The Integrator Blog
Home
Share |
about
Contact Me, Experience, Mission, Sabbatical in Central America, plus
Editorial Advisory Board
Columnists
Michael Levin
Taylor Walsh
background resources in PDF
Insurance, Integrative Clinics, Industry Summit Reports, News Files '99-'04
some organization links
Professions, Academia, Research, Policy
some CAM/IM publication links
Electronic, Peer-Reviewed, Blogs, More
Bradly Jacobs, MD, MPH, Revolution Health Blog
supported conference
Institute for Health & Productivity Management - Integrative/Complementary Healthcare
Stephen Bolles: Capstone View of MD-ND-CAM Bashing - Professions Seeking Wholeness Seek Integration PDF Print E-mail
Written by John Weeks   

Stephen Bolles: Capstone View of MD-ND-CAM Bashing - "Professions that Seek Wholeness Seek Integration"

Summary: The perspective on integration of Stephen Bolles, DC is shaped by leadership in developing the Woodwinds integrative clinic, service as a vice president at the multidisciplinary Northwestern Health Sciences University, a couple years inside United Healthcare and clinical practice as a chiropractor. So when Bolles wrote and said he had read the series of heated exchanges on MD-ND bashing and ownership of "integrative medicine," I was curious to see what he'd say. I wasn't disappointed: Bolles speaks of the "halo effect" of (MD) medical education, the depth of disenfranchisement of many MDs, political medicine, from political/AMA medicine, and how disenfranchisement has kept the non-MD professions from exploring integration to the same degree as MDs. Take a read.  
Send your comments to
for inclusion in a future Your Comments Forum.

Image
Stephen Bolles, DC
"The highly-charged issue of language, ownership, and the tug of war over what 'integration' means." With these words Stephen Bolles, DC describes the series of Integrator columns and perspectives, with Drs. Benda, Rakel, Ballard and Glidden figuring prominently, over the last few months. The topics have been who owns "integrative medicine" and the bashing of one profession by another. It's been challenging content.

Bolles brings the seasoned perspectives of educator/executive (Northwestern Health Sciences University)
, hospital-based integrative clinic developer (Woodwinds), consumer health and web products designer (United Healthcare) and clinician to his perspective. Among his present projects is a conference/conversation on vitalism for Life University scheduled for April 17, 2009. Presenter/discussants include the Queen's physician, an array of thoughtful leaders in sociology, holistic medicine, chiropractic, integrative care, acupuncture and Oriental medicine and other fields. Looks intriguing.

As I said in my intro to the last piece in this series,
if one cares about one's cultural competency for practice with practitioners from other disciplines, this set of comments is excellent, raw and eye-opening material for reflection. Bolles' views are a thoughtful, Cliff's Notes commentary on much of the light and shadow that moves through the earlier pieces. (See list of prior columns at the bottom of this article.) As working with one of my Integrator-adviser teachers, Carla Mariano, RN, EdD, BC-HN on a multidisciplinary project two years ago underscored for me, the evidence we need to take into account as we seek optimal integration must include the impacts of each discipline's relationships to power and inclusion.
________________________________

A Profession that Seeks to Make Itself Whole
Seeks Integration

-  Stephen Bolles, DC

John, good morning.


I've been reading the posts on the obviously highly-charged issue of language, ownership, and the tug of war over what "integration" means. Like the old story of the blind men feeling the elephant and each decrying the others' description of the different parts they are feeling, it's often hard to even agree on what the problem is.

   
 
 Bolles:

"Integration" is derived from integer,
so 'integration' is 'to make whole.'
In a sense, then, any profession
that seeks to make itself whole
seeks integration.

I don't know that I have much to add, but offer these thoughts. As I read and think about all this, I am reminded that "integration" is derived from integer, so 'integration' is 'to make whole.' In a sense, then, any profession that seeks to make itself whole seeks integration.

