March 2014 John Weeks Integrator Round-Up: Policy

by John Weeks, Publisher Editor of The Integrator Blog News & Reports Department of Defense report to Congress details military use of CAMOn January 8, 2014, the U.S. Department of Defense submitted required testimony to U.S. Senator Carl Levin (D MI) that

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

Department of Defense report to Congress details military use of CAM

On January 8, 2014, the U.S. Department of Defense submitted required testimony to U.S. Senator Carl Levin (D-MI) that "explains the criteria used to evaluate integrative medicine programs, the results of those evaluations and the number of people receiving services, by branch of service and location." The 24-page document includes the following summary information.

  • FINDINGS: The review found that 120 Military Treatment Facilities (MTFs), 99 in the continental United States (CONUS) and 21outside the continental United States (OCONUS), offer a total of 275 complementary and alternative medicine (CAM) programs. Active duty (AD) military members used 213,515 CAM patient visits in calendar year (CY) 2012 with the most visits for chiropractic care (73%) and acupuncture therapy (11%). In addition, the United States Army (USA) Medical Research and Materiel Command (MRMC) funds CAM related research to identify safe and effective therapies to treat MHS patients.
  • EVALUATION: Various assessment tools are being utilized by many of the sites offering CAM therapies. Patient assessment/feedback, qualitative assessment by the provider, pre- and post-appointment questionnaires, patient satisfaction questionnaires, and measurement of physical improvement are being used to evaluate the CAM therapies offered to AD military members. Patients reported improvement in symptoms, reduction in anxiety, improved sleep and decline in psychological symptoms across the CAM modalities in use.
  • CONCLUSION: There is wide-spread use of CAM therapies across the MHS. Providers and patients were interested in using CAM therapies even though many are not evidence-based. Some providers have added CAM therapies as an adjunct to conventional therapies for a holistic approach to patient management.
  • RECOMMENDATIONS: The MHS will evaluate CAM programs for safety and effectiveness, as well as cost-effectiveness. As resources allow, the Department will consider widespread implementation in the MHS of cost-effective CAM programs meeting TRICARE guidelines for safety and effectiveness.

Comment: It is common in integrative health and medicine circles to say that the military is leading the way. Some even suggest that wounded warriors will break down conventional medicine’s barriers to inclusion in the way that the HIV-AIDs community shifted FDA’s slow-moving acceptance practices. (Think Military Buyer’s Club.) Findings on the number of facilities where selected therapies are found include: chiropractic (59), acupuncture (83), massage (9), yoga (11), clinical nutritional therapy (68), naturopathic medicine (1), breath therapies, biofeedback (13), and meditation (14). (Thanks to Joan Walter of the Samueli Institute for the link.)

NCMIC Foundation supports presence of licensed integrative practitioners in the nation's workforce debate

The 10th Annual Health Workforce Research Conference of the American Association of Medical Colleges will have a new presence, thanks to a visionary grant from the NCMIC Foundation. The grant, to the Academic Consortium for Complementary and Alternative Health Care (ACCAHC), will allow the organization to be present and exhibit at the gathering of workforce leaders. In addition, the organization will be able to print and make available to the 150-200 workforce policy leaders hard-copies of its highly-regarded white paper Meeting the Nation's Primary Care Needs: Current and Prospective Roles of Doctors of Chiropractic and Naturopathic Medicine, Practitioners of Acupuncture and Oriental Medicine, and Direct-Entry Midwives. Notably, the meeting is the AAMC's first that focuses broadly on the "health workforce" rather than merely the needs for medical doctors and osteopaths.

Comment: NCMIC and the NCMIC Foundation have a long history of investing in forward thinking and visionary projects, including kick-starting the field of chiropractic research a half-century ago and its more recent series of reports on chiropractic’s future. This grant is timely. Chiropractors and other licensed integrative health and medicine practitioners are formally included as part of the professionals to be considered in U.S. workforce planning under the Affordable Care Act (see Section 5101, here). ACCAHC has prioritized inserting the 350,000 licensed practitioners, who presently are already relieving a portion of the Nation's primary care burden, into proactive consideration in the workforce dialogue. In addition, the white paper, co-led by Michael Goldstein, PhD, a senior researcher at the UCLA Center for Health Policy Research, and this writer, has been called by workforce expert Richard "Buz" Cooper, MD "the best compendium of thoughtful analysis and information on these disciplines that exists. I admire the scholarship of this document." NCMIC Foundation is supporting a tremendous opportunity to leap-frog into the consciousness of workforce leaders.

Anti-discrimination petition filed at by expectant mother seeking coverage of licensed midwife; IHPC endorses, and KHN covers

When expectant mother Stephanie Taylor learned that her desired practitioner for her birth process, a licensed midwife, was not covered by her health plan as she expected under the Non-Discrimination in Healthcare, Section 2706 of the Affordable Care Act, she filed a petition at Abide by the Law (Section 2706) and Stop Discriminating was quickly endorsed by the Integrative Healthcare Policy Consortium. As of this writing the petition had garnered 2010 of the 10,000 signatures needed to get on the government's radar. In an e-note to interested parties, Taylor writes: "Since our last contact, my appeals have been rejected 2 more times. One from the Department of Managed Health Care and again from Blue Shield of California. In both instances I specifically appealed based on the Harkin Amendment. Both groups rejected my appeal without once even mentioning the Harkin Amendment. In fact, during this entire process I have not once been able to get any agency to address this law. They all seem to want to act like it doesn't exist, which since they are breaking it, I guess they are setting up their argument to be ignorance." Meantime, Taylor managed to capture the attention of Kaiser Health News (KHN), which published Health Law Provides No  Guarantees Of Access To Midwives, Birthing Centers on March 4, 2014.

Comment: Never underestimate the power of an expectant mother. Taylor spoke with me after seeing my Huffington Post piece on Non-Discrimination: A 'Big Honking Lawsuit' to Advance Integrative Medicine and Health? Take a moment, click in to her site above, and go sign. No harm. Perhaps some good! This is terrific citizen action. Meantime, the KHN piece is a significant mainstream piece on 2706.