The Coming of the Light! A Solstice Celebrating Integrator Top 10 from 2006
Written by John Weeks
The Coming of the Light! A Solstice-Celebrating Integrator Top 10 from 2006
Summary: For the impatient, progress is always caught in a traffic jam. Looking back, we see how far we have come. The year of 2006 has seen many advances for the multi-disciplinary and multi-stakeholder field of integrated health care. This article, published on the winter solstice, provides you with the Integrator Top 10 from 2006 - with links, should you wish to explore them further. Send your suggestions, disagreements, and reflections to
Here's to the coming of the light!
Send your comments to
for publication in a future Your Comments article.
Around our house, with the last belief in Santa shorn this year, we
view our holiday season in the old-fashioned way: a celebration of the
coming of the light. This is a big deal in Seattle where short winter
days and thick overcast skies can make one yearn for light and heat. Especially this year. My
daughter and I typically have the responsibility, as we put it, for, doodling
with multi-colored holiday strings of lights on the trees, bushes,
fence and house walls to do our neighborly part in kick-starting the
New Year.
What a good time to celebrate action in 2006 that suggests an increase
of the light for better integrated care as 2007 dawns. Here is the Integrator Top
10 for 2006. I selected these for their potentially foundational impact
on the inclusion of integrated services in the betterment of people's
health. If you missed the full stories, I provide links.
Send me your comments and any actions you would like to honor that are not
included here. Congratulations to these leaders for these advances.
Happy holidays!
_____________________________
1. Holistic Nursing Embraced as a Specialty by the American Nurses Association
Carla Mariano, RN, EDD, AHN/BC - taking the lead for the AHNA
Through all the robust work of the last 30+ years, no part of
integrative care, of holistic medicine, or of any complementary and
alternative medicine field has ever gained official sanction from a
major, dominant healthcare discipline. In November, the American Nurses Association, representing the nation's 3-million nurses, formally accepted the application of the 3,200 member American Holistic Nurses Association to be a recognized specialty society. Carla Mariano, RN, EdD, AHN-BC,
led the effort. Holistic thinking and practice has a seat at nursing's
table. CAM professionals fields have focused on
relationship-building with medical doctors. Perhaps we would do well to spend more
energy working with the largest organization of, if this action speaks a trend, healthcare professionals. Integrator article here.
2. Executive Teams of Conventional and CAM Educator Consortia Meet
Six years ago, Integrator advisor Clyde Jenson, PhD, gave a multi-stakeholder group at the first Integrative Medicine Industry Leadership Summit a simple phrase: Those who are educated together practice together. Last May, a small but significant step in toward "education together" was taken when the executive committees of the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM), representing 36 conventional medical schools, and the Academic Consortium for Complementary and Alternative Health Care
(ACCAHC), representing educators from a half-dozen licensed disciplines, plus, met in
a joint reception in Edmonton. The development of these relationships,
between individuals and organizations, suggests the potential for a
future when these educators might better model multi-disciplinary
activity in their institutions. A recent payoff: CAHCIM invited ACCAHC to serve on the planning team for the next North American Research Conference on Complementary and Integrative Medicine. Patients will only benefit if we know each other better. Integrator article here.
Historic meeting: Conventional (*) and CAM Consortia (^) exec teams gather in Edmonton: Back row - Adam Perlman, MD, MPH*, Don Warren, ND, DHANP^, Brian Berman, MD*, David O'Bryon, JD^, Kathleen Healy, David Eisenberg, MD*; Middle row- Reed Phillips, DC, PhD^, Adi Haramati, PhD*, Bradly Jacobs, MD, MPH*, Janet Kahn, LMT, PhD^, Mary Jo Kreitzer, RN, PhD*, Rita Benn, PhD*, Vic Sierpina, MD*; Front row - Pamela Snider, ND^, Susan Folkman, PhD*, John Pan, MD*, Anne Nedrow* MD*, Liza Goldblatt, PhD^; photo - John Weeks, National Education Dialogue
3. Good Samaritan Engages Full-on Exploration of In-Patient Acupuncture
Jeannette Painovich, LAc, DAOM
In-patient integration of natural health care has typically been a zone
defined by a little Reiki, a little music, a fountain, a family room,
some healing touch and perhaps, for the outrageously adventurous, a bit
of MD-delivered acupuncture for pain. Such integration is controlled,
typically, by a constitutionally suspicious toward alternatives, conventional medical mind.
At Los
Angeles' Good Samaritan Hospital (GSH), acupuncture will be
fully-embraced as a partner to conventional medicine in improving
patient outcomes. According to project manager Jeannette Painovich, LAc, DAOM,
rather than "protocol acupuncture" which limits acupuncture practices,
Good
Samaritan will allow licensed acupuncturists, working with their
medical counterparts, to put their needles to work as they best know in
helping patients across a broad band of cardiovascular, neurological
and musculoskeletal conditions. The project, funded late in 2006, will
look at
satisfaction, clinical outcomes and potential cost savings. Notably, GSH is
partnering with Emperors College of Traditional Oriental Medicine to provide the services. Integrator article here.
