January 2016 John Weeks Integrator Round-Up
Research & PublicationsSpecial Issue: The Role of CAM in Public Health, Disease Prevention, and Health PromotionThe peer-reviewed Evidence-Based Complementary and Alternative Medicine has published a special issue entitled “The Role of CAM in Public Health, Disease Prevention, and Health Promotion.” The guest editors are Cheryl Hawk, PhD, DC in the U.S., Jon Adams, PhD in Australia and Jan Hartvigsen, PhD, in Denmark. The openly accessed editorial notes the surprising feature that most of the articles included in the issue “tended to focus more on single herbal or other traditional preparations or procedures for both treatment and prevention, with very little emphasis on health behavior, which is typically a cornerstone of public health programs.”Comment: Hawk, a co-chair of the Research Working Group for the Academic Consortium for Complementary and Alternative Health Care is a long-time leader in drawing the lines between the whole system principles in integrative health and actual engagement in public health. My guess is that the more reductive submissions from the fields must have been disappointing. This may be an area where we unfortunately reap what we sow. Most government-backed public health activity does not directly seek out and include “CAM” professions. Thus the numbers of those from these fields who identify themselves as public health workers is small, and low research production in this domain follows.Assist by January 18: FON Consulting’s Glenn Sabin’s N of 1 “Cancer Cure” Is a Platform to Highlight Integrative OncologyThe remarkable story of Integrator advisor and FON Consulting founder Glenn Sabin’s “incurable” cure from chronic lymphocytic leukemia, has not only been published at Cureus by a team of 5 authors - including the NIH’s former integrative oncology lead Jeffrey White, MD. The paper is part of a competition, as Sabin notes here: “Cureus, in partnership with Cancer Commons, created a publishing competition for ‘Exceptional Responders in Oncology’ … If this article—the only paper involving an integrative approach to cancer care—wins the competition, integrative medicine wins.” He urges all who are interested to judge the paper as part of the competition. Take a look!Comment: This news is remarkable at many levels. First, not to be forgotten: Sabin is cancer free, gracias a las diosas and to his lead oncologist Kenneth Block, MD. Sabin views Block, one of the paper’s co-authors, as “arguably the father of modern integrative oncology.” Integrative cancer care freed from his cancer the leading marketing consultant for integrative cancer centers. The second is Sabin’s perseverance in working with his busy clinicians to get the paper published. This is already double victory for integrative oncology – even as winning the Cureous/Cancer Commons competition would further catapult awareness of integrative approaches.If this paper wins this competition, it could save lives, and not just of those with leukemia. Functional integrative oncology needs a good deal more attention. Finally, the publication and competition train attention of Sabin’s upcoming book, n of 1, presented as “an inspiring story about challenging medical dogma and activating the body’s innate capacity to heal.” If it makes sense, take time to participate in this potential win-win-win-win.Opportunity: Senior Clinical Scientist Opening for Complementary and Alternative Medicine for the Military Health SystemOne of the most influential research positions for integrative health and medicine is open. The scientist will lead the robust Department of Defense exploration of integrative strategies. Military medicine is ahead of civilian medicine in integrative care exploration. The findings in military medicine will increasingly inform transformation of civilian healthcare and medical delivery practices. The person who formulates the questions in this position can have a major influence on human health. Help find the right person! Is it you? The job description is here.Comment: Thanks to colleague Patricia Herman, ND, PhD at the Rand Corporation for notifying me of this opportunity.
