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Issues #60-62 - March-April 2009 PDF Print E-mail
Written by John Weeks   

Issues #60-62 - March-April 2009



Issue #62 - April 28, 2009


April 28, 2009

Daphne White: The "Kabuki Play" of Monied Interests Around the $1.1-Billion Comparative Effectiveness Research Initiative

In this section of a two-part series, Integrator contributor Daphne White, CHTP focuses on the political-economic dynamics behind the $1.1 billion "clinical effectiveness research" (CER) initiative. White examines what she calls the "Kabuki play" - intense dynamics as the medical industry seeks to gut the value of the initiative, while not appearing to do so. Would you assume that this initiative would look at cost or would inform the care people receive? As White points out, Congress appears to already have caved in on key aspects of apparent value. One wonders if CER can be the point of leverage for reform which White House Budget Director Peter Orszag thinks it can be. And if Orszag can't get what he wants out of CER, what might the integrative practice community extract from this big money battle in which maybe we can't, well, talk about money. In White's other piece on CER, she explores the potential value of CER for the integrative practice community. More


April 28, 2009

Daphne White: CAM and Comparative Effectiveness Research - Are We Going to Play?

The idea of "comparative effectiveness research" (CER), the new $1.1 billion economic stimulus program, strikes a happy chord for many in the integrative practice community. Isn't this the appropriate research terrain for showing value of integrative care?  In this first of two part Integrator series, reporter and regular Integrator contributor Daphne White, CHTP, shares how she attended the "listening session" of the government's CER advisory board to understand what was going on and see if the integrative practice community was showing up. White ended up taking off her journalist hat and testifying. She shares her perspectives on why and how the integrative practice community should be involved. White's other piece on CER is a very well-reported analysis of the "kabuki dance" she witnessed as vested medical interests developed their strategies to make sure that the CER initiative does not gore their own oxes. More 
  


April 28, 2009

Wayne Jonas, MD on Obama's White House Office of Health Reform: No Clear Commitment to Health and Wellness

On March 5, 2009, Barack Obama convened a White House Forum on Health Reform in which the administration underscored its commitment to take on the nation's crisis in its medical processes. A month later, on April 8, 2009, Obama acted again by establishing the White House Office of Health Reform. For perspective on these developments and what they mean to integrative practice, the Integrator turned to Wayne Jonas, MD, president and CEO of the Samueli Institute, where Jonas has led the development of the ambitious, and long overdue, Wellness Initiative for the Nation (WIN). In this invited column, Jonas notes shortcomings of current thinking and the pressing need for an "Executive office to focus specifically on developing policies and programs for lifestyle-based chronic disease prevention and management, integrative health care practices and health promotion." This posting also includes the full Executive Order. More

April 28, 2009

Jacobs/Grundling Evidence-Based CAM Guide for American College of Physicians Sets Standard for Internists

The American College of Physicians, representing the nation's internists, turned to integrative medicine leader Bradly Jacobs, MD, MPH to take the lead in their textbook on complementary and alternative medicine. The book, An ACP Evidence-Based Guide to Complementary and Alternative Medicine, lives up to its billing To evaluate evidence, the editors use, uniquely for this field, the GRADE Working Group method, also favored by the WHO, the Cochrane Collaboration and others. Appropriately, the editors also introduce readers to some of the challenges regarding evidence for these fields. While the chapters are provided almost entirely by MD authors, the co-editors include a substantive appendix on "Systems of Practice" for which they took consultation from leading members of complementary healthcare disciplines. The success of the text, excellent for its audience, may be a plebiscite on whether medical doctors, and internists in particular, believe it's finally time to pay attention. More
 