To the extent that any profession sees itself as 'less than whole'--whether economically, clinically, sociologically, or in any respect--they are 'speaking from a wound.' As clinicians, we understand that there's an emotional force when this occurs, and that's certainly visible in many of the recent posts. I doubt any profession is immune to this.


So given that, I'm struck by a few observations on the back-and-forth that have taken place.

First, I think it's rare to have any dominant culture really understand the full impact of its dominance. Medical doctors are products of a very codified process of acculturation, and I think it's difficult to for even those who thoughtfully reflect on the full effects of this to understand at times the 'halo' effect of authority that this process conveys.

   
Bolles:

Medical doctors are products
of a very codified process
of acculturation ... It's difficult
for even those who thoughtfully
reflect on the full effects of this
to understand at times the 'halo'
effect of authority that this
process conveys.
 
 
Second, we're all part of a dysfunctional American health care system, in that it is fragmented, uncoordinated, economically unsustainable, and generates remarkably poor outcomes. That is not to say there are not stunning successes and good people who populate every segment of it; there are. But many of the plaints of non-physician voices need to be heard with the understanding that there has been systematic disenfranchisement of everyone but allopaths for over a century. That disenfranchisement has included areas of finance, policy, professional relationship building, research, professional development, leadership, education, and on and on.

I think it's important to understand and remember Lou Sportelli's point about the difference between clinical and political medicine. Political medicine, with what can only be charitably described as a monopolistic agenda, is alive and quite well. At the same time, I don't know many physicians I would say feel that they are 'at cause' within their own system; their sense of disenfranchisement, disillusionment and isolation often runs more deeply than those of naturalistic professions. In a sense, the professional target has been moved farther for

   
  Bolles:

Many MD's sense of
disenfranchisement,
disillusionment and
isolation often runs
more deeply than those
of naturalistic professions.
 

them than for any of us. What was sold and what was bought are quite different. And, with the healthcare ecosystem under the stress it is, the duress on even the dominant culture produces behavior that I'm sure even its most ardent proponents cannot always proudly defend.

I am not suggesting that we need a 'truth and reconciliation' commission to rectify the 'sins of their forefathers,' but I think to the extent physicians are sensitive to the reality of this disenfranchisement is the extent to which they will understand that being given a ticket to the party doesn't mean that it's our party. Cultural assimilation looks quite different, depending on whether you're looking down from on top of the mountain or up from the bottom. That doesn't mean physicians should don hair shirts, beat their chests, shuffle along and act as apologists, but it does mean that when non-physicians don't hear an acknowledgment of cultural dominance--whether conferred or assumed--it is hard to accept the concept of integration as a shared goal. The perspectives--and what is at stake in both success and failure--are too different.


And finally, given the power of language, I think it's important to be careful what we each try to own or claim as our province. I have little trouble letting medicine own 'integrative medicine' as a term, as it acknowledges the reality that 'medicine' alone is less than whole.
   
Bolles:

I don't know that anyone
knows yet what 'whole
medicine' looks like; perhaps
Earl Bakken has said it best
when he has spoken of
"blended medicine."

 
It also allows the establishment of some sort of limits, as well; I will never forget the Hawai'ian healer who decried 'CAM-grafting' some years ago at a sun-drenched conference on Maui. I don't know that anyone knows yet what 'whole medicine' looks like; perhaps Earl Bakken has said it best when he has spoken of "blended medicine."

But by the same token, I have little trouble allowing naturalistic professions to 'own' their own versions of integration; in the spectrum of patient care, no matter how complete or intact our individual cosmologies may be, I don't know of any one who cannot claim an 'integrated' form of their profession. I suspect that the rest of us have just not really had to explore it to the same degree, because paradoxically by being disenfranchised, most of us have been able to hold our cosmologies more intact and with less dilution. Medicine, it would appear, is crying out for healing. The rest of us, it seems, are crying out for enfranchisement in a system that does not appear prepared to effectively respond.

