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Integrative Medicine and Integrated Healthcare Round-up: August 16-31, 2008 PDF Print E-mail
Written by John Weeks   

Integrative Medicine and Integrated Healthcare Round-up: August 16-31, 2008

Summary:  Data on total number of AOM students ... Hawaii med school opens complementary medicine center ... Ralph Snyderman, MD, a top influencer of medical school-based integrative medicine, tells academic medicine to "lead, follow or get out of the way" of what he calls "prospective health care" ... Bradly Jacobs, MD, MPH leaves a Revolution Health that is on the decline ... Physician staffing firm reports survey on MD views of CAM ... Delaware gets medical association's support in successful licensing campaign ... AHPA firms look good in JAMA study ... Integrative Medical Consortium formed of half-dozen other national professional associations ... Yoga leader Terri Kennedy selected for American Heart Association role ... Integrative program for the disabled seeks information on other models ... plus more
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Academics

AOM students, TCM
Council of Colleges of Acupuncture and Oriental Medicine
Data Snapshots of Acupuncture and Oriental Medicine Education


Currently there are 61 acupuncture and Oriental medicine colleges approved by the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM). Roughly 14 new schools have been approved in the last 5 years. From 2005 to 2007, the number of students in AOM programs rose continuously from 7,717 in 2005 to 8,075 in 2007. David Sale, executive director of the Council of Colleges of Acupuncture and Oriental Medicine, shares that additional data concerning the profession’s schools should be available sometime in 2009 as ACAOM is in the process of developing a more sophisticated data base that will permit "the generation of aggregate AOM educational information for the benefit of all of the Commission’s constituencies." To gain a sense of the growth of the field, these 8,000 students, once graduated from the 3-year programs in 2010 and licensed, will create roughly a 25% boost in the total number of licensed acupuncturists in the United States. Currently the number is between 20,000-25,000.



Snyderman to academic medicine: Lead, follow or get out of the way


First, some background. Ralph Snyderman, MD, is arguably the most influential educator in the academic, integrative medical community. He is also one of the most influential leaders in U.S. medical education, period. The former chair of the Council of Deans of the Association of American Medical Colleges, Snyderman used that position as bully-pulpit to promote integrative medicine thinking amongst his brethren (and they are mostly men). He was honored with the $100,000 2003 Bravewell Leadership Award. The Chanceller Emeritus of Duke University currently serves as chair of the planning committee for the Institute of Medicine/Bravewell National Summit on Integrative Medicine and the Health of the Public.

Prospective health care, integrative medicine
Ralph Snyderman, MD urges prospective health care
So when Academic Medicine, the AAMC's flagship journal, ran a "perspective" by Snyderman called "Prospective Health Care and the Role of Academic Medicine: Lead, Follow, or Get Out of the Way," well, it's worth a read. Snyderman uses "prospective health care" as a way to frame a healthcare approach which is not reactive and disease-focused, yet is limited to a population-based orientation toward "prevention." The approach includes the latest high-tech practices in understanding individual influences on health. Key elements are that it is "personalized, predictive, preventive and participatory." The term "integrative medicine" does not figure prominently. The value of this article to the integrative practice community is to see the context in which such practices are embedded in an emerging vision which includes leading edge thinking in genomics and information technology.

Comment:
This is not the usual neighborhood for historically high-touch integrative practices. For those who believe that our most significant work toward better health is in the human-to-human side of healing, which we poorly fund and tend to avoid because we're not very good at it, I have a suggestion. Recall that former California Governor Jerry Brown acknowledged years ago that even a small-as-beautiful approach must have a place for the tech-minded to put all that energy. Brown recommended space exploration in lieu of military preoccupations. This prospective health care approach provides plenty for those in medicine who aren't so long on human skills and are intrigued by ever more elaborate and amazing machines. Note that, unlike the label "integrative medicine," Snyderman calls what he is promoting prospective health care. The accent is on health. Good for him. Good for us. Acad Med 2008; 83:707-714

integrative medicine, CAM, Hawaii, clinics
Rosanne Harrigan, PhD - Hawaii med school's IM leader
Hawaii Medical school opens "Wellness Center and Integrative Medicine
Clinic"

The Kakaako Campus of the John A. Burns School of Medicine in Honolulu is the location of a new
Wellness Center and Integrative Medicine Clinic, established through the medical school's Department of Complementary and Alternative Health Care, directed by Rosanne Harrington, PhD. Says Harrington: “Our mission is to practice integrative medicine by integrating allopathic medicine and complementary/alternative holistic as well as non-traditional methods and approaches that are not being fully used by health care providers.” The staff will include four medical doctors and an advanced practice nurse, each of whom are trained in non-conventional healing modalities. (Thanks to the Hawaii State Consortium of Integrative Health Care for the news.)


