Institute of Medicine's Names Planning Team for Integrative Medicine Summit: Snyderman to Chair
Written by John Weeks
Institute of Medicine's Names Planning Team for Integrative Medicine Summit: Snyderman to Chair
Summary: The Institute of Medicine (IOM) of the National Academy of Sciences has announced a 12-person planning committee which will oversee development of the February 25-27, 2009 National Summit on Integrative Medicine and Health of the Public. The IOM is sponsoring the Summit in partnership with the Bravewell Collaborative of philanthropists. Here is a look at the 12 member team, chaired by Ralph Snyderman, MD, plus some musing on their not very integrated mix. Nine are MDs, suggesting that to the IOM, "integrative medicine" is an MD franchise.
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Institute of Medicine of the National Academies
The Institute of Medicine (IOM) of the National Academy of Sciences announced in March that the Bravewell Collaborative of philanthropists and the IOM have "partnered to convene a summit that
will explore the science and practice of integrative medicine." The Summit will be held February 25-27, 2009 at the National Academy of Sciences Building. Last week, the IOM announced the planning team which will be charged with developing the Summit. The team is anticipate to recommend themes, individuals to whom to contract papers, presenters, and perhaps even parameters for the guest list.
The most significant question around this Summit is for what purpose? Just 3 years ago, the IOM published its 337-page Complementary and Alternative Medicine in the United States. Many IOM volumes gather dust without having too much impact. What new could this Summit format offer?
The most significant question around this Summit is for what purpose? Many IOM volumes have little impact. What new could this Summit format offer?
One answer is the participation of the Bravewell Collaborative. Bravewell has had a powerful influence on the advance of "integrative medicine" inside conventional academic medicine. The organization could make a difference here by creating visibility and pushing the Summit content out into the public; by, in short, giving the meeting legs.
According to information from the IOM in response to an Integrator query, the total contract for the Summit, which Bravewell is paying, is $445,592. This includes some funds for printing summaries of the Summit.
Bravewell showed a bit of its clout by announcing the collaboration on the Charlie Rose Show on March 28, 2008. Rose'sinterview featured Christy Mack, Bravewell's president, Harvey Fineberg, MD, president of the IOM, and Ralph
Synderman, MD, Chancellor Emeritus at Duke University and chair of the planning committee (see below). Rose noted during the segment that he is a former brother-in-law of Mack. Clearly, the well-connected Bravewell can make things happen. A second answer is that the IOM's planning committee could frame the Summit around questions that distinguish it significantly from the 2005 report. I offer my perspectives on such directions in a separate column available here. Below are the planning committee members who will have the responsibility to decide if this Summit is meaningful, or if it becomes little more than a summary booklet languishing on shelves.
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IOM National Integrative Medicine Summit Planning Committee
February 25-27, 2009
Ralph Snyderman, MD (Chair) Chancellor Emeritus Duke University
Dame Carol M. Black, MD, FRCP Chair Academy of Medical Royal Colleges
Elizabeth Ann Goldblatt, PhD, MPA/HA Vice President, Academic Affairs American College of Traditional Chinese Medicine
Erminia Guarneri, MD, FACC Founder and Medical Director Scripps Center for Integrative Medicine
Michael M.E. Johns, MD Chancellor Emory University
Richard P. Lifton, MD, PhD Sterling Professor and Chair Department of Genetics HHMI Investigator Yale University
Bruce S. McEwen, PhD Alfred E. Mirsky Professor and Head Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology The Rockefeller University
Dean Ornish, MD Founder, President & Director Preventive Medicine Research Institute
Victor S. Sierpina, MD WD and Laura Nell Nicholson Family Professor of Integrative Medicine Professor of Family Medicine University of Texas Medical Branch
Esther M. Sternberg, MD Director, Integrative Neural Immune Program National Institute of Mental Health
Ellen L. Stovall President & CEO National Coalition for Cancer Survivorship
Sean Tunis, MD Director Center for Medical Technology Policy
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Summit's financial backers
The planning team make-up provokes a few observations:
MDs uber alles
Okay, this is the Institute of Medicine. Filling the team with 9 medical doctors out of 12 members (75%) is a strong message that the IOM views "integrative medicine" as an MD franchise. The Bravewell's Mack pointedly stated that "this is not (about) CAM" on the Charlie Rose Show. This is unfortunate. There is of course no such thing as "CAM." The acronym and the words represented are nothing more than a useful, if misleading, bundling of diverse therapies and whole systems of care which are not conventional medicine. Many of these whole systems have been "integrative" mind-body practices for millenia. Can we have reform of clinical care in this country if MDs don't realize they have something to learn by integrating others into their decision processes - including meta-processes like this? It's time we end the era of segregation in the "integrative" dialogue. Here is hoping that the IOM team includes the richness of these disciplines in the Summit itself.