Respectfully,

Stephen Bolles, DC
Consultant, Minnesota

Comment
:  For those of you following this dialogue, neither Benda nor Glidden, in private emails to me since the most recent post, were entirely pleased with my views of their views, expressed in the last set of responses. I am thus (comfortably) in the position of the legislator who, on offering to the Committee of hte Whole a revised, substitute, amended version of a bill for passage says: I think we are getting close. No one likes this. I thank all the contributors deeply for this sharing. We need to go deep into understanding each other's cultures and perspectives to move together well. These have taken us deeply into our different experiences of power, and of each other. Now Bolles' column offers a new platform for looking at the issues. These may be some of the colors of this dialogue's parachute. What do you think of Bolles' perspective?
_______________________________

Related Integrator content:


Send your comments to
for inclusion in a future Your Comments Forum.


< Prev   Next >
Search
Advertisement
Advertisement
Sponsors
Integrative Practitioner
The Westreich Foundation
voluntary contributions
Support the work!
Archive
All Integrator Round-ups
Integrator Top 10 Lists 2006-2015
Issues #140-#142 Oct-Dec 2015
Issues #137-#139 July-Sept 2015
Issues #134-#136 April-June 2015
Issues #131-#133 Jan-March 2015
Issues #127-#130 Sept-Dec 2014
Issues #123-#126 May-Aug 2014
Issues#119-#122 Jan-April 2014
Issues #116-#118 - Oct-Dec 2013
Issues #113-#115 July-Sept 2013
Issues #110-#112 April-June 2013
Issues #108-#109 Jan-March 2013
Issue #105-#107 Oct-Dec 2012
Issues #102-#104 - July-Sept 2012
Issues #99-#101 - April-June 2012
Issues #96-#98-Jan-March 2012
Issues #94-#95 Nov-Dec 2011
Issues #92-#93 Sept-Oct 2011
Issues #90 and #91 - July-Aug 2011
Issues #88 and #89 - May-June 2011
Issues #86 and #87 - March-April 2011
Issues #84 and #85 - Jan-Feb 2011
Issues #82 and #83 - Nov-Dec 2010
Issues #80 & #81 - Sept Oct 2010
Issues #78 & #79 - July August 2010
Issues #76 & #77 - May June 2010
Issues #74 & #75 - March-April 2010
Issues #73 & #73 - Jan-Feb 2010
Issues #69, #70 & #71 - Nov-Dec 2009
Issues #67 and #68 - Sept-Oct 2009
Issues #65 and #66 - July-August 2009
Issues #63-#64 - May-June 2009
Issues #60-#62 - March-April 2009
Issues #57-#59 - Jan-Feb 2009
Issues #55-#56 - Nov-Dec 2008
Issues #51-#54 - Sept-Oct 2008
Issues #47-#50 - July-August 2008
Issues #46 & -#47 - May-June 2008
Issues #43-#45 Mar-April 2008
Issues #41 & #42 - Feb 2008
Issues #39 & #40 - Dec-Jan '08
Issues #37 & #38 - Nov 2007
Issues #35 & #36 - Oct 2007
Issues #33 & #34 - Sept 2007
Issues #30-#32 - July-Aug 2007
Issues #28 & #29 - June 2007
Issues #26 and #27 - May 2007
Issue #25 - April 2007
Issues # 23 & #24 - March 2007
Issues #21 and #22 - Feb 2007
Issues #19 and & 20 - Jan 2007
Issues #17 and #18 - Dec 2006
Issues #15 and #16 - Nov 2006
Issues #13 and #14 - Oct 2006
Issues #11 and #12- Sept 2006
Issues #9 and #10 - Aug 2006
Issues #7 and #8 - July 2006
Issues #5 and #6 - June 2006
Issues #3 and #4 - May 2006
Issues #1 and #2 - April 2006
All Articles by Subject: 2006
All Articles by Subject: Jan-June 2007
IAYT-Sponsored Series on the Future of Yoga Therapy