April 25, 2009

Integrative Medicine and Integrated Health Care Round-up: April 8-April 25, 2009

Holistic nurses take on Catholic Bishops over Bishops' position against Reiki ... Oregon Collaborative for Integrative Medicine, nation's top inter-institutional effort in integrated care, expands action ... Minnesota Center for Spirituality and Healing strikes strategic alliance with Alternative Medicine Clinic of Hennepin Faculty Associates ... Community Acupuncture Network seeks NADA alliance in opposing first professional doctorate for acupuncture and Oriental medicine field ... Survey shows low uptake of key NCCAM research by internists, acupuncturists, naturopathic doctors and rheumatologists ... Significant CAM/IM chapter by Academic Consortium for Complementary and Alternative Health Care in new textbook, Collaboration Across the Disciplines in Health Care ... AAAOM hires DC lobbying team, including former NIH and Congressional staffer Beth Clay ... Chiropractors set up ChiroVoice.org to foster patient communication with members of Congress during reform era ... Pioneering work of Joe Chang, MAOM, LAc shows initial penetration of licensed acupuncturists in military services ... IHPM/Intel pilot of onsite manual therapies program show positive outcomes. More

April 18, 2009

David Cundiff, MD: Bias Issues Inherent in Bravewell's Focus on Evidence-Based Medicine in Reform

In this response to the Bravewell Collaboration's listing of evidence-based medicine (EBM) and reimbursement reform as key factors in any healthcare transformation, David Cundiff, MD points out that "randomized controlled clinical trials and other tools of EBM are mostly funded by special interests and interpreted by researchers paid by those special interests." Thus "the evaluation of EBM trials is and will remain controversial." Cundiff, author Money Driven Medicine, argues that one-third of the HEDIS measures which shape insurer decisions on what get covered, are "highly questionable." Sponsors of these measures, Cundiff notes, include a who's who of major pharmaceutical firms. Can one even imagine a level playing field for an evidence-based inclusion of integrative, natural therapeutic approaches? More

April 14, 2009

Columnist Michael Levin: Pepsico May be Our Guru on How to Reduce Behavior-based Healthcare Costs

Did you know that Pepsico is threatening to move all its operations out of New York if the state passes a "sin-tax" on soda pop? Integrator columnist Michael Levin recognized in this story that the giant firm has a rather strong perspective on whether economic incentives can be a powerful stimulus for behavior change. Levin uses the story to wade into questions raised in a recent British Medical Journal article on what it will take for people to make healthy decisions. Fascinating piece. Levin invites you to weigh in on the topic. More






Issue #61 - April 8, 2009

April 8, 2009

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

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. More ...

April 3, 2009

Forum on the IOM: Bravewell's Post-Summit Statement on "Key Factors" in Any Health Reform Plan

The alpha and the omega of the IOM Summit is the Bravewell Collaborative. The organization of philanthropists laid down $445,000 to sponsor the gathering. Bravewell now plans significant additional investment to ensure that the outcomes have legs in shifting US healthcare. Just after the Summit concluded, Bravewell issued a statement which included eight "key factors which should be included in health reform." Here is the Bravewell list. Are you aligned? What did the Bravewell downplay or miss which you felt were key health reform outcomes which the IOM Summit began to shape as consensus? More 

April 3, 2009

Forum on the IOM and IHS: Molly Punzo, MD Thinks CAM/IM has Lost It's Way; Is the IOM Summit Corrective?

Molly Punzo, MD, is a veteran integrative medicine practitioner who established an early program at Hartford Hospital in Connecticut. After attending the February 2009 Integrative Healthcare Symposium and the first day of the IOM Summit, Punzo argues that the "CAM/IM movement" is losing its promise, partly through the dominant therapeutic and economic influence of reductive, green-pharma. While Punzo doesn't address this, a fascinating question arises: Is it possible that the IOM Summit may be viewed as a corrective measure for not just conventional medicine, but for the integrative practice movement? I take a first stab at this in the comment field and invite your responses. More



March 30, 2009

Action Alert: AANP Invites You to Legislative Training and Lobby Day in Nation's Capitol, May 2-4, 2009

Interested in making a difference in U.S. health policy? Curious how to formulate a message and take it to your Congressional representatives and their staff? Wish to hob-nob with literally hundreds of legislative staffers? If the answer is yes, you've a chance to do so May 2-4, 2009. The American Association of Naturopathic Physicians (AANP) has stepped out of the typical professional box and is opening its "DC-FLI" - Federal Legislative Initiative - to any individuals who have interest in the federal legislative process. As Integrator adviser and AANP board member Bill Benda, MD, writes in his invitation from the AANP: "Wellness and prevention are on the agenda for healthcare reform. Whether they become law is another matter, and essentially depends upon applied political pressure – by us." The agenda, I am told, is not naturopathic centric, but health-centric. Here's hoping that many of you will take advantage of these training sessions on a range of themes, a lobby day and a Congressional Reception and Health Fair which last year drew 300 staffers and a handful of Members of Congress and staff, sumptuously fed by Whole Foods Natural Markets. Take a look at this unique invitation and schedule of events! Perhaps it will appeal and serve your needs. More


