June 2015 John Weeks Integrator Round-Up

by John Weeks, Publisher/Editor of The Integrator Blog News and Reports  

Maryland Becomes 29th State to Regulate Direct-Entry Midwives

Colleague Nichole Reding, MA, CPM from the Birthingway College of Midwifery shares the news that Maryland has become the 29th state to regulate the practice of direct-entry, homebirth-oriented midwifery as practiced by Certified Professional Midwives. The release points toward future work:

by John Weeks, Publisher/Editor of The Integrator Blog News and Reports

Policy  

If I Ran the Zoo: Quality Measures in Accountable Care and the Fit with Integrative Health and Medicine

How well aligned do you think the “quality measures” in the conventional delivery environment are with concepts of “quality” in integrative health and medicine? On June 17, 2015 at 1:00 EDT, four integrative health leaders who work at the intersection of integrative care and the emerging “values based medicine” world are part of a webinar on the topic:  If I Ran the Zoo: Quality Measures in Accountable Care and the Fit with Integrative Health and Medicine. The webinar was organized by Jennifer Olejownik, head of the Project for Integrative Health and the Triple Aim, with which this writer is associated.

The four panelists are David Fogel, MD, with the Casey Health Institute (featured in Integrative Services, below); Regina Dehen, ND, LAc, chief medical officer at National College of Natural Medicine where she is leading efforts to turn the naturopathic primary care in that teaching clinic into a Level 3 PCMH (patient centered medical home); pioneering integrative medicine doctor, homeopath and health system quality leader Molly Punzo, MD; and James Whedon, DC, MS, now with Southern California University in health services research and until recently part of the health services team associated with the Dartmouth accountable care group.

Comment: Fascinating topic where the rubber of integration meets the road increasingly traveled by the best in conventional medicine. A taste of the topic: conventional measures may specifically ask clinicians to document use of cholesterol lowering drugs. Might functional outcomes or lifestyle measures be more appropriate? In a health-focus system, what do we need to be measuring? Will naturopathic medicine and other integrative care be corrupted, somehow, if it submits to regular medicine measures? There will be a good Q& A segment. Take a listen!

HHS Corrects FAQ on 2706/Non-Discrimination: IHPC’s Traub Calls It a Victory

The May Integrator Round-up noted the apparent non-engagement of the US Department of Health and Human Services on a request from both the US Senate and the American Association of Naturopathic Physicians (AANP) regarding its position on Section 2706, Non-Discrimination in Health Care. (See HHS Shuns Congressional Intent on "Non-Discrimination in Health Care" and Refuses to Clarify Position.) The Senate had twice chastised HHS for violating its intent and urged the agency to reverse itself. Finally on May 26, 2015, HHS issued FAQs about Affordable Care Act Implementation (Part XXVII).

In a note to colleagues, Michael Traub, ND, DHANP, CCH, FABNO, the lead on Section 2706 for the Integrative Health Policy Consortium (IHPC), offers the following key points. First, while Section 2706 may not apply to Medicare, it does apparently apply to Medicare supplemental plans. He opines that these may be a useful doorway into Medicare coverage for professions that are not presently included. Second, he notes that HHS says it was compelled to re-think its position by the “breadth of issues” raised. This appeared to affirm the influence of IHPC which had generated significant outcry in a thorough survey and response in its comment period campaign. Finally, Traub notes that, with the correction, “the problematic statements in the 2013 FAQ have all been superseded by the new FAQ and effectively removed.” He adds: “In my opinion, this means that insurers no longer have any basis to claim they can exclude certain licensed provider types from their networks, nor use ‘market considerations’ etc.. for varying reimbursements. This is a victory. This is primarily what we asked the departments to do in our responses to the RFI.”

On June 30, the American Chiropractic Association issued a media release and note to its members entitled ACA Efforts Result in Federal Agency's Clarification of PPACA Language on Access to Non-MD/DO Providers. The organization took credit for the new FAQ forbidding plans from improperly excluding doctors of chiropractic.

Comment: Some observers view the 2015 FAQ as a sort of one step forward following the one step backward of the 2013 FAQ. The result, in this view: we are only where we were had HHS never spoken up. With the kind of organizing and lobbying from IHPC, AANP and the ACA, this is worth a brief sigh of victory, or at least relief that the cloud of the erroneous 2013 FAQ has lifted. Notably, this was accomplished post the retirement of integrative health and medicine’s former Congressional protector, Senator Tom Harkin. Good sign of work getting done without Daddy Big Bucks – the former Senate Appropriations chair for HHS matters.

