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Integrator Short Notes: Complementary, Integrative and Natural Health Professions & Associations PDF Print E-mail
Written by John Weeks   

Integrator Short Notes: Complementary, Integrative and Natural Health Professions & Associations

Summary:   Consortium of Academic Health Centers for Integrative Medicine selects new chair and vice-chair ...  Controversial Arizona homeopathic medical board gains 2 year extension  ... AMTA survey of massage therapy use documents continued growth in respect and use ... Chiropractic initiative on state of the research gains ACA endorsement, network into 22 states ...  Acupuncture organization brings in Michael McGuffin of the American Herbal Products Association for industry perspective ... AAAOM announces new acupuncture leadership and closing date for comments on accreditation standards for "first professional doctorate"  ...  Kasra Pournadeli, ND, past president of the Washington Association of Naturopathic Physicians on the outcomes of a lengthy, rule-writing negotiation which followed a statutory broadening of ND prescription and injection rights ... There are changes here that won't please the AMA's Scope of Practice Partnership.
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CAHCIM, leaderfship, CAM, academics, educators
Victor Sierpina, MD, incoming chair
1.   Sierpina and Perlman Elected as Chair and Vice-Chair of Academic Consortium

Victor Sierpina, MD was elected to serve as the chair, and Adam Perlman, MD, MPH, as the vice chair of the 40-member Consortium of Academic Health Centers for Integrative Medicine. Sierpina, an Integrator advisor, is a tenured professor of family medicine at the University of Texas Medical Branch (UTMB) and the Laura Nell Nicholson Family Professor of Integrative Medicine. Perlman is the Hunterdon Endowed Professor in Complementary and Alternative Medicine at the University of Medicine and Dentistry of New Jersey, founded an early integrative clinic with the Saint Barnabas Health System in a New Jersey health system prior to taking his academic post. Both Sierpina and Perlman have been strong proponents of strengthening inter-disciplinary relationships between conventional academics and those involved with the complementary and alternative healthcare disciplines. Each served on the planning team for the 2005 National Education Dialogue to Advance Integrated Health Care: Creating Common Ground. Perlman co-chaired a multi-disciplinary curriculum task force and Sierpina was part of a similarly diverse values working group, a year-long process funded for NED through a grant from the American Holistic Nurses Association.

2.    Arizona Homeopathic Medical Board Renewed for 2 Years

The controversial and inappropriately-named Arizona Board of Homeopathic Medical Examiners has been renewed for 2 years by the Arizona State legislature. The board, established in 1980, actually provides a much broader license which
covers classical homeopathy, acupuncture, orthomolecular medicine, chelation therapy, nutritional medicine and neuromuscular massage therapy, and conventional medicine. MDs and DOs who seek the license must have completed 40 hours of classical homeopathic training in 300 hours in CE from among a diverse array of other possible training. On November 6, a joint legislative committee unanimously chose to extend the board's recognition during a period of additional  study. The case for extension was assisted by a citizen's group which provided 70,000 signatures from supporters according to the website of Martha Grount, MD, MD(H). (Thanks to health freedom activist Merrily Manthee for notice of the action.)
massage use, consumer survey, AMTA, therapeutic massage
Survey documents growth in use
3.    American Massage Therapy Association Post 11th Annual Survey Findings

The annual survey of consumer views of massage therapy by the American Massage Therapy Association is once again a finger on the pulse of the US consumer. In general, massage is increasingly viewed as therapeutically valuable, and not just useful as a "feel good addition to life." Not surprisingly, those of us who have had more years to acquire aches and pains are more likely than younger consumers to see a therapeutic value in massage. 32% have used massage for pain relief at some point in their lives, behind chiropractic (38%) or physical therapy (44%). At the same time, the trend toward gifting massage is growing.

  • 87 percent agree that massage can be effective in reducing pain.
  • 85 percent agree that massage can be beneficial to health and wellness.

Despite the perceived therapeutic value, just 19% reported discussing massage with their physicians while 59% would like to see their insurance plans cover massage therapy. Overall, 24% of those  surveyed reported receiving a massage last year. More information is available on this and surveys from previous years at this link.

ACA, COCSA, chiropractic research, practice-based research
Multi-faceted research agenda for chiropractic
4.   Chiropractic "State of Research" Initiative Picks up Steam

The Foundation for Chiropractic Education and Research (FCER) has initiated a "state of the research" initiative through which it networks
with state chiropractic associations "to identify practitioners’ research-related needs, assists in getting the research conducted, and helps the practitioner to use the research in evidence-based practices."  To date, 22 state associations has appointed liaisons. The American Chiropractic Association recently formally announced its support, noting a special interest "in the area of reimbursement." The project is linked to FCER's Evidence-Based Resource Center initiative, also launched this year. Based in Norwalk, Iowa, the 60-year-old FCER presently has a mission which is direct, and ambitious: "Translate Research into Practice.”

