December 2014 John Weeks Integrator Round-Up: Policy

by John Weeks, Publisher Editor of The Integrator Blog News & Reports    Republican Senate Win Sweeps Key Integrative Health Leaders from Powerful Roles  That integrative health and medicine’s would lose its top champion for the past 20 years, US Senator

by John Weeks, Publisher/Editor of The Integrator Blog News & Reports

Joint Commission Elevates Potential for Acupuncture, Chiropractic, Massage and Relaxation in Pain Care in Response to Integrative Team

The Joint Commission has issued a  revised accreditation standard for pain that significantly elevates numerous non-pharmacologic approaches. These include “acupuncture therapy, chiropractic therapy, massage therapy, osteopathy, and relaxation therapy.” In addition, the new standard cautions clinicians to consider negative consequences of opioids as well as positive values when making treatment decisions. The decision followed organizing work led by acupuncture researcher Arya Nielsen, PhD, LAc, and Marsha Handell, MLS, each of Mount Sinai Beth Israel. Ben Kligler, MD, MPH, the vice chair for integrative medicine at MSBI then helped organize 20 members of the Consortium of Academic Health Centers for Integrative Medicine to support the petition that the Joint Commission re-open consideration of non-pharmacologic approaches. The new standard will apply to all institutions under the agency's guidance and review: hospitals, ambulatory care facilities, home health and senior homes. A Huffington Post article, Chronicles of Health Creation: Joint Commission Issues New Pain Standards in Response to Integrative Medicine Team, details the remarkable sequence of actions that led to the change.

Comment: Credit the Joint Commission for its responsiveness. Credit Nielsen for seeing the opportunity and doing the major work, with Handel, to create the case as the core Mount Sinai Beth Israel team. Credit Kligler and the Consortium of Academic Health Centers for speaking up for the need for change. The new standards will bring patient care a step closer to a "Never Only Opioids" era that can help us undo the present harm to human beings, families and communities from unnecessary use, and overuse, of prescription pain-killers.


Herb Industry Pleased with Pallone as New House Commerce Minority Leader

The American Herbal Products Association in its December 2014 newsletter reports that the industry’s “big question on the House side” was settled with the selection of Frank Pallone (D-NJ) as minority leader for the influential House Energy and Commerce Committee. Pallone narrowly defeated Rep. Anna Eshoo (D-CA). AHPA notes that “since Pallone is co-chair of the Congressional Dietary Supplement Caucus, the industry had been pulling for him to prevail in this contest.” Pallone replaced the panel’s current ranking member Henry Waxman (D-CA), who has been a vocal critic of the supplement industry, who will retire after a 40 year career. AHPA also reports with pleasure that Jason Chaffetz (R-UT), who, like Pallone, is co-chair of the Congressional Dietary Supplement Caucus, was named the next chairman of the House Oversight and Government Affairs Committee.

Comment: Waxman’s retirement marks the end of a long hate affair. Waxman’s disposition toward more rather than less public protection and thus regulation of industry of all kinds led him to push for more oversight than the dietary supplement industry has typically wanted. Waxman’s activism in this area given that he is the Congressman from Hollywood was always nearly as surprising as are his looks given Hollywood’s premium on beauty and perhaps the highest supplement sucking demographic in the U.S.


Educating a Oregon’s Medical Home Policy Leaders on Integrative Medicine and Health

The Oregon Health Authority may be the only such state agency in the nation with an Integrative Medicine Advisory Group. In July 2014, “IMAG” presented to OHA using a slide show available here. The three priorities of the group, which meets monthly, are here: 1.Credentialing of Integrative Medicine providers (IM Credentialing Information Tool (almost complete); 2.Integrative Medicine and Oregon’s achievement of the triple aim - Resource guide identifies IM best practices (still in development); and 3. Exploring opportunities for participation and recognition in the Patient Centered Primary Care Home Program - Communication plan (still in development).

Comment: The state of Oregon is one of the very few with a long history of licensing in all five licensed integrative health and medicine disciplines (chiropractic, acupuncture and Oriental medicine, naturopathic medicine, massage therapy and direct-entry midwifery). The state also has quality academic centers in each of these fields. The relative respect and inclusion in the very existence of IMAG flows from there. The state is become a proving ground for models for inclusion across other jurisdictions.


British Agency Urges Homebirths for Uncomplicated Pregnancies

Women with uncomplicated pregnancies — about 45 percent of the total — are better off in the hands of midwives than of hospital doctors during birth. This is according to new guidelines by

the British National Institute for Health and Care Excellence that “reversed a generation of guidance on childbirth” according to a December 3, 2014 New York Times article entitled “British Regulator Urges Home Births Over Hospitals for Uncomplicated Pregnancies.” The agency has “advised healthy women that it was safer to have their babies at home, or in a birth center, than in a hospital.”  The analysis showed that for low-risk mothers-to-be “giving birth in a traditional maternity ward increased the chances of surgical intervention and therefore infection.” Typical costs to the system of hospital births is $2500, of birth center births $2,200 and homebirth $1500.  The article concludes that “the findings could affect how hundreds of thousands of British women think about one of the biggest questions facing them.” Nine in 10 of the roughly 700,000 babies born every year in England and Wales are presently delivered in a hospital.

Comment: The leaders of the Socialist State of Washington are the closest in the U.S. to have imagined that the U.S. should follow a similar evidence-based path. (See Homebirth Midwives and the Hospital Goliath: Evidence Builds for Disruptive Innovation, the most commented upon article I have ever writing for the Huffington Post.) Nowhere is the trumping of evidence by economics so clear as in U.S. birthing practices. The movement to drive health care back into the outpatient world and enhance communities misses its engine, and its heart, by allowing the huge edifices on the hill to brand the birthing process as something that needs the machinery and scarring of inpatient care. (Thanks to William Wulsin, ND, LAc, MPA, MPH for the link.)