthcare system and what can be done about it opens with a face and voice quite familiar to the integrative medicine movement: Andrew Weil, MD. The movie, from top notch, award-winning documentary makers, is called The documentary opened October 5, 2012. The next well-known face on the screen is former Center for Medicare and Medicaid Services director . A newsletter from the Samueli Institute notes that CEO Wayne Jonas, MD is also featured. The list of also includes Dean Ornish, MD. Influential author Shannon Brownlee, who has written on over-treatment and the perverse incentives in the system, is also highlighted. 

 

Comment: Interesting that this came out within 3 weeks of Doctored,which also examines the mess of US healthcare. Here integrative medicine is presented as a voice for solution. “Doctored,” on the other hand, focuses on the complicity of the American Medical Association. Positive contributions, not of integrative medical doctors, but of the chiropractic profession, are highlighted.

Perhaps one day all of the integrative health vectors, from holism in medicine and nursing through chiropractic to patient-centered care to massage and yoga, may be brought forward in the same medium to name the value of this movement to shift the healthcare system. An LA Times review of Doctored is here. The movie will be featured at the upcoming Heal Thy Practice conference organized by Holistic Primary Care. HPC editor Erik Goldman calls it “a pretty right-on documentary that manages to get across some really important points w/o succumbing to partisan polemics. Please help us spread the word if you can.”  

 

Taylor Walsh seminars for Integrative Practitioner on social media in integrative practice

The Integrative Practitioner online community for integrative healthcare professionals is offering a series of seminars by Taylor Walsh on using social media in integrative practice. Walsh is the founder of Integrative Health and Wellness Strategies. His background includes a successful high tech start-up from the 1990s. He has recently consulted with the Samueli Institute and The Institute for Integrative Health. He is a columnist and adviser to the Integrator. The three down-loadable sessions are available for $59.

 

Report says NFL great Larry Fitzgerald uses Peter D’Adamo, ND’s genotype diet to extend career

A report in the Atlanta BlackStar on September 28, 2012 states that Larry Fitzgerald, the record-breaking receiver has turned to the genotype diet developed by clinician, researcher and author Peter D’Adamo, ND in order to “extend his career.” The 29-year-old Arizona Cardinals all-pro explains his decision to adopt the genotype diet: “The older you get, you start fine-tuning what works for you and what doesn’t work for you. You stick on the things that you know work and can help you have that longevity that you are looking for.” The writer notes that “as with most dieting fads, the [D’Adamo] routine has met its share of controversy as well as attracted a loyal legion of disciples.” Fitzgerald is clearly in the latter camp: “I think it makes me feel cleaner, not just body wise. I feel good. My energy levels are off the charts.”

 

A on September 28, 2012 states that , the record-breaking receiver has turned to the genotype diet developed by clinician, researcher and author in order to “extend his career.” The 29-year-old Arizona Cardinals all-pro explains his decision to adopt the genotype diet: “The older you get, you start fine-tuning what works for you and what doesn’t work for you. You stick on the things that you know work and can help you have that longevity that you are looking for.” The writer notes that “as with most dieting fads, the [D’Adamo] routine has met its share of controversy as well as attracted a loyal legion of disciples.” Fitzgerald is clearly in the latter camp: “I think it makes me feel cleaner, not just body wise. I feel good. My energy levels are off the charts.”

 

Comment: D’Adamo has established a Center for Excellence in Generative Medicine, in collaboration with the University of Bridgeport Department of Naturopathic Medicine, where his ideas are being explored.

 

Research on naturopathic approach to diabetes gives that field significant positive attention in key diabetes publication

The 3 page feature in Diabetes Practice Options is entitled Naturopathic Care Can Enhance Diabetes
Patients’ Outcomes, Self-Management
. The side-bars are: “Research Shows Naturopathic Care Complements Usual Care for Diabetes Patients” and “PCPs Should Be Open to Patients’ Use of Naturopathic Providers, Researcher Says.” The articles feature lead researcher Ryan Bradley, ND, MPH, of Bastyr University, who partnered with Dan Cherkin, PhD, at Group Health Research Institute on the study which was reported out in April 2012. The positive report follows similarly positive coverage in an array of media, including MedicalNews Today, Diabetes Pro Smart Briefs, Huffington Post, and headlined articles in Yahoo and Google news.  

Comment: This study is a classic example of a profession advancing via quality research. Bradley and his team had the guts to proceed via the real world ambiguity of examining the whole practice of naturopathic medicine. Because reductionist researchers can’t pinpoint the cause of the success, this leaves single agent researchers with, as a colleague of mine likes to put it, “their panties in a bunch.” Instead, Bradley and Cherkin researched the way naturopathic doctors actually practice, using individualized multiple inputs that reflect their whole person approach. The result is the best press the naturopathic profession, as a profession, has ever received based on a researched contribution to human health. 

 

 

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Esther Sternberg, PhD to lead research at University of Arizona Center for Integrative Medicine

On Sept. 25, 2012, the University of Arizona Center for Integrative Medicine announced that world-renown researcher on mind-body interactions Esther Sternberg, MD has joined the Center as director of research. According to the release, Sternberg also joins the faculty of the UA College of Medicine – Tucson and the UA College of Architecture and Landscape Architecture (CALA), where she will establish and direct the Institute on Place and Well-Being. Sternberg will relocate to Tucson with her research team and program from the National Institutes of Health (NIH) in Bethesda, Maryland. Center founder Andrew Weil, MD welcomed Sternberg: “We’re honored that a researcher of Dr. Sternberg’s caliber has decided to join us, and commit to important research on the integrative mind-body connection and practical applications. Her dedication will produce the science-based outcomes and cost-effectiveness research that will take the national health-care discussion to the next level.”

Comment: Sternberg is indeed quite a catch for the Center. Anyone who comes and brings barrels of money is! Weil’s comments on the “practical applications,” “outcomes” and “cost-effectiveness research” are intriguing, however. While this is what the field desperately needs, these are not areas of special strength in Sternberg’s past. He background is  compelling: chief of the Section on Neuroendocrine Immunology and Behavior at the National Institute of Mental Health, Director of the Integrative Neural Immune Program, NIMH/NIH, and Co-Chair of the NIH Intramural Program on Research in Women’s Health. But there is not a lot of health services type experience here or in her CV. Perhaps the Center should re-enforce their connection with economist-researcher Patricia Herman, MS, ND, PhD who led the major cost-effectiveness review reported in this issue of the Round-up for some tutoring. Herman, who has a role in the Center’s most significant cost study, recently left University of Arizona for the RAND Corporation.


Acupuncture and ACCAHC leader Elizabeth Goldblatt, PhD featured in Institute of Medicine Spotlight

In what may be a first for an individual principally associated with the so-called “CAM” disciplines, the Institute of Medicine of the National Academy of Sciences has featured Elizabeth (Liza) Goldblatt, PhD, MPA/HA in special Spotlight portrait. Goldblatt is among the most influential leaders in the development of educational standards in acupuncture and Oriental medicine via various roles in the leadership of the Council of Colleges for Acupuncture and Oriental MedicinE (CCAOM). Goldblatt was featured for her work as CCAOM’s representative to the Academic Consortium for Complementary and Alternative Health Care (ACCAHC), which she chairs. ACCAHC is a sponsor of the IOM’s Global Forum on Innovation in Health Professional Education. Goldblatt’s comments in the Spotlight include this: “ACCAHC has identified the need to better educate students, faculty and practitioners to not merely be reactive and treat symptoms, but also to focus on helping people get healthy.”