One side note: too bad that the ACA felt the need to claim the victory as entirely its own doing. That’s neither aligned with what ACA knows to be the case, nor the spirit of integration that Section 2706, implemented, can foster. Let’s celebrate the group effort – then go forward with this tool for greater enforcement!

North Dakota Becomes 45th State to Regulate Acupuncturists

A notice in the newsletter of the National Certification Commission for Acupuncture and Oriental Medicine highlighted the work of “a small group of acupuncturists” in North Dakota that led the legislature to pass and Governor Jack Dalrymple to sign a law to regulate acupuncture in the state. The NCCAOM article states: “One of the members of the above group, Steve Spader, Dipl. Ac. (NCCAOM)® who, along with others, worked tirelessly on the passage of this legislation stated, ‘Though there have been attempts in the past to introduce a practice act, this time we were blessed with guidance from Beth Allen, ND and other experienced people both locally and nationally.’”

Comment: Fascinating to see the interprofessionalism here. Allen is a naturopathic doctor in a state that only recently licensed her field. Great model of collaboration! Nice to see the LAcs hit 90% on the way to 50 state regulation.

Maryland Becomes 29th State to Regulate Direct-Entry Midwives

Colleague Nichole Reding, MA, CPM from the Birthingway College of Midwifery shares the news that Maryland has become the 29th state to regulate the practice of direct-entry, homebirth-oriented midwifery as practiced by Certified Professional Midwives. The release points toward future work: “However, Maryland still has work to do to ensure safety and access for all women and families during the birthing process. Out-of-hospital birth is still not covered by most medical insurance plans and remains too costly for many who desire this kind of care. Additionally, women desiring home births who have had previous cesareans are barred from Certified Professional Midwife care under the new law.”

Comment: A fully transformed delivery system will be characterized by systematically, fully-empowering women and families, in their homes, for the delivery of human beings onto the planet. This reality is beginning to dawn on mainstream obstetrics practice. See this column by a Harvard OBGyn on a site funded by the Robert Wood Johnson Foundation and mainline foundations: Are hospitals the safest place for healthy women to have babies? An obstetrician thinks twice.  Anything short of a focal role for homebirth is over-expensive, practitioner and industry-focused medicalization that sends the wrong message about our basic relationships to natural processes. As this 2015 Father’s Day approaches, see my June 2007 piece: Father's Day: Reflections on My Firstborn's Homebirth as Alignment with Healthcare Reform.

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Research Advances

Systematic Survey of Naturopathic Whole Practice Research Published:

The peer-reviewed and indexed BMC Open has published “Estimated Effects of Whole-system Naturopathic Medicine in Select Chronic Disease Conditions: A Systematic Review.” The 8-person research team, led by Erica Oberg, ND, MPH and Ryan Bradley, ND, MPH, found fifteen studies that met a set of inclusion criteria that included focusing on “chronic diseases of public health significance.” These studies “were of good quality and had low to medium risk of bias.” In general the “effect sizes (Cohen's d) for the primary medical outcomes varied and were statistically significant (p<0.05) in 10 out of 13 studies.” In each of these randomized controlled trials with a medium effect size “a quality of life metric was included and found statistical significance in some subscales.” The conclusion: “Previous reports about the lack of evidence or benefit of naturopathic medicine are inaccurate.” They add: “A small but compelling body of research exists. Further investigation is warranted into the effectiveness of whole practice NM for a range of health conditions.”

Comment: The conclusion reminds me of the statement of RAND researcher Patricia Herman, PhD, ND on completing her exhaustive cost-effectiveness study of complementary and integrative medicine: "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." Wallace Sampson, MD (see People, this Round-up issue) and his nattering nabobs of negativity aside, it’s time for the rest of medicine “to take this evidence and run” about the value in integrative, whole person, naturopathic care. “It’s time

Unfortunately for the naturopathic profession, one of the rules by which research proposals to the NIH are gauged is the breadth of the usefulness of the outcomes. Any proposal by NDs can be flushed away due to the small size of their profession (5,000). Reviewers need to respect the model they provide for all care relative to integrative treatment. That needs to change. Kudos to the team. Someone in the MD integrative medicine field needs to undertake a similar piece that surveys for the still limited number of whole practice studies for the broader IM field.

