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Your Comments: A Pot-Pourri of a Dozen of Your Comments on a Wide Range of Integrator Subjects PDF Print E-mail
Written by John Weeks   

Your Comments: A Pot-Pouri of 10 of Comments on a Wide Range of Integrator Subjects

Summary:  William Wulsin, ND, MPH on the potential AHNA-AHMA-AANP collaboration ... Robert Lynch, DC on efforts to unite the ICA and ACA ... Author and participant Alison Rose Levy casts light on the Donna Karan Urban Zen event. Participant Ather Ali, ND, MPH also comments ... Ryan Vos, LAc seeks information on inpatient acupuncture models like that piloted by Painovich at Good Samaritan Hospital, Los Angeles  ... Researcher Ali, the Karan event commentarist, clarifies issues for young investigators ... Jordan Van Voast, LAc expands the Community Acupuncture Network model of care into my neck of the woods ... Integrative consultant Linda Rapuano on the value of Design Principles for Healthcare Renewal in work with clients ... Former AHNA president Sonja Simpson, RN, MSN, AHN-BC thanks Benda for his column on NCCAM's new director ... Curtis Jones, PhD proposes a pathway he believes useful in whole systems care, plus ...

Send your comments on these or any Integrator article
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Image
William Wulsin, ND, LAc, MPH (cand.)
1.   3 Way Collaboration Between AHMA, AHNA and AANP


William Wulsin, ND, MA, LAc, MPH (cand.) has been a practicing clinician in the Seattle area in both solo and a community health setting where he has pioneered a relationship at the Country Doctor Clinic for naturopathic physicians. Wulsin served on the integrative care team at the Bastyr Center for Natural Health.

"Good article and hopeful that three holistically focused organizations may learn that the medicine of inclusion spawns diversity, even when it seems unimaginable. Benda and the Integrator seem to understand that no one individual can make a revolution for the public's health, and nor can such change occur quickly.

"As we stand in our corners, others may help us to see what is holding us back from engagement within a shared ring."

William F. Wulsin, ND, MA, LAc, MPH (cand.)
Seattle, Washington


Image2.   The Berlin Wall and COCSA's Call to Unite the National Chiro Associations

The Integrator brief on a push from the Congress of Chiropractic State Associations (COCSA) stimulated this response from Portland, Oregon chiropractor Robert Lynch, DC.
"The time has come again for our profession to unite. It is interesting it is now coming from COCSA. While it is long over due I wonder what the tipping point was that got this resolution off the ground?  I am assuming it is the lack of or regression our profession is making in the health care markets. Medicare reduced our fees 8% while MD’s were organized and avoided the reduction in reimbursement. Whatever it is we need to get this done. The Berlin Wall came down. We as a profession can do this!!

Robert P Lynch, DC
Lynch Chiropractic Arts Center
Portland, Oregon
www.drlynch.com
 
3.  Alison Rose Levy: Writer Casts New Light on Karan Urban Zen Event

Image
Alison Rose Levy - participant blogger
Alison Rose Levy
is a journalist and blogger with the Huffington Post who informally became the designated reporter for the Urban Zen event promoted by fashion designer Donna Karan. This initiative linked a score of celebrities to an exploration of integrative medicine and the future of health care during a 10 day period in New York City in May. Levy's reports on the event can be accessed at her blog-site. The Integrator noted the event here and included an interview with participant
Robert Duggan, founder of Tai Sophia, here.
"Thanks for sending me the link to your blog on the forum— though of course, I am familiar with your work (and a fan) for many years and though you may not recall, I interviewed you for a piece on what we then called CAM that I did for Spirituality and Health about nine years ago.

"I wanted to let you know that the atmosphere on the ground at the event was a bit different from what you might have gleaned through a look through Urban Zen website and the printed materials. For one thing, this was not an audience of celebrities, but one of hardworking integrative practitioners from all over the country. The few celebrities present were there as caregivers and patients, often indistinguishable from other participants (except for Christy Turlington!) and if they can help marshal resources and attention for integrative health, I say: Good.

"Some of those you mentioned were not present, as far as I know, though they may have supported the effort in other ways.

    
 


"On every single day
of the forum, during
a polling session,
participants proposed
wide-ranging health
and policy initiatives
."

