John Weeks July 2013 Integrator Round-up covering the topics of Integrative health care policy, research and publications, integrative practice, academic medicine, professions, natural products, conferences, people

Washington state massage team publishes paper on massage in Essential Health Benefits

A team led by Dianna Thompson, LMP and Marybeth Berney, LMP has produced a useful paper on the massage profession and essential health benefits. The PDF is available as Evidenced-Informed Massage Therapy: The Research Supporting Massage Therapy is an Integral Component in the Affordable Care Act’s Essential Health Benefits. A one page summary is also on the website of the Washington State Massage Therapy Association, which funded the project. 

Comment: Massage therapists in Washington State have historically pushed the value of the field in heath care and medicine when other parts of the massage leadeship have preferred that the field sit back into its role as a trade that offers “relaxation” (never mind for a moment how such stress reduction can also be a benefit to one’s health outcomes). Good for Thompson, Berney and their team, including Marissa Brooks, LMP, MPH, for pushing this envelope. This is a useful document for many, across the U.S. 


Hassles of midwifery customers insurance coverage featured in New York Times

The midwifery profession got a boost from the New York Times in an article called Getting Insurance to Pay for Midwives which began: “At a time when the United States is looking for ways to rein in its runaway medical spending, a surprising glitch is preventing American women from choosing the low-cost option: Many insurance plans do not have midwives in their provider networks, or do not cover midwife care at all.” The article was provoked by consumer ire as expressed in comments on an earlier Times piece. Ironically, hospital rules that require midwives to be supervised by medical doctors jack up rates as they are treated as physician extenders rather than as lower cost providers who “generally order fewer tests and their patients are less likely to end up having Caesarean deliveries, studies have shown.” The author links to a site on how midwife care saves money. In states with high percent of midwife attended births, such as Oregon and New Mexico, the rate of midwifery usage is just above 15 percent while in in Britain and Denmark, more than two-thirds of all births are attended by a midwife.

Comment: A radical shift to midwifery care will be a sign of actual health reform in the U.S. Notably, the author did not clarify whether births by direct-entry licensed midwives are included. 

Related note: This article notes that Indiana has become the 28th state to regulate direct-entry midwives. Advocates were not all happy with the scope restrictions. (Thanks to Lou Sportelli, DC for the link.) 



Naturopathic doctors  move into key roles in medical homes in Oregon

Martin Milner, ND, the founder of the Center for Natural Medicine (CNM) in Portland, Oregon has received a Patient Centered Primary Care Home (PCPCH) certification as the first naturopathic group practice in that state to receive the credential according to this article in the Portland Business Journal. The article states that Milner’s CNM “is the first naturopathic clinic in the U.S. to receive the credential as a Patient-Centered Primary Care Home.” Milner and his team must still work out their relationship with that state’s Coordinated Care Organization (CCO) movement. Meantime, Bill Walter, ND’s intensive work to penetrate the CCO development in Lane County, south of Portland, has led to work as a staff provider in the Lane County Community Health Center, a county-run Federally-Qualified Health Center (and PCPCH). Walter notes that discussions continue about formal primary care status for naturopathic doctors in the Oregon CCO movement. He, however, has been “internally designated” as such by his Lane County group. Walters’ work with the CCO movement was featured in the Integrator earlier this year in Integrative Medicine in Accountable Care: Report from Oregon Naturopathic Physician Bill Walter, ND.

Comment: These are intriguing steps. Milner has pioneered a series of important steps for his profession in Oregon, including establishing the CNM 20 years ago as a large, integrative cardiology center that also serves as a teaching clinic for National College of Natural Medicine. Here’s looking forward to the data on the outcomes from these pilots in care delivery.

Related note: David Schleich, PhD, president of National College of Natural Medicine offers a perspective on the challenges the naturopathic doctors face in an article in the Lund Report entitled Inconsistent Oregon Healthcare Workforce Policies Undermine the triple AIM



Foundation for Chiropractic Progress continues to gather strength as chiropractic visibility group

A June newsletter for the Foundation for Chiropractic Progress (F4CP) announced a series of significant accomplishments: an additional $100,000 from Standard Process; paid distribution of the documentary Doctored to all members of Congress; the number of entities making monthly contributions surpassing 4500; completion of a white paper on chiropractic and Accountable Care Organizations; a blurb referencing the field’s 30 celebrity supporters (including the likes of NFL great Jerry Rice); a notice on ad placements, frequently using these celebrities, in June 2013 (including the Wall Street Journal and USA Today); a push to contact Congress on a legislative issue for chiropractic; and an honoring of Kent Greenawalt of Foot Levelers, one of the organization’s founders. The website announces the F4CP’s mission as “generating positive press for the chiropractic profession and increasing public awareness to the many benefits associated with chiropractic care.”

: Good public visibility and public relations are ongoing desires of all emerging fields- both to rise from relative obscurity with a positive story and to combat negative perceptions. The F4CP organization models behavior in unity. Every other integrative practice field would be served to go to school on their structure and game plan.