Integrative Medicine & Integrated Healthcare Round-up: June 1-15, 2008
Written by John Weeks
Integrative Medicine and Integrated Health Care Round-up: June 1-15, 2008
Summary: Among those
noted: University of Arizona Program in Integrative Medicine designated
a Center of Excellence by Arizona Regents ... Council on Naturopathic
Medical Education gains 5 years from the USDE ... US/China accord on
traditional Chinese and integrative medicine ... Integrative MD/ND/LAc
Goshen Cancer Center awarded ... Trustee
features integrative medicine for Boomers ... Integrated community care
leader Community Health Centers of King County becomes HealthPoint ...
The debate over the JAMA St. John's wort for ADHD article ...
National advertising campaign for chiropractic and the IOM use the
Alternative Medicine Inc. study on cost savings ... AMI's state
partnerships grow ... Chiropractic associations in agreement on pediatrics specialty ...
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This
is the second of an ongoing "Round-up" feature in which I attempt to
capture, in short notes, some of the top developments in the previous 2
weeks (plus). I am dependent on many of you as my "news service." Send
me good information. Robust developments, here.
Academic Medicine
Andrew Weil, MD: a dream becomes a Center of Excellence
U Arizona Program in Integrative Medicine earns Center of Excellence designation
The Arizona Board of Regents recently conferred Center
of Excellence status on the Arizona College of Medicine Program in Integrative Medicine. The program was founded 14 years ago by Andrew Weil, MD.
A June 12, 2008 release from the Program states that the action
"reaffirms the positive impact integrative medicine has had on
health-care system transformation." The contributions to date, from the
Program, as noted in the release, are remarkable: creation
of 5 integrative medicine fellowships,
receipt of over $7 million in federal funding, and graduation of nearly
300
integrative medicine fellows. Many of these graduates are now leading
integrative medicine programs in such institutions Johns Hopkins
University, Stanford University, Duke University, Tufts
University, The University of Wisconsin, and the University of Maryland. The Board's decision to confer this status topped this list, according to Weil: “Having our
work recognized in this way is among our greatest accomplishments to date.”
Vicoria Maizes, MD: at the helm for the last decade of steady, visionary growth
Two of Weil's smartest moves - not
directly mentioned in the release - were the selection of the two
individuals
who have served the Program in Integrative Medicine as executive
director. Tracy Gaudet, MD, guided action through the first, rough,
founding and defining years before taking the helm at Duke Integrative Medicine. Since then, Victoria Maizes, MD, has steadily expanded the program around a vision which has been reformed to meet and create opportunities. According to the release, PIM
anticipates "a new era of program growth – led by the center’s most
ambitious program to date - the Integrative Medicine in Residency
(IMR)." Via the IMR, the new center plans to have its integrative medicine
curriculum incorporated into standard family medicine residency
programs
across the nation. States the release: "Residents will learn
to incorporate integrative medicine concepts into their practices,
including
patient-centered care techniques that facilitate lifestyle change." Says University of Arizona president Robert Shelton: “Through the center’s leadership in education and research,
the role that integrative medicine plays in health-care transformation
has been revealed in exciting new ways. I celebrate the center’s
roots right here in Tucson, and I am eager to see
its future unfold as a Center
of Excellence.” A designation, and launching pad, well-deserved.
Government Action
Naturopathic Accrediting Body Gains 5 Years Recognition from USDE
Dan Seitz, JD, executive director of the Council on Naturopathic Medical Education sent this note of another important recognition: "On June 9, representatives of the Council on Naturopathic
Medical Education (CNME) appeared before the National Advisory Committee on
Institutional Quality and Integrity (NACIQI) for the hearing on CNME's
application to the US Dept. of Education (USDE) for re-recognition as an
accrediting agency. CNME is the only agency recognized by the USDE that
accredits 4-year, residential doctoral programs that lead to the Doctor of
Naturopathy (N.D.) degree and that qualify naturopathic physicians for
professional licensure in the U.S. and Canada. The USDE staff analyst who
reviewed CNME's application stated that the agency was fully in compliance with
USDE recognition criteria, and recommended that CNME be granted a five-year
re-recognition--the maximum length of time allowed. The analyst also noted that
over 400 letters of support for CNME re-recognition had been received by USDE
(possibly a record number), and that there were no letters of opposition or
individuals who wished to testify in opposition. Following a brief
question-and-answer period, NACIQI voted unanimously to recommend to the US
Secretary of Education that CNME's recognition be extended for a period of five
years."Marcia
Prenguber, ND, CNME's president (see Goshen story below) stated via an
email: "I don't think that there are words to express my joy with this
event." US-China in TCM and integrative care research agreement
Marcia Prenguber, ND: clinical work and accreditation work (see CNME, above) each honored
Goshen Center for Cancer care honored
The integrative program at Goshen Center for Cancer Care
is the recent recipient of a Hope Award as "an example of practice
excellence in integration of care." An article on the program in the
May 2008 Hemotology and Oncology News and Issues Online, led by surgical oncologist Douglas J. Schwartzentruber, MD, FACS, and hands-on integrative care leader Marcia Prenguber, ND, is available here.
Interestingly, the Goshen Health System is in the state of Indiana,
where naturopathic physicians are not licensed - yet the "Physicians
and Staff" page of the Center notes both Prenguber and another naturopathic
physician who is also a licensed acupuncturist, Emily Moore, ND, LAc.
