November 2014 John Weeks Integrator Round-Up

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

Veterans Health Administration Initiates Integrative Health Coordinating Council to Set System-wide Plan via Gaudet’s Office

On November 4-5, 2014, roughly 40 leaders in integrative health practices across the US Veteran’s Health Administration met in Salt Lake City over a 3 day period to “create a plan to roll out a standardized, sustainable, measurable plan that will make the strongest possible business case for integrative health practices” in the VHA. The work is led by long-time integrative health and medicine leader Tracy Gaudet, MD, the director of the VA’s Office of Patient-Centered Care and Cultural Transformation. The first half of the meeting involved input from a set of six outsiders who were brought in as subject matter experts. It concluded with detailed work on a plan development led by members of an outside agency that is consulting with VA... Read More

 

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

• Policy  

 

• Integrative Centers 
• Academic Health 
• Resources 
• Organizations 
• Professions 
• People 

 

 

Policy 

Republican Senate Win Sweeps Key Integrative Health Leaders from Powerful Roles

That integrative health and medicine’s would lose its top champion for the past 20 years, US Senator Tom Harkin (D-Iowa), was one foregone conclusion of the 2014 Congressional election. Harkin had announced plans to retire. Now the new Republican majority in the United States Senate will remove from their positions of power the next two most significant advocates. First, the person known as the third most powerful elected official in the United States, the chair of the US Senator Appropriations Committee, will no longer by Maryland Senator Barbara Mikulski. She has been Harkin’s close colleague on all things integrative, is a strong advocate for acupuncture, in part through her close relationship with Brian Berman, MD, of the University of Maryland Center for Integrative Medicine and Charlotte Kerr, LAc, MPH and the Maryland University of Integrative Health. She also championed the resolution that gave naturopathic physicians their first formal standing in a Congressional act. An additional significant loss is in the Senate Committee on Veterans’ affairs. The current chair is Bernie Sanders, the independent from Vermont. Sanders is credited with inserting the licensed complementary and alternative medicine professions into Section 5101 on workforce of the Affordable Care Act. He’s also a strong advocate for vast expansion of access to integrative services across the Veteran’s Health Administration.

Comment: Hand-wringing is probably in order. One area of major concern is likely the ongoing funding levels for the NIH National Center for Complementary and Alternative Medicine. Yet at the same time I recall that the Design Principles for Healthcare Renewal, an important early document in the assertion of the emerging integrative medicine movement, was first crafted following a daylong session in the Rayburn House Office Building chamber directed by then Congressman Dan Burton (R-IN) who, to use a line of my father, was “to the right of Attila the Hun.” Complementary and integrative health and medicine has always made for strange bedfellows. Utah’s Republican Senator Orrin Hatch has been a champion for access to botanicals and dietary supplements, for instance. Still, it’s hard to imagine replacement by leaders with the passion for our fields as these three. A lucky era of political stability and strength for integrative health and medicine is over. Who has quality relationships on the other side of the aisle? A longer article on the subject, and looking at likely Republican successors, is here in the Huffington Post.

 

IHPC Opens Much Needed CoverMyCare Campaign for Consumers on Non-Discrimination in Health Care

The Integrative Healthcare Policy Consortium (IHPC) has sent a release to kick off its national campaign called CoverMyCare to engage and support citizens in gaining coverage of services of licensed complementary and integrative health practitioners. The campaign is pegged to Section 2706, Non-Discrimination in Health Care, of the 2010 Affordable Care Act. The site is expertly developed and managed by integrative health and medicine consultant Taylor Walsh, an Integrator adviser. The campaign is supported by grants from Bastyr University and the American Massage Therapy Association (AMTA).

Comment: Take a look at this compelling, active web-site for a campaign that optimally would have begun the minute the Affordable Care Act was passed with Section 2706 as part of it. Stirring the grassroots is particularly timely and necessary, particularly with the loss of defenders Harkin and Mikulski (see above, and below). Credit IHPC, Bastyr, AMTA, and Walsh, who proposed and developed the site. The chief problem I have with it is that this is only funded for 6 months. Others need to step up to power this further, and more broadly.

