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Hospitals: Integrative Medicine at Goshen, CTCA Sights on Phoenix, Swedish Sells "Integration Light" PDF Print E-mail
Written by John Weeks   

Hospitals: Integrative Medicine in Goshen, Indiana; CTCA to Phoenix; Swedish Sells "Integration Light,' plus ...

Summary:  Cancer Treatment Centers of America sets Phoenix as the site for its 4th hospital ...  An article in the Seattle Post-Intelligencer underscores how "integration light" can be passed off as the real thing as a Swedish Hospital oncologist reportedly speaks of an off-site ND who draws no salary from the institution as an "in-house naturopath" ... If Goshen, Indiana seems an unusual place for a robust integrative medicine effort then this short profile of the Goshen Cancer Center, in a state where naturopathic physicians are not licensed, but in which an ND serves as director of integrative care, will surprise you ... Plus, massage at Mayo Hospice, and more ...

Send your comments or hospital or integrative clinic news
to for publication
in a future article.

1.  CTCA to Open its 4th Integrative Cancer Hospital in Phoenix

Image Zion, Illinois-based Cancer Treatment Centers of America announced on March 8th that it plans to build its 4th inpatient cancer facility in Phoenix, Arizona. The 210,000 square foot facility will have 24 beds, cost $75-million to build and will ultimately employ over 400 people. CTCA is known for what it calls its "
unique treatment model that fully integrates state-of- the-art medical treatments and technologies with scientifically-based complementary therapies like nutrition, naturopathy, physical therapy, mind- body medicine and spiritual support all under one roof."

CTCA already has facilities in Zion, Tulsa and Philadelphia, and an outpatient center in Seattle. A plan to build an additional facility in Kent, Washington, has been stymied by a controversial denial by the State of Washington of CTCA's application for a certificate of need which was investigated by the Integrator.
(Thanks to Sita Ananth, MHA for bringing the CTCA release to my attention.)

2.   Swedish Hospital Oversells Its "Integration Light" in Cancer Story

In other CTCA news, the firm's integrative model was given a ringing coverage by the Seattle Post-Intelligencer in a story
(Deadly cancer, a winning fight - a dose of naturopathy gives a man a second chance at life, by Cherie Buck, March 21, 2007). The story featured a half dozen CTCA patients with pancreatic cancer who have survived longer than expected with a low-dose, frequently-pulsed chemotherapy regime plus natural healthcare support - an MD-ND combination.


Re "Integration Light"

Despite the oncologist's
assertion, the main way one
can speak of an "employed"

  naturopath at Swedish except
is the way
one speaks of
smoke and mirrors
to create a favored

The Seattle PI article demonstrates an ugly theme uncovered in the Integrator exploration of how "integration light" by competing hospitals may have led to the denial of CTCA's bid for a Seattle-area hospital. The hospital which appeared to have the most similar service alignment was Swedish Cancer Institute. But on closer look, the Integrator determined that Swedish was mainly marketing. The naturopathic services, celebrated in an online video, were actually not only not on staff, but only accessible on the Swedish site if a person persevered in exploring down diverse virtual back-alleys to find a phone number for the off-site, consultants in a PDF file.

Yet, in the article, Swedish's director of medical oncology reportedly said that "the Swedish Cancer Institute employs its own in-house naturopath." Unless something new has happened, this is a gross overstatement which, on the street, would be called a lie. Swedish has no "in-house naturopath" but instead has an arrangement with a small naturopathic group that is off-site. There is no ND "employed" by Swedish except as one may say one "employs" the use of smoke and mirrors to create a fiction. (For what an employed naturopathic physician looks like on a hospital site, take a look at either a CTCA hospital site, or the Goshen site, below.) Kaplan's truer perspective came next: "Whether you agree with it or not doesn't matter anymore, because patients want it."

3.   Indiana Hospital, Following CTCA Boost, Offers Expanding Integrative Program

I contacted Marcia Prenguber, ND, regarding one of her other hats, as the volunteer president of the Council on Naturopathic Medical Education, her profession's accrediting body. Her day job is directing integrative care at Goshen Health System in Goshen, Indiana. How did this town, not known as a hot-bed of integration activity, end up with a program and a naturopathic doctor directing it, particularly as NDs are not licensed in the state? The story began in 1998, when CTCA was contracting with Goshen to develop an integrative cancer program. They shared that their model was to use an ND; in 2000 Prenguber was brought in. While the two healthcare entities later split, Prenguber stayed on. She now oversees a department that includes the hospital dietitians and counselors who provide mind-body services, as well as a full time naturopathic resident (a bargain at ($25,000-$30,000 a year).

Marcia Prenguber, ND
Prenguber, who spends most of her time in oncology, is listed on the hospital's staff list. The majority of her patients are outpatients though inpatients visits are not rare. A typical example is getting called about a patient who is using a lot of supplements and Prenguber helps manage their use, especially relative to contra-indications. The integrative care is deepened through four weekly team meetings: breast clinic, new patients, hospital patients and difficult cases. For ongoing education of the staff, Prenguber has a routine 5 minute segment at a weekly staff meeting for some piece of information. She also spends a day a week in the hospital's women's center.

The program has taken off. "The goal originally was to provide integrative care to the local community," notes Prenguber, adding that word of the services are spreading beyond what we'd intended and now (the system) is trying to capitalize on it." Regional and local television have featured the program.

How are the relationships with the oncologists? "There's significant variability, but I'd say for the most part great support," responds Prenguber. The key factor, says Prenguber, is how well educated they are. She related a story of taking one of her MD colleagues to hear a presentation by Jeffrey Bland, PhD  Bland's tours through the biochemical pathways of functional medicine can only be compared to violinist's virtuosity as he ripples across the polysyllabic phrasing.

Not having studied biomedicine, I can only hear the music. Prenguber said the oncologist turned to her and said: "Do you know what he's talking about?" Prenguber's response: "Yeah, I do." The experience of the knowledge of the other was a break-through in the oncologist's understanding.

4.    Short Notes: Massage in Mayo Hospice, Life Coaches in Rehab, a Grant to Abbott   

A short article in the newsletter of the Minnesota Chapter of the American Massage Therapy Association, featured the work of member Deb Ganrude, LMT in the hospice program with Mayo Clinic. According to the article, Ganrude
had to spend a full year convincing them it was time to include it. “Everyone needs nurturing, everyone deserves to transition with grace”, Deb says. She's now been their for 8 years, using a combination of Swedish, reflexology, lymph drainage and breath work ... Keith W.L. Rafal, MD, MPH, the founder of an integrative clinic in Rhode Island called Healing Choices notified the Integrator that he is working with patients via a "comprehensive interdisciplinary approach which includes a focus on overcoming barriers to health and healing." Rafal, who also serves as the medical director of the Rehabilitation Hospital of Rhode Island, sees an important role for life coaches in the basic strategy ... Missed this one while I was away department: just stumbled upon news on the web that in 2004 web the Abbott Northwestern Hospital's Institute for Health and Healing received a $2-million grant for integrative medicine from the Ted and Robert Mann Foundation. For those who follow the activities of the Bravewell Collaborative, this is evidence of the visionary ability of co-founder Penny George to create enthusiasm for projects ...

Send your comments or hospital or integrative clinic news
to for publication
in a future article.

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