Finally, kudos to Carlo Calabrese, ND, MPH, one of the authors, and a former member of the advisory council to the NIH National Center for Complementary and Integrative Medicine. Calabrese, the founding executive director of the Naturopathic Physicians Research Institute where he still sits on the board with Oberg, Bradley (and this writer), is the godfather of outcomes, whole practice and whole systems efforts to research the way we practice for the naturopathic profession. He has also been a key mentor and influencer of many, including me, for over 25 years. Nice work Carlo!

“To Pause and Protect” – Mindful Police Work Featured at Oregon Collaborative for Integrative Medicine SPARC Research Conference

A notice from the Oregon Collaborative for Integrative Medicine promoting their June 12, 2015 SPARC Conference included some unusual fare. In a panel on mindfulness that includes content on the mindfulness in medical education, and more on mindfulness research via clinical neuroscience, two additional panelists have this topic: “To Pause and Protect – Mindfulness Training in Law Enforcement.” The presenters include Lt. Richard Goerling, MBA, of the Hillsborough Police Department.

Comment: Given the high visibility of the need for mindfulness in the behavior of municipal police across the U.S., perhaps one way for integrative medicine and health to make its name is to be a bit opportunist here. Why not adopt the police departments in your own town or cities to offer courses and programs? With the growing awareness of the fact that non-clinical factors are the most significant contributors to health of communities, sharing mindfulness strategies and building skills with your local police may be a relatively efficient was to impact the health of communities.

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Integrative Services

Casey Health Institute: Marrying Integrative Health and Values-Based Medicine

The co-founder of Casey Health Institute (CHI), David Fogel, MD, recently shared with the Integrator that the Gaithersburg, Maryland-based integrative center has now “met almost all of the criteria for a Level 3 PCMH.” By the fall of 2015 the Center will employ four primary care integrative medical doctors, one nurse practitioners, two licensed acupuncturists, one naturopathic doctor, [two psychologists (“we do a lot of mindfulness, and mind-body work”), a full time Reiki master/massage therapist, a full-time Yoga therapist, a full-time nutritionist, and a full time nurse care coordinator.

In addition, the not-for-profit 501c3 health center has “just signed up to become part of a Medicare ACO” (Accountable Care Organization). In the ACO, CHI will join with 5 other non-integrative primary care practices. Adds Fogel: “We’re spending enormous time and effort to get highly-coordinated processes down to operationalize true collaborative, integrative health.”

Fogel believes that following this strategy will lead to a quantum leap in evidence to support integrative care: “I think a lot of integrative practitioners are focused on proving that each individual modality is valid. The power in integrative medicine is team-based collaboration. I think we will blow values-based metrics out of the water with our outcomes using a team-based staff model of care.” One hold-up in CHI in proving integrative health’s value in the context of outcomes-oriented PCMH’s and ACOs has been the quality of electronic health records as a collaborative tool. Recalls Fogel: “Our first EHR (Electronic Health Record) was a disaster. It set us back almost a year in many ways.”

The Center is, as Fogel asserts, “one of the few IH settings that accepts all major insurance, Medicare, Medicaid, and charity care.” He notes that CHI has “a charity care policy that is based on federal poverty guidelines and includes all modalities.” As a result, he says, “the clinic has a bi-model population with some patients very familiar with integrative medicine and others with no knowledge of anything integrative and we are teaching about integrative health from square one.”

Attracting patients never has been an issue says Fogel: “We have gone from zero to 3000 patients in two years. The challenge has been how to handle the demand: front desk, telephone, electronic health record, and creating high-functioning teams.” Fogel, who with his spouse Ilana Bar-Levav, MD, CHI’s FIRST COO, spent a great deal of time researching the national landscape for models prior to developing CHI, observes: “The majority of people in integrative medicine appeared to place little emphasis on the power of marrying team-based integrative collaboration and population health strategies.”