Follow-up on the U Bridgeport debate on chiropractic prescriptive authority

James Lehman, DC, an assistant professor at the University of Bridgeport College of Chiropractic notes that his school's August 29, 2008 debate on whether chiropractors should press for limited prescriptive rights, as many patients want, was "well received by the student body."  The students, he said, "enjoyed the diametrically opposed positions."  Lehman said he personally was "disappointed that the arguments by his opponent, who opposed prescriptive authority, were centered on "drugs are bad, chiropractic and patients don't need drugs." Adds Lehman: "A more contemporary argument would have been more interesting to me."


Business

Image
Down the Revolution
Case's Revolution Health on the block; Brad Jacobs, MD, MPH leaves


An early August report in the Wall Street Journal states that Revolution Health, founded with great hoopla by former America Online founder Steve Case, is exploring a possible sale or merger. Integrative medicine leader Bradly Jacobs, MD, MPH, a former senior medical director at Revolution Health, who stayed as core staff through a series of layoffs in 2007 and earlier in 2008, is no longer with the firm. (As of September 8, 2008, his likeness still graced the RH home page, suggesting that his virtual presence may have a longer commitment than Jacobs did.) Jacobs, an Integrator adviser who helped establish the integrative clinic at the University of California at San Francisco, said he planned to take some time and travel, see his book on book on omplementary medicine written for the American College of Physicians published, and figure out what's next.
Comment: Alas, the (shallow) depth of Case's Revolution became obvious a few months into its launch when one of its paid bloggers (yours truly) was essentially fired - they used a technicality - for describing American Medical Association efforts to kill chiropractic in the way that those efforts were portrayed by the federal courts which held against the AMA in an anti-trust case (see Wilk vs AMA). Such a revolution.

Jackson & Coker Industry Report: Date on MD use of complementary medicine


The physician staffing firm, Jackson & Coker chose to focus on complementary and integrative practices in their most recent survey and Industry Report. The document, entitled Making Complementary and Alternative Medicine Mainstream, is based on a survey of the firm's list of physicians. The survey focused on how
familiar they are with CAM, and to what extent they incorporate these procedures and therapies as part of their personal health program and in their own medical practice. The respondents who use these therapies tend to do so for stress relief, general health, and relief of pain. Massage/reflexology, yoga and herbs/supplements topped the list of therapies they were most likely to prescribe. Nearly a quarter of the 300 participants use CAM frequently in their practices, and another 40% occasionally. Roughly 60% foresaw increasing their use of CAM methods; 31% weren't planning on it. The report concludes with a perspective from Frenesa Hall, MD, an internist who is founder, CEO and chief medical officer of Mobile-Medicine.net. All the results are available here.

Government & Regulation


Delaware licenses acupuncturists - state medical association helps put herbs in bill

A report in August 18, 2008 issues of Acupuncture Today (AT) notes that the state of Delaware now has licensing standards for the first time to cover the practice of acupuncture and Oriental medicine, including the use of herbs. In an interesting twist, Lorna Lee, the acupuncturist who led the licensing effort, credits the Medical Society of Delaware for the inclusion of herbs in the bill. States Lee, in the AT article:
“We set out just to have an acupuncture bill, but the Delaware Medical Society wanted the bill to reflect both acupuncture and herbs ... It would protect our ability to work with herbs, and the doctors were happier with the higher licensing standard.” The full text of the law is available here.

