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Integrative Medicine and Integrated Health Care Round-up: March 3-April 7, 2009 PDF Print E-mail
Written by John Weeks   

Integrative Medicine and Integrated Health Care Round-up:  March 3-April 7, 2009

Summary: NCCAM challenged in Washington Post piece ... Consumer Reports finds highest satisfaction with chiropractors for back pain ...  Economic downturn and consumer-directed healthcare appear to be good for supplements sales ... American Health Journal and AANP team for 6-part PBS series on naturopathic medicine ... Massage licensing boards under attack in 2 states ...  InnoVision, publisher of ATHM and other peer-reviewed journals in integrative practice purchased, exits Chapter 11  ... Lobbyist Peter Reinecke and Jeanne Drisko, MD on Obama's HHS nominee, Kansas Governor Kathleen Sebelius ... Disease management giant Healthways appoints Mark Nolting, ND, LAc to head up integrative medicine ... Andrew Weil's foundation scores coup in appointing former medical school dean James Dalen, MD, MPH to executive director ... Two Integrator contributors, Stephen Bolles, DC and Erik Goldman organize conferences on key integrative practice themes, the Vis Medicatrix Naturae, and business success, respectively.

Media


ImageChange.gov campaign against NCCAM continues in a Washington Post article

The campaign against NCCAM on the www.change.gov site, to which the Integrator helped mount a response in mid-January made it inside the Washington Post. (Regarding the campaign, see
Integrator Urgent Action Update: Your Vote Needed TODAY at Change.gov Against De-Funding NCCAM, January 18, 2009.) The March 24, 2009 article, Scientists fight against federal cash for research on alternative medicine, focuses on what appears to be a pre-dominance of anti-NCCAM comments on the Obama site. Unfortunately, the writer did not understand what a well-timed anti-NCCAM campaign this was, and that once the pro-NCCAM voices were alerted, shortly before the site was closed, many (of you) responded in defense of federal support. After being alerted to this article (by Matt Russell and activist Merrily Manthee, thank you!) I wrote the writer, David Brown, the following note.
Hello Mr. Brown -

I write in response to your piece on opposition to NIH NCCAM.


If you had read ALL of the comments on the Obama site you would have seen a distinct pattern. From the posting on the Wednesday (I believe it was) prior to the closure of the site, there began a rash of negative comments. This has all the signs of a campaign, as in: Friends, I am positing this, please join me. The people who are opposed to NCCAM are an organized group (SEE SAMPLE: http://scienceblogs.com/insolence/2009/03/senator_tom_harkin.php ) with their own list-serve, their own blog. My guess is that this was an organized campaign, smartly timed to fall shortly before the closure of the site. No wonder a skim through those comments would net what you reported.


However, if you read on, the comments begin to change on Saturday then change in a major way in the last 6 hours of posting, on Sunday. That is because those opposed to shutting down NCCAM began discovering the question and notifying some of their friends.  I was among those notified as I am known for a loyal opposition stance toward NCCAM. I think the Center is critically important but believe the reductive research, not appropriate for integrative practices, has guaranteed the poor results. I mailed an alert to my own list (www.theintegratorblog.com) at 9:00 AM PST, 6 hours before the site was to be shut. (See below.) Take a look at the multitude of comments that came in on Sunday. If it hadn’t shut 6 hours later, many more comments would have been posted, in favor of NCCAM over the ensuing few days.


The “grassroots” can be manipulated, and were twice, here. Only, unfortunately, by limiting your review, you were utterly duped by the first post, and the result was bad journalism. Can you make amends?
Thank you.
I have, not surprisingly, not heard from the reporter.
Image
Taught by consumers to respect chiropractic?
Consumer Reports finds consumers most satisfied with chiropractors for back pain


The May 2009 Consumer Reports  includes a survey that found that 59% of consumers who used chiropractic were "highly satisfied" with their care. This compared to 55% for those seeing physical therapists, 53% for those seeing acupuncturists, 44% physician specialists and 34% primary care physicians. (The review did not appear to consider massage therapists or yoga therapists or other practitioner options.) The positive portrayal of chiropractic was a shift for the magazine, which has historically been antagonistic to the field, according to chiropractor Lou Sportelli, DC. A factor in the shift appears to  have been the January/February 2008 special issue of The Spine Journal which focused on ways to treat low back pain. Scott Haldeman, MD, co-editor of the Spine issue was among those interviewed by Consumer Reports for the piece.