The article notes that The national Press Ganey patient satisfaction
survey "has listed Goshen CCC in the 95th to 99th percentile in patient
satisfaction over the past two years." (As noted above, Prenguber is
also president of her profession's accrediting agency, which just secured 5 years of USDE recognition.)
Community Health Centers of King County Expands Integrative Care, Becomes "HealthPoint"
In 1995, word broke nationally that a public health-based natural
medicine clinic was to begin operation, through a $1-million state
grant, at a clinic operated by Community Health Centers of King County.
Tom Trompeter, CEO, managed to continue the services after the grant
ran out. He
expanded naturopathic medicine, acupuncture and massage services
through CHCKC's network of clinics. Earlier this month, CHCKC announced
a name change to HealthPoint. The new name is intended "to better
capture our intention to be a health care network whose community
connections radiate in all directions and are deeply integrated with
the social infrastructure." CHCKC, aka HealthPoint, has been a
national resource on
complementary health services to the underserved. It will be
interesting to observe the way these services change or expand with the
not-for-profit's new face.
AHA's Trustee features integrated care as Baby Boomer Medicine
The May 2008 issue of Trustee , an American Hospital Association publication, includes a feature entitled "Baby Boomer Medicine: An Integrated Landscape"
by Laurie Larsen, the magazine's senior editor. Among those
featured are Sam Benjamin, MD, an early integrative medicine leader
with the AHA, Mimi Guarneri, MD, with Scripps Center for Integrative Medicine and Christy Mack, leader of the Bravewell Collaborative. A side-bar features the Osher Clinical Center for Complementary and Integrative Medical Therapies
associated with Harvard which was made possible with a $5-million gift
from the Osher Foundation. An observer wondered whether the article was part of a Bravewell-led media push. It was notable that all of those interviewed
are medical doctors, reinforcing that we still live in an era of
segregation in the integrative medicine dialogue. (Thanks to Taylor
Walsh for sending the article to me.)
Insurance & Third Party Payment
Outcomes-based approach showing dividends
Alternative Medicine Inc. Study Featured by IOM and in Advertisement fro Chiropractic
Bumped into two references on the same day, June 18, 2008, of the watershed study by Alternative Medicine Integration Group
which found savings from broadscope chiropractors and other integrative
medicine practitioners in primary care. The Institute of Medicine
sent a copy of the study as one of 17 articles to prep its planning
team prior to their first gathering toward the February
2009 National Summit on Integrative Medicine and Health of the Public.
Later in the day, the Foundation for Chiropractic Progress
(F4CP) - which runs an ongoing national visibility campaign for
chiropractic - sent a newsletter which noted that AMI co-founder
Richard Sarnat, MD, will be featured in an upcoming national advertisement. Sarnat will make the following statement, based on the study outcomes:
“My research, conducted over a ten-year period
utilizing clinical and cost-outcomes data from one of the nation’s largest
insurance underwriters, suggests that the regular utilization of chiropractic
could reduce the need for hospitalization, pharmaceutical usage, and overall
global healthcare costs by almost 50 percent.”
Meantime, AMI, an Integrator sponsor, notified readers of AMI Hot Topics (Volume 1, Number 3), that the Maryland Chiropractic Association, working with AMI, had convinced CareFirst BlueCrossBlueShield to open 18 radiology codes to chiropractors. The same issue of Hot Topics noted that chiropractic state association in Arizona, Missouri, Kentucky, Minnesota and New Mexico have recently established "Joint Promotional Agreements" such as AMI pioneered with the Maryland association.
Natural Products
St. John's wort study in JAMA hotly debated
Publication in JAMA of a study which found St. John's Wort
(SJW) to be no better than placebo for children with ADHD was widely
picked up by the press and then immediately challenged. The American Herbal
Products Association sent out a June 11, "Update"
- the same day as the JAMA publication - which questioned both the focus of the study (who uses SJw for ADHD?) and on
product quality (even if SJw was useful for ADHD, we wouldn't have known
it from this study due to the poor quality of the herbs that were used). Said Steven Dentali, PhD, AHPA’s chief science officer and past chairperson of NCCAM’s Product Quality Working Group: “I
don’t believe that this test material would pass muster if the proposal
was submitted to NIH’s National Center for Complementary and
Alternative Medicine (NCCAM) today because something as basic as
ensuring the quality through the duration of the trial was not
assured.” More antagonistic voices were also heard. One challenged a Harvard-affiliated member of the research team for failure to disclose conflicts of interest. The principal investigator was Wendy Weber, ND, MPH, PhD, with the research department Bastyr University. Amidst a flurry of responses received here on the topic, one naturopathic researcher sent a terse note: "Good study. The
only problems are that nobody uses St J's w for ADD and it was a very crappy
product. No wonder JAMA picked it up." The dust hasn't settled on this one yet.
Professional Associations
ICA and ACA both recognize Pediatric Diplomate certification
The
American Chiropractic Association’s (ACA) Council on Chiropractic Pediatrics
and the Council on Chiropractic Pediatrics of the International Chiropractors
Association (ICA) announced that the Diplomate in Clinical
Chiropractic Pediatrics (DICCP) is now recognized by the ACA and its council
as the official credential for specialization in chiropractic pediatrics. The certification program and information on the chiropractic schools offering the instruction are at ICA
Council on Chiropractic Pediatrics or the ACA
Pediatrics Council.