 

IHPC on HHS Missing Deadline for Response to US Senate Demand That It Follow Congressional Intent on Non-Discrimination in Health Care

The November 3, 2014 date has passed by which the US Department of Health and Human Services and two other federal agencies were to have responded to the demand from the US Senate Appropriations Committee that it rescind the misleading guidance document. The guidance was relative to Congressional intent on Section 2706, Non-Discrimination in Health Care. The HHS had effectively let insurers do nothing. The Integrative Healthcare Policy Consortium (IHPC), which has been dogging the issue for the public, released these remarks to the Integrator:

“Michael Traub [ND, co-chair of IHPC’s Non-Discrimination Committee] has been in touch with Senator Harkin’s office. [He reports that] both HHS and the White House were stalling because of Election Day and not wanting to upset insurers. After the result of the elections, that won’t be as much of an issue and it may be possible to get HHS to take more seriously the request to clarify the faulty guidance. The Nov 3^rd deadline given by Sen. Mikulski and Harkin was responded to by HHS with a letter that they are reviewing the responses to the RFI but no indication about processor conclusion. Janet Kahn [IHPC senior policy adviser] indicated that Sen Mikulski will be a strong voice in the near future.”

Comment: If anyone had any questions about the extent of losses with Harkin and Mikulski no longer empowered after January 2014, noted above, this memo should convince. It also puts a premium on the activity of these two in the next two months of their waning influence. One wonders how much other unfinished business each has that will be competing for their time.

 

Veteran’s Health Administration Initiates Integrative Health Coordinating Council to Set System-wide Plan via Office of Patient Centered Care & Cultural Transformation

On November 4-5, 2014, roughly 40 leaders in integrative health practices across the US Veteran’s Health Administration met in Salt Lake City over a 3 day period to “create a plan to roll out a standardized, sustainable, measurable plan that will make the strongest possible business case for integrative health practices” in the VHA. The work is led by long-time integrative health and medicine leader Tracy Gaudet, MD, the director of the VA’s Office of Patient-Centered Care and Cultural Transformation. The first half of the meeting involved input from a set of six outsiders who were brought in as subject matter experts. It concluded with detailed work on a plan development led by members of an outside agency that is consulting with VA. Kennita Carter, MD, a Bravewell Fellow who is a leader in the effort, clarifies that the plan, while standardized, is envisioned as “a flexible framework – a flexible, tiered, phased-in approach” that can be useful regardless of the state of integrative health practices in a given facility. The over-arching goal is to meet a core VA goal of “advancing a model of health care that is personalized, pro-active and patient-driven and engages and inspires veterans to their highest level of health and well-being.”

Comment: VHA has a unique role in US healthcare as our own “single payer” system. The agency’s success in implementing electronic health records positioned it as a model, even as recent reports around access issues seem to echo the broken nature of the civilian system. One can only whole-heartedly hope that the commitment at the top of the VA to an integrative health focus, as evidenced by the hiring of Gaudet and formation of this group, will once again position VHA as a model for transformation into a true healthcare system.

For more information on the transformation read the Department of Veterans Affairs “Blueprint for Excellence.”  This document outlines four themes and ten essential strategies which frame a set of activities that simultaneously address improving the performance of VHA healthcare now, developing a positive service culture, transitioning from “sick care” to “health care” in the broadest sense, and developing agile business systems and management processes that are efficient, transparent and accountable.  Strategy Six focuses specifically on advancing health care that is personalized, proactive, and patient-driven, and engages and inspires Veterans to their highest possible level of health and well-being.  Read the entire document at: http://www.va.gov/HEALTH/docs/VHA_Blueprint_for_Excellence.pdf

 

Does the Concept of the Commons Have a Role in the Future of Integrative Health and Medicine?

The Omega Institute in Rhinebeck, New York, has long been a center of activity relative to integrative health and medicine. Omega has lately taken up the idea of the “commons” as part of its mission to “through innovative educational experiences that awaken the best in the human spirit, provide hope and healing for individuals and society.” The Commons are Making a Comeback, a November 2 opinion piece via Aljazeera America, described a “historic conference” at Omega called Building a Collaborative Commons. Speakers ranged from environmentalist Bill McKibben to former Obama adviser Van Jones to internet pundit Jeremy Rifkin. The integrative health and medicine movement was not directly represented.

