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Integrative Medicine and Integrated Healthcare Round-up: September 4-October 6, 2009 PDF Print E-mail
Written by John Weeks   

Integrative Medicine and Integrated Healthcare Round-up: September 4-October 6, 2009

Summary: Andrew Weil, MD offers 7 point action plan on health reform, community responds ... IOM report on Summit due out in November ... 47 members of Congress send letter backing non-discrimination among provider categories ... Academic Medicine article blasts R-25 integrative medicine programs in medical schools, U Minnesota responds ... Shifting landscape for massage educational organizations ... Group to issue educational standards for Yoga therapists ... NCCAM distributes portion of its Obama stimulus funds ...  Beth Clay on controversy over trial of Gonzalez' integrative pancreatic cancer treatment ... FCER, the former spearhead for chiropractic research, ends 60 years of visionary action ... Women legislators back anti-discrimination approach toward licensed acupuncturists ... Blue Cross Blue Shield federal employees program continues to list chiropractic doctors as physicians ... Holistic nursing certification agency marks upbeat in interest ... Employer's story shows how prejudice may restrict appropriate use of workplace massage as cost-saver ... Review paper of cost-related studies of acupuncture ... Economist Herman clarifies how she selected studies used in her reported presentation on areas for cost-savings from CAM ... Members in Bravewell Collaborative show some change since 2007 ...  Ricki and Gunn big winners with $250,000 Dr. Rogers' Prize in complementary medicine ... Taylor Walsh shares his list of integrative medicine tweeters ... Unique Hawaii Consortium for Integrative Health Care selects Wong as exec ... Dana Ullman, MPH now blogging at influential HuffPo ...  Pathways to Wellness expanding, seeks new executive director ... John Scaringe, DC chosen as president of Southern California University of Health Sciences ... Tim Birdsall, ND, FABNO honored as AANP Physician of the Year. 


Andrew Weil, MD issues call to action
Andrew Weil, MD issues 7-point Health Care Call to Action - community responds

Author and integrative medical education pioneer Andrew Weil, MD, founder of the influential Arizona Center for Integrative Medicine, has issued 7 recommendations which he believes will drive the healthcare debate toward true healthcare reform. He opens with a statement of rights to
"good health care that is effective, accessible, and affordable, that serves you from infancy through old age, that allows you to go to practitioners and facilities of your choosing, and that offers a broad range of therapeutic options." He then blasts the current expensive system and the failure of the current debate to focus on "the content of health care" before offering "some changes we can demand immediately." These are:
  1. Ban direct-to-consumer marketing and advertising by big pharma.
  2. Create a National Institute of Health and Healing at the NIH and fund it generously.
  3. Create an Office of Health Promotion within the U.S. Department of  Health and Human Services and fund it appropriately.
  4. Teach health promotion and integrative medicine at medical schools and residency programs.
  5. Require insurers to cover health promotion and integrative care.
  6. Establish an Office of Health Education within the U.S. Department of Education.
  7. Learn how to take care of yourself!
A discussion forum on Weil's points showed broad alignment, with the one caveat, expressed by naturopathic physicians, that Weil does not appear to be actively promoting the potential contributions to improved health from distinctly-licensed practitioners of natural health care. Weil's call was made as part of the promotional effort for his new book Why Our Health Matters: A Vision of Medicine That Can Transform Our Future.

IM paper to be released on November 4, 2009
IOM report from Summit on Integrative Medicine to be released online November 4, 2009

The long-awaited report from the Institute of Medicine on the influential February 25-27, 2009 National Summit on Integrative Medicine and the Health of the Public is scheduled for release on November 4, 2009. The date coincides with an expensive, black-tie shindig in Washington, D.C., hosted by the Bravewell Collaborative, which backed the Summit with a $445,000 grant. According to a spokesperson working on the event, the report is to be available online on that date. The official IOM summary of the Summit report will be presented that evening by IOM president Harvey Fineberg, MD. (For more on changes in the powerful Bravewell, see Philanthropy, this issue.) 

Congressman Bruce Braley (D-IA) leads group of 47 in letter asking for language to stop discrimination between the professions in health reform bills
Letter urging non-discrimination against provider types, signed by 47 members of Congress, sent to Speaker Pelosi

On September 14, 2009, a letter signed by 47 members of Congress was sent to Speaker Nancy Pelosi (D-CA) which urged that any legislation passed include "a provider non-discrimination provision at the federal level, and make it applicable to all plans." The letter does not mention any particular health care disciplines. Taking the lead on the letter drafting were Rep. Bruce Braley (D-Iowa) and Rep. Martin Heinrich (D-NM), according to a notice from the American Chiropractic Association (ACA), which supported the initiative. The focus, generally, is on "the importance of patients being able to choose the type of health care provider that will treat them as well as the need to prevent discrimination against entire classes of health care providers by insurance plans. Another focus is on maintaining any hard-won rights and inclusion professions have gained at the state level. The ACA e-note to its members clarified that "while ACA remains focused on many chiropractic-specific legislative initiatives, there are certainly some areas where the profession shares concerns with a larger body of health care providers. ”
Comment: Since winning its protracted anti-trust lawsuit against the American Medical Association in the late 1980s, the chiropractic profession has blazed multiple paths that have created opportunities for other licensed complementary healthcare disciplines. This is another. Inclusion of a non-discrimination concept in any health reform legislation would be a huge win for many professions - including the other licensed "CAM" fields.

Academic Medicine and Education

Article in Academic Medicine blasts medical school integrative medicine programs, U Minnesota responds

The September 9, 2009 issue of Academic Medicine, the publication of the American Assiociation of Medical Colleges, includes an article by long-time anti-CAM activist Donald Marcus, MD entitled "An Evaluation of the Evidence in “Evidence-Based” Integrative Medicine Programs. Marcus et al reviewed the curricula at the 14 medical and nursing schools which received R 25 education grants from NIH NCCAM and concluded that "these curricula, which are used all over the country, fail to meet the generally accepted standards of evidence-based medicine." Further: "By tolerating this situation, health professions schools are not meeting their educational and ethical obligations to learners, patients, or society. Because integrative medicine programs have failed to uphold educational standards, medical and nursing schools need to assume responsibility for their oversight."
Karen Lawson, MD and Mary Jo Kreitzer, PhD, RN, FAAN, two leaders of the program at the University of Minnesota, one of those challenged in the Marcus article, wrote a response to Academic Medicine which they shared with the Integrator. They argue that "unfortunately, [Marcus et al] failed to live up to their own standard of 'evidence based' by making multiple assumptions about the content and format of teaching integrative medicine in medical schools." Lawson and Kreitzer argue that the conclusions of Marcus, relative to the University of Minnesota program, are "erroneous and inflammatory."
Comment:  Credit Lawson and Kreitzer for their quick, corrective response. Here is hoping Academic Medicine publishes it. The journal has been very response in the past, including publishing favorably on the R 25 programs. An October 2007 issue included nearly 50 pages written by investigators for these programs.
New alliance of massage educators seeks to fill gap
American Massage Therapy Association disbands Council of Schools; new Alliance forming

At its September 2009 national meeting, the American Massage Therapy Association chose to disband its Council of Schools (COS). A report in the Massage Today stated that the COS began as an independent entity in 1982. Then in 1999, the COS chose to formally become part of the AMTA, after which it's membership jumped from 55 to 480 schools. The September 2009 AMTA action followed a decision by some AMTA-COS members, at the last regular AMTA-COS meeting in January 2009, to seek independence as a separate not-for-profit corporation. The organization since formed, Alliance for Massage Therapy Education, is seeking "to become a nonprofit organization designed to serve as the independent voice and advocate for the entire education sector." The Alliance is "still in its developmental stages," according to the Massage Today article. In place of the COS, the AMTA is expected to create a committee of educators and schools which does not have the independence of the COS.
Comment: From the perspective of professional development, the disbanding of the COS looks like a step backward. The typical pattern of mature professions is for the professional association to help create an independent entity, often nursed into being by the professional body. Then again, massage/massage therapy lives in a limbo between being a trade (with an exceedingly low entry standard of just a couple hundred hours in some jurisdictions) and those promoting higher standards and a move for greater professionalism. In addition, there are over 1600 massage schools in the U.S. and Canada, and an estimated 12,000 teachers, according to an article on the founding of the Alliance. It will be interesting to see if the new void will be filled, by the emerging Alliance, or some other entity. For now, those looking for standards in massage therapy education should look for COMTA-accredited programs.  Of the 1600 schools, just slightly over 100 are accredited by this specialized, federally-recognized agency.
Takes lead in organizing Yoga therapy education standards
IAYT's new Education Standards Committee for Yoga therapy to recommend entry-level standards