 -  Alison Rose Levy

"In fact, if anything, the celebrity participation revealed that even millions of dollars and designer clothes can’t save you or your loved ones if you wind up requiring conventional care in a hospital setting. (Although the money— not the clothes-- will certainly help in covering costs of non-reimbursable therapies that can be life-saving.)

"There were many nurses present, and the cross discussion and networking beyond the panel events was significant.

"And although conventional MDs were well-represented on panels, most of them were calling for systemic change just like the energy healers, Buddhist teachers, Qi Gong practitioners, and a much wider range of practitioners— even though, yes, Donna Karan is very committed to yoga and there were lots of yoga practitioners.

"On every single day of the forum, during a polling session, participants proposed wide-ranging health and policy initiatives— so these were definitely up for discussion. What forward going actions, Karan and Urban Zen will ultimately undertake is currently unknown."

Alison Rose Levy

Best-selling Author and Blogger

Participant Ather Ali, ND, MPH with the Yale Prevention Center (see #5, below) read Levy's remarks and concurred:
"I also want to second Alison's comments: 'The few celebrities present were there as caregivers and patients, often indistinguishable from other participants (except for Christy Turlington!)...' She was sitting at the table next to me, and I did obviously notice her.

"Being the media ignoramus that I am, I didn't realize who she was until she spoke on a panel the next day. She didn't speak much in relation to the others on the panel as the physicians tended to have plenty to say. Lou Reed was relatively silent for the same reason as well."
Ali sent me some other useful commentary during the Urban Zen event from which the following were extracted:
Report #1: "The event has really surpassed my expectations ... There were excellent programs and even better small-group discussions on how to empower the integrative medicine cause. It brings together IM docs, nurses, yoga practitioners, patients, philanthropists, influential people, and celebrities dedicated to the cause. The 'consensus' of the group discussions will help guide the efforts of the Urban Zen Initiative.

"Hillary Clinton provided a taped welcoming message in support of reforming health care and the importance of integrative medicine. Not much fluff and nonsense at the program, perhaps because not much media is paying attention.

"Donna Karan remarked yesterday that the media is more interested in 'what people are wearing to the program' rather than the content of the program.

"It seems that people pushing their personal agendas are frowned upon ...  My thoughts are also that this group is more influential in the philanthropic arena and creating systems change. In other words, to pass a bill, one must lobby politicians. To build an institution, one must lobby funders. This group is certainly the institution-building and systems change crowd and not the political crowd."
  
 


"The event really

surpassed my expectations.
There were excellent programs
and even better small-group
discussions on how to empower
the integrative medicine cause."

- Ather Ali, ND, MPH


..........

Report #2: "On the train back home from today; another good day. The theme today was 'empowering patients.' Dean Ornish, Mehmet Oz, Barrie Cassileth, and Christy Turlington were among the panelists.

"One of the themes I spoke about in our small group discussions was making a distinction between our 'spheres of concern' and our 'spheres of influence.'

"Our sphere of concern is wide - the group in general wants to advance integrative medicine. Some have influence in the public arena, some in the hospital arena, and some in other areas. Many felt helpless at creating change in academic medicine; where much of the frustration is directed. I remarked that I am able to do something in that arena, though I can't influence other aspects of the machine that others in the corporate or celebrity world can."

Ather Ali, ND, MPH
Yale Prevention Center

Image
Painovich - her work stimulates a query
4.   Acupuncturist: Seeking More Good Samaritan-like Models of Inpatient Care


Acupuncturist Ryan Vos, LAc came across on Integrator article on a ground-breaking model, led by Jeannette Painovich, LAc, DAOM using licensed acupuncturists in in-patient care while searching on line for information to support his proposal to develop an inpatient acupuncture program for a Seattle-area hospital.

"I just read through one of your articles online, "Good Samaritan Hospital & Emperors Look at Cost Benefits of Inpatient Acupuncture" from Saturday, 09 December 2006, in the course of some research I am doing.

"I am an acupuncturist in Washington State, running several private practices and working in a hospital as well. In the hospital setting we currently provide acupuncture care as an out-patient procedure, and I now have the fortune to be part of a project exploring the possibility of acupuncture as an in patient procedure. 

"I was searching for other hospitals where this is being done, which led me to your article.   In the course of your writing, I wonder if you found many other hospitals offering inpatient acupuncture?  I would be very interested to hear about where else this is being done, and how their results are going. 