Comment: In 1993 in my transition out of a decade of organization-building and politics in the naturopathic medical field, I attempted to write a book under the working title of Our Healthcare Commons. The choice was a response to the under-powered reality of all natural healthcare in our present form of capitalist organization. Each is strapped by the common “non-patentability” of natural agents and practices. Everything from self-care to botanicals to nutrition to mind-body to physical medicine to group programs to mental health to coaching to movement has in common this non-patentable characteristic - and thus this economic disadvantage. So why not turn the negative on its head and seek to promote these as our “commons” – figurative meadows that we own together? What if instead of shrugging our shoulders in resignation regarding the non-patentability, we actively promote our special responsibility and shared “ownership” to elevate and protect? For multiple reasons, the book never got finished. Perhaps its value was simply that twenty years later I’d write this note that we see our close connection to this broader movement. (Thanks to Jamie Harvie, director of the Institute for Sustainable Future, and a member of the Commons Health Network, for the link to the article. See his comments below.)

Comments from Jamie Harvie: "As Integrative Health and Medicine has at its core a systems worldview, patient agency and a preventative approach, it should be clear that the commons are implicitly part of Integrative Health and Medicine. To understand, it helps to recognize that a discussion of the commons must necessarily include both common resources - food, climate, water, green space - all connected to a prevention agenda, but as well commons principles, or how we manage these resources. These principles have a strong relationship basis and include shared decision making (or agency), boundaries or a sense of place and more. In fact the commons are already embedded within the Affordable Care Act, through a variety of drivers such as the Community Health Needs Assessment Process.  It becomes clear, that the extensive place-based health creation work in communities such as Atlanta, or Akron or national programs such as Place Matters, are beginning to employ components of a commons framework.  In Portland, a variety of community and healthcare partners received a health commons grant from CMS.  These projects don’t yet include an integrative clinical approach. Our take is that that the integrative health community is at the forefront of this collective health creation work and that to truly catalyze health we need to connect this burgeoning clinical community with communities and visionary healthcare leadership. This is the case and narrative we've been making over the last two years in the work and conferences of the Commons Health Network. The future of health, necessarily includes an emphasis on community, relationships, prevention and engaged and empowered individuals. It is not hard to understand how integrative health and medicine will be central to the future of our shared health.”

 

The Bridge to Health Creation through “Community Development” Workers/Organizers

The September 2014 editorial co-written by Michele Mittelman, RN, MPH, co-founder and managing partner of Global Advances in Health and Medicine (GAHM), declares the journal’s dedication to being “systems’ focused – our approach will transcend academic or professional disciplines.” This commitment is manifest in an 8-page submission entitled “Fostering Health Creation: Community Development to Address Long-Term Conditions.” The international set of authors led by Brian Fisher, MBBCh, MSc, MBE includes long-time integrative health and medicine leaders from England, Sweden and the United States: George Lewith, MD, PhD, Torkel Falkenberg, MD, and Wayne Jonas, MD, respectively. The focus is on “the role of community development in health, focusing on how it works on the ground, the evidence base for clinical and cost effectiveness, and gaps in that evidence.” Bottom line, as the authors note, is that the Institute of Medicine’s Shorter Lives, Poorer Health (2013) found that “countries that invested more in community development than in advanced medical treatment had better trends in the majority of health indicators.”

Comment: Those with integrative health’s health-creating values orientation have much to learn from this emerging orientation. Participants in the September 2014 event to honor US Senator Tom Harkin will have seen evidence of this cross-over work in projects of Jonas’ Samueli institute and the Institute for Integrative Health founded by top NCCAM grant-getter Brian Berman, MD. I was amused on reading to see the profound overlap between the “community organizing” tenets of the likes of Saul Alinsky to empower communities politically with those of the softer-sounding “community development” in empowering communities toward health. Personal note: an expert cited by the authors in a side-bar is Jim Diers who cut his teeth as a community organizer in the late 1970s in the Southeast Seattle Community Organization. There he worked with under-served populations at a time when I was doing similar organizing and writing work in Seattle – including with his organizer spouse, Sarah Driggs - prior to applying what skills I had to the early emergence of integrative health and medicine. Funny how circles can come around.