ImageEvidence that economic problems are good for supplement sales

A recent article in the New York Times (As Economy is Down, Vitamin Sales are Up, April 4, 2009) suggests that what is good for the goose may not indeed be good for the gander. The 414 store chain Vitamin Shoppe has seen a 20% rise in new customers in the last 6 months. Vitamin sales were up 8% in December of 2008 over the prior year. Interestingly, the writer interviews Princeton's Uwe Reinhardt, MD, a top medical economist and healthcare analyst, who positions this shift more broadly as a logical extension of "consumer-directed healthcare." Reinhardt also links the decision-making to consumer awareness that once they step into the "formal health system, you very quickly lose control over what this costs you." The article reflects the perspective in a January 2009 ABC News item (With Economy Sour, Consumers Sweet on Herbal Meds). Thanks to Mitch Stargrove, ND, LAc for send both items.
  
 

Professions


ImageNaturopathic doctors partner with American Health Journal for PBS series


A six-part series on naturopathic medicine will begin airing April 8, 2009 on Orange County, California's KOCE, the sixth largest PBS station in the country. The series is produced by PBS's American Health Journal "in conjunction with the American Association of Naturopathic Physicians (AANP)," according to a release from the national professional association. The AANP fundraised a portion of the show's costs over the last two years. According to the release, the series will focus on "
the training and education of naturopathic physicians, environmental health and cancer, naturopathic approaches to chronic disease, family medicine, preventing heart disease and diabetes, mental health, allergies, and chronic pain." For the small naturopathic profession, this represents the most significant national investment in promoting its visibility and will certainly have payoffs the more the series is taken up by other affiliates.

Licensing statutes for massage therapists challenged in two states


A recent article in Massage Today notes that legislators in Arkansas and New Mexico have introduced legislation that would
"threatens the authority of state boards currently charged with oversight of massage therapy regulation in those two states." The motivations are very different. In Arkansas, the legislator would seek to put the board under the state board of health while in New Mexico the effort would push the field into an unregulated zone under a health freedom-oriented drive. The American Massage Therapy Association and the Associated Bodywork and Massage Professionals , a business that provides malpractice services to the profession, are among those actively opposing both bills.


Policy

Image
Kathleen Sebelius: consumer advocate for HHS Secretary
Lobbyist Peter Reinecke and Jeanne Drisko, MD on HHS Secretary nominee Kathleen Sebelius


While many in the integrative practice community has some familiarity with Tom Daschle, who withdrew from consideration as Obama's Secretary of Health and Human Services, less is known about present nominee, Kansas Governor Kathleen Sebelius. Jeanne Disko, MD, who heads up integrative medicine at the University of Kansas responded to an Integrator query with this comment:
"Governor Sebelius has been an effective 2-term Democratic governor in a staunchly Republican state. She is well respected and managed to get many beneficial projects conceived and completed during her tenure. In addition she has experience as insurance commissioner increasing insurance benefits to underserved children in our state. Gov. Sebelius leaves Kansas for Washington DC with very few detractors. We all wish her the very best!" Thanks to the LDI E-News Update from natural products maven Loren Israelson and the LDI Group, I pass on the following comments from Peter Reinecke, a former staffer to US Senator Tom Harkin who now works as a lobbyist in D.C.:
Governor Sebelius is seen as pro-consumer and very good at working with both political parties as she twice won in very Republican Kansas. I'm hearing now that Margaret Hamburg, former Clinton HHS staff and NYC Health Commissioner is likely to get FDA with Sharfstein being her principal deputy. Also, Bill Schultz is still likely as HHS General Counsel.

Sebelius is the daughter of former Ohio congressman and Governor John Gilligan. Indeed, she and her father, who also served as former President Jimmy Carter's administrator of the United States Agency for International Development (USAID), form the first and only father-daughter team of governors in U.S. history.
 
But it is not actually Sebelius' experience as a governor that matters so much as her previous experience as Kansas' elected state insurance commissioner. Elected to that position as a Democrat running in the very Republican year of 1994, she redefined the job, breaking the hold of the big insurance companies -- whose contributions she had refused -- on the department and establishing it as a strong and independent defender of consumers.
 
Sebelius employed all the powers of her position -- something her predecessors had failed to do -- to crack down on HMOs that denied care to Kansans and pressed for expanded access to care and prescription drugs. She would maintain that pressure after being elected governor in 2002, another very Republican year when her reputation as an independent, consumer-defending reformer helped her survive the GOP tide.
 
In what was arguably her most significant act as insurance commissioner, Sebelius took on the Blue Cross and Blue Shield of Kansas monolith, blocking the sale of the state's largest health insurer to an out-of-state corporation that was all but certain to raise premiums. That was a groundbreaking move as Kansas became the first state to effectively challenge the Blue Cross and Blue Shield acquisition and merger frenzy.
 
It was also as insurance commissioner, and as the president of the National Association of Insurance Commissioners, that Sebelius emerged as an outspoken and effective proponent of a national bill of rights for patients -- something the insurance conglomerates and the health care industry feared -- and she took a leading role in drafting a proposed bill of rights.
 
Insurance Commissioners do not usually get a lot of national notice, but Sebelius became a regular at congressional hearings -- establishing herself as an expert on the complex interplay of the federal government and the states when it comes to health care policy -- and she was named by Governing magazine as one it its "Public Officials of the Year."

Peter Reinecke
Reinecke Strategic Solutions, Inc.
6107 Ridge Drive
Bethesda, MD 20816

Hearing to be held on move toward comparative effectiveness research


The move toward "comparative effectiveness research" (CER) got a $1.1 billion boost in the Obama economic stimulus package. But will the look at effectiveness extend to integrative practices or be limited to comparison of conventional treatment? A "public listening session" on CER will be held April 14th by the
Federal Coordinating Council on Comparative Effectiveness Research.  An Integrator reader writes urging that integrative practice-related organizations submit comments and show up to testify. According to HHS spokesperson Jenny Backus in an HHS release: "The Obama Administration is committed to openness and transparency. Comparative effectiveness research will expand choices for patients, not limit them, and the council looks forward to hearing from all parties as it moves ahead." To register to attend the listening session, nominate a person to make a three-minute oral statement, and/or submit a written statement for the Coordinating Council's consideration, go here. Individuals should register by Monday, April 13, at 5:00 p.m. EDT. Space and audio conference lines are limited. Time to show up!


Business


Image
Ready to roll following purchase
InnoVision (ATHM, Integrative Medicine, Advances)
out of bankruptcy following acquisition

InnoVision Health Media, the publisher of 3 key peer-reviewed journals in the integrative practice field, was acquired by American Securities and ACI Capital (AS/ACI), two private equity firms with "consistent track records in building successful, enduring businesses," according to a release from the firm. InnoVision publishes Alternative Therapies in Health and Medicine, Integrative Medicine: A Clinician's Journal and Advances, as well as Natural Solutions: Vibrant Health, Balanced Living magazine and other consumer products. The purchase allows InnoVision, which has been strapped for cash to promote expansion activies, to move out of bankruptcy. (See Integrator article
Bankruptcy for InnoVision: Publisher of ATHM, IMCJ and Advances Expects Recovery under Chapter 11, November 26, 2009.) The innoVision team will remain, working out of their Boulder, Colorado offices. The private equity group also owns Healthy Directions, LLC, a firm for which the business model includes publishing newsletters then selling natural health products referenced in them. Among the most widely-read of the newsletter are those from Julian Whittaker, MD, Stephen Sinatra, MD and Susan Lark, MD. In Whittaker's case, monthly subscriptions has reached a half-million during its decade and a half of publication.
 
Image
Mark Nolting, ND, LAc
Nolting takes key CAM and integrative medicine role with disease-management giant Healthways


Mark Nolting, ND, LAc has taken over the leadership for complementary and integrative medicine with the giant disease management firm, Healthways. Prior to his appointment, Nolting was with the firm in a regional role in the Northwest, overseeing the managed care contracts of the former American WholeHealth (AWH). (Healthways purchased a firm which had purchased AWH.) I asked Nolting, a former associate professor at Bastyr University where he chaired the acupuncture and Oriental medicine program, for a comment on his position. Nolting writes: "As far as the Healthways job (almost 6 years now) I certainly have an expanded and more challenging job. It has opened some new roles for me, as the only ND and LAc - there are good pools of DCs and MDs around - in this very large, formerly only disease management company. I am working on a campaign to raise the inner company awareness of CAM as well as give them more tools to reach out to the all important clients." Healthways' multitude of roles in US healthcare includes a Medicare pilot and a recent alignment with the Gallup polling firm through which they are regularly reporting on the "Well-Being Index" for US adults. Recent findings are that 40% of us have been 'put on edge" by the economic situation and 24 million of us have gone "from thriving to struggling."

