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Bravewell - "The New Medicine" Debuts on PBS March 29 PDF Print E-mail
Written by John Weeks   


Bravewell-Backed March 29 PBS Features Integrative Medicine 

On March 29, a two hour PBS program entitled "The New Medicine" is expected to reach 27-million viewers. The program, one of the strategic projects of the Bravewell Collaborative, is expected to give the field of "integrative medicine" the same kind of boost that Bill Moyers' Healing and the Mind series on PBS gave to complementary and mind-body medicine 13 years ago. This show also focuses on the mind-body connection.

The goal of the program's backers, according to the show's producer, Muffie Meyer of Middlemarch Films, is "to change what people felt they could ask for -- indeed should expect -- from the medical system." Among the integrative medicine leaders featured are Mimi Guarnieri, MD, Tracy Gaudet, MD, and Ralph Snyderman, MD, winner of the first $100,000 Bravewell Leadership Award.

The Bravewell Collaborative, founded in 2002 by Penny George, PhD, Christy Mack and other philanthropists as the Philanthropic Collaborative for Integrative Medicine, has prioritized a program like this since the organization's inception. Other sponsors, such as Web MD Health Foundation and Wyeth have since been brought in. Bravewell is doing all it can to maximize its investment. A companion book and DVD are being published. Additional small grants have promoted use of the show as a change agent in various communities. (Mayo Clinic and the University of Washington School of Medicine are among those creating Town Hall meetings in their respective communities before the show's airing.) The program hasImage its own site, which includes not only information about integrative medicine but also includes guides to help viewers address their own health issues. Bravewell also updated its own site, using material from the show.

The web content focuses on MDs, with integrative medical doctors cast as change agents in the healthcare system. Distinct CAM disciplines typically show up as sub-topics. CAM typically shows up as "approaches" or "therapies" to be integrated, rather than as a whole discipline, developed by human beings. The one mention of other CAM "systems" on the page which defines integrative medicine makes a point of distinguishing IM from CAM: "So, although IM utilizes complementary therapies, the stringent requirement that these treatments have a solid scientific basis exists, making it 'once removed' from complementary and alternative systems."

Comment:  Commenting on this program is challenging. There are two very different stories here. On the one hand, the program and related activities may one day be viewed as the moment in which "integrative medicine" hit the consciousness of the North American public. The show salutes the ground-breaking work, over the past 10-15 years, of scores of integrative medical doctors fighting uphill to bring whole person and mind-body and CAM practices into the conventional system. The pioneering work of these professionals will receive a great and deserved boost, in visibility, legitimacy and eventually in support. Particular beneficiaries will be the 30 conventional academic programs which have formed as the Consortium of Academic Health Centers for Integrative Medicine. (This group was funded for five years as another of Bravewell's strategic initiatives.) Another beneficiary may be Bravewell itself, through drawing more funders to support the Collaborative's work. The medicine advocated can provide a significant betterment of care for millions. 

On the other hand, the goal of the Bravewell Collaborative is to transform (their word) medicine. Yet by focusing almost solely on the work of medical doctors, Bravewell - through this and the others of their strategic initiatives - misses an opportunity to broker healing between the disciplines. The story-line in the program and on the sites -- I saw previews at Seattle's Town Hall -- recapitulates the diminution of the contributions of non-MD providers that is deeply problematic in the present system. Think of the under-appreciated roles today of nurses, psychologists, nutritionists, public health professionals, and social workers. Now think of all the distinctly licensed CAM providers who are similarly being relegated to second class status, and near invisibility, in this "new medicine".

This vision of a new medicine influences not only the future we create, but also the past which has brought us here. An example: A newcomer clicks on "Alternative Medicine" in a time-line of key developments on the site. He or she is taught that growth in CAM usage began in the 1990s. Not mentioned is the substantial growth of popular use from from 1970-1990. In that era, leaders of CAM in acupuncture and Oriental medicine, chiropractic, massage therapy, naturopathic medicine and direct-entry midwifery set up schools, formed accrediting agencies, developed professional organizations, and established federal recognition of their education, and state licensing for their disciplines. (Chiropractic's development was a little earlier.) Hard work, all of this, mostly engaged without government support, amidst great political-economic opposition, and with extremely limited philanthropic assistance. I know first hand: I pitched in on some of the work. Ironically, these hard-won successes were key influences in creating the population data on CAM usage which David Eisenberg's 1990 survey captured. History, of course, is the winner's story. 

I have had occasion to speak privately with some Bravewell leaders on this topic. Some editorial decisions on the show's focus were apparently made by Middlemarch and PBS, not by Bravewell. In addition, there is apparently a subset of Bravewell members who are arguing for more inclusiveness and respect for the other disciplines. But the acceptance of the dominant, top-down, MD-centric paradigm clearly dominates Bravewell's practice, not only here, but in other initiatives. This appears to be partly tactical-strategic. Given prevailing medical prejudices, medical school deans or hospital department heads find it relatively easy to accept a person who advocates for one CAM therapy or approach, delivered by an MD. More challenging is to accept an advocate who strolls in with a chiropractor on one arm and a naturopathic physician on the other. The MD-centric strategy may also be shaped by cultural and class factors. Fear figures in.

Future Bravewell investment will help us better know whether this is merely tactical, or if it truly means a continuation of the old order in provider relations. Bravewell leaders might ask themselves if, by promoting the dominant paradigm in provider relations they may be limiting their ability to achieve their very visible mission of "transforming healthcare."

This significant concern aside, the program and related initiatives are an exceptional realization of a key element of the strategic plan that Bravewell set for itself five years ago. I highly recommend that all watch and learn. For better and for worse, the show is a defining moment in the integration dialogue. 

Contact: www.thenewmedicine.org, www.bravewell.org

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