Economic development officials in Asheville, North Carolina explore integrative medicine as a growth opportunity  The March 19, 2011 feature is headlined “Asheville thrives as regional hub for integrative medicine.” The surrounding county is reportedly home to 32% of the state’s

Economic development officials in Asheville, North Carolina explore integrative medicine as a growth opportunity 

The March 19, 2011 feature is headlined: “Asheville thrives as regional hub for integrative medicine.” The surrounding county is reportedly home to 32% of the state’s licensed acupuncturists and nearly a half of its licensed massage therapists. The area also includes 30% of the state’s naturopathic physicians and 60% of the American Herbalist Guild members in the state. The article notes that the Institute for Emerging Issues at N.C. State University recently urged that Western North Carolina consider investing in integrative medicine “to generate high-quality jobs.” The topic of integrative medicine was recently one of 11 breakout sessions at the Institute’s 26th annual forum. David Brown, executive director of the Asheville Hub Alliance, an economic development group, notes that “the area has a high concentration of Western and alternative medical providers and the health industry is one of the few areas that has grown during the recession.” He adds: “If you put all these things together, you conclude that Asheville could have a competitive advantage in advancing integrative health.”

Comment: The nation’s most well-developed model for this approach to economic development, and medical tourism, is the Hawai’i Consortium for Integrative Healthcare. The Consortium was the brainchild of Integrator adviser Ira Zunin, MD, MPH, MBA. Take a look at the stakeholder mix on the Consortium’s board.

Expanded Aetna yoga trial with Duke Integrative Medicine, Kraftsow to examine cost-savings related to stress 

“The positive results seen in these studies offer evidence that mind-body approaches to health improvement are an effective and targeted solution for employers who want to lower the costs associated with stress and help their employees achieve better overall health.” The speaker is Kyra Bobinet, MD, MPH, medical director of Health and Wellness Innovation at Aetna, and clinical director of an expanded Aetna study based on two pilots. The studies were developed in collaboration with Duke Integrative Medicine and American Viniyoga Institute (AVI).

A Businesswire release from Aetna shared that early results from randomized controlled pilot studies found significant reductions in stress as compared to the control group. In addition, Aetna’s review of medical claims’ data showed a positive correlation between costs and stress levels. Among the Aetna study volunteers, those reporting the highest level of stress had nearly $2,000 more medical costs annually than those reporting the lowest level of stress. The findings, according to the release, “suggest potential health care costs savings could be realized by reducing stress.” Ruth Wolever, PhD, director of research at the Duke IM program is principal investigator on the study. AVI founder Gary Kraftsow, MA, E-RYT 500 is consulting on the project.

Comment: The Aetna move recalls Mind Matters, Money Matters, the breakthrough article written by Kaiser physician David S. Sobel, MD, MPH over a decade ago. Sobel concluded: “Mind/body medicine is not something separate or peripheral to the main tasks of medical care but should be an integral part of evidence-based, cost-effective, quality health care.” The still slow uptake is likely linked to system discomforts with new players, approaches and patterns of behavior. Credit Aetna for its published commitment.

Dan Redwood, DC: Two additional recent resources show cost savings from “CAM”  

The Integrator column entitled The Big Money in Integrative Medicine, based in part on a review of cost-related findings from 2010, stimulated educator-writer Dan Redwood, DC to suggest two additional recent resources. 

  • $2000 for chiropractic versus $20,000 for microdiskectomy 

A comparison between chiropractic and microdiskectomy (low back surgery) found that 60% of those randomized to chiropractic care were able to both avoid surgery and achieve long-term outcomes equal to those who underwent the surgery. Chiropractic care cost roughly $2,000 versus approximately $20,000 for the surgery. The lead author is a chiropractor. The other authors include 3 neurosurgeons. Redwood’s review of the research article is the second piece here. The research citation is McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ. Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. J Manipulative Physiol Ther. Oct 2010;33(8):576-584.

  • $2.75-billion to $3-billion in annual savings in the U.S.? 

A follow-up article in Employee Benefits News by Gerald Clum, DC extrapolates from these findings: “In the U.S., at least 200,000 microdiskectomies are performed annually at a direct cost of $5 billion, or $25,000 per procedure. Avoiding 60 percent of these surgeries would mean a reduction savings of $3 billion annually. In the Canadian study, patients receiving chiropractic care averaged 21 visits during their course of care. If a cost of $100 per patient visit is assumed for the care provided by the chiropractor, then the total cost per patient would be $2,100, yielding per patient savings of $22,900, or $2.75 billion dollars annually. The conclusion: $2.75 billion of savings each year if patients used chiropractic treatment first.

Comment: If researchers for a pharmaceutical company or a medical device company had this level of comparative evidence to support the comparative effectiveness of a new approach or product, what do you suppose the response would be? Heck, the benefits are merely positive clinical outcomes plus significant cost-savings. The question this begs is whether integrative practitioners should continue using their breathing and meditation skills to manage their outrage. The lack of significant, proactive response to such results is the context in which to understand that flavor of the recent commentary by Lou Sportelli, DC and Jim Winterstein, DC posted here.


Read other sections of the April 2011 John Weeks Round-up: