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Integrator Advisor Speaks: Benda on the Selection of the New NIH NCCAM Director PDF Print E-mail
Written by John Weeks   

Integrator Advisor Speaks: Benda on the Selection of the New NIH NCCAM Director

Summary:  The selection of the new director of the NIH National Center for Complementary and Alternative Medicine may be the most important decision for integrative medicine in the next half decade. The Integrator has weighed in on the topic. Now Integrator advisor Bill Benda, MD, takes another look at its importance. Benda wonders if NCCAM has drifted in recent years from the "philosophical beauty and awe that comes from awakening to a new perspective for the first time" and offers ideas on what might right its course.
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Integrator advisor Benda
When Integrator advisor Bill Benda, MD, told me he had a column he wanted to write about the selection of the
new director of the NIH National Center for Complementary and Alternative Medicine, I immediately said, yes, please do. As in: Let's keep this important decision front and center. Benda has been a participant-observer in policy developments in the integrative medicine field since he graduated with the first set of residential fellows from the Program in Integrative Medicine at the University of Arizona. He recently began writing the back page column for Integrative Medicine: A Clinician's Journal. Benda wonders if NCCAM has drifted in recent years from the "philosophical beauty and awe that comes from awakening to a new perspective for the first time" and gives us ideas on what might right its course.

Benda was last seen here in a column on the recognition of holistic nurses by the American Nurses Association.
I have added the subheads, for you ADHD skimmers ...

NCCAM and the Bureaucratic Blues

  - Bill Benda, MD

"A month or so ago, when the NIH was soliciting for a new NCCAM Director, a dear friend of mine paid me the compliment of suggesting I apply.  'No, but thank you for the kind thought,' I replied, citing two reasons this would not be a good match.  First, I would likely prove an inelegant federal bureaucrat.  And second, I’m not really in the mood for rejection right now.

"A reading of the required credentials for the position clearly revealed the type of partner the NIH was seeking for a long-term relationship: 'senior-level scientific and management experience ... outstanding scientific knowledge of research programs ... distinguished record of research accomplishments ... leadership and broad vision in biomedical and clinical research ...' and so on (I did meet the M.D., D.O., or Ph.D. criterion).  However, there were a few pragmatic requirements missing.  Research experience in CAM.  Understanding of CAM.  A basic clue as to what CAM is, or integrative medicine, or integral medicine, or anything not conventional medicine."

ImageInstitutional Drift

"Fortunately, this was not always the case.  From 1992 through 1998 NCCAM went by its christened name, the OAM, or Office of Alternative Medicine.  For much of that period it was under the reign of Wayne Jonas, MD whose spiritual resume did include periods of what we 60s generation called 'finding ourselves,' stirring Dr. Jonas to deeply consider how 'respect for rigors of science could fit with unifying concepts of holistic practices.'(1) And even though there was rejoicing in the integrative halls when the OAM morphed into NCCAM, something was lost in the process as well.  As the institution became a Center of the NIH, it began to drift from the center of its origins – the philosophical beauty and awe that comes with awakening to a different perspective of health and healthcare for the first time."

An Alternative Mindset

"Which is sad.  Because although the word 'alternative' has been losing reverence as academic centers pursue integration, what is acutely needed at this tipping point in time is an alternative mindset, an alternative perspective, an alternative to trying to squeeze unconventional philosophies into a conventional research paradigm.  When John Astin, PhD surveyed the American public in 1998 as to why they were turning to unconventional therapies, he discovered that “the majority of alternative medicine users appear to be doing so … to be more congruent with their own values, beliefs, and philosophical orientations toward health and life.” (2) He did not find that the populace was attracted to how CAM could fit into randomized controlled trials.

Standard process is an Integrator sponsor
"But politics aside, what is really making us so uncomfortable about the thought of a un-CAM entity taking over the helm of NCCAM?  It is, after all, a governmental agency charged with investigating unconventional therapies utilizing scientific methodology.  What’s wrong with a scientist taking the lead role in a scientific research organization?  Wouldn’t a brilliant researcher be the appropriate choice?"

More than a Brilliant Researcher

"Yes and no.  We must have a Director both intimate with the complexities of basic science as well as hardened from the battles of a bureaucratic career.  But I believe what we subliminally fear is that someone who does not embody the very soul of what CAM represents will facilitate, not advancement of the field, but its eventual transformation into another set of rigid clinical protocols, fretting about dosages and adverse effects rather than reflecting why we prodigals diverted from conventional medicine in the first place.  Because we are in it for love, not for science.  And we would love to save our healthcare system.

"Oh yes, a candidate who has lived the life of a basic science researcher could and would be perfect for the position, if he or she understood and embraced the essence of integrative healthcare.  Because in the end, its not about degrees.  Its about heart."

1.  Benda, Esalen – The Lost Years, unpublished manuscript.  Personal communication with Dr. Jonas 2004
2.  Astin, JAMA 1998;279:1548-53
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