Comment:  Fogel and Bar-Levav and their team are clearly in the trenches. They don’t have much company, unfortunately. As part of the Project for Integrative Health and the Triple Aim (PIHTA), my colleague Jennifer Olejownik, PhD, has been developing a resource list on integrative PCHMs.  From what Olejownik has discovered, some of Fogel’s closest colleagues in this work may be PCMHs directed by naturopathic physicians. One is the Level 3 PCMH Center for Natural Medicine in Portland, Oregon, run by Martin Milner, ND, another the Burlington, Vermont Mountain View Natural Medicine founded by Lorilee Schoenbeck, ND, also a Level 3 PCMH. A third is that overseen by Regina Dehen, ND, LAc the chief medical officer at National College of Natural Medicine who is seeking to turn that center into a PCMH. Both Fogel and Dehen are part of a June 17 PIHTA webinar entitled If I Ran the Zoo: Quality Measures in Accountable Care and the Fit with Integrative Health and Medicine.

Fogel’s assumption and assertion is spot on: the best way for integrative care to make a quantum advance in the evidence game is to bypass the proof of individual modalities and go straight to the real world competition between PCMHs on accepted quality measures. There is evidence from a late 2014 PIHTA survey that that the business of medicine’s move to values-based care from a production-based medical industry is creating more alignment with the patient-centered, functional outcomes interest in integrative centers. Here’s looking forward to CHI’s report(s) of the outcomes. Meantime, in the upcoming July 2015 Round-up: how “speed-dating” is serving CHI’s effort to create high performing teams. Stay tuned!

Quick Links to Integrative Medicine News in Medical Systems and Communities: May 2015

This typically monthly Integrator feature is, for May 2015, a quick capture of highlights from the stories that flow in daily from various sources relative to "integrative medicine." A couple of significant themes and events from May are the Tracy Gaudet-Bernie Sanders chat about integrative VA care, an interesting reference to a Joint Commission note on dietary supplements, the new website for the new ACIMH a.k.a. "The Consortium," a new clinic for the Weil/U Az program, an intriguing John Templeton Foundation grant to better arm chaplains for work in the evidence-based medicine (EBM) environment. (Note that Global News Links are now posted at The Global Integrator Blog for Global Advances in Health and Medicine - see related notice here.)

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Integrative Academics

University of Western States in Partnership with Veteran’s Group for Chiropractic, Functional Medicine and Massage Services

In a media release, the Portland, Oregon-based University of Western States has announced that its new center of excellence, the Northwest Center for Lifestyle and Functional Medicine (NWCLFM), is partnering with the Returning Veterans Project. Via the alliance, “post 9/11 war-zone veterans are eligible to receive (free) chiropractic care and therapeutic massages at one of the university’s outpatient clinics located on the UWS campus.” The NWCLFM will provide up to 28 hours of therapeutic services per week to veterans, “making it the largest provider of health services in the Returning Veterans Project network.” Belle Landau, executive director of Returning Veterans Project is quoted as saying: “What we have found is that through services like massage and chiropractic care, vets get the help they need to get off their pain meds, stay in school, stay in their jobs, and hopefully become more open to counseling.”

Comment: Great to see these partnerships forming in the community. Interesting, also, to see the “functional medicine” branding in this predominantly chiropractic institute. UWS president Joe Brimhall, DC comes from a quite broad-scope clinical chiropractic background and is a leader in driving segments of that profession in that direction.

Puerto Rico’s University of Turabo the 8th Naturopathic Program to Gain Federal Recognition

A small program in naturopathic medicine at the University of Turabo in Caguas, Puerto Rico has gained status as a candidate for accreditation with the Council on Naturopathic Medical Education (CNME). The news reached the Integrator via Michael Cronin, ND. The small program, founded by Efrain Rodriguez, ND and presently led by Milva Vega Garcia, ND, presently has 40-50 current students. It has been in a process toward candidacy for 3-4 years. The island, a colony of the United States, has a limited licensing statute for naturopathic doctors. Candidacy status gives students the ability to access federally guaranteed students loans. In addition, in Puerto Rico, the school’s achievement of recognition was needed before any of its graduates could sit for licensing.

Comment: In 1987, there were just 2 U.S. ND programs with CNME recognition and that the option of membership in what would become the Association of Accredited Naturopathic Medical Colleges. The Caguas program has great potential. It may draw Spanish speaking students from throughout South America, and even Spain, thus stimulating the global reach of that profession. The Turabo program is also likely to eventually draw Hispanic students from the United States who would prefer to learn naturopathic medicine in Spanish, or at least the Puerto Rican Spanglish. As a recent Puerto Rico resident (2012-2015), I can attest to the need for quality, life-style-oriented doctors. The jurisdiction has higher obesity and diabetes rates than even the states of the Deep South.