Associations

Integrative Medical Consortium (not the academic group) formed by 5 organizations

A collaborative alliance of complementary and integrative medicine professional organizations has quietly been formed over the last year and a half as the Integrative Medical Consortium. The group has a web page on the American College for Advancement in Medicine (ACAM) website. Also involved are the American Academy of Environmental Medicine, American Association of Naturopathic Physicians, American Holistic Medical Association, the International College of Integrative Medicine and, most recently, the Pan Allergy Association. The site says that "this collaborative alliance of CAM associations is committed to advancing integrative medicine for the well-being of patients worldwide.
" The group most recently met at ACAM's spring 2008 meeting. (Note that, while there are overlaps in personnel, the group is not the Consortium of Academic Health Centers for Integrative Medicine, which is sometimes referred to as the Integrative Medicine Consortium.)
 
Image
Americna Herbal Products Association
JAMA article: 
AHPA members less likely to have contaminants in ayurvedic medicines

In a August 26, 2008 release, the American Herbal Products Association pointed out a silver lining in a recent article in the Journal of the American Medical Association (JAMA) which reported that 20% of ayurvedic products were contaminated with metals. The study
concluded however "that Ayurvedic medicine products made by American Herbal Products Association (AHPA) members are significantly 'less likely to contain metals.'"  AHPA concludes that the "findings demonstrate the commitment of AHPA member companies to the sale of safe and high-quality herbal products." Comment: This finding follows experiences in other professions and industries that problems with standards are more frequently associated with non-joiners.

Massage therapy association pushes qualitative research methods, new journal


The American Massage Therapy Association is featuring a 4 hour workshop on
qualitative research methods for massage at their 2008 annual conference in late September. The presenter, Ania Kania, BSc, RMT, is working at the University of Calgary with Marja Verhoef, PhD, an international leader in the field and a prime-mover of the IN-CAM Outcomes Database. At the September 2008 confernece, the Massage Therapy Foundation is also announcing their new International Journal of Therapeutic Massage and Bodywork at the meeting. The journal, edited by Glenn Hymel, EdD, LMT, will be peer-reviewed, open-access and quarterly.
 
Research

Put this in your abstract when you study an herb (or supplement) out of the whole practice context

The abstract of a 2007 study of black cohosh was just sent my way because it includes language in the abstract which researchers should consider including in every trial of an individual botanical, vitamin or dietary supplement, whatever the outcomes:
"Limitations: The trial did not simulate the whole-person approach used by naturopathic physicians."
Sensitivity to the issue was likely through co-author Jane Guiltinan, ND, a natruopathic medical clinician for over 20 years. The statement could also have read " ... the whole person approaches used by integrative medical doctors, naturopathic physicians and others." See Treatment of Vasomotor Symptoms of Menopause with Black Cohosh, Multibotanicals, Soy, Hormone Therapy or Placebo." Ann Intern Med 2006: 145; 869-879. Newton K M et al. The study was negative.  

People
King County Executive Ron Sims joins Bastyr's board

The multi-disciplinary
Bastyr University featuerd it's new board member King County Executive Ron Sims in its recently published magazine. Sims is quoted in the article commenting on the first profession for which Bastyr provided education: "Naturopathic medicine has moved to the mainstream of traditional health practices and Bastyr is at the forefront of natural medicine education ..." Sims has moved beyond the mainstream in his view of what constitutes a public park. He has dedicated 2 public reflexology paths in his county's park system.

yoga
Terri Kennedy - yoga leader in American Heart Association role
Yoga leader Terri Kennedy tapped as spokesperson by the American Heart Association


Teresa (Terri) Kay-Aba Kennedy, PhD, MBA has been named a national spokesperson and ambassador for the American Heart Association. Kennedy is the chair of the Yoga Alliance, a national not-for-profit which oversees registry of 20,000 yoga teachers and over 1000 yoga studios nationwide. Kennedy, a former
MTV/Viacom executive played a significant role in re-shaping and re-directing the Yoga Alliance in a stint as interim executive director. She also runs Power Living Enterprises, a business which is "focused on helping individuals, communities an and companies create purposeful choices that crate long-term sustainability."

Queries


Group seeks information on CAM, integrative practice projects of individuals with diabilities


Chanda Hinton, the executive director and founder of the Denver, Colorado-based Chanda Plan Foundation, a 501c3 non-profit organization with a mission is "to improve the quality of life for people with physical disabilities through alternative therapies," wrote to seek information about other state or government agencies with outcomes such as those shared by the Alternative Medicine Integration Group in their Florida Medicaid Pilot. Please send information to
. Send it on to me, so I can report it while you are at it.

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for inclusion in a future Integrator.


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