Executive Adrian Langford on Relations Between Natural Products Industry and CAM Practitioners
Written by John Weeks
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.
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Should practitioner organizations representing integrative medical doctors, naturopathic physicians, acupuncture and Oriental medicine practitioners and chiropractors consciously work to forge a closer relationship with the natural products industry? Should that industry actively solicit stronger ties with these professionals in their effort to expand their market share?
In a guest Integrator column, consultant David Matteson
recently opened up a forum on this topic by noting that, to the public and to policy makers, integrative health practitioners and the natural products industry are viewed as the "flip sides of the same coin." Their destinies are tied. Matteson suggested that failure to more deeply ally closes
off important opportunities.
In this response, complementary and alternative medicine managed care executive Adrian Langford shares his experience of the issue from inside healthcare businesses which have sought to increase inclusion of natural health services in benefits policies. Langford describes both upsides and downsides of this potential. Langford is currently vice president for
Alternative Medicine Integration Group of Florida, the firm responsible
for the Medicaid pilot which is the subject of a recent Special Report.
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Thumbs Up and Thumbs Down on the Practitioner-Industry Alliance
- Adrian Langford, managed care executive; Vice President, AMI of Florida
"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."
Comment: Langford makes an excellent point in his reference to the AMA. The quality problems in the natural products industry are used as evidence that certain complementary and integrative practices cannot be valued. This supports Matteson's view that the "two industries" are typically painted by the same brush.
Meantime, Langford lands with both feet on the shakiness of both products and practitioners in the payer's world:
"The problem for our industry is still credibility among
those who pay for care." Both sides of the coin are still hampered by quality economic evidence, even though adherents readily make claims to the overall cost savings of each.
The perspective of David Barnes, PhD, director of research and development for Standard Process, captured inthis Integrator interview, may provide a useful focus for a deepened alliance. Can it be that a robust body of supportive evidence of the effectiveness and cost-effectiveness of herbs and dietary supplements will flow from the outcomes of whole practices of integrated care in which these products are embedded, rather than the current focus on single agent natural product trials?
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