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Integrative Medicine and Integrated Health Care Round-up: July 16-31, 2009 PDF Print E-mail
Written by John Weeks   

Integrative Medicine and Integrated Health Care Round-up: July 16-31, 2009

Summary: Report shows hundreds of millions in savings to states from wellness model ... Center for Disease Control director Gerberding calls for "shifting the (health reform) dialogue" in order to make the U.S. the "healthiest nation" in new CDC campaign ... Licensed complementary healthcare practitioners still out of healthcare workforce dialogue ... Debate at University of Bridgeport to focus on whether chiropractors should push New Mexico model of limited pharmaceutical, primary care ... NCCAOM takes lead in promoting acupuncture and Oriental medicine recognized as a profession by the U.S. Bureau of Labor Statistics ... AMA and OB/Gyn opposition to home-birth sparks debate ... Chiropractic lobbying may open a door for all "CAM" colleges ... Wake Forest integrative medicine's Kathy Kemper, MD, MPH notes new integrative clinical services ... True North's Bethany Hays, MD honored by Institute for Functional Medicine with 2008 Linus Pauling Award ...
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Prevention, Wellness and Policy

ImageReport: Big bucks would be saved by states via wellness

The Washington Post reports that states can save hundreds of millions with wellness programs, according to a Trust for America's Health, an advocacy group (Disease Prevention Called a Better Bet: Wellness Programs Yield Greater Returns, Report Finds, July 18, 2008). The report analyzed state-by-state potential for savings, concluding that the District of Columbia, for instance, could save $9.90 for every dollar spent, Virginia $6.00 and Maryland $5.20.
The report is entitled "Prevention for a Healthier America."

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CDC director Julie Gerberding, MD: shifting the dialogue
Gerberding and CDC seek "change the conversation" with "healthiest nation" campaign


Meantime, the Center for Disease Control launched its "Healthiest Nation Campaign" which is meant top take the US from 26th or 47th, depending on the study, to #1 among nations. In an interview in USA Today on the launch, Gerberding makes a statement familiar to many in the integrative practice community:
"[The Campaign] is basically about changing the conversation. People are talking about health care reform, but they're not really talking about health." Gerberding's outspoken views were covered here in the Integrator relative to necessary changes in academic medicine to move this health-creating agenda (Radical Reform: CDC Director Urges "Schools of Health" to Foster Shared Mission Among Professions, July 18, 2007). Conceptually, Gerberding is spot on. Now if the Institute of Medicine's National Summit on Integrative Medicine and Health of the Public can help articulate how integrative practice models a clinical approach that actually helps create health. Thanks to Joe Brimhall, DC, for the link.

Academic Medicine

Non-Conventional Practitioners and the Emerging Work Force Dialogue

Out of Order, Out of Time: The State of the Nation's Health Work Force
is a new report from the Association of Academic Health Centers. The report calls for more centralized planning to deal with the nation's healthcare workforce, and particularly to deal with the primary care shortage. An article on the study in the Chronicle of Higher Education noted that one issue in meeting the need is the battle in many states over scope of practice, especially regarding pharmacy rights. The report calls for "a broader, more integrated national strategic vision" than that which has characterized our historic approach to health workforce policy-making." The AAHC also proposes that "a mechanism is needed to serve the currently unfilled integrative role that existing health workforce policy-making and planning processes are not designed, and are ill-equipped, to serve."  Notably, the executive summary includes no reference to the way non-conventional practitioners may help meet the need. It would be helpful if any such agency acknowledged that we have many different disciplines providing care, and all should be included in the effort to meet our needs.
(Thanks to Jan Schwartz, CMT, for sending the article.)

U Bridgeport to Hold Debate on Chiropractors as Prescribing PCPs on August 28, 2008

James Lehman, DC, a member of the faculty at the University of Bridgeport shares that he will be part of a debate at the school, scheduled for August 28, 2008. The proposition on the table is "The Chiropractic Profession Should Pursue Advanced Practice Training, So as to Function as Primary Care Providers with Limited Prescriptive Authority." The debate should be interesting. Many in chiropractic have held to "drug-less healing" as their Rosetta stone while subset have moved toward broader scope, and having some pharmaceuticals in their scope. A recent change to the law in New Mexico is modeling this primary care approach. The law established an Advanced Practice Chiropractic Registry and authorizes a specially "certified chiropractic physician to issue prescriptions."
Lehman, who originally hails from New Mexico, will debate in favor. The University of Bridgeport offers an array of allied health sciences programs, plus programs in chiropractic, naturopathic medicine and acupuncture and Oriental medicine.