Midwifery Education Accreditation Council Seeks Executive Director

The accrediting agency for education of direct-entry, Certified Professional Midwives, is seeking a new executive director. The position is described here. A small taste of the organization’s work and direction is available through this link to the Association of Midwifery Educators’ webinar entitled “Leveraging Competency-Based Education and Direct Assessment to Advance Midwifery Education.”

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Organization and Professions

Ryan Cliché, MBA, FAE Named Executive Director of the American Association of Naturopathic Physicians

Veteran professional association director Ryan Cliché, MBA, CAE has been named the new executive director at the American Association of Naturopathic Physicians (AANP). The notice from the AANP shares positions Cliché has held with organizations such as the American Institute of Cancer Research, the Endocrine Society, the American Society of Hematology, the American Society for Nutrition, and others. Perhaps hopefully, AANP notes that he score a $5.2-million grant for the latter. His bio features his role as a “rainmaker.” His Linked-In profile is here. A blog post is here.

Comment: As a person who held that role for the AANP from 1989-1993 I say: good luck with a fascinating, potent, small and often challenging profession about which the RAND consultant and RAND-Samueli chair in integrative medicine Ian Coulter, PhD once said, “fights above its weight class.”

AAAOM Creates Three New Committees in Additional Priority Areas

In a June 2, 2015 message to members, the Board of Directors of the American Association for Acupuncture and Oriental Medicine (AAAOM) announced new priorities with the formation of these new committees and their respective chairs: Acupuncture Science & Research Committee (Jacob Godwin, DAOM, LAc) to “develop evidence-based acupuncture documents, including health technology assessments and clinical practice guidelines;” Practice Management Committee (Jamie Davis, LAc) to “provide resources and tools to help licensed acupuncturists run a successful practice, including resources to assist acupuncturists with patient education, community and inter-professional outreach, and maintenance of a profitable practice;” and Inter-Professional Practice Committee (Amanda Gaitaud, LAc) to “provide resources to improve patient-centered care through inter-professional collaboration” including professional standards in AOM practice. Godwin is also AAAOM’s newly elected vice president.  The full AAAOM committee list is here.

F4CP and the IAYT/Yoga Therapy Version of Five Stages of Professional Development

A recent note from the executive director of the International Association of Yoga Therapists (IAYT) John Kepner spoke to a planned presentation he was planning for a gathering of Yoga therapists where he’d be speaking on that field’s maturation. The proximal cause of our dialogue was yet another in a remarkable series print advertisement in the Wall Street Journal for chiropractic from the Foundation for Chiropractic Progress. Says Kepner: “Indeed I am going to show this ad at our meeting of schools, for the 5th stage of our standards process: 1) bringing the field together and gaining agreements on direction and financing; 2) education standards; 3) accreditation; 4) certification, and now, 5) promoting the ‘demand’ for yoga therapists.” Kepner adds that “all the first steps were focused on creating the supply” with the fifth on expanding demand.

Comment: Love the move here, from internal to outside. Follows a recommendation from one of the great educators of our day, Bob Dylan: “Gonna know my song well/before I start singing.” As I have repeatedly suggested in the Integrator, anyone working to strengthen any profession, integrative health and medicine or not, should be required to go to school on the “how and why” and tremendous reach of the F4CP campaign. Check out the ads here. Read ‘em and weep, for what your profession or organization is not doing.

Integrator’s John Weeks Leaves ACCAHC Executive Directorship after 8.5 Years

In a June 2015 media release from the Academic Consortium for Complementary and Alternative Health Care (ACCAHC) on the transition of executive director John Weeks, chair Elizabeth A. Goldblatt, PhD, MPA/HA, states: “John’s work has been extraordinary. He’s built bridges with multiple national organizations, federal agencies and academic institutions. He is the most prolific and productive person I have ever met. Through his work we’ve been able to make some remarkable strides.” The work is detailed in this Chronology of Accomplishment. Noted, for instance, are impact on 3 Institute of Medicine processes, significant advances in widening the circle in the interprofessionalism and team care movement to include integrative health and medicine disciplines, publication of numerous texts and white papers, and a six-fold increase in revenues through philanthropic partnerships.

