Issues #60-62 - March-April 2009
Issue #62 - April 28, 2009
April 28, 2009
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
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
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
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
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
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
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, 2009April 8, 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
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
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
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
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
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
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
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
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
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
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
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
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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