Your Comments: Riley on origins of "integrative medicine," plus Spelman, Crites, Bark, DellaGrotte
Written by John Weeks
Your Comments Forum: Riley on how "integrative medicine" was coined, Spelman, Crites, Bark, DellaGrotte
Summary: Ever wonder the origins of "integrative medicine" as a descriptive term? David Riley, MD, recounts the story ... Laura Crites, executive director of the Hawaii Consortium comments on a proposed strategy for the IOM Summit ... Bodyworker Josef DellaGrotte has additional suggestions for Intel and otehr employers on the value of body work ... Linda Bark, RN, found good news at the recent Health Forum conference and suggests a Samueli Institute text as a resource ... Kevin Spelman comments on Stargrove's work on drug-nutrient interactions ... plus an anonymous follow-up to Glidden's naturo-centric view of "integrative medicine" ...
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David Riley, MD
1. David Riley, MD: On the first mention of "integrative medicine"
David Riley, MD, wrote to correct a statement in an article in which I attributed the use of the phrase "integrative medicine" to Andrew Weil, MD (Next Generation Integrative MD Leader David Rakel, MD on ABIHM, CAHCIM and Family Medicine, May 31, 2008). Riley, the past editor of the Explore journal, has a long history in complementary and alternative and integrative medicine (pre-dating the use of the term). He provides a nice bit of history.
"The
term integrative medicine was first mentioned at one of the Harvard CAM
conferences by a speaker who said it was more correct from a linguistic
perspective than integrated medicine. In
1994 I created the Integrative Medicine Institute and secured the domain
name integrativemed.org.
"I
actually applied for a trademark in the same year and there is a one year
waiting period. I was told that during that year the name had become used
so much that it could no longer be trademarked. Andy's
program began in 1997."
David
Riley, MD Clinical Associate Professor, University of New Mexico Medical School Member, Board of Trustees, American Holistic Medical
Association Founder, Integrative Medicine Institute
"I just read about the IOM-Bravewell Summit on your
Integrator Blog and very much appreciated your comments and suggestions.
"Although your suggestions all address the topic, I think a direct and specific
articulation of the goal of 'exploring the role of integrative health care in
healthcare reform' would establish clarity about what the summit is
about. Thus, I urge the planners to establish this as a priority.
"Healthcare reform is one of the biggest topics addressing presidential
candidates as well as local governments. This is THE moment for us to
open the dialogue. In today’s local paper, the headline is that the
leading insurance company, HMSA, will be increasing their premiums by 10%.
This occurs as a shortage of doctors and nurses is acute and rural areas are
going unreached by health professionals.
"It is clearly time for new
thinking. Making a broken system more available to more people is not the
answer."
"A different approach such as the Rolf-based massage techniques [goes] a step beyond
conventional medicine (which has virtually no sustained results despite the
enormous costs of MRIs and cortisones, etc.)
"However, even
treatment by alternative means will not lead to sustained improvement for
life. Back pain is the result of too much sitting, poor walking, poor
posture, the loss of core stabilization, plus compression of the spine.
The research is very clear.
"The next phase
of effective treatment will include myofascial release and
neuromuscular re-education. That is how we are getting sustained improvement,
and, we have clinical research to back this up.
"Visit our
website for the clinical research study, and the description, on video, of the
method of Core Integration together with the Feldenkrais principles of
functional movement integration."
Josef
DellaGrotte Muscular
therapist, trained with Ida Rolf and Moshe Feldenkrais Author of: Core
Integration: Instructions From Within. 2007 Director:
Core Integration Training Institute, Inc. www.dellagrotte-somatic.com
"I attended the conference Leadership and Business Strategies for Integrative Health
Care, May 14-17 in Phoenix sponsored by the Health Forum and the American Hospital
Association. In the 90’s, when I was consulting in healing centers start-ups, there was a saying that out of 100 groups that wanted to start a center,
one actually was established. Out of the 100 that were created, only one
made it for more than a couple of years.
"HOWEVER, things are different now. Business models are more realistic.
More people know about the integrative services. Hospitals are
developing healing environments and patient centered care. Healthy
organizational cultures are a hot topic these days and progress is being made
in how to develop and maintain them.
"At the conference, center directors, consultants and researchers described
hospital integral centers that were working…and preliminary research from one
integrative hospital showed that it was saving some money because of the
integral services and innovative approaches provided at no cost to the
in-patient population. Once we have solid ROI numbers that prove what
people have predicted, many hospitals will jump on the integrative care and
patient centered band wagon.