Don Berwick’s 9 Steps to Ending the Era of “Complex Incentives” and “Excessive Measurement”The former administrator of the Center for Medicare and Medicaid Services and co-founder of the most influential progressive force in U.S. Medicine, the Institute for Healthcare Improvement (IHI), is Don Berwick, MD. Berwick named and promoted the Triple Aim, the value-based approach to medicine that many in integrative medicine feel is aligned with their views. He has also distinguished himself in the integrative health world for his 8 Principles for Integrative Medicine and as a proponent of a radical shift toward “salutogenesis” or “health creation” for medical delivery organizations. In December 2015, in his annual IHI keynote, Berwick again took the pulse of US medicine. He offered 9 prescriptive measures:
- Stop excessive measurement;
- Abandon complex incentives;
- Decrease focus on finance;
- Avoid professional prerogative at the expense of the whole;
- Recommit to improvement science;
- Embrace transparency;
- Protect civility;
- Listen. Really listen; and
- Reject greed
Academics & Education
BAIHM Interprofessional Fellowship Recognized by American Board of Integrative MedicineThe Academy of Integrative Health and Medicine has announced a milestone for its new interprofessional Fellowship in Integrative Medicine. A December 22, 2015 release shares that the combination onsite-online program has gained approval from the American Board of Integrative Medicine of the American Board of Physician Specialties. The release states that the action “affirms that the Academy’s 1,000-hour Fellowship, under the directorship of Tieraona Low Dog, MD, meets or exceeds the highest standards set forth for the study of Integrative Medicine.”Comment: This is a milestone. It is interesting that this approval comes from a Board that already made a remarkable historic move by allowing education as a chiropractor, naturopathic doctor, or acupuncture and Oriental medicine practitioner as a basis for certification. Side-note: AIHM is about to open a new website.U Bridgeport and U Arizona Integrative Health and Medicine Initiatives Shared in IOM PublicationA new publication of the Institute of Medicine (IOM) of the National Academy of Sciences, Envisioning the Future of Health Professional Education: April 23-24, 2015 Workshop Summary includes full-page abstracts from two presentations about integrative health and medicine academic initiatives. One, by the University of Bridgeport’s Jennifer Brett, ND, LAc, summarizes her presentation, including outcomes data, from an interprofessional clinical initiative at the University’s clinics. Students in chiropractic, naturopathy, acupuncture and dental hygiene were involved. Video available here.The second, a presentation by Elizabeth Goldblatt, PhD, MPA/HA, describes goals and activities of the University of Arizona’s National Center for Primary Integrative Health Care. Goldblatt is a member of the HRSA-funded project’s leadership advisory team. The project’s goal is to change the education of primary health care professionals to Incorporate an interprofessional and integrative approach. The video is here.Comment: Both the presentations and the IOM reports on the work are products of the 4-year membership of the Academic Consortium for Complementary and Alternative Health Care, which Goldblatt co-directs, in the IOM’s Global Forum on Innovation in Health Professional Education.Job Opening: Academic VP/Provost at a Leading University for Integrative Health and Medicine, MUIHAn emerging academic player in the IHM field is the Maryland University of Integrative Health (MUIH). The university's 16 degree and certificate programs - onsite and online - presently boast 1300 students from 43 states and 21 countries. It's collaborations and partnerships with local and distant partners are expanding rapidly. Responsibilities for this new Academic VP/Provost cut across a classroom-clinical-research-policy spread. One "preferred qualification" is "interest in policy and change agency." The application information is here.Comment: East of Chicago, there is no other university of natural health sciences, with a mission-level commitment to integrative health and medicine, other than MUIH. Some formerly chiropractic schools like National University of Health Sciences (Chicago), Northwestern Health Sciences University (Twin Cities), Southern California University of Health Sciences (Los Angeles) and University of Western States (Portland, Oregon) share some parallel, multi-disciplinary characteristics. Two formerly single-purpose naturopathic medical schools have followed a similar path: Bastyr University (Seattle) and National College of Natural Medicine (Portland, Oregon).Yet the Eastern part of the US has little such activity. The only school that boasts multiple programs in integrative health fields, University of Bridgeport, in Connecticut, does not share, at the university’s executive level, a fundamental commitment to these insurgent methods of practice. I think the geographic location of MUIH, and especially its proximity to the Nation’s Beltway, make this position particularly interesting. Send it around to the right souls! (Alignment of interest note: I provide some strategic consultation to MUIH’s