AHPA leader Michael McGuffin
Herbal Products Leader McGuffin in Key Roles at AAAOM Meeting

The recognition of the inter-locking futures of the natural products industry and the integrative and natural healthcare disciplines was implicit in the involvement of Michael McGuffin in the October 2007 meeting of the American Association of Acupuncture and Oriental Medicine (AAAOM). McGuffin, president of the American Herbal Products Association (AHPA) provided the Integrator with a brief report to AHPA members on the meeting. McGuffin's roles at the AAAOM annual conference included participation in 3 panels. McGuffin made a point of sharing with his members two of AAAOM's initiatives. One, states McGuffin, is "
an [AAAOM] plan to standardize practitioner scope of practice to include the use of herbal therapy in all states where acupuncture is licensed." The second is AAAOM's continuing support for the development in the United States of a separate regulatory class of traditional medicine products. AHPA and AAAOM are part of a multi-stakeholder group which supports this direction. (See related Integrator article.)

naturopathic physicians, scope of practice parrtnership, WANP, pharmacy prescription
WANP's Kasra Pournadeali, ND, hails new pharmacy scope
6.   Naturopathic Physicians in Washington Expand Pharmacy Scope of Pharmacy Rights

The naturopathic physicians are increasingly included in public policy in Washington State as a part of the state's primary care matrix. As such, the Washington Association of Naturopathic Physicians (WANP) has continuously promoted a an expansion of their prescription rights in their scope of practice. A lengthy process of rules writing was recently completed. I asked Kasra Pournadeali, ND, immediate past-president of WANP - who was president when the statute passed - for a comment or two. Pournadeali presented the changes as a win for his professions, for patients, and for the medical  doctors and insurers with whom they collaborate. (Bolding is added.)

"Thanks for passing on the word about on the scope expansion we accomplished in 04/2005 being implemented.  It represents big win for NDs, patients, MDs, and Insurers.

"Implementation of the new law is a win for NDs It means that the ND scope of practice is now consistent with current ND training.  The last scope update for NDs was in the 80's (where a few drugs were included for the 1st time). It means that NDs are no longer restricted to using a list of legend drugs, but instead have all ("non scheduled"/ "non-controlled") legend drugs included in scope.  More importantly, as new drugs are developed, they are automatically included.  The law now only restricts "controlled substances" (allowing codeine & testosterone preparations) where none were allowed previously. The only broader prescriptive scope is in Arizona where all "controlled substances" are included.

"The new law sets a precedent for ND with respect to our injection scope.  In Washington, NDs are now able to inject anything within prescriptive authority- including drugs (chelation is restricted to use in heavy metal toxicity, and cosmetic injections are excluded until rules are developed for them).  Previously, ND scope in Washington only allowed intramuscular B12 injections (where B12 deficiency existed) and immunizations.

"The new law removed the exclusion of intrauterine device placement for NDs, and made it allowable for to perform biopsies and take tissue samples.

"The new law will allow more opportunity for graduates.  No longer will requirements for broad prescriptive authority be a barrier for new graduates wanting to achieve positions and serve in subsidized rural environments. 

"The new law is a win for patients. It means the many patients choosing an ND for their primary care will no longer have to undergo a second doctor visit for a simple prescription not on the old ND drug list.   It means patients wanting to get off a drug and use effective non-drug treatments now have the option of doing so safely by seeing an ND with training in both pharmacology and non-drug approaches.

"The new law is a win for MDs. No longer will the services of medical specialists be inefficiently utilized by the patient (of an ND) who needs a simple prescription outside the old ND scope, but consistent with ND primary care.

"The new law is a win for insurers that provide ND primary care benefit. Because NDs inherently prefer to avoid prescriptions where possible, because NDs are educated in effective non-drug management of chronic conditions, insurers who provide (and promote) ND primary care benefits will realize savings in prescriptive benefit payout- simple math: cut the drugs, and you cut the cost.

"For decades patients have been looking to NDs for their primary care.  This era appropriate modernization in legislation, based on ND training represents the next step in facilitating the profession's evolution toward serving a growing need."

Kasra Pournadeali, ND
Washington Association of Naturopathic Physicians
Seattle, Washington
Martin Herbkersman, MTOM, DAC, incoming AAAOM president
7.   AAAOM Announces New Acupuncture Leadership, Calls for Response on "First Professional Doctorate"

The newly re-unified American Association of Acupuncture and Oriental Medicine (AAAOM) recently announced its new leadership. Martin Herbkersman, MTOM, DAc, who has a special clinical interest in fertility and reproduction issues, will serve as president and Corrine Axelrod, MPH, LAc, DiplAc, a senior officer with the US Public Health Service, will be the new vice president. The past presidents of the two organizations which unified this year have become advisers to the new board. In the same November release from the AAAOM, the organization noted that December 15, 2007 will end the final comment period for accreditation standards for a new "First Professional Doctorate" program which has been advanced by the Doctoral Task Force of the Accreditation Commission for Acupuncture & Oriental Medicine (ACAOM). Interestingly, divisions around the first professional doctorate are seen by many as the original cause of the rift which split the profession 15 years ago and which is only now healing.

Comment: While we haven't heard much lately from the AMA's Scope of Practice Partnership (SOPP), two of these items would probably be of great consternation to those seeking to limit the incursions of non-MD professions into their turf. The ACAOM "first professional doctorate," if it takes hold, will add to the list of professions increasingly likely to be addressed as "doctor" by their patients. While not as problematic in numbers to the AMA SOPPers as the nursing doctorate, this AOM incursion into the naming turf will be similarly viewed. The ND scope expansion is also not as threatening, in sheer numbers, as the prescriptive rights campaigns of psychologists, but will also be viewed as erosion by the SOPPs of the AMA.     
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