"If
you are interested in finding out more about this trend, read Reinventing
the Patient Experience: Strategies for Hospital Leaders by Jon Christianson,
Michael Finch, Barbara Findlay, Wayne Jonas and Christine Goertz Choate,
(Health Administration Press). The book describes 8 hospitals considered innovators
in patient centered care.
Windber Medical Center
(PA)
St.
Rose Dominican Hospitals—Siena
Campus (NV)
Abbott
Northwestern Hospital (MN)
Florida Hospital—Celebration
Health (FL)
Highline Medical Center
(WA)
St.
Charles Medical Center—Bend
(OR)
North Hawaii Community Hospital
(HI)
Valley Hospital
(NJ)
"More
than half have medium to high emphasis in holistic nursing, healing
environments, CAM therapies
and spiritual support. They discuss their keys to success as well as the
barriers they encountered and how they overcame them."
"We met many years ago at a DC meeting. After reading the well done review
article on Herb, Nutrient, and Drug
Interactions: Clinical Implications and Therapeutic Strategies
(Stargrove, McKee, Treasure) I wanted to alert
you to the upcoming issue of Molecular Nutrition and Food Research (July
08) that was edited by Jerry Cott (one of the first true researchers in the US
to open-mindedly investigate Hypericum).
"In this issue, herbalists such
as myself and Kerry Bone write on drug-herb interactions (which is a more
appropriate name than herb-drug interactions; when the medical system suggests
that agricultural products are screwing up their therapies based on
new-to-nature molecules coming from corporate interests, it is truly time for a
reevaluation of medical therapies). Originally, the whole issue was supposed to
be on HDI, but I don't know how many authors successfully completed their
proposed papers. I have attached a draft of our paper (Freeman &
Spelman, abstract below).
"This paper is also significant because it represents
our first graduate from Tai Sophia's MS in Herbal Medicine to make it into the
peer review literature. If I may be so bold, we challenge the dogma!
A critical evaluation of drug interactions with Echinacea spp.
- Camille Freeman 1, 3 and Kevin Spelman2, 3
1 Department of Physiology and Biophysics (MS candidate), Georgetown
University, Washington, DC, USA
2 Department of Chemistry and Biochemistry, University of North Carolina,
Greensboro, NC, USA
3 Department of Herbal Medicine, Tai Sophia Institute, Laurel, MD, USA
Accurate information concerning drug–herb interactions is vital for both
healthcare providers and patients. Unfortunately, many of the reviews on
drug–herb interactions contain overstated or inaccurate information. To provide
accurate information on drug–herb interactions healthcare providers must
account for product verification, dosage, medicinal plant species, and plant
part used. This critical review assessed the occurrence of drug interactions
with one of the top selling botanical remedies, echinacea including Echinacea
angustifolia, E. pallida, and E. purpurea. Only eight papers containing primary
data relating to drug interactions were identified. Herbal remedies made from
E. purpurea appear to have a low potential to generate cytochrome P450 (CYP
450) drug–herb interactions including CYP 450 1A2 (CYP1A2) and CYP 450 3A4
(CYP3A4). Currently there are no verifiable reports of drug–herb interactions
with any echinacea product. However, further pharmacokinetic testing is
necessary before conclusive statements can be made about echinacea drug–herb
interactions. Given our findings, the estimated risk of taking echinacea
products (1 in 100 000), the number of echinacea doses consumed yearly (A10 million), the number of adverse events
(a100) and that the majority of use is short term, E. purpurea products (roots
and/or aerial parts) do not appear to be a risk to consumers.
Kevin Spelman
Research Scientist
Department of Chemistry & Biochemistry
University of North Carolina
435 Science Building
Greensboro, NC 27412
Core Faculty
Department of Herbal Medicine
Tai Sophia Institute
7750 Montpelier Rd
Laurel, MD 20723
Comment: Congratulations to Tai Sophia for this outcome of their Herbal Medicine program!
6. A side challenge to NDs on the Peter Glidden's challenge to "integrative medicine"
An interesting perspective on naturopathic physician Peter Glidden's assertion that "integrative medicine" is a pale reflection of his own field came from an integrative center activist who wished to remain anonymous ("Guest Column: Peter Glidden, ND, Lashes Out Against His Idea of MD-led "Integrative Medicine," July 2, 2008). .
"[Glidden's] absolutely correct. However, one of the effects of this allopathic hegemony
is that far too many naturopaths also
cower before the almighty allopathic approach and are too timid, leading to prescribing antibiotics (too soon) or
afraid of detoxification strategies."
Comment: The writer, neither an ND nor an MD, touches on an internal dialogue in the naturopathic field about the ultimate outcomes of increasing prescription rights.
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