Bravewell connections
Three of the members have had their work honored by Bravewell. Snyderman won the $100,000 Bravewell award for leadership in integrative medicine in 2003. Two years later, Guarneri was one of the nominees for the Bravewell's second award. When Bravewell named six as "Pioneers in Integrative Medicine" in 2007, Ornish was among them, picking up a $25,000 prize.
Academic consortia represented
Two academic consortia are represented here, through their chairs.Sierpina is the chair of the Consortium of Academic Health Centers for Integrative Medicine, with 41 member medical schools, which was founded through significant Bravewell support. Goldblatt is chair of the Academic Consortium for Complementary and Alternative Health Care (ACCAHC). ACCAHC includes among its membership the councils of colleges of the licensed complementary healthcare disciplines. Inclusion of Goldblatt is the IOM's first formal recognition of the extensive infrastructure created by the licensed complementary healthcare disciplines. ACCAHC actively sought representation on the planning team. (*)
Low presence of licensed CAM disciplines
Other than Goldblatt, the licensed complementary and alternative healthcare fields are not present. However, because Goldblatt chairs ACCAHC, the case might be made that all of the licensed disciplines whose councils of colleges are ACCAHC members.
Specialist versus family medicine
With two cardiologists (Guarneri and Ornish) and just one family medicine practitioner(Sierpina), the team has a tilt toward inpatient care. See my separate commentary which touches on how conventional medicine's inpatient bent and tertiary care power center has tended to take complementary and alternative health care out of the outpatient environment from which it principally emerged.
No nurses
Given the role of nurses, particularly in managing and delivering in-patient complementary healthcare services, and the recognition of holistic nursing as a boarded specialty by the American Nurses Association, this oversight is unfortunate.
NIH presence
Sternberg, based in the
NIH, was a name mentioned as a potential candidate for the
directorship of the NIH National Center for Complementary and
Alternative Medicine before that position was filled last January. Sternberg has research experience in the relationship between stress and emotions and health.
As seems the practice with these national gatherings, those with background in complementary or integrative medicine are matched by a strong subset of individuals with little or no connection to the field prior to their appointments.
Ralph Snyderman, MD, planning committee chair
Background of Snyderman - academic and entrepreneur
Snyderman's participation in "integrative medicine" has always been intriguing. By lending his name to the movement, the former chair of the council of deans of the American Association of Medical Colleges has been perhaps the most useful credibility-builder and namedrop for academic leaders in integrative medicine, other than the IOM itself. He has also been the figurehead for a significant integrative medicine program at Duke, funded largely by the Macks and directed by long-time academic IM leader Tracy Gaudet, MD.
Known for his work at Duke, Snyderman's other hat in recent years is as health care entrepreneur. He serves as a venture partner with investment firm NEA. He serves on the board of Proctor and Gamble and of XDx, Inc. The latter is a firm which seeks to "improve patient care by developing molecular diagnostics that translate
an individual's immune status into clinically actionable information.Snyderman also co-founded Proventys, a "personalized medicine knowledge service." Snyderman promotes a version of integrative thinking which he calls "prospective care." The approach is "emergent" rather than reductive. An article on the approach is available here.
Bravewell's Christy Mack
How to stay tuned
The IOM's website on the Summit can be found here. Some of the initial thinking about the Summit's directions are hopeful. For instance, there is reference to "integrative medicine research
methodology and ways to measure the interaction of multiple therapies." The IOM's announcement also shows a refreshing public health orientation regarding "the ways integrative medicine
seeks to address the personal and community environments that shape and
empower patients’ knowledge, skills, and support to be active
participants in their own care."
Those interested in following the process can sign up for a newsletter which will feature updates on developments. Summit manager Samantha Chao, MPH, can be contacted at 202-334-2368 or by email at
. I plan to continue to follow the development of this Summit. (*) Disclosure note: as ACCAHC executive director, I was charged by the ACCAHC board of directors to contact the IOM to engage them about having representation of complementary and alternative healthcare disciplines on the planning team. We found openness. Goldblatt, who has 20 years of leadership in the acupuncture and Oriental medicine education and in promoting multidisciplinary collaboration, was named after ACCAHC provided IOM with bios of potential members from the complementary healthcare fields, all of whom had significant multidisciplinary experience.
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