March 29, 2009

Forum on IOM Summit: Comments from Participants Kreitzer and Simons and the Planning Team's Goldblatt

Among the 650 participants in the IOM Summit were a few score professionals who were invited by the IOM, and in some cases contracted, for specific roles. Among these were Mary Jo Kreitzer, PhD, RN, FAAN, director of the Center for Spirituality and Health at the University of Minnesota and a long-time promoter of inter-disciplinary education and practice. Kreitzer had dual roles. She was contracted to lead multidisciplinary team on a paper and she presented on a plenary panel. Elizabeth "Liza" Goldblatt, PhD, MPA/HA had four significant roles: Planning Committee, moderator of the panel on which Kreitzer served, facilitator of an "assessment group"on imagining the future of integrative practice, and wrap-up panel member. The third report here is from Michelle Simon, PhD, ND who was invited to be a member of an assessment group on "designing and building the economic incentives." Simon focuses on her take-home of key tactics to resolve systemic issues. Enjoy the diversity and overlap of perspectives. We have the ways to do what we need. Do we have the will? More

March 11, 2009

Forum on the IOM Summit: AMI's Richard Sarnat, MD, Leader in Integrative Business, Offers a Report and Musings

One sign of the IOM's good faith effort to bring the best people to the table for the Summit was the invitation the IOM extended to Richard Sarnat, MD, to participate in one of the Summit's influential working groups. Sarnat co-founded  Alternative Medicine Integration Group, the business that has brought us two of the most significant integrative care effectiveness experiments in the nation (HMO in Illinois, Medicaid in Florida). Sarnat takes the opportunity to summarize his perspectives on health reform, suggesting innovative polities, research models and business practices that came from discussions at the IOM. He lays out what he believes will support health-oriented, integrative practices that will break the cycle of of our degenerative addiction to disease-focused interventions. Sarnat calls on all of us to provide the grassroots backing that he believes such change will require.    More 

March 8, 2009

Forum on the IOM Summit: Holistic Primary Care's Erik Goldman and JMPT's Claire Johnson

The Integrator is honored and pleased to present two submissions from editors of leading publications in the field, relative to their experiences at the recent Institute of Medicine Summit which each attended. Claire Johnson, DC, MSEd is editor of Elsevier's Journal of Manipulative and Physiological Therapeutics, the leading peer-reviewed journal in the chiropractic profession. Johnson ticks off key principles listed by IOM president Harvey Fineberg, MD and notes that "integrative healthcare" was an "inclusive" term, increasingly used, aligned with these key principles. Goldman, a past Integrator contributor, offers a different take altogether, a kind of run-and-gun, hopeful-skeptical, guerrilla warfare dispatch of field notes from an event that often left him wondering. Goldman, a former bureau chief for Elsevier's International Medical News Group, edits Holistic Primary Care, which reaches over 100,000 primary care offices of MDs, DOs, DCs and NDs with each publication. Enjoy the diversity of perspectives from two respected colleagues.


March 7, 2009

Daphne White: Harkin Urges End to Discrimination Against Alternative Healthcare Practices

When the Integrator's Daphne White, CHTP observed the February 26, 2009 US Senate hearing on integrative healthcare chaired by Senator Tom Harkin (D-IA), she chose to focus on Harkin's introductory comments in which he calls for an "end to discrimination against alternative healthcare practices." White then reviews the comments of the sterling panel of Oz, Weil, Ornish and Hyman.The odd point is that Harkin and Mikulski, after specifically focusing both of the week's hearing on "integrative healthcare" - language preferred at the parallel IOM Summit - Harkin announces an interest in changing the name of NCCAM to "National Center for Integrative Medicine." White has captured a provocative dialogue. Has our time actually come? What time is it? We've got a challenge to make sure Harkin and his colleagues get that right.







