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Issues #37 & #38 - Nov 2007 PDF Print E-mail
Written by John Weeks   

Issues #37 & #38


November 29, 2007

Medicaid Acupuncture and Massage Therapy Pilot, Part #3: Survey Data and Interviews with Patients

In 2002, the legislature of the state of Florida created a pilot program which gave high cost, frequently disabled, chronic pain Medicaid beneficiaries access to the services of licensed massage therapists and acupuncturists. As a pilot project, the state's vendor, Alternative Medicine Integration Group (AMI), was required to annually survey their patients through an independent researcher. This article, Part #3 of the Integrator series on Florida Medicaid Integrative Therapies Pilot, reports data and qualitative information from these mandated patient surveys, SF-12 surveys, and findings from Integrator patient interviews. The short story: beneficiaries speak eloquently about an experience 93% say reduces pain levels and 84% believe boosts their quality of life. The comments from beneficiaries on this whole system of care are more powerful than the hard numbers. One certain conclusion is that the pilot shows us as a caring people. More ...

November 27, 2007

Reimbursement Brief Notes: Complementary and Alternative Medicine in Covered Benefits

Chiropractic action forces United Healthcare to rescind refusal to cover pediatric chiropractic care ... Mandate to include naturopathic services begins in Vermont, including in Medicaid ... American Specialty Health's COO White steps into presidency ... Boeing restricts access to naturopathic physicians among employees ... Complementary Healthcare Plan acknowledged by Oregon Business as key player in state's health care ... Landmark signs deal with CNCA for natural products, plus.  More ...

November 27, 2007

Wellspace/SickSpace:  Reflections on a Pioneering Integrative Clinic Gone Down for the Count

Wellspace, the pioneering, 10,000 square foot integrative center in Cambridge, Massachusetts, has gone belly up. Founder Mort Rosenthal, one of the more intriguing entrepreneurs in the field, tested a business model and concluded that his goal of a national roll-out of similar clinics was not possible. He sold the firm. To all accounts, the Harvard pedigreed characters who held the reins in the organization's death throes were a different breed. Within short months of a January 24, 2007 press release which waxed eloquently about the venture's future, the two shut the operation's doors. A trial of emails from disgruntled parties reached the Integrator, seeking information about how to get paid back on broken promises and bad debt. Here is a short review of an immensely instructive, if unsuccessful, venture, together with a concluding comparison with Massage Envy, which appears to have broken the code for a successful, national, complementary healthcare services business. More ...

November 27, 2007

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

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. More ...

November 25, 2007

Awards & Fellowships: Dr. Rogers' Prize, Bravewell, FCER Fellowships, ND Underserved Posts with Loan Repayment

The first $250,000 Dr. Rogers' Prize to a leading integrative medicine figure in Canada is split between two ... 3rd Bravewell event draws 600, grants $25,000 each to 6 pioneers ...  Foundation  for Chiropractic Education & Research awards $23,000 in fellowships ... Washington State names a record 5 naturopathic physicians to participate in loan repayment programs by serving in underserved primary care areas ... Natural Products Association honors Block and Low Dog. More ...

November 23, 2007

Your Comments Forum: CAM Practitioners in CAHCIM, ND as "medical doctor", Pimp My Health, CAM Ghetto, plus

University of Colorado integrative medicine leader Lisa Corbin, MD on participation of a chiropractor and licensed acupuncturist in the conventional academic consortium ... Nancy Aagenes, ND, on health care's version of "pimp my ride" and the possible value to humanity of sterilizing outspoken natural healers  ... Three MDs, two anonymously, look askance at the recent American College of Physicians' low back pain guideline ... An ND, an MD and a DC weigh in on whether the education of naturopathic doctors should be considered "medical schools" (and the practitioners "naturopathic medical doctors") ... A clarifying note on the earliest integrative activity at Yale ... and a question about whether iridologists are welcome in the "CAM ghetto" More ...




November 14, 2007 mailing - Issue #37


November 14, 2007

Yale Integrative Medicine: A Story of Growing Acceptance from Medical Leaders

Those who have followed the short history of integrative medicine will know that the Yale name has been associated with an integrative clinic for nearly a decade. Yet it was only two months ago that a website at the Yale School of Medicine affirmed that conservative institution's participation in integrative medicine. This article describes the process over the past decade of a public health medical doctor, a Planetree hospital, a medical student and a series of naturopathic physicians quietly "tearing down an Iron Curtain." How? That conservative institution discovered that forms of integrative medicine already existed within its walls. On April 2, 2008, Yale will sponsor an "Inaugural Scientific Symposium" which is expected to significantly advance that academic health center's involvement with the field. More ...