"I saw this kind of integration when I studied post-grad in China, and I am convinced, as Dr.  Painovich said, that the integration of both eastern and western medicine is capable of better results than either system alone, can reduce the cost and side-effects of care, while increasing comfort and recovery rate in patients. Thank you for bringing such developments into the public eye! Please let me know, if you can, where else this work is going on!

"Yours in Wellness."

Ryan Vos, LAc
Seattle
Comment: I sent Vos some leads. Do any of you have examples of inpatient care provided by licensed acupuncturists? I will be pleased to report it, and get the information to Vos.


Image
Ather Ali, ND, MPH - young investigator
5.    Cuts at NIH NCCAM and Challenges for Young Investigators


Ather Ali, ND, MPH, of the Yale Prevention Center, is an East Coast counterpart to Lynne Shinto, ND, MPH, with the integrative medicine program at Oregon Health & Science University. Both represent their respective institutions on the Clinical Working Group of the Consortium of Academic Health Centers for Integrative Medicine and are trail-blazers for their profession in being selected to do so. Shinto's report on challenges in funding for researchers,and especially young investigators, was reported here.
"Thanks again for your service. I read the post (regarding NIH funding decreases and their potential effects on your investigators) with both trepidation and enthusiasm.

"This has been an issue that I have been discussing with colleagues for the past few months. From my understanding, there has been talk of the NIH actually providing some 'affirmative action' for new investigators in order to prevent mass exodus from the biomedical research career track."

Ali then provided a link which provides information on NCCAM's anticipated success rates for 2007, which were projected to be significantly higher than the Integrator reported, at 15%.

Ali concludes with:
"Nevertheless, it's a bleak situation but perhaps slightly brighter for new investigators."

Ather Ali, ND, MPH
Yale Prevention Center


Image
Community Acupuncture Network logo
6.    Jordan Van Voast: Spread of the Community Acupuncture Model


The articles and debate around the Community Acupuncture Network model of practice stimulated a local acupuncturist, Jordan Van Voast, LAc, to inform me of an article on the clinic, called Communi-chi. I can report that my 11-year old daughter has twice enjoyed and benefited from the services of Van Voast's colleague. My spouse reports positively on the feeling of the place, the light, the breeze, and the location, inside El Centro de la Raza, a community center for the area's Hispanic population. 
"Thought I would share this news of our clinic opening in (which was covered in) Real Change News. If you have any friends or family in the Seattle area, we'd be delighted to introduce them to a different kind of acupuncture experience.

"Peace,"


Jordan Van Voast, LAc
Communi-chi
Seattle

Image
Linda Rapuano - using principles in integration
7.    The Use of Design Principles to Create Healthcare Renewal

Linda Rapauano was last seen in the Integrator here for her integrative care work at St. Vincents' Hospital in New York City. A former marketing exec who was part of the original Sesame Street team, Rapuano assists other clients in development of integrative programs. She finds principles a useful tool. She reflects on a now defunct  organization with which we were both involved, the Collaboration for Healthcare Renewal Foundation.
"I see you’ve absorbed the old Collaboration files into the blog.  They’ve been very helpful to me in the past.  

"Also, if the whole 'industry' would actively use the (Design Principles for Healthcare Renewal) I believe it would provide a greater coherence and understanding to the many in Western medicine who still don’t get it.  I use the Principles when appropriate and have also created a modified version that seems more suited for holistic health practitioners and organizations.  

"In May, I’ll be addressing the NYS Reflexology Assn. and will make that group aware of them. I’m still calling them CHR’s Principles but I guess that organization is now history.  Too bad."

Linda Rapuano
New York City

8.    Former AHNA President: Appreciated Benda Column on NCCAM

Sonja Simpson, RN, MSN, AHN-BC, is a past president of the American Holistic Nurses Association.
"Really appreciated the comments written by Bill Benda on the new head of NCCAM (National Center for Complementary and Alternative Medicine).  Right on and well put!"