4. Coalition for Patient Rights Unites Allied Health, Integrated Care Fields
When the American Medical Association's strategists for their Scope of Practice Partnership
began planning their campaign to limit the scopes of other fields, the
planners most likely failed to foresee a certain unintended
consequence. They immediately stimulated organized opposition, likely
foreseen: the American Nurses Association - the AMA's increasingly
unruly bigger sister - organized the Coalition for Patient Rights (CPR). That multi-disciplinary group originally included most allied health fields, plus the limbo-discipline, chiropractic. Unforeseen by the AMA was that, within months the American Association of Oriental Medicine, the American Association of Naturopathic Physicians, the Integrated Healthcare Policy Consortium and the Academic Consortium for Complementary and Alternative Health Care
had each joined CPR. We know that war is often the father of
invention. What the AMA created by its ill-advised and thus far
non-evidence based war was the Mother of All Health Healthcare
Coalitions. Virtually everybody but the AMA is involved. One only hopes that the
group will begin to feel its combined power, deal with its own internal rifts (easy to say!) and see what it can move as
a proactive coalition for health reform.
Integrator article here, and for a list of six related Integrator articles, here. 5. Research Group Explores and Promotes Whole Systems Research
Last May, and also in Edmonton (see #2 above), the International Society for Complementary Medicine Research (ISCMR) produced a forum on a critically important topic at the first North American Research Conference on Complementary and Integrative Medicine
(a historic gathering which merits mention on this list). As part of
the gathering of over 600 researchers, ISCMR focused attention on
methods for engaging what the organization calls "whole
systems research." In short, how do we measure the impacts of care that engages the whole person? Notably, Integrator readers strongly support such a direction for research investment. (See "Readers Say Research "Whole Practices" - NCCAM Needs Focused Program" .) In November, the Journal of Alternative and Complementary Medicine
worked with ISCMR to sponsor a forum on whole systems research issues.
Participants underscored the political
and economic challenges of getting research funded and then published
if researchers look at the whole practices and whole processes which
typify whole
person treatment. Whether this informal gathering will gel into an
active special interest group or organization is not yet clear. What is
clear is that whole practices and whole systems need such
organizational attention and visibility. Integrator article here.
6. Group of Large Employers to Explore Integrative Medicine Strategies
Kenneth R. Pelletier, PhD, MD (hc)
No one who explores the question doubts that large employers
(including government) are the non-consumer
healthcare stakeholder interest which has the most to gain from
forging better
integration of natural healthcare professionals and disciplines into
the care their employees receive. The strengths of complementary and
alternative health care, as proclaimed in convention hot-tubs around
the globe, are precisely in those areas which can positively impact
the global costs of health: patients feel better, become more functional and more productive, and
limit their needs for more expensive and debilitating pharmaceuticals. Under
the direction of Integrator advisor Kenneth R. Pelletier, PhD, MD (hc), the Corporate Health Improvement Project (CHIP) will, in this third round of CHIP activity over 20 years, focus expressly on integrative medicine strategies. (The recently engaged pilot project led Bernie Noe, ND, with naturopathic doctors in Vermont merits mention here as an employer-based model currently underway.) Integrator article here.
7. New York Beth Israel Creates Department of Integrative Medicine
Woodson Merrell, MD, NYBI's first IM department chair
With a few rare exceptions such as the Cancer Treatment Centers of America hospitals, integration, where it exists in inpatient care, is piece-meal, poorly coordinated and often failing even to make it into a hospital's strategic plan. A decision this fall by the New York Beth Israel Hospital (NYBI) changes this pattern. Woodson Merrell, MD,
will become the first director of integrative medicine for the
hospital's new Department of Integrative Medicine. Like the decision of the ANA to accept
holistic nursing, this action gives integrative medicine a seat at the
table in that large, influential health system. Merrell and his colleague at the Continuum Center for Health and Healing will help advise, coordinate and build services across diverse disciplines at NYBI and the other Continuum Health Partners
hospitals. Here's hoping other hospitals will have their competitive
juices riled - or better yet, actually see the value for doing so
themselves as part of a strategic plan to limit errors and become more
patient centered. Integrator article here. 8. New Acu Business Model Prompts Debate on CAM Access & Economics
An ugly little secret among the CAM and integrative medicine
professions is the challenge of developing business models that work.
Boutique practices only reach a small population, and require the
talents of but a limited number of available practitioners. Huge populations are
not served. Yet a high percent of those licensed are either seeing few
patients or have left their fields. Into this little house of horrors stepped Working
Class Acupuncture (WCA)offering acupuncture in community rooms, on a
$15-$35 sliding scale and without participation in insurance. In October, the first meeting of the Community Acupuncture Network
(CAN)
drew 40 individuals who are developing similar practices in 22 states
around
the country. The coming year will see how well some of these models
will take off and sustain as an ongoing part of acupuncture care.
