June 2012 John Weeks Integrator Round-up: Media
Economist poll 2-1 in favor of “alternative medicine” being taught in medical schools
In early May, The Economist asked its online readers: Should alternative medicine be taught in medical schools? Your guess for the answer? The response has bounced around. On May 12, 52% were in favor. By June 4, the pro-factor had surged to 66%. Where is it now.
Comment: The Economist has not typically been friendly toward complementary and alternative medicine. When International Association of Yoga Therapists executive director and economist John Kepner, sent the notice of the poll, he asked me to guess. I was expecting it to be going down at a margin of 45%-55% or so. It was barely ahead. At this writing, the pro-vote was up to 66%. My guess is that many who don’t typically come to the site were steered to it and have voted late. They may have also followed the Chicago political adage to “vote early and vote often.” Still, it’s nice to see. I wonder how the poll would have been had the question been phrased like this: Should medical schools stick their heads in the sand, deny consumer use of alternatives to what their doctors typically recommend, and refuse to allow education in alternative practices inside their hallowed halls that have steered us toward a healthcare system in which half of what we do is waste and much of that harmful? Oops, I think I was allowing full knowledge of the insanity of our practice to emerge. (See reference immediately below.)
New York Times writer excoriates the annual physical and routine testing as sources of over-performance of waste and harm
Medical doctor and New York Times writer Elizabeth Rosenthal takes apart the testing and so-called prevention infrastructure of US medicine in a June 2, 2012 piece entitled “Let (Not) Get Physicals.” Rosenthal focuses on the over-use of the lowly physical as the tip of a cascade toward unneeded and unnecessarily-performed surgeries and procedures.
Comment: Great and perturbing piece. I have many times quoted a statement from an IOM leader in a JAMA editorial (2008) saying nearly half of what we do is waste and most of it harmful. I quibble with Rosenthal’s statement that the contribution to over-testing and overuse of procedures by our high supply of specialists is “sociological.” We are better off calling it by its more naked appellation: economic. This allows us to think more clearly about what the solution might be. Clearly a part of it is to take the lion’s share of responsibility for our payment priorities away from the AMA’s specialist-dominant Relative Value Scale Update Committee (RUC) committee that are followed by Medicare 90% of the time. Such advice should be in some vehicle that leans towards community medicine, true prevention (lifestyle change, self-efficacy outcomes versus early diagnosis) and outpatient services.
Our reality is political-economic. We need to be able to count the votes to make the change. A specialist-dominated committee will likely produce specialist-dominated outcomes. Rosenthal does mention a terrific, countervailing campaign that underscores that some change can be fostered against prevailing economic self-interest. This is the Choosing Wisely initiative from the American Board of Integrative Medicine Foundation. In the campaign, engaged with Consumer Reports, each specialty chooses five tests or procedures commonly used in their field, whose necessity should be questioned and discussed. This campaign has now attracted nearly 20 specialty societies..
Nominations open for IMCJ’s new “Award of Excellence” in Integrative Medicine
Integrative Medicine: A Clinician’s Journal has announced that it has a new Award of Excellence to “honor those leaders who contribute to CAM Medicine without expecting any recognition.” The nomination form states that IMCJ is “allowing you, our readers to assist in selecting a practitioner who has had an impact on how integrative healthcare is applied in practice.” A winner will be announced in November.
Comment: From the looks of the IMCJ notice, the award will not, alas, be a big fat check, which is what most in the integrative practice world would probably like, if not need, as pay-off for laboring without recognition.
Taylor Walsh makes case for integrative medicine
Integrator adviser and frequent contributor Taylor Walsh sometimes writes for other medical blogs, including the Altarum Institute Health Policy Forum. Walsh begins his most recent offering, Health Care Transformation: Still a Work in Progress with: “Five years ago I slid serendipitously onto the outer edges of health care, landing in the highlands of integrative medicine.” Walsh, a skilled writer with a marketing mind, artfully weaves a story that allows the values in integrative care to sneak up on the reader. The might be useful to one or more of you who is working to open the heart and mind of a colleague or friend.