president.)Professions The Naturopathic Medical Profession's Powerful Impact on the Emergence of Integrative and Functional MedicineBefore “functional medicine” and before the medical doctor-led movement for “integrative medicine” came the standard-setting re-emergence of the naturopathic form of integrative medicine. Some of the powerful influences of this profession on functional/integrative models is detailed in this widely shared Huffington Post column. The list of these contributions is enfolded in a recommendation: going forward, mightn’t the small naturopathic profession, with just 5000 or so licensed practitioners, take a lead from this past influence and focus on the high road of its mission as change agents and on transforming the practices of others? Isn’t this a more productive path than lowering its gaze to the naval of merely advancing guild interests. The choice is tough with still limited cultural authority and mounting student loan debt of new graduates. But might not such a strategy end up actually benefiting the naturopathic profession’s guild interests?Comment: For reasons of space limitation, the writer – yours truly - neglected to share a few areas of significant merit that I briefly note here. First, the 1985 Textbook of Natural Medicine (Joseph Pizzorno, ND and Michael Murray, ND) provided the first model of a science-based natural medicine clinical resource. Patricia Herman, ND, PhD, now with the Rand Corporation, is the field’s foremost cost-effectiveness expert. Twenty years ago Tim Birdsall, ND and a stream of naturopathic physicians since at Cancer Treatment Center of America have pioneered clinical integrative oncology. Naturopathic physician and acupuncturist Rick Marinelli, ND, MSOM, played a significant role in advancing the integrative pain model at the Institute of Medicine. See comments from his IOM colleagues at In Memoriam: Rick Marinelli, ND, LAc (1954-2013). A global service model for integrative medicine has been under development by the naturopathic physician founded Natural Doctors International. The through-line for 20 years in integrative health policy – including providing key language in the NCCIH legislation and White House Commission document - has been Pamela Snider, ND, a guiding light and co-founder of the Integrative Health Policy Consortium, and of the Academic Consortium for Complementary and Alternative Medicine. I am sure there is more that might be shared.This piece has stimulated a good deal of discussion, online and off, inside some of that profession’s closed discussion groups, and from the Polarization-Based Medicine bloggers who can see them only as quacks and frauds. A former dean of naturopathic medicine at University of Bridgeport, Beth Pimentel, ND, sent me this, which captured the dominant shared response on the site and in emails (who knows about those who didn’t respond directly):
“I think your assessments of the profession’s impact and contributions, as well as focus for moving forward are spot on. It takes a leap of faith to release the grip on guild-focused interests, but that’s what patient-centered care is all about - letting go of ego and the need to be the one and only right answer in order to facilitate health creation for individuals and their communities. Guild-centric interests have greatly contributed to the deterioration of healthcare quality and the prohibitive expense of medicine, in addition to promoting separation and conflict within the health and healing professions. Adopting a non-guild strategy has the potential to unify professions and embrace a truly patient-centered strategy for health creation. NDs are small in number, but by infusing naturopathic principles and therapeutic order into other healing professions, we are greatly increasing the number of patients benefiting from preventive, whole-person care. And that’s a good thing.”American Chiropractic Association Urges Members to Take Medicare’s Documentation TrainingA recent brief to members from the American Chiropractic Association urges all to take the time to review a new public video, titled "Improving the Documentation of Chiropractic Services." The issue links to the April 2015 enactment of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) that includes provisions related to chiropractic services. One section required “the development of educational and training programs to improve a doctor of chiropractic's ability to document services and increase compliance with Medicare's policies.” The requirement was carried out by the Provider Compliance Group (PCG) at the Centers for Medicare and Medicaid Services (CMS).Comment: I include this note mainly so that other professions that are seeking Medicare inclusion – acupuncture and Oriental medicine and naturopathic medicine in particular – can track the kinds of steps that may one day be part of their own futures. Perhaps requesting a booklet on documentation should be part of the opening gambit.OrganizationsWellness Warrior Szekely Offers a Top 10 of “Wellness Wins” in 2015The organization started by the remarkable nonagenarian Deborah Szekely has published a Top 10 of Wellness Wins for 2015. Among these: banning “microbeads,” stalling the DARK Act, halting approval of a harmful herbicide, introducing a handful of wellness