Image
James Dalen, MD, MPH
Weil foundation appoints James Dalen, MD, MPH executive director


James Dalen, MD, MPH, former dean of the University of Arizona College of Medicine has been appointed executive director of the Weil Foundation. The foundation, founded by integrative medicine leader Andrew Weil, MD, focuses on transforming medical education. He notes in a release from the Foundation that Dalen was "the first medical school dean in the country to promote the values of integrative medicine," and that Dalen's past work will add to the Foundation's credibility. The is 90% funded through Weil's own contributions, including all of the after-tax profits from the sales of Weil's natural products line, Weil Lifestyle, LLC. In 2008, the foundation awarded $670,000 in grants. The major beneficiary of Foundation funding is the Arizona Center for Integrative Medicine which Weil founded. An article in the Arizona media on the appointment is located here.



Conferences


These two conferences are on subject matter of key importance to the integrative practice field, the connection with natural health philosophy and the successful business models. The organizers are each Integrator contributors.

ImageStephen Bolles-coordinated conference on vitalism and the healing power of nature at
Life University April 17-18

Stephen Bolles, DC is coordinating a unique, 2-day conference focusing on a critical subject which is at the heart of natural healing but is rarely on conference agendas, the healing power of nature. The focus of the event is on what Bolles terms "the New Vitalism." The April 17-18 event at Life University is called Vis Medicatrix Naturae: Stewardship of the Source of Health." Among the sterlling, multidisciplinary group of faculty members assembled by Bolles are a sociology professor from the University of London, Monica Greco, PhD, Peter Fisher, MD, personal homeopathy to the Queen of England, Integrator adviser William Morris, PhD, LAc, president of the Academy of Oriental Medicine in Austin, American holistic Medical Association board member Molly Roberts, MD, Joseph Pizzorno, ND, editor of Integrative Medicine: A Clinician's Journal and Ian Coulter, PhD, with Rand and the Samueli Institute.

Writes Bolles:
"We're going to spend the first day talking about the 'container' of our efforts: what the new vitalism is, can, or should be; what our common touchpoints of the cosmology are from the different perspectives of each 'natural' healing profession; and in what ways do we need to apply some degree of intentional listening to develop stronger relationships that do not devolve in a competitive marketplace. This seems especially important after what we heard at the IOM Summit. Don Berwick in particular spoke directly to the issue of expectations, stating that 'if all we're doing is getting a bunch of guilds together to split up the compensation pie into more pieces, we're wasting our time.'" The second day will be panel discussions based on this broad issue.

ImageHolistic Primary Care sponsors "Heal Thy Practice" conference in Tuscon, June 5-7, 2009

Medical reporter Erik Goldman, editor of Holistic Primary Care (HPC) is a keen observer of the integrative practice field. Goldman's insights are rolled into the fabric of the publication's first venture into the conference world, June 5-7 in Tucson entitled: "Physician, Health Thy Practice: Transforming Primary Care."
The conference is dedicated to "exploring effective practice models and business strategies for patient centered health care." Among the subjects to be explores as attendees "benefit from the experience of physicians who have successfully regained control of their professional and personal lives," include:

  • The Concierge Health Care Model
  • Essential Do's and Don’ts for Marketing a Holistic Practice
  • Transitioning from Insurance-Based Medicine to Fee-For-Service
  • Online Marketing
  • The Return of the House Call Physician
  • Group Nutrition Counseling: A Model for Change
  • Medicolegal Issues in Holistic Health Care
  • Creating "Five-Star Medical Care": Restoring the Physician-Patient Relationship
  • Successful Implementation of Electronic Health Records & Practice Management Tools
  • Finding Balance in a Medical Life
  • Practice Management Nuts & Bolts: Understanding Profit/Loss, Right-Sizing Your Staff, Engendering a Culture of Excellence in Your Office

The link to the conference brochure is here.




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