November 11, 2007

Medicaid Integrative Therapies Pilot, Part 2: Holistic Nurse Management of Covered Benefits for Services of Licensed Massage Therapists and Acupuncturists, Plus

Imagine you have the opportunity to create an integrative therapies program for a chronic pain population. Your boss is the Florida state legislature. For the first time, thanks to a Medicaid waiver, limited services of massage therapists and licensed acupuncturists can be included. Your outcomes will be measured and published. What goes into such a program? How does one manage it? Such was the problem set and opportunity handed Alternative Medicine Integration Group (AMI) when the firm won a contract under the Florida MediPass program in 2003. So far so good for AMI: Florida's legislature extended the contract in 2007 following reports of positive clinical and cost savings. This article, Part 2 of a 5-part series, examines the management and care process.  More ...

November 12, 2007

Alternative Medicine Integration Group's Medicaid Integrative Pilot and the Importance of Whole Systems Research

The Medicaid integrative therapies pilot has huge variability of care. Included may be various conventional services, mind-body CDs, massage and acupuncture and chiropractic care from licensed practitioners, educational materials, counsel from a holistic nurse, and more. Can anything with this kind of variation be a "pilot" project? Richard Sarnat, MD, AMI's co-founder, provides a perspective which begs a second question. Given that all integrative practices show great variation and individualization, what model which is less complex could possibly be considered a pilot? A line in the sand for the future of integrated health care research becomes more visible. More ...

November 8, 2007

Therapeutic Order: An Interview with Roger Chou, MD, Lead Author of ACP "Integrative" Pain Guideline on the Role of Non-Pharmacological Approaches

Analysis of the new "integrative" pain guideline published by the American College of Physicians and the American Pain Society provoked questions. The guideline notes spinal manipulation, acupuncture, massage, exercise, yoga, cognitive-behavioral approaches. But they are mentioned last, with an asterisk: only these were tagged as "weak recommendation." What is the recommended therapeutic order, here? I contacted internist Roger Chou, MD, the lead author of the guideline, at his base at Oregon Health and Science University. Chou commented candidly on the panel's thinking about these "non-pharmacological" approaches in the guideline's development. More ...

November 7, 2007

American College of Physicians & American Pain Society Issue "Integrative" Back Pain Guideline: Sportelli & Choate Respond

The American College of Physicians (ACP) and the American Pain Society (APS) recently issued a comprehensive joint clinical practice guideline for the diagnosis and treatment of low back pain. Published in the October 2, 2007 issue of the Annals of Internal Medicine, the guideline may be considered "integrative" as it includes self-care and "non-pharmacologic" approaches. Chiropractic and integrative care veteran Lou Sportelli, DC, who brought the guideline to my attention, shares his views on the pros and cons of this guideline iteration. What do you think? More ...

November 7, 2007

Your Comments: 4 Naturopathic Physicians on Whether NDs Go to "Medical Schools" and are "Naturopathic Medical Doctors"

In the last Your Comments Forum, naturopathic physician and researcher Julie Chinnock, ND, MPH, questioned the choice of language for her profession in a prior Integrator article and wrote: "I would like to clarify that NDs are medical doctors. It is a common misconception that I often see in print and in conversation. We are naturopathic medical doctors and MDs are allopathic medical doctors." I asked for reader response on my appropriate editorial line. Illinois-based Peter Green, ND, Colorado-based Jacob Schor, ND, an anonymous practitioner-educator ND and Chinnock each responded with a diversity of views, and, in one case, with tongue at least partly inserted into cheek. Hot topic.
More ...


November 5, 2007

Academic Medicine Journal Devotes October Issue to NCCAM-Funded Integrative Education Initiatives

For the last half decade a series of multi-year grants from the NIH National Centers for Complementary and Alternative Medicine have quietly allowed significant explorations in transforming medical education. Some have given medical students their first mind-body medicine experience. Others allowed ties to be forged between conventional academic health centers and academic institutions which educate chiropractors, acupuncturists, naturopathic physicians and massage therapists. In October 2007, Academic Medicine, the journal of the American Association of Medical Colleges, devoted over 50 pages to reports on these NIH programs. Medical troglodytes across the country must have developed hives on picking up Volume 82, Number 10. More ...
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