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Integrative Centers 

 

Former Scripps Integrative Leader Mimi Guarneri Opens Pacific Pearl in La Jolla, Consults on Chambers Center of Atlantic Health

The activism on behalf of integrative health and medicine of Mimi Guarneri, MD, a former invasive cardiologist, has been a compelling story since she founded the integrative center at Scripps.  Since leaving Scripps, Guarneri has founded an integrative medicine center, Pacific Pearl, in the pricey La Jolla, California, and recently was in the news as senior adviser to the huge Chambers Center for Well-Being in the Morristown, New Jersey’s at Atlantic Health System. At Pacific Pearl, for which the executive director is Rauni King, RN, Guarneri has surrounded herself with three naturopathic medical doctors, a chiropractor, and additional integrative medical doctors. She is senior medical adviser for the splashy 20,000 square foot Atlantic Health initiative, for which $6-million has been raised by prime benefactor Ray Chambers. Meantime, Guarneri is the founding president of the Academy of Integrative Health and Medicine (see related story, this Round-up). A release on the Chambers Center is here.

Comment: One proof that god is on the side of integrative health and medicine is that some sort of personal meditative or well-being practices often come along with the gonzo level of activity of integrative leaders such as Guarneri.

 

From Google Alerts: Links to Integrative Medicine in Health Systems and Communities from October 2014

This typically monthly Integrator feature is a quick capture of highlights from the multitude of links that flow in daily via Google Alerts for "integrative medicine," "complementary and alternative medicine" and "alternative medicine." This month the field's cup runneth over. Tremendous level of news and developments. This is in part due to my use of a broader inclusion net for what I am selecting. At the same time, the activity level suggests that those who believe the movement is headed toward a "tipping point" may have something. Here are 25 selections related to hospitals and medical organizations and integrative medicine, 10 from alternative and integrative medicine in community non-system practices and media, and 25 developments from around the world for October 2014.

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Academic Health 

 

Touchstone/Wilder: Footholds for Integrative Health in the National Center for Interprofessional Practice and Education

The founding leader of the Penny George Institute, Lori Knutson, RN, is presently with Touchstone Mental Health., an organization connected via grant with the $13-million, HRSA and foundation-funded National Center for Interprofessional Practice and Education (NCIPE). Knutson sent the Integrator this useful notice: “I wanted to let you know about the IPE/CP [interprofessional education/community practice] work going on in Minneapolis focused on community health. There was an [NCIPE] grant with the U of M School of Nursing, Pharmacy, and Occupational Therapy with Community Partners:  Touchstone Mental Health (adults) and The Wilder Foundation (child/adolescent mental health). Through Touchstone the IPE team includes acupuncturists, massage therapist, nurse practitioner in functional medicine, exercise physiologist, and a health coach. The focus of this integrative IPE team with the U of M Students is the development and implementation of Integrative Wellness Plans for individuals with serious and persistent mental illness and chronic health conditions. Measures include Triple Aim as well as specific PROMIS indicators. This project is the only ‘integrative’ initiative [via NCPIE] I am aware of.”

Comment: Efforts have certainly been made to insert licensed complementary and alternative medicine professions and integrative practices into the national IPE dialogue- and specifically NCIPE. The Academic Consortium for Complementary and Alternative Health Care (ACCAHC), with which I am involved, has prioritized this work. Over 4 dozen individuals and organizations with which it is associated have signed up into NCIPE’s community – which you can do by following that link. NCIPE director Barbara Brandt, PhD keynoted the CAHCIM-ACCAHC-Georgetown International Congress for Educators in Complementary and Integrative Medicine. Yet what Knutson describes is the only place that these professions have their “boots on the ground” in this major initiative. Good work!

 

Community Clinical Training Programs at Southern California University and Canadian College of Naturopathic Medicine Noted in IOM Report

The Institute of Medicine workshop summary, Building Health Workforce Capacity Through Community-Based Health Professional Education, is a rare IOM report that references institutions associated with the licensed complementary and alternative healthcare professions.  The references came from work led by Robb Russell, DC, of Southern California University (SCU), Nick De Groot, ND of Canadian College of Naturopathic Medicine (CCNM), Myles Spar, MD of Venice Family Clinic and this writer. The team produced a 6 minute webinar segment and a poster, delivered by Russell and available here, the abstracts for which are included in the Appendices B and C, respectively. Both related to community-based education experiences: SCU’s collaboration with Spar’s Venice Family Clinic, and CCNM’s with a local hospital. These placements grew out of the membership of the Academic Consortium for Complementary and Alternative Health Care (ACCAHC) in the IOM Global Forum on Innovation in Health Professional Education, which convened the workshop.