Meantime, the model has stimulated a good deal of useful dialogue and
encounters with our shadows as the difficult economic issues for
practitioners -
and not just in the AOM fields - are outted. Thanks to the acupuncture
field for "going first." What might new models be for other
disciplines? See Integrator article here and respondent commentary from a dozen readers here and here.
9. Alternative Medicine Integration Group's HMO Outcomes Hold for 7th Year
AMI Group CEO Jim Zechman
The uptake of CAM into conventional practice and institutions is accompanied by two demands: show me the evidence and show me the money.
Unfortunately, few integrated health researchers or entrepreneurs (for
profit or not-for-profit) take the latter to heart. An exception is
Integrator sponsor Alternative Medicine Integration Group (AMI
Group), which from the get-go has pursued capture and analysis of financial
cost-benefits as part of its business plan. Led by Jim Zechman and Richard Sarnat, MD, the AMI Group's seven-year outcomes
from its unusual integrative independent practitioner association, under contract with Blue Cross Blue Shield's HMO-Illinois in Chicago are compelling. As compared to the HMOs norms, AMI's members had 60% fewer hospital admissions, 59% lower hospital costs, 62% fewer outpatient procedures and 62% lower costs on pharmaceuticals. This business model remains a beacon to others. Why don't more of you look at cost issues?Integrator article here.
10. Natural Products Industry Passes Adverse Events Reporting Bill
US Senator Orrin Hatch (R-UT), prime sponsor for the AER bill
In a year in which NIH-funded research on natural products continues to
both question the value of herbs as captured in randomized controlled trials (and stir controversy over the
research designs which led to negative outcomes), the dietary supplement
industry appears to have been successful in its first national
legislative effort in a decade to collectively show itself as a responsible
part of the healthcare community. The passage of the Adverse Events
Reporting (AER) bill, otherwise known as the Dietary Supplement and Non-Prescription Drug Consumer Proterction Act, was backed by the leading organizations representing the industry. The United Natural Products Alliance, the Natural Products Association and the American Herbal Products Association
all promoted proactive engagement in a level of scrutiny
which is an entry requirement in US healthcare. The bill, passed as the last act of the 109th Congress, may well also call
the bluff on antagonists who claim that natural products are frequently
involved in adverse events. Integrator article hereandhere. Comment and an Addendum: As I reflect, there is much that points to the coming of the light amidst the struggles that have characterized integrated care in its first decade. For the impatient, the road is always a traffic jam. Why weren't we here a decade ago? My bully-pulpit comment sections must reach some of you who are on the ground, wrestling to better your small corner of this $2-trillion plus juggernaut, as obnoxious horn-honking. Hold your horses, you jerk! But looking back, even over one year, we can see these important ways that the multi-disciplinary and multi-stakeholder effort toward better integrated care has gained ground.
I would like to add here, in a spirit of utter self-promotion, the important contributions to lighting a few candles in 2006 from the NCMIC Group (Lou Sportelli, DC), Triad Healthcare (Agostino Villani, DC), Standard Process (Charlie DuBois and David Barnes, PhD) and Alternative Medicine Integration Group (Jim Zechman and Richard Sarnat, MD). Yes, these are the Integrator sponsors. These are the individuals and companies without whose generous and mission-focused sponsorships the Integrator would never have seen the light of day when I was first considering organizing this newsletter and networking site late last winter. Click on their banners on the upper right of the site to visit them. If you like the Integrator, let them know. Of course, my holiday wish is that they renew in 2007! ... and that I find a couple more sponsors to make the Integrator business model actually sustainable.
Here's to the coming of the light - even if the form it takes is cash!
Credit: Photo of dawn from ilind.net.
Disclosure, aka, alignment of interest statement: I was intimately involved with the meeting of the two academic consortia (#2) as director of the National Education Dialogue to Advance Integrated Health Care, and the company mentioned in #9, as noted, is an Integrator sponsor. Close readers of this Top 10 will also note that actions led by a number of Integrator editorial advisors are also honored here. I attribute this to my good luck in having the editorial involvement of individuals who are leaders in the field.
Send your comments to
for publication in a future Your Comments article.
Around our house, with the last belief in Santa shorn this year, we
view our holiday season in the old-fashioned way: a celebration of the
coming of the light. This is a big deal in Seattle where short winter
days and thick overcast skies can make one yearn for light and heat. Especially this year. My
daughter and I typically have the responsibility, as we put it, for, doodling
with multi-colored holiday strings of lights on the trees, bushes,
fence and house walls to do our neighborly part in kick-starting the
New Year. 