Sonja Simpson, RN, AHN-BC
9.    Medical School Administrator Questions the New York Times Big Pharma Connection

The Integrator received the following from an individual who preferred to remain anonymous, perhaps due to employment inside the medical system at the University of California at San Francisco.
"I was very interested to read your article about the NYTimes decision not to print the letter from Senators Hatch & Harkin.  I sent it to a friend who commented that he had heard that the members of the board of the Times were known for their big business ties.  It's absolutely true and one of the 2 directors of the NYT Board of Directors is very closely related to Schering-Plough.

I'm sure they would be the first to tell you, though, that this had nothing to do with their decision to ignore 2 senators.  There probably just wasn't room on their op-ed page...

(name withheld)
San Francisco
Comment:  I checked out the link to the Times' board. It is a useful journey, to look at the backgrounds of these individuals and ponder the ways they may have an opinion or two on the appropriate direction for objective journalism.

10.    Whole Systems Research and a Proposed Pathway

Image
Jones - a strategy for whole systems care
Curtis Jones, PhD
is a Revolution Health blogger and clinical thinker whose passion is to create a decision-making protocol for integrative care. He wrote in response to an Integrator article about the challenges in whole systems research models which reflect the whole practices of integrated health care. He has published in Journal of Alternative and Complementary Medicine. He wrote to me once, then wrote again with more detail.
"Regarding the conversation on whole systems research methodologies (Dec. 8, 2006):  possibly part of the dilemma in the research itself (aside from the massive resistance of the establishment with its single-variable bias) is the need for a nuanced set of parameters from which to do whole systems research.  Admittedly, I know all too little of the particulars of such research (will work on that as I get into conversations here) - but, there is a possibility of nuancing such research approaches by considering the human-structure from the perspective presented in my 'periodic table'. Because, the table is secondarily about healthcare and primarily about understanding (structuring) human being in healthcare.  (Contact Jones for the table.)

  
 

 
"Possibly part of the dilemma
in the research itself (aside
from the massive resistance
of the establishment with
its single-variable bias) is the
need for a nuanced set of
parameters form which to do
whole systems research."

- Curtis Jones, PD

"From this perspective of the person/patient/research subject, we have 6 categories of variables (each a type of treatment intervention) as compared to the 3 in mind-body-spirit perspective of the patient or whatever parameters are being used in whole system research..  Additionally, within this 6 parameter perspective there are sub-categories allowing further clarification of the areas from which the effects of intervention can be measured.  So, is this relevant to some part of this conversation ?  I will send the same message to some of the participants in this conversation on your blog.

"So, along with searching for a place to research the clinical protocol based on this table, I continue to figure how to become a constructive part of all this wonderful conversation. 
Jones then got back to me with details of his protocol:
"The decision-making protocol of Healthcare Pathways, is composed of six steps:

"Step 1.  First, it is helpful to have a view of the field of all healthcare options.  This is supplied by the “Periodic Table of Healthcare”, attached.  (JACM, CH Jones, Vol. 11. No. 5, 2005. Mary Ann Liebert)   The table is designed around modes of therapeutic influence and is an organizational tool for all conventional, complementary, alternative, and traditional methods of healthcare. This allows for immediate general comparison of any treatment choices.  The table is based on ways of influencing the person/patient; it is not based on therapies.

"Step 2.  Literature review to discover the treatments for which efficacy is supported/proven regarding the patient’s primary complaint. This results in a set of research-based treatment options.

"Steps 3- 6.  Consideration of 4 personal (patient-centered) parameters. This allows for determining a set of options for treatment that depend upon the patient’s perspective, history, and interests.

"Step 7.  Combining the results of steps 2 & 3 creates the field of choices that clinicians or case managers can review with patients. Thus, a “healthcare pathway” is developed that is constructed around the patient, not around therapies or practitioners.

"Proposal:  I am interested in an opportunity in a clinical setting for testing possible advantages of this approach. Clearly, the first application will involve refining this decision-making method for clinical application.


"The staffing requirements include a case manager who explains the decision-making process to patients and guides them through it.  The case manager structure greatly reduces the need for practitioner meetings (team approach) that are not cost-effective.  (Possibly this could eventually be done in a class setting with numerous patients, for economy.)   I have worked up detailed plans for practitioner communications, a common assessment form, and helping practitioners understand the process.

"The bottom-line question – who would have an interest in funding this research?"

Sincerely,
Curtis H. Jones, Ph.D.
Healthcare Pathways

Send your comments on these or any Integrator article
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