Comment:  Both were truly made possible via Russell’s work, SCU’s support, and the leadership of ACCAHC’s chair Elizabeth Goldblatt, PhD, MPA/HA, who is a member of the Global Forum.

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Resources 

 

Society for Integrative Oncology Publishes Practice Guidelines/Report Care for Integrative Breast Cancer Therapies

The president of the Society for Integrative Oncology (SIO) Heather Greenlee, ND, PhD, sent news that SIO has had published in the Journal of the National Cancer Institute its Clinical Practice Guidelines on the Use of Integrative Therapies as Supportive Care in Patients Treated for Breast Cancer. Greenlee wished it known that the “guidelines are now live and are freely accessible” via full-text, at the link above, and as a PDF here.  The widely reported publication of the guidelines was in part due to the decision of the SIO team to rank the evidence for various therapies. For instance, according to the abstract:

“Meditation, yoga, and relaxation with imagery are recommended for routine use for common conditions, including anxiety and mood disorders (Grade A). Stress management, yoga, massage, music therapy, energy conservation, and meditation are recommended for stress reduction, anxiety, depression, fatigue, and quality of life (Grade B).”

In addition, 32 other types of interventions had weaker evidence of benefit (Grade C), 7 were deemed unlikely to provide any benefit (Grade D) and just only one intervention, acetyl-l-carnitine for the prevention of taxane-induced neuropathy, was identified as likely harmful (Grade H) as it was found to increase neuropathy. Still, 138 majority interventions or modality combinations were found to not have sufficient evidence to form specific recommendations (Grade I). Said lead author Greenlee: “The SIO is very pleased to present this important resource for clinicians, patients and researchers.”

Comment from Integrator adviser Glenn Sabin (a former SIO board member): Sabin sent out the following comments with this excited post on the date of the long-awaited publication: “Given that over 75% of breast cancer patients currently use complementary therapies following diagnosis, these highly effective clinical guidelines offer medical oncologists, physicians and practitioners across disciplines, and, just as importantly, patients and caregivers, an extremely useful tool. Now, virtually any private practice oncologist, hospital or health system—especially those with minimal experience discussing or recommending integrative cancer therapies—should feel quite comfortable and confident in the quality and ratings of these core evidence-based modalities. Congratulations to SIO and the team of researchers, evaluators and collaborating institutions for developing such a timely set of clinical guidelines rendering valuable support to millions of breast cancer patients through their cancer care journey.”

 

CAHCIM and SIO Team Up to Publish Monograph on Integrative Cancer Care via NCI’s Journal

The Consortium of Academic Health Centers for Integrative Medicine partnered with the Society for Integrative Oncology and four healthcare delivery organizations to publish a monograph entitled “The Role of Integrative Oncology for Cancer Survivorship” for the Journal of the National Cancer Institute (JNCI). The monograph highlights research in the field of integrative medicine for cancer as presented in 16 peer-reviewed articles. In a media release, Lorenzo Cohen, PhD, director of integrative medicine at the MD Anderson Cancer Center and co-editor of the JNCI monograph states: “Integrative oncology is an emerging field with a lot to offer patients to help improve outcomes. It is incumbent upon us as scientists and practitioners to determine what will help improve clinical outcomes and what may interfere. The JNCI monograph is a step in the right direction and a catalyst for more high quality research in integrative oncology to speed our quest to prevent and control cancer.” The partners are the Abramson Cancer Center at the University of Pennsylvania, Allina Health, Beth Israel Medical Center and MD Anderson Cancer Center. Jun Mao, MD, of Perelman School of Medicine, University of Pennsylvania, is the co-editor.

