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Pelletier-Weil Program Has Major Employers Exploring Integrative Medicine Approaches PDF Print E-mail
Written by John Weeks   

Pelletier-Weil Program Has Major Employers Exploring Integrative Medicine Approaches

CHIP's Pelletier - sailing into the employer/IM intersection
Summary: Kenneth R. Pelletier, PhD, MD(hc) and his Corporate Health Improvement Program (CHIP), which involves over a dozen of the nation's largest employers, is focusing its research and clinical programs on prevention and disease management "using an integrative medicine approach." Outcomes of the multi-year project will focus on both clinical and cost-effectiveness. CHIP's development since 1984, and the list of areas of potential exploration, are lessons in understanding the large employer as an integrated care partner.

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The shared interests of progressive-thinking employers and business-savvy integrative medicine leaders are viewed as wide and deep by close observers of the two fields. Yet few proactive projects are presently exploring this confluence of interests.

Some of this potentially fertile landscape is about to be explored, according to Kenneth R.  Pelletier, PhD, MD(hc) the founder of the
Corporate Health Improvement Program (CHIP). CHIP plans to "use integrative approaches" in it next and third phase. A the present time, the CHIP members each of which ante-up a $25,000 annual grant, include the Ford Motor Company, IBM, Corning, Kimberly Clark, Dow Chemical, Medstat, Nestle, National Grig (NGT of London), NASA, Canyon Ranch Resorts and American Specialty Health.

Image The focus on integrative medicine approaches coincides with a move of the program to a new base at the University of Arizona Program in Integrative Medicine, founded by Andrew Weil, MD. Weil and Pelletier have been colleagues and friends for over 30 years. Areas under consideration for exploration include some with clear IM components, and others in which an integrative approach could clearly be useful.

CHIP Phase 3

Areas Identified by Corporate Members and University of Arizona's PIM
for Potential Program Development

Clearly integrative areas

A state of the art worksite assessment and subsequent applications of meditation and relaxation
for stress management at NASA

A two year RCT focused on an integrative medicine interventions for back pain at Ford Motor Company usuing usual care plus chiropractic, acupuncture, mind-body skills and back-saver education

Physical fitness and back saver programs

Integrative approaches to anxiety and 
depression in the workplace with a new RCT being developed with a focus on Tai Chi for
pre and post retirement workers

Developing predictive return on investment (ROI) equations in a joint R&D project involving American Speicialty Health, Medstat and CHIP

Lifestyle management of women's health issues.

Other areas where integrative
medicine approaches may be useful

Disease management of hypertension and
coronary heart disease with a comprehensive, multifactorial, individual and total worksite intervention at Dow

Computer and/or telephone health delivery systems

Early cancer screening, especially
mammography for women

Smoking cessation and policy development with a "total worksite" RCT at National Grid and Corning under the acronym "OBI-WAN"

Health promotion programs to reach
minorities, dependents, and retirees

A developing RCT focused on the use of green tea extracts to restore the decrement in pulmonary function of former smokers and/or workers exposed to petrochemicals

Reaching small and/or remote worksites

Positioning Integrative Medicine in the Employer's Universe

CHIP notes that 52% of the annual $1,700,000,000,000 ($1.7 trillion) USA medical budget in 2006 is paid by employers. Pelletier positions the role of integrative medicine as part of a global solution to this soaring cost problem. Pelletier outline three major, necessary components to this solution as clinical and cost studies, managed utilization (to capture both over- or under-utilization) and, thirdly:

"Comprehensive health promotion, and disease management programs,
and integrative medicine interventions.

Andrew Weil, MD, founder of the Arizona IM program
Pelletier's work with CHIP has focused on aspects of this last component, since 1984. CHIP's first phase, with its founding at the University of California School of Medicine - San Francisco (UCSF) 1984-1990, was involved with "health promotion in its infancy." CHIP developed health promotion's the initial data-base. From 1990-2001, the program moved to Stanford University School of Medicine (where Pelletier was also a leader in Stanford's IM exploration). In Phase 2, CHIP focused on the prevailing interest in the management of high cost conditions, such as cardiovascular disease. With the current Phase 3, which is a collaboration between the University of Arizona School of Medicine and the University of California Schools of Medicine, integrative medicine is firmly announced as a conceptual approach for researching health producing and cost-saving strategies.

The CHIP research development process involves identifying priorities, shaping ideas, then joint grant-writing for major projects. One study presently engaged is
Ford Motor Company research which will look at an acupuncture-led integrative protocol for low back pain. In the study, 80 patients will receive acupuncture plus educational materials plus Ford's current back care program; 80 others will receive only Ford's programs. Services will be delivered in Ford's onsite clinics with Brian Berman, MD, of the CAM program at the University of Maryland as the principal investigator and Pelletier as the co-principal investigator. Both clinical and cost outcomes will be assessed. The project aims at cost-savings from limiting disability.

For those who wish more information on Pelletier's work, see the recent WELCOA (Wellness Councils of America) expert interview with him.

Comment:  Notably - and CAM/IM researchers and NIH NCCAM staffers listen up -- all of the projects that these corporations are interested in will examine clinical outcomes and cost outcomes. Clinical outcomes alone are not sufficient to foster the uptake of these integrative protocols into the system. So, if you are interested in changing the care people receive, capture cost data!

Now, if Bluesman Robert Johnson Were an Integration Activist ...

Readers will know that the happy intersection of the interests of progressive employers in the global costs of health and integrative medicine is a song I have been singing for years.

Robert Johnson - blues at the crossroads
Integrative leaders have clarified that, next to consumers, employers are the healthcare stakeholder with the strongest alignment of economic self-interest. Employers are looking for what integrated healthcare promises: helping individuals feel better and become more functional; relieving debilitating pain and boosting low energy; diminishing use of costly procedures and emphasizing the use of appropriate pharmaceuticals (and thus avoiding many harmful and costly adverse effects).

Yet the virtual non-responsiveness of the IM, CAM and research and business communities (with a few rare exceptions) to this obvious direction - particularly given IM's adverse economic alignment with other key stakeholders - turns this hopeful intersection into a famous crossroads.
I've been down to the crossroads
(of corporate health/integrated care interests)
Tried to flag a ride
Nobody seemed to know me.
Everybody pass me by.

-- Robert Johnson

Pelletier's CHIP #3 gives some hope that maybe one day integrated health care will no longer be singing the they-don't-know-enough-about-what-I-cost-to-include-me blues.

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