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

Kreitzer-Saper team to serve as co-editors for Global Advances in Health and Medicine Journal 

Michele Mittelman, RN, MPH, the cofounder and power behind the scene of the most intriguing journal to emerge in the integrative health and medicine space recently, Global Advances in Health and Medicine (GAHM), has announced the hiring of a new editorial and leadership team with whom she will be working in setting the magazine’s direction. It’s a powerful nurse/medical doctor duo: Mary Jo Kreitzer, RN, PhD, FAAN, the founding and longtime director of the Center for Spirituality and Healing at the University of Minnesota; and Robert Saper, MD, MPH, director of The Program for Integrative Medicine and Health Care Disparities at Boston Medical Center and associate professor of Family Medicine at Boston University School of Medicine. Additionally, Avery Stirratt has joined the team as president and publisher.

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

Kreitzer-Saper team to serve as co-editors for Global Advances in Health and Medicine Journal 

Michele Mittelman, RN, MPH, the cofounder and power behind the scene of the most intriguing journal to emerge in the integrative health and medicine space recently, Global Advances in Health and Medicine (GAHM), has announced the hiring of a new editorial and leadership team with whom she will be working in setting the magazine’s direction. It’s a powerful nurse/medical doctor duo: Mary Jo Kreitzer, RN, PhD, FAAN, the founding and longtime director of the Center for Spirituality and Healing at the University of Minnesota; and Robert Saper, MD, MPH, director of The Program for Integrative Medicine and Health Care Disparities at Boston Medical Center and associate professor of Family Medicine at Boston University School of Medicine. Additionally, Avery Stirratt has joined the team as president and publisher.

Krietzer, a former vice chair of the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM), as well as a Council of Advisers member of the Academic Consortium for Complementary and Alternative Health Care, is the most significant nurse leader in integrative health and medicine. She has a passion for community and public health, health creation, and coaching.  Saper is viewed as one of the standout emerging leaders of CAHCIM. He will chair the organizing of the 2016 iteration of the International Research Congress on Integrative Medicine and Health. Stirratt is a senior media executive with 25 years’ management experience with a wide range of companies, from iconic brands (Forbes, Newsweek) to foundations and new business ventures. Mittelman shared with the Integrator that she is excited to see the journal’s interprofessional mission reflected at the top. She envisions the journal as a comprehensive communication platform that will advance health and well-being around the globe. The new editorial team replaces David Riley, MD, who resigned last spring.

Comment: Many assumed that when Riley, GAHM‘s founding editor, left the journal that it would collapse. They underestimated Mittelman and the power of her vision and partnership in creating GAHM as it is today. I am a big fan of GAHM‘s three ongoing priorities, set in Riley’s term: global convergences in health and medicine, whole systems approaches in healthcare, and high-quality case reports. What’s not to love in that? Riley led some fine work, particularly in the remarkable case reports area, and in turning out some exceptional, focused issues. I am very curious to see where the Kreitzer-Saper-Stirrat team, working with Mittelman, will take the journal next.

 

Explore Commentary: Is there a “Town and Gown” Split Related to Science and Evidence in Integrative Medicine?

“Evidence based medicine…evidence-informed practice…patient-centered care…the art of medicine…These terms fly around the landscape of integrative health and medicine with the potential to ultimately generate a meaningful consensus and a shared language for how we discuss clinical decision-making and clinical practice. But more often than not the discussion around evidence and knowing degenerates into a Tower of Babel.” This is the opening of a commentary in Explore co-authored by Ben Kligler, MD, MPH, a past chair of the Consortium of Academic Health Centers for Integrative Medicine, and this writer, entitled Finding a Common Language: Resolving the Town and Gown Tension in Moving Toward Evidence-Informed Practice.  The perspective explores the mixed views of research and evidence as cited in “gown” (academic medicine) and “town” (practice-driven functional, naturopathic and integrative conferences and texts). How do we explain decrees that there is “none or limited evidence” from the National Institutes of Health about something on which one has just received a hand-out with 150 scientific references?

The authors explore the cultural-economic-scientific rift that has led to differing uses of evidence. For instance, “town” dwellers may speak about in vitro studies as though they prove something in vivo. Meanwhile, “gown” oriented academics, who may be over-critical about such an infraction in application of science, may have little appreciation that they are daily reimbursed for treatments for which only a small fraction have quality evidence. The authors make the following recommendations. First, embrace mixed methods research to better capture whole person outcomes. Second: promote case reports “as a legitimate means to accumulate new clinical knowledge.” The final recommendation is, according to the authors, recognized as a challenge for those who “hide behind the notion that every question can ultimately be answered with randomized clinical trials.” In fact, “there will always be many answers only available to us through intuition, experience, and patient-centered communication.” The kicker: “… as of this moment we hide this from our students and residents.” All parties “need to be open and honest about how much of even our own type of practice is based on not knowing what evidence has to say.”

Comment from Ryan Bradley, ND, MPH: “My overall response to your editorial is positive. I think you two do a good job of being humble and bring needed light to the issue of evidence limitations in all categories of practice. Ironically in all settings ego and ‘status quo’ practices, based on history and not evidence, often win out over the art of individualized practice, based on a balance between patient preferences, the available evidence and rational thought.

“My friendly fire would be, the first several paragraphs appear to be very ‘stream of consciousness’ and casually written. Also it takes over a page (of a two page editorial) to make your recommendations. I think your recommendations could be developed more, including how/where your suggestions apply in diverse practice settings, how they may specifically encourage integrative practices/cooperation between providers, and how to specifically encourage doctors/policy makers to accept broader perspectives on the evidence hierarchy.

“For example, is a couplet of a prospective, quasi-experimental (1) and qualitative (2) studies evaluating patients’ experiences with naturopathic care for diabetes, including evidence of improved blood glucose, improved self-management, increased medication adherence, increased self-efficacy, improved mood and overall complementarity to usual care, enough to incorporate naturopathy into conventional practice settings, or leverage the need for demonstration projects of integrative care teams for diabetes? It hasn’t been enough yet, and I’d sure to know why not!  ;)”

1. Bradley R, Sherman KJ, Catz S, Calabrese C, Oberg EB, Jordan L, Grothaus L, Cherkin DC. Adjunctive naturopathic care for type 2 diabetes: Patient-reported and clinical outcomes after one year. BMC Complementary and Alternative Medicine. 2012. 12:44. doi:10.1186/1472-6882-12-44

2. Oberg EB, Bradley R, Sherman K, Calabrese C, Hsu C, Catz S, Cherkin DC. Patient-Reported Experiences with First-Time Naturopathic Care for Type 2 Diabetes. PLoS ONE. 2012. 7(11): e48549. doi:10.1371/journal.pone.0048549

Comment: Bradley’s final point is good: having the mixed methods research is not necessarily enough to get the ball of coverage and inclusion rolling. One his other commentary: far be it for me to argue that Bradley, or anyone else, has wrongly stated that I have ever been involved in using too many words or not being succinct enough.