 

New Text on Integrative Nurse Coaching by Dossey-Luck-Shaub Trio

The trio of activists and educators promoting nurses as a core workforce in health coaching, Barbara Dossey, PhD, HN-BC, Susan Luck, RN, BS, MA, HWN-BC and Bonney Schaub, RN, MS have published Nurse Coaching: Integrative Approaches for Health and Wellbeing. In a note to the Integrator, Dossey shared that “our model includes health advocacy and health policy. A January 2014 webinar with Dossey and Luck on nurse coaching is available here via Integrative Practitioner. The book is published via the International Nurse Coach Association. The book advances work steadily developed and promoted since 2010 by the 3 long-time holistic and integrative nursing leaders.

 

Integrator Editor John Weeks Offers Daily News via Center for Optimal Integration: Creating Health and ACCAHC Facebook Pages 

In an October 19, 2014 note to subscribers to the Integrator Blog News and Reports, editor-publisher John Weeks announced that he has begun a regular, nearly daily service of posting integrative health and medicine news via the Facebook pages of two sites. For clinical, policy, and system developments he is posting via the Facebook at Center for Optimal Integration: Creating Health and for education, academic and research-related, he is posting via Facebook at ACCAHC. Each site is linked to the Academic Consortium for Complementary and Alternative Health Care (ACCAHC), with which Weeks is in a leadership role.

Comment: I have found this an enjoyable daily practice – less than blogging but room for a comment or two and a relevant link. Hope some of you might find this useful.

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Organizations 

 

NCCAOM Steps Up to Fill National Leadership Gap for the Acupuncture Profession

As the American Association of Acupuncture and Oriental Medicine continues to struggle with issues of funding, membership and credibility, the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is increasingly filling a professional organization role. NCCAOM took a lead, with multiple other organizations (including the AAAOM), in promoting the international Acupuncture and Oriental Medicine Day, October 24, 2014. The organization has doggedly pursued formal recognition from the Bureau of Labor Statistics. It has helped inform about the state of the profession via its expansion of the Job Task Analysis that is bread and butter work for a certification body to develop Descriptive Demographic and Clinical Practice Profile. Most recently NCCAOM partnered with the Integrative Healthcare Policy Consortium to “rally Congress on House Resolution 4887” which would expand complementary and integrative care for Veterans by clicking on an NCCAOM Call-To-Action.  Much of this is noted in the recent NCCAOM newsletter.

Comment: The NCCAOM under the guidance for a decade of CEO Kory Ward-Cook, PhD, CAE, has readily collaborated with multiple organization while also stepping in to fill needs as necessary. The field’s Council on State Associations has also helped fill the national professional organization leadership gap.

 

Breakdown on Turn-out for the First Conference of the Would-Be Multidisciplinary Academy of Integrative Health and Medicine

To all accounts, the turnout of over 700 to the October 26-31, founding conference of the emerging Academy of Integrative Health and Medicine (AIHM) was a rousing success. But how did this organization, formed principally of MDs and DOs, succeed in its effort to create a more multidisciplinary gathering? Figures released by executive director Nan Sudak, MD, were as follows: MD 492, DC 62, RN 28, PhD 21 (other), ND 20, LAc 11 and 87 “other.” The latter encompasses Ayurvedic medicine practitioners, nutritionists, pharmacists, physicians’ assistants and more. In addition, over 8 countries were represented, with a significant group from the Middle East.

AIHM invested in stimulating this multidisciplinary turnout through a program of selected and subsidized “ambassadors” from different disciplines. The emerging organization also held two pre-conference business meetings exploring significant collaborations with organizations linked to multiple integrative health and medicine professions. In a related move, AIHM continued to diversify its Board of Directors with a new chiropractor and two nurses. The board already included a naturopathic doctor, a licensed acupuncturist, and two individuals with close ongoing relationships with multiple non-MD/DO groups. (Alignment of interest disclosure: I am one of those latter two individuals on the AIHM Board.)

Comment: I am an interested party, as noted, and I have found the level of commitment to inclusion of this still MD/DO dominant organization remarkable. I’d judge the diversity of this conference good for a first time event in a very busy AIHM year. Some of us are betting on this being the best chance for creating a truly horizontally integrated and inclusive organization that can power-up our efforts to contribute to the move of our medical industry toward a system focusing on health creation. More to come.

