Comments: A DC, an MD, 2 RNs, and a PhD on Bolles, Managed Care, NCCAM, Cultural Authority, plus
Written by John Weeks
Comments: A DC, an MD, an MSW, an RN, and a PhD on Bolles, Managed Care, NCCAM, Cultural Authority and More
Summary: Bob Sager,
MD wanted integrative MD questions in the CodeBlueNow! voter surveys
... Wellpoint fraud expert Howard Levinson, DC comments on the state of
managed care ... Former holisitic nurses association leader Sonja
Simpson, RN, AHN-BC believes commentator Beth Wooton, ND was spot on
regarding practitioner education ...
Researcher Lyn Freeman, PhD has some suggestions about new routes to
project funding that are not NCCAM dependent ... Lisa Yater, LCSW, on
how the structure of conventional care delivery limits the opportunity
for inclusion. More ...
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Bob Seger, MD
1. Bob Sager, MD: More information on MD practices would have been good
"I found this interesting and the results expected. I wish this could be
done countrywide for voters, politicians and Presidential candidates. I have
posted something about this post to my blog with a link back to yours. "What
was missing in the question about coverage for CAM was mention of physicians
using CAM and what types of CAM they use. Overall a great idea for a
pilot survey ad I hope more is done on this topic."
2. Howard Levinson, DC: Wellpoint investigator agrees with Bolles' article on managed care
Howard Levinson, DC works with a managed care firm, Wellpoint, which owns former Blues plans which operates in over a dozen states. He comments on the perspective of former United Healthcare leader Stephen Bolles, DC on coverage trends.
"I am a chiro working within the fraud/abuse area of
WellPoint primarily involved in chiro/pain mgt./phys med issues. Bolles is on
target. I opined a bit of a more optimistic article in March and April issues
of JACA on-line, but the facts remain that although we were early in the MCO
arena, we have not and probably never will be, a 'valued' member of a payors
healthcare delivery team. And this, despite some good research and favorable
studies such as the IL AMI [Alternative Medicine Inc.] study. "We are coming to the party way too late. Thanks for
running this informative website."
Howard Levinson, DC, CFE, AHFI
Clinical Investigations
Wellpoint
Sonja Simpson, RN, MS, AHN-BC
3. Sonja Simpson: On the comments of Beth Wooten, ND, on education strategies
"I
really enjoyed the comments by Dr. Beth Wooten regarding the “current
educational paradigm does not support the kind of experiential learning that
may be more conducive to integrative medicine”.
"She
is so 'right on' about the 'neglect of the vessel through which the m\medicine
will be practiced.' She expresses so clearly the importance of relationship and
connection in healing. As I put it, at first the person needs to connect with self
and be clear about the fact that healing is not so much about doing but 'being'
and then connect with the client to form a relationship within which
healing can occur. "Thanks
for your interesting blog….always food for thought." Sonja
Simpson RN MSN AHN-BC
Former President, American Holistic Nurses Association
Lyn Freeman, PhD, LPC
4. Lyn Freeman: NCCAM is not the only option for research funding Lyn Freeman, PhD, LPC is a specialist, researcher, and consultant of
mind-body medicine as treatment for chronic disease. She is the founder and President
of Mind Matters Research, an Alaskan-based research center specializing in
interventions for late-term and long-term effects of cancer and its treatments. I first met her when she was completing her first edition (now in its 3rd) of Mosby’s Complementary and Alternative
Medicine: A Research Based Approach.
"I have read with interest your
recent articles on NCCAM. I would like to point out an issue that I think
should be addressed more fully in the Integrator. NCCAM is not the only
institute at NIH that supports research on CAM. In fact, the other
centers and institutes combined actually spend more money on CAM research than
does NCCAM. "I will give my situation as
one example. In 2005, I was funded by NCI (National Cancer Institute) to
perform imagery research with breast cancer survivors. The research and its
publications were completed in 2007. I was not funded through a
university, but through my small business, Mind Matters Research. The
outcomes of that trial were quite good, and results from that study are being
published this year in peer-reviewed oncology journals. I have recently
submitted for Phase II funding. "My grant was funded by SBIR
funds (i.e., small business innovation research), a funding mechanism intended
specifically for the business community. You must not only demonstrate
the quality of the research you intend to do, but you must also create a
business plan to show how you will make your ‘product’ available to the public,
if your outcomes are good. NIH has recognized that the best research in
the world is of little value, if what is learned is not made available to the
public. That is why the SBIR grant mechanisms exist. I would really
encourage readers of the Integrator to consider applying for grant funding,
using this mechanism. "I am not suggesting that it
is easy to get funding—far from it-- but simply that it is certainly possible
to do so, if those in the business community want to pursue CAM research.
There are three keys to success in this regard: a great deal of planning,
teaming with more experienced and recognized researchers who can advise and add
to your research, and a willingness to listen carefully to critique, and
respond in constructive ways. "There is also another
mechanism—STTR—which I am not as familiar with, but one worth reading about on
the NIH website. This mechanism requires much more direct
involvement with universities. "As always, thank you so
much for bringing the voice of the Integrator to these issues. Perhaps I
am just an uncontrollable optimist, but I do get a sense that we will see a new
level of support from NCCAM in the near future." Lyn
Freeman, PhD, LPC
Mind Matters Research
Lisa Yater, LCSW
5. Lisa Yater: The challenge is the "structure" of current delivery
Lisa Yater, LCSW, has been a community organizer as well as holistic practitioner. Yater, whose networking business was the subject of an early Integrator article, offers some poignant thoughts on the challenges of practical integration of integrating into existing structures.
"I had the luxury of speaking to you and emailing at the
beginning of The Integrator Blog. Now you and the blog are going full blast and
it is one of my favorite web oases.
"I was able to scan the article sent out
recently about DCs and cultural authority. Many good thoughts from reading
this. After working in the inpatient psych unit at a rural hospital here in West Texas, I got a new eye-ful of healthcare. It came to
me that the problem with CAM, integration,
conventional care, etc, wasn’t in the realm of ideals – despite clashing
paradigms. It was in the realm of STRUCTURE. In everything we did for patients
in our unit, we barely had time for the stuff we provided. Everyone showed up
and fit in their piece just right or the day moved on. The result was damn good
a lot of the time. Even if it was miraculous in efficacy, where were we going
to fit a new different form of healing?
"This has been a back-burner thought as
I’ve returned to direct care practice. Despite my ability to sneak in CAM
within the context of psychotherapy, I still wonder about structure and how
this angle can explain some of the struggle without the thin-air
philosophizing.
"How the heck are CAM therapies
going to structure themselves when actually delivering services and stay linked
to reality? Certainly 'cultural authority' gives services and institutions
time, place, structure, income by its very nature."
Lisa Yater, LCSW
West Texas
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