Weeks started the position in January 2007 on a 30 hour/month retainer. He helped grow ACCAHC to an organization with over 18 national organization members and 40 academic organization members. Revenues from membership were typically multiplied five-fold through philanthropic partnerships. In the recent years, Weeks was working three-quarter time with the organization. He will continue to be involved in one or more ACCAHC projects while expanding his writing and reporting and also “opening the windows to what else might be next.”  In May 2015, ACCAHC participated with two other consortia and others to present Weeks, who has over three decades in the field, with a Lifetime Achievement Living Tribute award.

Comment: With my long-time, intimate relationship with the subject matter here, I can say for certain that a change is in order. Because two prior jobs in the late 1980s and early 1990s in which I’d helped grow ideas into organizations had become challenging events in staff management, I’d sworn off directing anything ever again before consenting to take the ACCAHC retainer on a 6 month interim. I’m proud, personally, of having helped develop and work with a terrific staff and a network of over 100 highly skilled volunteers. Teamwork with Elizabeth A. Goldblatt, PhD, MPA/HA ACCAHC’s board chair for most of this time, was a noteworthy part of our successes.

Next up? Some focus for the first time in years on ways The Integrator might better serve. Got any ideas? More work, certainly, with the leaders and exciting mission of Global Advances in Health and Medicine Journal and my Global Integrator Blog on that site. Perhaps some time to actually think, again, after recent years of often overwhelming organizing activity. Perhaps something on the ground in Seattle when my spouse and I return, also this month, after 3 years in Puerto Rico. The relative quiet of the beach and island life has been a great stress modifier. Mainly what comes next is a little time to breathe, and think on the future with this chunk of responsibility lifted. It was a good run with a lot of great souls!

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Philanthropy

It’s Official: Bravewell Collaborative Sunsets after $30-Million of Investment

In an aptly titled June 1, 2015 media release, “The Bravewell Collaborative Leaves a Legacy of Transforming Healthcare,” these influential philanthropists in integrative medicine officially announced that they will sunset their operations in June 2015. The direction was previously announced at its final awards dinner in November 2013. The media release links to an extraordinary set of accomplishments through the $30-million of investment over the 14 years of the organization’s run. The Bravewell website will remain open until 2020. A book about the collaborative is planned for 2016,

Comment:  I have had a mixed relationship with this group over the course of this run. The strategic decisions and successes have been phenomenal. See this Huffington Post piece, for instance on the occasion of the 2013 announcement: Honoring How Powerful Consumers Known as Bravewell Implanted Integrative Medicine in the System. At the same time, the strategic and perhaps cultural-economic decision of these philanthropists to focus its $30-million on the integrative MD community was a chronic set-back for interprofessionalism in integrative health, a dulling of the vital force of a fully integrated “integrative medicine.” Amidst their good, they had a cooling effect on relationships between the IHM professions.

I confess to a conflict of interest in the level-headedness in my reporting on this topic. As an executive director of a consortium of the academics in the so-called “CAM” professions, Academic Consortium for Complementary and Alternative Health Care during half or Bravewell’s run, I was quite frustrated that the philanthropists did not share the view that the future of integrative medicine and health would best be advanced by lifting all boats. Quite the contrary: “CAM” seemed to be viewed as little more than a sea-anchor, holding back their progress. This was despite the fact that most of the integrative services in the US are delivered by one of the 375,000 licensed “CAM” professionals. The annual contributions and special grants of Bravewell to the 61 medical school organization in what is now the Academic Consortium for Integrative Medicine and Health were huge in that organization’s founding, maturation, research meeting, visibility and impact. They weren’t interested in investing in the maturation processes of the nation’s chiropractors, acupuncturists, naturopathic doctors and etc.

Okay, I was jealous! Envious of my neighbor! Smitten with deadly sins. Bottom line: Bravewell’s contributions have been inestimable. Where would be without them? We all owe these powerful women – the demographic was largely females 50-70- significant gratitude for their strategic choices that have leveraged change in medicine and health in the U.S. Thank you!

A Case of Ethical Relativity: Australian Natural Products Giant Blackmores Funds $1.3-million Chair in Integrative Medicine at University of Sydney

The highly politicized Australian natural medicine scene had a $1.3-million dollop of additional controversy stirred into the mix late May 2015 when Blackmores, the natural products giant that dominates that market, announced a $1.3-million grant to the University of Sydney to create the Maurice Blackmores Chair of Integrative Medicine. The move has sparked debate over corporate gifts. An academic group slammed the move. Supporters have lauded the move. One commentator suggest the new position might create value. A related story speaks to the difference between “registered” and “listed” products, complaining that non one honors the distinction between those with research and those without.

