Integrative Medicine Journal Offers Practitioners a Tool for Natural Product Quality Assurance
Summary: The ability of complementary and integrative health care professionals to guarantee that they are using products which meet label statements and are not contaminated is a challenge which most practitioners meet with fingers crossed - trust in product lines built on trust in the individuals involved. The August-September issue of the journal, Integrative Medicine, through it's "Quality Assurance Advocate" Rick Liva, ND, RPH,
includes a four-page self-audit questionnaire for product suppliers. Integrative Medicine urges their 20,000 practitioners-readers to ask all of their favored suppliers to participate in filling out the form. The form is available by clicking here.
The title of the Integrative Medicine article, part of a two-year long series on product quality, is "You Only Find What You Seek." Those who prescribe natural products who read through the full acticle, which includes an attached 4-page Manufacturer Certification and Quality Assurance Self-Audit, will probably realize that they haven't been asking all the questions required to guarantee the quality of their products.
The author is Rick Liva, RPh, ND. Liva has written a column entitled "The Quality Assurance Advocate" for Integrative Medicine for the last two years. The column has meticulously described the many ways that a product delivered to patients may not be what the practitioner expects. Typically, these descriptions are coupled with information on the testing processes needed to guarantee quality. Rick Liva, RPh, ND, a passion for quality assurance
The Manufacturer Certification and Quality Assurance Self-Audit may be viewed as the end product of this work - taking information and moving to action. The sections of the document include:
- Corporate and personnel information
- cGMPs (Good Manufacturing Practices proposed by the FDA for dietary supplements) & Quality Procedures
- Raw Materials
- Finished Products.
In total, the document includes 63 questions, many of which have sub-questions, for over 100 total fields to be completed. Integrative Medicine has made the Self-Audit, and supporting materials, available by clicking here.
 IM's Boulder-based publisher
In an introductory editorial in the issue, Integrative Medicine editor-in-chief, Joseph Pizzorno, ND, makes it clear that the journal doesn't view the quality assurance initiative as an academic exercise. States Pizzorno: "If all of IMCJ's 20,000 readers adopted this standard and sent out this form to their manufacturers, we could change the industry overnight. Please join us in this process and tell us what happened so we can compile a list of responsible manufacturers."
Comment: When I first got involved in the integrated health field, in 1983, Pizzorno, then president of a then little college of naturopathic medicine, now known as Bastyr University, shared with me a plan he had for using his young institution as a bully-pulpit on quality. His passion for the topic grew out of the uncertainty on quality he had experienced as a practitioner.
Twenty-something years later, following quality initiatives from the National Nutritional Foods Association, the US Pharmacopoeia, and others, all the quality issues a product must meet are yet poorly tackled. The work of Liva, who is a practitioner, a 20+ year clinician with a large Middletown, Connecticut, practice, and a manufacturer (Vital Nutrients), is commendable. I worked with Liva seven years ago on a more elementary version of this survey which I published in my former, hard-copy Integrator.
The Self-Audit, as a campaign, has two limits. One is that the word among some is that Liva has gone overboard on his passion for quality assurance. If the standard suggested by this questionnaire simply too high? Second, to truly make a difference, Integrative Medicine must truly make this publication into a campaign. They must have clear plans to compile and report findings, or at least make them available. Perhaps other journals in the field would support this direction. Without clear accountability - which may include an independent audit of the self-audits - Pizzorno's desire to "change the industry overnight" is not likely.
But if Liva's document is put in the hands of tens of thousands of practitioners, who start walking conference exhibit halls primed with these questions, purchasing practices may well change, one by one.
Note: The photo of Joseph Pizzorno, ND that appeared here from September 9, 2006, to November 4, 2006 is copyright by Peter Barry Chowka."
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