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Integrative Medicine & Integrated Healthcare Round-up: June 1-15, 2008 PDF Print E-mail
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.”

integrative medicine, academics, excellence
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

Another outcome of Health and Human Services Secretary Mike Leavitt's trip to China is
a memorandum of understanding with Chinese Vice Minister of Health Wang Guoqiang to foster collaboration between scientists in both countries in research on integrative and traditional Chinese medicine. The memorandum was announced at a roundtable which was coordinated by NCCAM, National Cancer Institute’s Office of Cancer Complementary and Alternative Medicine and the Fogarty International Center at the NIH. The roundtable was held in advance of the 4th session of the United States-China Strategic Economic Dialogue. (Thanks to Matt Russell for sending this story.)

Hospitals and Health Systems

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.

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