 

Bravewell-Funded Duke Program in Leadership in Integrative Health Has Triple the Target Applicants

Would there be a market for a program in leadership in integrative health and medicine that costs north of $20,000, not inclusive of travel costs, for onsite portions of the education? Many observers, including this writer, wondered whether there was a market when the Bravewell Collaborative announced that one of its legacy projects would be such a program, through the Duke integrative medicine program. Now sources close to the program say the first group of student of the program, capped at 35, had 106 applicants.

Comment: This interest level bodes well for the field itself. Congratulations to Adam Perlman, MD, MPH and the rest of his team at Duke.

 

Veterans Health Administration Joins Consortium of Academic Health Centers for Integrative Medicine

A few years back the leaders of the Consortium of Academic Health Centers for Integrative Medicine changed the organization’s bylaws to allow health systems to join. A handful of these systems have joined the 56 academic health centers members, thus allowing additional integration with the delivery system, and another source of revenue for CAHCIM in the era post core support from the Bravewell Collaborative. CAHCIM has recently registered a coup with the membership of the Veteran’s Health Administration (Office of Patient Centered Care and Cultural Transformation). CAHCIM also announced three additional new members: Pennsylvania State College of Medicine, Hershey Medical Center; Tecnologico de Monterrey School of Medicine, Mexico; and the University of Kentucky College of Medicine.

Comment: The VHA’s membership marks an ongoing trend of deeper connection between military and Veteran’s health and medicine and the integrative health and medicine movement. This is manifested most significantly in the make-up of the NIH National Advisory Council for Complementary and Alternative Medicine with two members and two ex-officio members related to the military. Good for CAHCIM. Good for the VHA.

 

Campaign Underway to Create ISHAR as Wikipedia-like Archive of Energy Medicine Information and Research

Six months ago the idea was cooked up to create, via collaboration, an Integrated Studies Historical Archives and Repository (ISHAR). The not-for-profit initiative is presented as a kind of “reliable comprehensive evidence-based information and research” Wikipedia for subtle energies and alternative therapies. Among these: homeopathy, acupuncture, acupressure, energy medicine, energy healing, herbal medicine, and “numerous other kinds of integrative and holistic medicine.” Running point on this is Melinda Connor, PhD, who also serves as the chair of the annual science symposium of ISSSEEM (International Society for the Study of Subtle Energy Medicine). Deepak Chopra is a backer. In this YouTube video Conner describes the effort. The group is seeing to raise funds to develop the archive via an IndieGoGo campaign that had hit 40% of its $50,000 goal as of November 7, 2014. In Sikh, Ishar in means “Almighty Supreme Being.”

Comment: It is fitting that this energy medicine resource seeks to begin with the non-local energy of crow-sourcing. Here’s hoping that the fund can approach a whole form before the campaign ends. (Thanks to Lucia Thornton, MSN, RN, AHN-BC for the news and Shamani Jain, PhD for additional insight.)

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Professions 

 

The White Folks Hate the Black Folks Department: The AAFP’s Formal Position against Naturopathic Physicians

This is not new news; it is only news to this reporter. The American Academy of Family Physicians (AAFP) has a formal position, dating to 2012, against the licensure of naturopathic physicians (NDs). The statement’s first line leaves no room for doubt: “The American Academy of Family Physicians (AAFP) opposes licensure of naturopaths.” The statement asserts that naturopathic medicine is unsafe, that naturopathic education is not based on science and graduates are not prepared. The AAFP concludes: “Governmental endorsement of naturopaths through licensure will jeopardize the health and safety of patients.” Of particular concern: “naturopaths [can] not be allowed, under any circumstances, to use the term ‘physician.’” Equally abhorrent is any formal appreciation of naturopathic doctors as “primary care.”

Comment: The naturopathic doctors should take solace from the fact that the AAFP is also taking the lead in opposing the right of advanced practice nurses to practice independently or to run patient centered medical homes. No evidence of harm is linked to either of AAFP’s campaigns to keep others out of independent roles in primary care. In fact, relative to nurse practitioners, the AAFP spits in the face of the influential Future of Nursing report from the Institute of Medicine and the Robert Wood Johnson Foundation. Family medicine, at the near bottom of the medical specialty pecking order, is doing its best to kick its fellow primary care colleagues off a cliff. Better politics would be to collaborate and coalesce all of the interests that are seeking to pull resources out of our rapacious tertiary care institutions and bring them back out into the communities where they belong. Besides, they could stop lying about the lack of safety. A thorough look at naturopathic doctors and primary care is in the white paper Meeting the Nation’s Primary Care Needs.

