Integrator Forum: Executive Adrian Langford on Relations Between the Natural  Products Industry and CAM Practitioners

Summary: A recent Integrator column by David Matteson opened a forum on the optimal relationship between the natural products industry and the practitioner organizations which represent those who use natural products in their treatment of patients. Matteson suggested that failure to more deeply ally closes off opportunities. Here, Adrian Langford probes into both the upside and downside of the potential. Langford is a 20-year managed care executive with the last decade in managing complementary and integrative health care networks. He is currently vice president for Alternative Medicine Integration Group of Florida, the firm responsible for the Medicaid pilot.

"I have a tendency to both agree and disagree (with Matteson).

"In my earlier years of my exploration in CAM I was approached by numerous nutraceutical organizations. It was the mid to late 90s. The venture guys were poking around. I can't tell you how many multi-level natural product organizations were seeking some sort of deal. In fact, I developed what I called the wall of shame.

	"To be honest I did not want to be painted with the same brush or perception from whence I viewed the industry at the time." - Adrian Langford

A wall in my office dedicated to the natural product hucksters. To be honest I did not want to be painted with the same brush or perception from whence I viewed the industry at the time. There were absolutely quality issues around products. It was truly buyer beware and in many aspects remains so today.

"Over time, with better quality management and better manufacturing standards, some products have risen to the challenge in terms of quality and bioavailability. I very much believe in an accreditation for good manufacturer standards. Without such accreditation, how does a consumer identify a product that is bioavailable in the right dosages? Well one way is by referral from a trusted holistic provider. That's why the natural product industry still seeks out relationships with providers. Its an old model, one that has made the Pharma industry a fat cat. So why not replicate it? I submit to you that the importance of provider support in lieu of front shelf retail can make or break a natural products manufacturer.

"The problem for our industry is still credibility among those who pay for care. I think as an industry we need to figure how to identify and stratify natural products in terms of efficacy, bioavailability, manufacturer standards. We need some quality standards for products or type of trusted accreditation that a (consumer) can identify. Until we get there, we as a profession will be weighed down by all the products that don't meet high standards.

"The AMA will continue to fight scope of practice expansion and continue to point to the quality issues of the natural products used for healing as one of the reasons why CAM should remain as is." - Langford

"The AMA will continue to fight scope of practice expansion and continue to point to the quality issues of the natural products used for healing as one of the reasons why CAM should remain as is. I think it is incumbent as a provider industry to demand more from the natural products industry in terms of product quality.

"At the same time a number of Medicare HMOs now cover a few natural products, because they work and save money. The trick is to recognize that the AMA does not have a monopoly on the development of quality standards or outcome measurement. Nor the FDA. The scientific method can be applied by anyone."