Summary: A month long Integrator website survey found that 72% view the NIH National Center for Complementary and Alternative Medicine as "critical in the advancement of integrated health care." Roughly 4 in 10 marked "strongly agree." The outcomes are compared in this article to a prior Integrator policy-related poll which explore the criticality to US health care of creating a federal office for integrated health care. Participation was higher and outcomes more polarized in the earlier of these two finger-in-the-wind polls.
Action at the NIH National Center for Complementary and Alternative Medicine has had high visibility in the Integrator recently. Founder director Stephen Straus, MD, viewed by some as its protector against more conservative National Institutes of Health forces, has stepped down (see article here). Some influential scientific publications as well as NBC news have chosen to devote editorial space to questioning the ongoing value of NCCAM (see article here).
Integrator readers have contributed insightful perspectives of their own (see article here and the recent comment here from Michael Levin). In this dynamic context, we posted a new Integrator poll on October 20, 2006 to capture some sense of the issues at stake.
What would the loss be if NCCAM's conservative detractors had their way?
How deep is the antagonism toward NCCAM among those who believe that the agency's agenda has been too reductive and betrayed the w/holism in the integrated care field?
We could not answer questions at this level of focus. We found these composite responses, to a general statement, from the Integrator's motley mix of visitors.
______________________________________________
Note Agreement or Disagreement with this Statement:
"The NIH NCCAM plays a critical role
in the advancement of integrated health care"
Number
Percent
Strongly agree
46
43.8%
Agree somewhat
30
28.6%
Disagree somewhat
9
9.8%
Strongly Disagree
6
5.7%
Not sure
14
13.3%
Number of Votes: 105
Dates: 20 October 2006 - 21 November 2006
______________________________________________
Findings and Discussion
We chose to use the word "critical" intentionally. Nearly three-fourths of participants (72.4%) affirmed this critical importance, with 43.8% in the "strongly agree" category. Certainly in this set are some who views are shaped by a direct self-interest: researchers and academics who either are recipients of NCCAM funds, or wish they were. Here NCCAM's critical role in their own futures may well be projected on the future of the field. Your author is indirectly biased by association.
For these and some others, the frequently expressed importance of "evidence" in fostering integration may be the reason for strong agreement. There is little money from anywhere outside the NIH funding CAM research. And though other federal agencies are funding some research related to natural and complementary therapies, the logic for pushing NCCAM may be that no other institute or agency is likely to take up the bigger issues and formulate the questions most important to us.
"Poll Finds NCCAM is Critical to Integrated Care's Future"
-- or --
"Nearly 60% Do Not Strongly Agree that NCCAM is Critical"
Interestingly - to spin this from an oppositional perspective- nearly 30 percent of participants don't believe NCCAM is important or are not sure. Nearly three out of five (56.2%) do not strongly agree that NIH NCCAM is critically important.
Compared to the Poll on a Federal Office of Integrated Health Care
A relatively low participation rate adds to a view that many are ambivalent or at least without strong opinion about NCCAM. Only 105 participated. This compares unfavorably with the 153 participants in a survey which ran less than half the time (13 days vs 31 days). The earlier survey (September 24-October 6, 2006) also ran at a time when Integrator visits were at roughly 60% of their average over the month-long period of the NCCAM poll, further lowering relative participation levels fin the NCCAM poll. Both polls were the subject of focused Integrator mailings.
The earlier poll asked participants to register their agreement with a statement which also queried readers about a federal policy issue: Creating a federal office for integrated health care is critical for improving health care in the US.
______________________________________________
Comparison of Outcomes of Integrator Polls
on a Federal Office and NCCAM NCCAM: "The NIH NCCAM plays a critical role
in the advancement of integrated health care"
FEDERAL OFFICE: "Creating a federal office for integrated health
care is critical for improving health care in the US"
NCCAM
Federal
Office
Percent
Percent
Strongly agree
43.8%
50.3%
Agree somewhat
28.6%
13.1%
Disagree somewhat
9.8%
10.5%
Strongly disagree
5.7%
24.2%
Not sure
13.3%
2%
Participants
105
153
Duration of poll
31 days
13 days
______________________________________________
The poll exploring the criticality a federal office may have to the future of integrated health care drew a more polarized and opinionated response. "Strongly agree" and "Strongly disagree" were both higher in views about a federal office, totaling 75% of participants, versus 50% at these extremes in the NCCAM poll. (For an article on the earlier poll, click here.) NCCAM, though generating significantly less participation, was viewed as more critical over-all. If those who are "not sure" are convinced that NCCAM is important, the positives could reach to over 85%.
Expression of Agreement, and Action
With the US Senate coming under control of the Democrats in 2007, NIH NCCAM sponsor Tom Harkin (D-IA) is expected to once again chair the Subcommittee on Labor, Health and Human Services, Education and Related Agencies of the US Senate Committee on Appropriations with jurisdiction over NIH funding. One might expect NCCAM to be protected from its detractors by the man who, in an act of classic pork-barrel politics, got the original exploration of "unconventional medicine" going in 1991 through a little slight of hand which appropriated $2-million for some work. Harkin continued as NIH-level examination of CAM's principal champion and sponsor as the exploration became an Office of Alternative Medicine and the Office a Center. To this extent that "great man theory" applies to this corner of political history, Harkin is the fellow who wears the mantle.
The need for defensive, protective action to save NCCAM does not, then, appear to be as likely with Harkin re-empowered. The question remains whether those who "strongly agree" with NCCAM's criticality will one day become part of a formal supportive network to insure that NCCAM does not just hang in there, but grows and flourishes with a destiny which embraces the whole practices which shape the movement that Harkin advanced.
I am told that other institututes and federal research entities have benefited from the lobbying of such groups. Those close to NCCAM will know that Harkin, generous spirited as he has been in what he has chosen to advocate through the many years of his service (1), does not mind having his electoral back scratched by those who value NCCAM. Such back-scratching is, as is said, a cost of doing business.
(1) I had an unusual insight into Harkin in the early 1980s when I was involved with some Washington State and national people promoting human rights in Korea after a particularly repressive governmental action in Kwangju led by a man, Kim Dae Jung, whose leading national backer was Harkin. Harkin would later be at Kim's side when he, after decades in-and-out of political prison, became president of South Korea and later a Nobel Peace Prize winner.
Thanks to Integrator advisor Christine Goertz Choate, PhD, DC, and Candace Campbell for their assistance in formulating the poll question. Neither of them are responsible for me writing at such great length on outcomes of two unscientifically delivered instrument.
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Action at the NIH National Center for Complementary and Alternative Medicine has had high visibility in the Integrator recently. Founder director Stephen Straus, MD, viewed by some as its protector against more conservative National Institutes of Health forces, has stepped down (see 
Compared to the Poll on a Federal Office of Integrated Health Care
