Why complementary and integrative medicine stakeholders should piggy-back on the interprofessional education/care movement; Pacific College of Oriental Medicine announces new holistic nursing program; First naturopathic student participates in month-long integrative medicine elective at Weil’s Arizona program
Roughly 750 professionals and clinicians involved in interprofessional education and care (IPE/C) attended the 3rd biennial Collaboration Across Borders conference in Tucson, November 19-21, 2011. The robust gathering, double the size of previous events, was described as a point of arrival for interprofessional education by the leaders of the movement. Team-care focused health professions education has a stronger foot-hold in Canada than in the United States. Speaker David Moen, MD, president of a 1300 physician Fairview Physician Associates told attendees that the value of interprofessional teams in US healthcare is advancing dramatically under changes in payment stimulated by Obama’s Affordable Care Act. These include payments related to patient satisfaction, limiting re-admission rates and lowering of tertiary care costs. Enhanced teamwork is anticipated to help produce these financial benefits. This in turn is expected to stimulate investment in IPE/C. Moen and others view this shift toward teams as a “culture change” throughout academic medicine and delivery.
Comment: IPE/C was first advanced in US medicine via the community clinic movement in the late 1960s and early 1970s. The field failed to gain traction as costs, waste and errors increased under a specialist-dominated system. The present rebirth of IPE/C followed the 1999 publication of To Err is Human by the Institute of Medicine. The report found that medicine kills over 100,000 a year, ranking it among the nation’s major killers. Subsequent analysis, published by the IOM in 2001 as Crossing the Quality Chasm, indicated that the most significant factor in medical errors is the lack of communication, understanding and mutual respect among doctors, nurses and other professions.
The parallel perspectives of Moen, regarding IPE/C’s re-emergence, and those of Allina leader Paulus, noted above, relative to the more positive horizon for integrative medicine, are striking. The changed payment structure under the Obama reform is opening interest in both IPE/C and integrative medicine. Enhancing teamwork is core to IPE/C and sometimes central to the integrative medicine effort. Colleagues in the Academic Consortium for Complementary and Alternative Health Care (ACCAHC) organized a donor-backed campaign that stimulated roughly a dozen representatives from educational institutions in these disciplines to attend the conference. This multi-disciplinary, allied-health-dominated community was quite receptive to integrative health ideas and disciplines. While the academic integrative medicine community was not well-represented in this conference, success of integrative medicine may be closely linked to IPE/C even as each appears to be linked to the shifting financial incentives under Obamacare.
The Collaboration Across the Borders IV meeting will be in Vancouver, BC in 2014. Another significant IPE/C conference will take place May 18-19, 2012 at Jefferson University entitled “Interprofessional Care for the 21st Century: Redefining Education and Practice.”
Pacific College of Oriental Medicine (PCOM) announced on November 30, 2012 that it will begin offering a unique holistic nursing Bachelor of Science Completion Program in Holistic Nursing through its New York Campus. This is the first bachelor degree nursing program within a CAM school in the country. The program was developed in consultation with Carla Mariano, EdD, RN, AHN-BC, FAAIM, who also initiated the holistic nurse practitioner program at New York University and is past-president of the American Holistic Nurses Association. Mariano told the Integrator that the program is particularly timely as the nursing profession has a growing commitment to establish a bachelors’ level as the basic educational standard for professional nursing. “BSN in 10” refers to the pending legislation requiring associate degree registered nurses to obtain the baccalaureate degree in nursing within 10 years of initial licensure. The states of New York and New Jersey each have legislation promoting this change. This direction for the nursing field was propelled by the October 2010 Future of Nursing report from the Institute of Medicine and Robert Wood Johnson Foundation.
Comment: Mariano, an Integrator adviser, notes other features of the PCOM program that are expected to draw nurses: “Integrative holistic health care is becoming more mainstream and nurses are increasingly focused the whole person and holism as a practice framework. PCOM nursing students will be prepared in holistic theory and therapies for health, healing, and wellness as well as leadership, community, and research.” She thinks that “a nursing program in a CAM school” will be attractive for the “interdisciplinary nature of the learning environment.” Students from acupuncture, massage, and nursing programs will share a number of required and elective courses. In addition, the nursing students are expected to have the opportunity to participate in various PCOM community health and health promotion programs.
Comment: This is a smart, intriguing link for PCOM, an entrepreneurial, for-profit AOM school. It will be interesting to see how this model of integrated education matures.
A November e-bulletin from the Association of Accredited Naturopathic Medical Colleges notes that earlier this year Adrienne Stewart became the first naturopathic medical student selected to participate in the month-long elective rotation in integrative medicine at the Arizona Center for Integrative Medicine. Stewart, now a naturopathic physician graduate from the Southwest College of Naturopathic Medicine (SCNM), jointed a group of MD students and residents from across the United States. A brief note in the SCNM news states:
“Dr. Stewart finished this rotation with a great sense of community and gratitude. As the first naturopathic physician to attend this rotation, she recognizes the need for naturopathic physicians to be involved in the discussion of integrative medicine. She says, ‘Making positive changes from the current health paradigm requires one of our greatest principles-docere. Docere not only involves the doctor and patient relationship, but also extends to doctors as educators throughout our evolving healthcare system.'”
Comment: Kudos to the Az Center for opening the door and to Stewart for walking through. My guess is that the interprofessional component of this educational experience may have been as rich for both Stewart and her conventional classmates as were any of the courses.