The International Association of Yoga Therapists has announced the creation of the IAYT Education Standards Committee. The
committee, composed of volunteers from IAYT's member schools, is charged with developing recommendations to the IAYT Board about entry level standards for the training of Yoga therapists and related issues. These recommendations are due in July 2011. In a note to members, IAYT executive director John Kepner writes: "This will not be easy. IAYT has wrestled with this for many years." IAYT is seeking to keep all interested members linked to what is expected to be a high-octane dialogue through it's members-only website. Kepner also notes that the organization is "getting valuable advice via our membership in the Academic Consortium for Complementary and Alternative Health Care as well as learning from the experiences of the Yoga Alliance and the current standards effort of the National Ayurvedic Medical Association." The formation of the committee is the latest step in a now 3-year IAYT process which included convening a set of now 47 member schools. More information is available via Kepner's article An Overview of IAYT's Efforts to Support the Development of Standards for the Training of Yoga Therapists

Jeanne Drisko, MD - U Kansas IM leader
U Kansas integrative medicine program seeks new applicants for 2010 fellowship

The Program in Integrative Medicine at the University of Kansas has announced that it is seeking applicants for its 3rd fellow at the University of Kansas Medical Center. This physician will start the fellowship in the Fall of 2010.  A note to the Integrator from program director Jeanne Drisko, MD clarifies that the program is not training a professional for delivery of one or more individual modalities. Rather, the Kansas fellowship was established "to develop the practitioner who’s knowledgeable enough about integrative care to be trained along side our faculty as a collaborative member of multidisciplinary patient care team," according to Drisko. The fellowship is a one-year intensive exploration of clinical, educational, and research activities related to integrative medicine. It is open to MDs, DOs and NDs who have satisfactorily completed their residency training. Information about the fellowship is here.
Comment: This is, as far as I am aware, the only such program which is open to candidates from all 3 of these physician-level disciplines.


American Recovery and Reconstruction Act
NCCAM's 52 grants, totaling $17.8-million, from Obama's stimulus funds

NCCAM has announced $17.8 million of 2009 awards
from the total of $32-million of American Recovery and Reconstruction Act (ARRA) stimulus funds the agency will dispense by 2010. The 2-year total represents 0.39% of the over $8-billion ARRA shot in the arm for NIH. The entire list of grants, investigators and amounts is listed here (thanks to the research of integrative practice publisher Taylor Walsh, who also shared the Twitter information in this issue). An analysis shows that over 40% of the projects funded continued the NCCAM pattern of prioritizing herb and dietary supplement-related research. All but two awards went to conventional academic medical centers; just a handful were connected principally with hospitals or, in one case, an integrative clinic (Marino Center). The two grants which went to researchers in complementary and alternative healthcare centers both focused on manipulation. One went to researchers Palmer College and the other to National University of Health Sciences. Of the total of 52, 6 were in mind-body, 4 related to acupuncture and Oriental medicine, 1 on massage, and there were 4 total focusing on manipulation. One study relates to insurance and payment-related issues.
Comment: It is not surprising, in the rushed context of the ARRA awards, that none appear to do what NCCAM most fails to fund, and in which it has the least expertise, but that practitioners most want: research on the kinds of whole person, multi-factorial protocols they routinely offer their patients. The practitioner communities, and those who educate them, must make this preference strongly known to NCCAM as that Center engages development of its next 5-year plan.
Nicholas Gonzalez, MD - effort to repeat his cancer protocol mired in battle
NCCAM-funded Gonzalez pancreatic cancer trial continues to generate controversy