Integrative Clinics

Image
Kathi Kemper, MD , MPH
Wake Forest Expands Integrative Clinical Services


Kathy Kemper, MD, MPH, sent an update to an Integrator feature on the Wake Forest program (Data Profile of Integrative Medicine in an Academic System: Wake Forest's 2006 Annual Report, March 20, 2007): "
A couple of years ago, you reviewed the integrative medicine program at Wake Forest. You constructively suggested that although we had great strengths in research, our clinical programs needed a bit of focus. We have taken that advice to heart, and been working hard on that area. I wanted to update you. Here's a link to our web page which lists clinical services in integrative medicine." Among these are a 'second opinion clinic," massage, yoga, animal assisted therapy, nutrition, supplement information services, arts therapy, healing touch, mindfulness based stress reduction. Kemper, the Caryl J Guth, MD Chair for Holistic and Integrative Medicine, notes that this list does not include other healthy additions such as "the employee wellness program or the on-site farmer's market which is mostly geared to employees." The web site focuses on things for patients. Kemper notes the need for additional services, particularly referencing acupuncture. "We're proud of our progress," she wrote, adding: "It's always a work in progress, but at times it's helpful to step back a moment and reflect on progress." Personally, I like the inclusion of the farmer's market as an integrative approach!

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Bethany Hays, MD
True North's Bethany Hays, MD Receives Linus Pauling Award


A release from the Maine-based True North integrative clinic notes that Bethany Hays, MD is the recipient of the 14th Linus Pauling Award from the Institute for Functional Medicine. The award is given annually
to an individual whose research or clinical expertise has contributed substantially to the advancement of knowledge in functional medicine. IFM president David Jones, MD, noted Hays' “dedication and leadership, both educational and intellectual, in creating, practicing and teaching a model of Functional Medicine designed to support clinicians and their patients in improving health outcomes.“ Hays leads a highly-regarded annual conference which will be held October 15-18, 2008, entitled, this year, "Relationship: Integrating the Science and Spirit of Healing." Congratulations!

Professions

NCCAOM Pushes Recognition of Acupuncturists as Profession with the US Bureau of Labor Statistics


"Did you know that if you were to search for 'Acupuncturist' as a distinct professional designation on the U.S. Department of Labor’s Bureau of Labor Statistics (BLS) web site, you wouldn’t find it? Additionally, if you searched the BLS database using the term acupuncture, you would find it is listed as a therapeutic technique under the professions of 'Chiropractors' and 'Registered Nurses.'" So  begins an article in Acupuncture Today on the work of the National Certification Commission for Acupuncture and Oriental Medicine to gain recognition of acupuncture and Oriental medicine as a distinct profession by the BLS (NCCAOM Seeks Federal Recognition of the Profession, August 2008). The effort, which NCCAOM has engaged in concert with other national acupuncture and Oriental medicine organizations, is to have “Acupuncturist” classified as a unique profession under the Standard Occupational Classification (SOC) codes. There is presently no listing in the BLS's Occupational Outlook Handbook. The Integrator contacted Kory Ward Cook, PhD, NCCAOM's CEO, who shared the numerous values from this work. Kudos to NCCAOM for taking this step.

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Homebirth
ACOG & ACNM Battle Over Control of Birth: Location, Location, Location


The opposition to home birth from the American Medical Association and the American College of Obstetricians and Gynecologists has stirred up some controversy (
AMA SOPP Escalates Campaign Against Nurses, Chiropractors, Naturopaths, Midwives and Others, June 21, 2008). An ABC News account notes that the AMA and ACOG "now find themselves at odds with those who say women should have the choice to give birth at home or in a hospital." They are also directly opposed by the American College of Nurse-Midwives. ACNM, citing a study in the British Medical Journal that showed home births to be no riskier than hospital births, issued a statement in support of planned home births. The ABC story elicited 185 powerful responses on their site - interesting reading for anyone interested in patient-centered care.

ImageACA Helps Open Doors for CAM Educational Institutions in IT Legislation

A note to members from the American Chiropractic Association included the following:
"This week, the House Committee on Energy & Commerce 'marked-up' legislation that promotes adoption of health information technology (IT).  One of the provisions in the bill allows for grants to be awarded to health care educational institutions to integrate information technology into clinical education.  As the bill was originally written, chiropractic colleges were not among the eligible entities that could receive funds. ACA weighed in with key [Congressional] contacts to ask for inclusion in the measure. In the committee discussions, an amendment was offered by Congressman Mike Rogers (R-MI) and agreed to, allowing for the inclusion of all graduate health profession schools, which qualifies chiropractic colleges as eligible." The ACA report noted that the future of this legislation is uncertain. It is notable that as the single potent integrative practice presence in the Nation's capitol, the chiropractors sometimes open opportunities for others.

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