March 2014 John Weeks Integrator Round-Up: Integrative Clinics

by John Weeks, Publisher Editor of The Integrator Blog News & Reports ND LAc recounts experience as Medicaid covered practitioner for Washington FQHC Healthpoint In a recent article in the newsletter for the Washington Association of Naturopathic Physicians, Chris Krumm, ND, LAc

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

ND-LAc recounts experience as Medicaid-covered practitioner for Washington FQHC Healthpoint

In a recent article in the newsletter for the Washington Association of Naturopathic Physicians, Chris Krumm, ND, LAc recounts developments in his 7 years of service as a practitioner in two Healthpoint clinics during which time his scope of practice as a naturopathic physician expanded and Medicaid opened coverage of his naturopathic services. Krumm notes that "many of my patients are Hispanic and prefer to use a natural medicine approach, but they will use conventional medicine when really needed or when a natural option is unaffordable." The Medicaid coverage began January 1, 2014. Writes Krumm:  "Just a few weeks into Medicaid coverage, I’ve already seen an increase in pediatric visits, and patients previously lost due to Medicaid barriers are beginning to come back. I’ve seen more walk-in patients, more acute triage patients, and more of Medicaid’s most difficult patients – those on disability." Healthpoint, the former Community Health Centers of King County, led by Tom Trompeter, MHA, presently is a network of 11 Federally Qualified Health Centers (FQHCs). Trompeter's reflections on integrative medicine in a patient-centered "health" home are here.

Comment: Krumm's statement that Hispanic patients would "prefer" his services certainly will come as a surprise to wonks who, since the Eisenberg study in 1993, have viewed "naturopathic" and "integrative" services as choices of the wealthy. Krumm seems to suggest a strong preference for his approach that is now kicking in big time as his naturopathic services can be covered.

Academic Integrative Centers in Ohio open doors to Traditional Chinese Medicines

The Cleveland Plain Dealer recently reported that there is a Chinese Herbal Therapy Clinic at the Center for Integrative Medicine at Cleveland Clinic and that this month Chinese herbal medicine consultations began at University Hospitals Ahuja Medical Center via the Connor Integrative Medicine Network. The opening of these services followed passage of a law licensing acupuncturists in the state. According to the report, Massachusetts-based Crane Herbs is one of three sources of TCM products at the Connor site while it is the company of choice at Cleveland Clinic. The services are embraced as complements by integrative internist Melissa Young, MD who called the availability of Chinese herbal therapy "an incredible step for patient care," adding: "The beauty of it - it's so complementary."

Boise's St. Alphonsus Medical Center begins referral service for prenatal yoga therapy

Boise, Idaho Yoga therapist Jennifer Knight, ERT 200, RYT 500 and Naomi Jones of Idaho Health and Yoga Awareness were the catalysts but the decision of St. Alphonsus Medical Center to endorse prenatal yoga therapy came via a personal experience of Mary Janowiak, MD, an OB/GYN at the medical center. Janowiak did prenatal yoga with her own baby and, according to the article here, "thinks it's all those head and hand stands at 36 weeks that flipped her baby head-down; otherwise she would have needed a caesarean section."  Janowiak is presently handing a referral card to her patients "referring them to prenatal yoga at the Yoga Tree, or the Birkeland Maternity Center in Nampa." Janowiak believes that an "expansion of yoga offerings will benefit the overall health of the population." She notes that:  "We're all concerned about the direction our country is going. Having one more program (like this) to emphasize health is better than just taking care of people when they get sick." Jones wrote in a note to the Integrator that "we are planning to expand the 'yoga referral' to include other special populations in the future such as obesity, diabetes, low back pain, asthma."

Comment: Kudos to Knight, Jones and to Janowiak. Integration and health creation advances one relationship at a time. (Thanks to the IHPC’s Alyssa Wostrel for the link.)

Manahan and Snider respond to article on the Secret Sauce and Positive Side-Effects Via Whole Person Integrative Medicine

The article published in the Integrator, the Huffington Post and in Alternative Medicine, Secret Sauce and Positive Side Effects in Treatment Via Whole-Person Integrative Medicine, elicited two useful responses from Integrator editorial advisers. The first is from holistic and integrative medicine leader Bill Manahan, MD and the second from Pamela Snider, ND, founder and executive editor of the Foundations of Naturopathic Medicine Project.

Here is Manahan: "Nice article in the Huff Post.  For a number of years, I have been teaching the medical students something like that.  Here is what I teach them. In chronic care, outpatient, primary care medicine, there are three important elements that help patients get better.

1.  About one-third of how well your patient does depends on the practitioner's presence. By that I mean how physically, emotionally, and spiritually attuned is the practitioner. Are we connected with our spiritual essence, and are we embracing our energetic and infinite nature?

2.  About one-third of how well your patient does depends on the practitioner's intention. By that I mean, how compassionate, forgiving, listening, and loving are we when we are with that patient?

3.  About one-third of how well your patient does depends on what therapeutic option you use. By that I mean is this the right person and the right problem to use a pharmaceutical, a herb, some mind/body exercises, Chinese Medicine, nutritional advice, or one of multiple other "treatments."

Manahan adds: "I tell them they will be amazed how often all they need to do with patients are the first two.  That stimulates the healing potential of each person, and many patients will return in a few weeks doing much better - and you have not yet begun your 'treatment options.'"

Here is Snider: "EXCELLENT article-great thesis John!!! Love that secret sauce, very tasty. Nice featuring of your esteemed wife and thought processes. That holistic care in the ‘sauce'? It is based on the understanding in naturopathic medicine that all diseases are one disease (the ill patient) and are fundamentally based on a violation of natural laws of healthy physiology-poor health and 'disease' is developed by disrespecting what determines health- the determinants of health Therapeutic Order, Level One."

Snider continues: "We ND's look at the totality of the equation (Zeff, Snider, Mitchell) of health promoting (+) and disturbing (-) factors, and get the plus signs to overpower the minus signs...builds vitality, stimulates vital force and triggers the innate healing response (VMN) and whammo. You are treating disease by restoring 'the health.' Lindlahr called this (1913) The Philosophy of the Unity of Disease and Cure, through Nature Cure and Clark (Australia) 1925 called this “The Unity of Cause and Cure Through Nature Cure.”