Meantime, Australian antagonists to the role of alternative therapies in their country, where 4 out of 5 people use them, continue to question the practices while providing short lists of some with evidence and others without. The Dean of the University of Sydney medical school, Bruce Robinson, MD and the firm’s CEO Marcus Blackmore talk about the grant here.

Approached by the Integrator for a comment, Australian integrative health and medicine leader Jon Wardle, ND, MPH commented: “What is often lost in the controversy around this development is that the Sydney School of Medicine approached the Blackmores Institute, rather than another way around. This is a story about one of Australia’s pre-eminent medical schools seeing the need and wanting to get further involved in integrative medicine, not a story about industry wanting to direct a medical school one way or the other.”

Comment: Is it defensible to argue against big pharma’s corruption of medicine through its octopusian reaches into every organization and organ system in medicine while also arguing in support of this Blackmores’ grant or others from the natural products industry? I believe it is. At this point in history, regular pharma controls not only where its own funding goes but substantially influences the governmental and foundation granting networks. Bluntly put: research on pharma is over-supplied and out of balance for the health and medicine system. Plugging some spigots would do us all good.

Meantime, little research money goes to natural health care or natural products research, except when it comes to exploration of synthesizing herbs as pharmaceuticals. Natural products and natural health care of all kinds need a great deal more research. Circumstances require that we stimulate the kind of investment that Blackmores has made. As the 2010 Lancet Report argues, the health professional of the future needs comfort with ambiguity. Good for Blackmores. Good for Dean Robinson!

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International   

The Global Integrator Blog Round-up from Global Advances in Health and Medicine: May 2015

In January 2015, Integrator publisher-editor John Weeks began producing "The Global Integrator Blog" for the web portal of the exceptional Global Advances in Health and Medicine Journal. The month of May 2015 offer posts that are gathered into the May 2015 Global Integrator Blog Round-up.  Posts include: “What Insurance Records Say about Homeopathy in France;” “US Agency Upholds Discrimination against Licensed Integrative Health Professions;” “Swiss Government Will Recognize Practitioners of TCM, European Traditional Medicine, Homeopathy, and Ayurveda;” “The Inspiring Tale of a Nigerian Monk, Sustainable Herbalism, and the African Research Institute;” and “Canadian College Offers Naturopathic Medical Bridge for International Medical Graduates;” and “Quick Links to Global News in Traditional, Alternative, and Integrative Health and Medicine for April 2015.”

Guara Workshop: Traditional Midwifery and Holistic Medicine in Urubamba, Peru

I recently had the opportunity to visit Peru to attend the wedding of my nephew, the sculptor Ishmael Randall Weeks, and his spouse Ale Arrarte, a devotee of natural childbirth and natural medicine. Ale sends news that she is helping promote a two-week Gaura Workshop: Traditional Midwifery and Holistic Medicine, taught by midwife and herbalist, Leonie Lange, originally from Germany. The intensive course will be held in the Sacred Valley of the Inca, in Urubamba where Lange is based, November 5-20, 2015. Arrarte says the workshop “will cover a range of woman and pregnancy-related things - diagnostic techniques, emergency procedures, herbalism, homeopathy, feminine medicine, children's medicine, traditional Peruvian customs” in child-bearing, and more.

The workshop, says Arrarte, “will be given in English, and is open to midwives, doulas, nurses, technicians, doctors, mothers, and any woman who finds it all interesting!” Information is available through this Facebook page. Testimonials include one from a faculty member at one of the accredited programs for direct-entry midwifery in the United States, the Birthingway School in Portland, Oregon. The cost is $1200, which includes materials, lodging, and three vegetarian meals a day for the 15 days.

Comment: If you have not been to the Sacred Valley, use this as your excuse! I have been blessed to have had a sister, Wendy Weeks, who settled there in 1975 in those Donde No Hay Doktor years when she birthed, with the assistance of local midwives, Ishmael and her other son, Joaquin, in their home, the first back-packer hotel in those parts. Under Wendy’s and then Joaquin’s management, El Albergue Hotel in Ollantaytambo, 10k from Urubamba, has become a different sort of place. Every room now has running water and bathrooms. There is a fine restaurant, an organic farm that feeds it, and a deep integration with the local town that retains its pre-colonial feel, and for which Joaquin presently serves as director of economic development and tourism. I am being the familial agent for Ale and Ollanta here! Fine people, if I do say so myself. Treat yourself!

