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Clinical/Academic: Services in Bravewell Clinical Network, Homebirth Midwifery Educators, Komen/PMTI PDF Print E-mail
Written by John Weeks   

Clinical/Academic: Services in the Bravewell Clinical Network, Survey of Homebirth Midwifery Educators, Komen Grant to Potomac Massage Therapy Institute Serves Low-Income

Summary:  A presentation on the Bravewell Clinical Network at the recent Health Forum conference provides a window into the types of services which are offered in some of the nation's more visible, academically-affiliated integrative centers ...  Susan G. Komen Foundation stepped out of its usual pattern to make its maximum grant for community clinical services to a Potomac Massage Training Institute. The focus: services to low-income women with breast cancer ... A study published by the Midwifery Education Accreditation Council provides a snapshot into the educational issues of the least known of the 5 complementary healthcare disciplines with a federally-recognized accrediting agency.
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1.    Services Offered in the Bravewell Clinical Network

Image
Funders of the network
Ever wonder what kind of natural health, complementary and alternative services are being offered in integrative clinics which are associated with conventional academic health centers? A report at the 5th Annual Integrative Medicine for Healthcare Organizations conference of the Health Forum/American Hospital Association provides a snapshot of services in 8 of these centers. The group profiled is the
Bravewell Clinical Network, organized through a $1-million grant from the Bravewell Collaborative of philanthropists. Duke University Integrative Medicine is charged with administering the 3-years for which the program is funded. The other programs are at Scripps (CA), UCSF, Advocate (IL), Alliance (OH), Thomas Jefferson (PA), U Maryland and Continuum Health Center (NY).
____________________________

CAM Services Offered in the 8 Integrative Clinics
of the Bravewell Clinical Network

Most Offered Services
 
#




Least Offered

#
Acupuncture 
 8

Acupressure 1
Massage
 8

Anthropsophical medicine
1
Nutrition
 7


Aromatherapy
1
Meditation/relaxation
 6

Diathermy
1
Hypnosis, Imagery,
Biofeedback
 6

Infusion therapies
1
Chiropractic manual
therapies
 5 

Nutrigenomics
1
Craniosacral therapy
 5

Osteopathic medicine 1
Yoga  5 

Prayer 1
Homeopathy  4 

Qigong 1
Energy medicine (Reiki
and healing touch)
4

Reflexology 1
Behavioral medicine/
psychotherapy


Rolfing 1
Exercise

Spirituality 1
Chinese medicine


Stress management 1
Feldenkrais

Tai chi
1
Functional medicine
2

Zero balancing
1
____________________________

Note that information on the "most financially successful services" at each of the clinics is available in this Integrator article.

Comment
: It occurred to me that a useful focus for the Bravewell Clinical Network in any subsequent survey would be to ask the types of practitioners who offer these services. That is, is the acupuncture from a licensed acupuncturist or an MD or DO with adjunct training? This is important given the importance of team care and the distinct values different disciplines bring to services. The definition of integrative medicine endorsed by the Consortium of Academic Health Centers for Integrative Medicine charges adherents to integrate not just "approaches" but also "healthcare professionals and disciplines." (See related Integrator article on the definition.)


2.    Potomac Massage Training Institute in $75,000 Susan G. Komen Grant

Image The Susan G. Komen Breast Cancer Foundation has awarded $75,000 to the Potomac Massage Training Institute (PMTI) for a pilot project to provide massage therapy to low-income women with breast cancer. Washington, DC has the nation's highest breast cancer rate and 2nd highest mortality rate from breast cancer. The grant is the highest amount Komen awards for projects of this sort. PMTI believes that this is the first significant grant for healthcare services to an institution which is not principally in the conventional medicine fold.

ImageMartha Menard, PhD, PMTI's director of research and manager for the program, explains the value of the services:
“Research has demonstrated that massage therapy can reduce the severity of symptoms such as pain, fatigue, nausea, anxiety, and depression by as much as 50%. For this reason, many patients with breast cancer use integrative therapies such as massage to mitigate these symptoms. Our goal is to provide an effective therapy that helps to reduce the symptoms of breast cancer and its treatment to women who would otherwise not have access to it.” 
A release from PMTI on the grant notes that students at the school also "provide seated massages at dozens of the school’s fieldwork placement sites." In addition, grants to PMTI have "allowed the school to provide massage to returning veterans and their families at the  Fisher House on the Walter Reed Army Medical Center campus."

3.    Survey of Educators of Direct-Entry (Homebirth) Midwives Offers View of the Profession

ImageAmong the 5 complementary and alternative healthcare disciplines with a federally-recognized accrediting agency, the direct-entry (homebirth) midwives are certainly the least known. (The other four are chiropractic, acupuncture and Oriental medicine, naturopathic medicine and massage therapy.) A recent report in a newsletter of the Midwifery Education and Accreditation Council (MEAC), which lists 10 accredited programs on its website, provides a window into this discipline's world.

The report was written by Jo Anne Myers-Ciecko, MPH, a pillar of that profession for three decades. Myers-Ciecko is past executive director of the Seattle Midwifery School , presently serves as an accreditation specialist for MEAC and is the profession's lead representative to the Academic Consortium for Complementary and Alternative Health Care. The report is based on responses to an internet-based survey of school presidents and administrators. While many of the outcomes were qualitative, some quantitative measures can be reported.

General Information

 
Total accredited programs
10
Estimated number of homebirth
midwifery educators in the US
1,000 
Requirements for educators
Relevant degree or at least 3
years of experience in the
relevant field.

Survey Findings

 
Participants in the survey 34
Importance of educators having
experience with out-of-hospital
births
- Essential (53%)
- Very important (35%)
- Somewhat important (12%) 
Top characteristic desired
in faculty
"Excellent critical thinkers"
- Essential (76%)
- Very Important (24%)
"Diversity in style of practice and
information taught from one faculty
member to another is helpful
exposure for students."
 84% agree
If you could change anything for
faculty it would be (top 3 listed):
- Higher pay
- Course assistants
- More office space

Source: Giving Birth to Midwives: A Forum for Midwifery Educators. Coordinated
by MEAC's Outreach to Educators Project which was funded by a grant from the
Daniels Foundation.

... Plus a Note on "Normal Birth"

In an Integrator interview, Myers-Ciecko adds that
a web-based registry of homebirth experience is an additional project underway through one of MEAC's sibling organizations, the Midwives Alliance of North America. The project, begun in 2003, allows midwives nationwide to report birth outcomes. Says Myers-Ciecko:
"The important thing about the database is not only that it characterizes midwifery practice. It is also the only database in the United States that describes normal birth  - primarily out-of-hospital practice where labor and delivery can progress without undo intervention."
Disclosure: I had the good fortune to have participated in the homebirths of both of my children, each attended by graduates of MEAC-accredited programs. That experience left me with a strong bias toward the teaching embedded in that process: healing, intimacy, relationship-building, honoring of natural process and human empowerment. All good qualities to shoot for in a reformed healthcare system ...

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