Notably, internist and Yale integrative medicine leader David Katz, MD, MPH recently opined that NDs are not only qualified as primary care but, in critical areas of primary care, are better trained than their family medicine counterparts: “As the president of the American College of Lifestyle Medicine, I am obligated to note in passing that lifestyle is the best medicine we have. In general, naturopaths are better trained in and more devoted to its delivery than are we in conventional medicine.” The AAFP’s bruising upbringing in the medical conventional specialty wars seems to have left them with PTSD. Does AAFP have no alternative than to strike out against others?

 

IAYT Focuses on Clarifying the Distinction between a Yoga Teacher and a Yoga Therapist

The volume 24, 2014 edition of the International Journal of Yoga Therapy (IJYT) opens with invited submissions from a half dozen yoga therapy leaders on a theme. Explored are the differences between: yoga teacher training and yoga therapy training; between a yoga class and a yoga therapy session; and the basic difference between the two types of professionals. The theme is kicked off by the executive director of the International Association of Yoga Therapists (IAYT), John Kepner, MA, MBA, CYTH, a driving force for standard-setting in the yoga therapy world. IAYT publishes IJYT. The prospective of Gary Kraftshaw of the American Viniyoga Institute, who has twice crafted protocols for NIH-funded yoga therapy studies, is that a yoga therapist should have “already completed an advanced yoga teacher training program, and should have integrated those teachings into their personal practices, as well as having applied them in different teaching context.” The yoga therapist then learns the “art and science of yoga therapy” and the “art and science of being a therapist.”

Comment: My guess is that this IJYT focus came out of something like the Bob Dylan line: “Even you, the other day/had to ask me where it’s at.” What is the difference? The first 15 content pages of the journal are devoted to the topic. The audience is both internal and external. Definitional clarity is part of the emergence of all professions. In a time when the full system of yoga is often being dumbed down to a club-based exercise program in the minds of most users in the U.S., establishing these distinctions is critical for yoga therapy to gain stronger footing in the treatment of people with frank conditions.

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People 

 

Leading Whole Systems Researcher and Dr. Rogers’ Prize Winner Marja Verhoef, PhD Retires

One of integrative health and medicine’s most significant, pioneering and visionary researchers, University of Calgary’s Marja Verhoef, PhD, is retiring.  In 2002, Verhoef co-founded the international Whole Systems Research Group (a.k.a. the Island Group). Via this team she published and helped clarify “Methodological Challenges in Whole Systems Research.” A believer in the importance of building capacity through networks, Verhoef co-founded and was the first president of the International Society for Complementary Medicine Research. She was also the co-founder and co-chair of Canada’s IN-CAM (Interdisciplinary Network on Complementary and Alternative Medicine) that focused on an outcomes and effectiveness agenda, rather than the inappropriately reductive, efficacy focus south of the Canadian border. Her publications, through 2009, are listed here. One jewel of that IN-CAM legacy is a resource for the international community of researchers who focus on the real world, the OutcomesDatabase.org registry. In 2011, Verhoef won the prestigious Dr. Rogers Prize award for excellence in leadership in complementary and alternative medicine.

Comment:  The Dr. Rogers’ page on the Verhoef award begins with this: “Dr. Marja Verhoef is far too humble to list the accomplishments that led to her winning the $250,000 Dr. Rogers Prize for Excellence in Complementary and Alternative Medicine.” That is my own experience of her when our paths have had a chance to cross over the years. Nothing I can say will speak more clearly to her value that her own words in that Dr. Rogers’ write-up: “I’m passionate about Whole Systems Research, because CAM treatment systems can only be done justice by research that acknowledges their complexity and the interconnectedness of the various treatment elements.  It is not acceptable to say that we don’t have such methodological approaches.  If that is so – we need to develop them.” If we don’t have such methods, we need to develop them! What researcher has done more to set the tone and build an infrastructure for the paradigm shift in research that necessarily must accompany, and lead, such shift to whole systems in care? It is clear from Verhoef’s life-work that the answers are not merely in the corporate, expensive and thus exclusive solutions of big data. The charge is to all of us.

 

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