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People 

Robert Rountree, MD is the 2015 Linus Pauling Award Recipient from IFM

The Institute for Functional Medicine has named integrative and environmental medicine leader Robert Rountree, MD as the 2015 recipient of the Linus Pauling Award. Rountree is credited with having “furthered the shift in medicine from an organ system paradigm to a systems-medicine approach and has helped to evolve Functional Medicine's clinical and patient-driven approach for prevention and comprehensive treatment of chronic, complex disease.” Rountree, an author are keynote speaker, works out of a new practice, Boulder Wellcare.

Comment: Rountree’s powerful keynote on environmental influences at the 2015 Integrative Healthcare Symposium was reason enough, for me, that he should earn this award. He’s clearly been a very significant influencer for the increasingly influential IFM model.

AOM Pioneers Robert Duggan and Dianne Connelly Retire from MUIH, Formerly Tai Sophia Institute

In a May 15, 2015 notice to the Maryland University of Integrative Health (MUIH) community, MUIH president Frank Vitale shared “with tremendous respect and admiration” the news that Robert Duggan and Dianne Connelly, are retiring their relationship with MUIH. The two co-founded what has become MUIH as the Tai Sophia Institute. Vitale was not overstating when he credited the two for being “bold trailblazers in the field of natural medicine.” In 1970 the two acupuncturists established one of the first acupuncture clinics in the U.S., and in 1985 the first accredited Master of Acupuncture program. At the Institute, they also founded the SOPHIA programs, a Master of Science in Herbal Medicine, Master of Arts in Applied Healing Arts. These laid the foundation of the transition of the Tai Sophia Institute into the present, regionally accredited, Maryland University of Integrative Health.

Comment: Duggan, in particular, is one of the great influencers in the AOM field. A former Catholic seminarian who was on the cover of Time magazine back in the 1960s when he left the fold to marry Connelly, Duggan was and remains an avid student of another former priest, the author and “maveric social critic” Ivan Illich. Duggan called the institution he and Connelly co-founded an “Academic Wellness Institute” before wellness reached its recent prominence. For a time, he was one of the few people in any of the integrative health and medicine field who could always be counted on to pull the dialogue back to a focus on health when it tended to stray and devolve into the dominant disease paradigm.  He would exasperate his AOM colleagues who were busy trying to establish professional legitimacy for their profession by announcing that the profession would be better off were it licensed through Parks and Recreation, to keep the focus on health.

I have been at times among the exasperated. We first met in 1996 when he was a discussant for a paper I presented at a small meeting of the NIH and the AHRQ on the coverage issues for complementary medicine. He didn’t much like the engagement with insurers. His concern for the corrupting, professional aggrandizement of most guilds led him to discount as a misdirected initiative my own strategic work in building the Academic Consortium for Complementary and Alternative Health Care as a power base for transformation toward integrative health and medicine. He never allowed his Institute to join while he was president. Yet I always remain soft for his radicalism. We do too often stray from our mission and roots. My guess is we’ll be hearing more from Duggan, and Connelly. Thanks for all you have given, and all you have shaped through your powerfully held views.

Bastyr University Names Charles “Mac” Powell as New President

Bastyr University, among the most significant academic players in the evolution in integrative health and medicine, has named a new president to succeed Daniel Church, PhD. Charles “Mac” Powell is the former president of John F. Kennedy University in Pleasant Hill, California. He received his B.A. in sociology/philosophy, M.A. in clinical psychology and Ph.D. in sociology from the University of Missouri. Powell also holds additional degrees from National University in San Diego, CA and Antioch University in Marina Del Rey, CA.  He is author of books on marriage and family therapy, and on golf.

Comment: An interesting choice, from outside the mainstream of academia, both in his own education and his recent position. Here’s hoping he will be a good fit in the peculiar culture of Bastyr and the dominant naturopathic medical profession that was described so candidly by Church is his exit interview with Natural Medicine Journal. We can all expect an increasing in golfing metaphors as applied to natural health.

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