bills in Congress, moves to limit antibiotics in food production, and more. The 92 year-old Szekely, a pioneering in the spa field, was honored with the Change-Maker Award in October by the Academy of Integrative Health and Medicine. Comment: Take a moment to peruse a little good news. Hopefully some of this introduced legislation may one day find its way into law.FON Consulting Publishes List of 2016 Integrative Health and Medicine ConferencesAn annual service of Glenn Sabin and FON Consulting is the provision of an amendable list of integrative health and medicine meetings for the coming year. The 2016 Integrative Health Conferences is here. There are as many as 8-10 a month, with low conference periods in late summer and, oddly, in October. Sabin asks: “Are we missing your integrative health and medicine conference? Please let us know.”Comment: While a business rather than an “organization,” some of the services FON and Integrator advisor Sabin provide for the field are very much the kind of services one sees from an organization. Thank you Glenn. BTW, one not notices is the significant presentation and poster content of the Integrative, Complementary and Traditional Health Practices Section at the American Public Health Association, October 29, November2, 2016, in Denver: Creating the Healthiest Nation, Ensuring the Right to Health. On an additional note, Sabin offers his top blogs from 2015 here. InternationalPAHO Initiates Nicaraguan Initiative on Integrative, Traditional and Complementary Therapies with US, Australian and Spanish Partner OrganizationsIn a remarkable first, Pan American Health Organization (PAHO) has announced a major, multi-party, global initiative to advance the integration of traditional and complementary medicine into a national health system. The nation at stake is the second poorest in the Western Hemisphere, Nicaragua. The driving force behind the series of December 2015 meeting in Managua is Maria Socorro Gross, MD, the representative in Managua of PAHO and of the WHO. The parties met in a workshop conducted through the Nicaraguan Institute for Natural Medicine and Complementary Therapies, previously established in December 2014. The purpose of the initiative was described as “capacity building in research and access to information to integrate natural medicine into the health system.”The aim is “contributing to the strengthening of the Model of Family and Community Health.” Key health local health officials attended. The meeting included the signing of Memoranda of Understanding with the National College of Natural Medicine (Portland, Oregon, USA), Australian Research Centre on Complementary and Alternative Medicine at the University of Technology (Sidney, Australia), the Program Philippus del Real Centro Universitario Escorial-María Cristina (Spain), Natural Doctors International (NDI - Portland, Oregon, USA & Ometepe, Nicaragua). The representatives of the international organizations included Tabatha Parker, ND (NDI, NCNM) and Jon Wardle, ND (Australia – pictured below). The goal: “strengthen the comprehensive approach to health care, to provide users with access to services natural medicine, respectful, affordable, safe and effective.”Comment: One of the most remarkable aspects of this activity is the person behind it. Socorro Gross has over 20 years in significant leadership promoting the WHO’s primary care mission. She has served with PAHO/WHO since 1994 in positions in Columbia, the Dominican Republic, and most significantly in Washington, D.C. as the subdirector of PAHO. This activity is potent for Nicaragua. Perhaps the initiative will also prove a precursor to an expansion.Portrait of an Integrative Hospital in Hong Kong LedBY Former U Maryland Leader Lixing Lao, PhD, MD (China), LAcThe January 2016 issue of Acupuncture Today includes a feature entitled “A Model of Integrative Medicine: How Chinese Medicine Integrates into a Western Medicine Hospital at the University of Hong Kong-Shenzhen.” The initiative of the Shenzhen Government, begun in 2012, is managed by the University of Hong Kong. It is described as “a conventional medical hospital but has a department of Chinese medicine along with other departments of conventional medicine.” The integration is both outpatient and inpatient, in both chronic and acute conditions – and in fact seeks to dispel the idea that Chinese medicine only acts “in a slow and gentle way.”Notably, the department at the hospital is directed by Lixing Lao, PhD, MD (China), LAc. Lao, who is the Chief of Service and the Director of the School of Chinese Medicine at Hong Kong University, worked at the University of Maryland School of Medicine for 21 years prior to his appointment at the University of Hong Kong in September, 2013. The authors note that “unlike hospitals in Mainland China where TCM practitioners prescribe both Chinese herbal formulas and western drugs although they are only licensed in Chinese medicine, Hong Kong has separate licensing for Chinese Medicine and Western Medicine trained practitioners,”Comment: A remarkable story, all the more so since it involves Lao, one of the leading figures in acupuncture research through his close association with Brian Berman, MD and the University of Maryland Center for Integrative Medicine.
