John Weeks April 2013 Integrator Round-up covering the topic of Integratve Healthcare Professions

Eligibility requirements, definition and principles for MD/DO Board Certification in Integrative Medicine

The American Board of Physician Specialties (ABPS) officially announced its eligibility requirements for medical doctors and osteopaths who wish to become board certified in integrative medicine (ABOIM). One initial path is a grand-parenting strategy, to respect long-timers in the field. New MDs/DOs already boarded in a specialty in their own field have two other paths. They can complete one of 21 recognized fellowships. Alternatively, they can complete a nationally-recognized program in chiropractic, naturopathic medicine or national certification in acupuncture and Oriental medicine (AOM).

ABPS also published the following as its core principles of integrative medicine:

  • A partnership between the patient and the practitioner
  • Consideration of all factors that influence health, wellness, disease – including mind, body and spirit
  • Use of conventional and alternative methods to facilitate the body’s innate healing response
  • Appropriate consideration given to use of less-invasive and less-harmful interventions, when possible, while addressing the whole person in addition to the disease.
  • The concept that medicine is based on good science, is inquiry-driven and open to critical consideration of new paradigms

Comment: It will be interesting to see if any of the accredited ND, DC and AOM schools busy themselves develop joint degree programs. A large door would seem to have swung open here. Meantime, the elevation of consideration of “less invasive and less harmful interventions” is pleasing. One gift of “integrative medicine” is to give tools to MDs/DOs who wish to “above all do no harm” but haven’t presently the clinical tools or referral networks to exit the binary world of prescribing or watchfully waiting.


Acupuncture accreditation body approved first professional doctorate standards

The Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) has a “hot news” link on its site that is headlined ACAOM approves FPD Standards. The brief paragraph begins: “The Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) is pleased to announce the approval of standards for a First Professional Doctorate (FPD) degree in Acupuncture and/or Oriental Medicine.” Applications will be accepted as soon as June 1, 2013. The note closes with: “ACAOM wishes to thank all those who participated in the development, review, and comment leading to the final Standards.” The standards are here.

Comment: The thank-you from the ACAOM “to all who participated” has wild resonance for those who have participated in this long, internal look at itself by this profession since a subset fought against the Masters’ level entry accreditation standards established in the late 1980s. Many wished that the field had either taught to, or simply claimed, a doctoral level in the first place. In the early 1990s, the issue split the profession. More recently, a subset, led by the community acupuncture movement, fought against the more costly FPD entrance standards which they argue will increase debt load and thus put acupuncture services out of reach to many. I share the concern.


American Chiropractic Association focuses on integration in new 10-year vision statement

The House of Delegates of the American Chiropractic Association has endorsed a new 10-year vision statement that elevates the important of team care and integration. The first in a series of 5 bullets is: “Collaboration with other healthcare disciplines and integration into all health care delivery models that enhance individual health, public health, wellness and safety.” At the same meeting, the House endorsed a policy related to this first point. The organization will establish an Integrated Practice Council “to improve patient health and patient care by advancing the quality and availability of chiropractic physicians and their services through full integration into mainstream, evidence-based health care systems.”

Comment: These are good steps for chiropractic.To focus on collaboration is the right remedy for a field in which significant subsets have long been known for going it alone. My wish list for this field that is continuously pondering whether or how it has “cultural authority” was that it take a strong principled position that it would own and promote for all of health care that is not about chiropractic, per se. The collaboration focus does this, though one feels the field pressing at the gates in the language chosen. One idea would be to promote the principle of what it has called for years “conservative” treatment. Using the least-invasive first is where the puck is going, in pain care and elsewhere. Such a vision is a direction that is not yet formally embraced, well rfesearched or well-articulate. Yet it could find many other supporters in the integrative health, community medicine, public health, and primary care communities. Witness the principles of integrative medicine for the new MD/DO board certification in integrative medicine, reported above. Leadership in this area would deeped chiropractic’s cultural authority. Meantime, the magic in promoting such a vision, without specific reference to back pain or to chiropractic, is that people would likely end up using more chiropractic. You can have your guild and leave it, too. Wish-list aside, it is good to see the new ACA vision, and the action step of setting up the Council of Integrated Practices.