Issue #60 - March 2, 2009



March 2, 2009

Integrative Medicine and Integrated Health Care Round-up:  February 18-March 2, 2009

Plan on the North American Research Conference, May 12-15, Minneapolis! ... New Jersey med school and massage school for tie in accredited massage program for service to the underserved ... Resource on school-based yoga ... Northwestern Health Sciences University has unique opportunity for new VP/provost ... Licensed acupuncturists beefing up "action agenda" ... Educator Steiner Leisure in huge contract for massage, acupuncture, spa, fitness services ... IM leader and Integrator adviser Bradly Jacobs, MD, MPH, re-emerges at Sausalito-based Carvallo Point ... More on policy: Does the Obama $634-billion for healthcare reform include a real shift toward wellness? ... Congrats to TAI for an investment in a relationship with U.S. Senator Mikulski, plus AP article on IOM, Redwood on Jonas' WIN, and Peer Barry Chowka tearing down the house. More ...

March 2, 2009

Special Integrator Forum: Integrative Healthcare Policy Week - What Did You Think?

We have just completed the most significant week for integrative health care, at the policy level, in the history of the known universe. Two U.S. Senate hearings. The 3-day Institute of Medicine Summit. Many superlatives were expressed about our time being now. Yet in this very week, president Obama announced a $634 billion health care fund in which the follow-up media said nothing on integrative care, and barely mentioned wellness and certainly no paradigm shift. Many of you were present at the hearings an Summit. Others, like me, were unable to be present except through the wonders of modern technology. (Links included within.) Take a listen or read. What did you think? What are our next steps? What do you think needs to be more visible? Less pronounced? How can we gain traction? Participate in this Integrator forum: Send your comments, and a jpg for you mug if you like  if I don't already have it - and let's see what we are thinking? More

February 26, 2009

Nancy Gahles: Homeopathic Leader Reports on the 1300 Participant Integrative Healthcare Symposium, February 19-21, NYC

For many of us, this weeks' "integrative health policy week" in Washington, DC actually began with the robust Integrative Healthcare Symposium (IHS) in New York City where a multidisciplinary gathering of 1300 met to explore policy, practice, science and business issues. Nancy Gahles, DC, CCH, RSHom (NA), an advisory board member for IHS, offers her review of pros and cons of the meeting. She explores roadmaps-for-the-future policy panels which included Wayne Jonas, Josephine Briggs, Mary Jo Kreitzer, Bill Benda and others. Some of what she experiences she celebrates. At the same time, Gahles, president of the National Center for Homeopathy, challenges the MD-centrism of much of the content and wonders whether these roads will take us "back to Rome?" It's a thought provoking, homeopathic-centric review. If you attended, what did you think about the inter-disciplinary balance at the IHS? Thank you Nancy. More ...

February 24, 2009

Daphne White Reports on US Senator Mikulski's Hearing on the Principles of Integrative Health, Feb. 23, 2009

Integrator readers: Here is a treat. Beltway resident, reporter and healing touch practitioner Daphne White, CHTP reports for us on the historic February 23, 2009 U.S. Senate hearing on the "principles of integrative health care" chaired by Barbara Mikulski (D-MD). Milkulski gets it. White quotes her: “'Wellness is not a silo, prevention is not a silo.'” Then: "Integrative health needs to be at the center of all health care discussions: 'Is that what you are saying?' Mikulski asked.  Yes, the panelists answered." White's article guides you to the hearing, and to links to the submitted papers of each of the panelists. Enjoy this report. More ...


February 23, 2009

Your Ideas: #10 for the Top 10 in Integrative Practice from 2008

When I published my list of the Integrator Top 10 from 2008 and left open #10 for your input. First, Bill Manahan, MD, offered his own list of 10 ideas for revisioning healthcare, and a couple of people quipped that the honoring of the AANP was too high, or premature. Then a half-dozen other ideas drifted in. I have been slow to assemble these. Here they are, finally, in various forms: Pathways to Wellness, the Myrna Brind Center, the National Center for Homeopathy, the "new family care doctor's office," and a suggestion that we take a collective back-patting for the resilience we are showing as a community. More ...
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