MiscellaneousNational Geographic’s Promotes a Fundamental Healing Power: “Your Brain on Nature”I was included recently on an e-list of naturopathic physicians to whom were sent the link to a recent National Geographic publication of a beautifully titled feature, ”This is Your Brain on Nature.” The subhead: “When we get closer to nature—be it untouched wilderness or a backyard tree—we do our overstressed brains a favor.” The lengthy feature begins with data on our estrangement -- a recent study, for instance, found that some 70 percent of U.S. mothers reported that they played outside every day as children while only 31 percent of their children do. Then it moves toward efforts to reclaim a connection. For instance, in South Korea, where “nature bathing” is recognized, and the people speak of “body and soil” as much as “body and soul,” a total of 37 official “healing forests” are planned by 2017.Comment: As a newcomer to these fields 30 years ago I was drawn by the naturopathic doctors to their fundamental principle of the vis medicatrix naturae – the healing power of nature. Yesterday in full wet suit I was practicing what they preach in a regular winter practice, on a paddle board in full wet suit in the middle of the Salish Sea (a.k.a. Puget Sound) with the winter sun illuminating the snow covered Olympic range to the West and small clusters of black ducks in groupings here and there across the glassy surface with a full regatta of sailing boats beating north with Mt. Rainier (a.k.a. Tahoma) beyond. Places like the Institute for Integrative Health with its Green Road initiative are embracing nature’s importance in healing. This is an area of human activity that the integrative health and medicine fields can and should individually and jointly officially promote.Meantime, sadly, with news that Rupert Murdock has purchased the publication – portrayed as a “python swallowing a gazelle” - readers must wonder what direction will be followed with This is Your National Geographic on Murdock. Hard to imagine that as a healing force.What Matt Damon’s Character in The Martian Says (in the Book) Re ChiropracticIn an end of year message to its investors – now over 10,000! – the Foundation for Chiropractic Progress noted the following from the novel of The Martian, the best-selling novel by Andy Weir that was made into the movie by Ridley Scott with the starring role played by Matt Damon: “In The Martian, Mark Watney -- the spunky protagonist-astronaut stranded on Mars -- injures his lower back during work activities. He agonizes over the pain and laments that there are no chiropractors on Mars! His only option was Vicodin.”Comment: The chiropractors, who have been fussing for decades over their cultural authority (or lack thereof), may take this for an affirmative sign that they are getting their due - at least on Mars. F4CP, meantime, estimates that over the years it has “generated over 31 billion positive media impressions through the distribution of advertisements, press releases, TV and radio public service announcements, advertorials, social syndications, and more.”Bastyr University: Where the Soundtrack of Golden Globes Award Winner The Revenant Was RecordedWhen Bastyr University purchased the campus that was once the St. Thomas Seminary, they got in the deal a chapel – now a meeting place – with internationally-revered acoustics. The day after the 73rd Golden Globes, a message from Bastyr’s communications lead Derek Wing shared that The Revenant, winner for drama, best director and best actor “was recorded in the Bastyr University Chapel last fall!” The chapel is widely utilized by musicians, Hollywood, and others. In fact, at the moment of his writing, Wing said, “I’m told music to a video game is being recorded here today and tomorrow, and another project is scheduled for the end of month.” Wing sent a link that shows the chapel during the prior recording of a game.Lori Knutson, RN, BC-HN, has taken a position with New Jersey’s Meridian Health. Knutson formerly led the Penny George Institute/Allina Health initiative that has generated some of the most significant, publicly-available data on the value of integrative practices in integrative environments. Knutson shares that Meridian, which has received many national honors for their excellence in patient care, “made a significant commitment to integrative health and medicine as the catalyst in achieving the triple aim, acknowledging that the future of healthcare must have a focus on empowering individuals to engage in healthy lifestyles, and providing all possible evidence-based therapies and treatments to address chronic conditions.” Knutson will serve in a system-wide position as administrative director of integrative health and medicine.Comment: Here’s hoping that Meridian will have the same commitment to gathering and sharing outcomes that characterizes the George/Allina programs. Great news. Stay-tuned.Dynamic Chiropractic Names Christine Goertz, DC, PhD its 2015 Person of the YearThe title of the Dynamic Chiropractic piece naming Christine Goetz, DC, PhD as its 2015 Person of the Year is “Defined by Dedication.” The article notes that Goertz, vice chancellor of research and health policy at Palmer College of Chiropractic, holds a set of truly remarkable positions: member of the board of governors for the Patient Centered Outcomes Research Institute; member of the American Medical Association PCPI Measures Advisory Committee; chair of the American Chiropractic Association’s Performance Measurement Task Force; and senior scientific advisor to that same chiropractic organization. In the interview that follows, Goertz shares the remarkable trajectory of her unique career which touches on virtually every significant moment in the history of chiropractic research, including recent activity with the Department of Defense.Comment: Not noted, interestingly, was Goertz pioneering role as the first “CAM” practitioner to be employed at the National Institutes of Health, and her appointment last year to serve as a member of the National Advisory Council on Complementary and Integrative Health. Goetz’ contributions overflow from chiropractic to significantly impact the broader integrative health and medicine terrain. Great choice! Arguably the chiropractic person of the modern era.