It has been 10 years since the National Cancer Institute announced the first ever direct comparison of an alternative and conventional approach to treating pancreatic cancer. The trial was to look at a protocol used by Nicholas Gonzalez, MD and was engaged via a team led by a physician associated with Columbia University Medical Center, John Chabot, MD. In May of this 2009,
Chabot's study, based on the Gonzalez regime, was published here in Journal of Clinical Oncology. The findings were negative. Gonzalez has posted a rebuttal on his site. More recently, anti-CAM writers have weighed in against Gonzalez at ScienceBasedMedicine.com. Beth Clay, a former staff member at the NIH Office of Alternative Medicine and Congressional staffer for the House Oversight Committee under Congressman Dan Burton (R-IN), is presently working with Gonzalez to publicize his views on the what happened with the research. Clay sent this note to the Integrator:
"The last decade as far as the general public and the alternative medicine community knew was devoted to the rigorous management of what might have been the most important pancreatic cancer study of the century. Instead what took place was a series of management failures by at the NIH both at NCI and NCCAM. Further, there were serious violations of the research protocol (including mismatching the arms of the study and then retrospectively re-staging them in an attempt to equalize them) and failure to insure human subject protections by the principal investigator; attempts at the NIH to brush the violations and mismanagement under the rug either through malfeasance or incompetence; and a government investigation that confirmed that Dr. Chabot failed two thirds of the time to provide adequate informed consent to patients. And finally, a failed and then successful attempt by Dr. Chabot to publish a fraudulent research paper." 
Clay references Gonzalez' rebuttal about many aspects of his experience with engaging both the NIH and Columbia. Clay argues that "his explanation is important for every individual interested in alternative health research as well as cancer." She states that the "misinformation campaign on this trial is ongoing on the internet." In her view, a link on NCCAM’s website should not have been provided "with no explanation, as if nothing irregular or inappropriate happened." Clay concludes: "I cannot help but think that had it been Dr. Gonzalez or any other ‘alternative’ doctor who had  done the things that Dr. Chabot has done, that it would have been splashed across the front of the New York Times, but so far the staff at the NIH, NCI, NCCAM as well at Columbia University, and the media have simply shrugged their shoulders as if it is no big deal."
Comment: I don't know what to make of this story, honestly. I spoke with Gonzalez roughly a year ago, following an introduction from Clay. I ultimately decided I did not want to wade into an area that was both exceedingly complex and beyond my expertise. (I've focused on the preventive, outpatient, family medicine end of healthcare rather than integrative specialty treatment.) Nor was I interested in blasting NCCAM. With this article, I share Clay's perspective both out of a relationship with Clay that goes back nearly 15 years and because there does seem to be an ugly pattern which is evident in the NCCAM letters referenced below. The present context for exploration and pilot projects in integrative practices, as the story in Employers in this Round-up reminds us, remains full of prejudice and politics. Those wishing to explore additional and more detailed views on the Gonzalez/Chabot, including NCCAM's various presentations (see here and here and here), can go to the links supplied.
Former torchholder for chiropractic research gives way to educational centers
Foundation for Chiropractic Education and Research (FCER) shuts down after 60 years

The Foundation for Chiropractic Education and Research (FCER) has shut its doors and turned off its website. For nearly the entire 63 years since its founding in 1946, FCER was the central focus of research in the chiropractic profession. Over $10-million in funds were raised, mainly through industry (most significantly Integrator sponsor NCMIC). With the growth of research capacity in the chiropractic medical schools and the increasing availability of government grants in the past 15 years, the center of research action in chiropractic medicine shifted in the last decade to these academic-based research centers. Researchers on chiropractic medicine with Palmer Chiropractic College, Western States Chiropractic College, Northwestern Health Sciences University, Southern California University of Health Sciences, National University of Health Sciences, and New York Chiropractic College are among those in the United States who have received significant federal grants. James Whedon, DC, an NIH-funded health services researcher at Dartmouth who recently commented on the Integrator article on IFM's 21st Century Medicine offers this obituary:
"When the Foundation for Chiropractic Education and Research (FCER) was founded in 1943 (known then as the Chiropractic Research Foundation), the phrase, 'chiropractic research' was almost oxymoronic. For decades, FCER provided invaluable non-partisan support for scientific inquiry. FCER fellowships helped launch the careers of research pioneers such as Scott Haldeman [DC, MD] and Reed Phillips [DC, PhD]. Despite rumblings of financial problems, the news that FCER had closed its doors was a shock, particularly coming right after FCER and the World Federation of Chiropractic co-hosted the International Conference on Chiropractic Research in Montreal.  Attended by 1,000 chiropractors from 38 countries, this year's conference was an astounding success, and a testament to the strength of our international research community. The research effort to which FCER gave birth is alive and well. Thank you, FCER - you were there when we needed you most."

Jim Whedon, DC

Health Services Research

Dartmouth Institute for Health Policy & Clinical Practice Trauma Program
Dartmouth-Hitchcock Medical Center Lebanon

Comment: One place where those schooled into conventional healthcare disciplines simply cannot understand the trials and tribulations facing outsider disciplines is in creating funding for research. I significantly credit NCMIC and Foot Levelers and Standard Process and a few other firms for filling in where the NIH, caught in prejudices, refused to tread. The businesses related to chiropractic medicine brought not only cash but vision, as Whedon notes, by literally creating the researchers through the fellowship program. While NCCAM is stepping up - witness the 2 ARRA "stimulus" grants to DC schools in the article above - it still doesn't touch what is needed in terms of building the research culture and capacity of chiropractic, and for that matter all of the licensed CAM fields, to make up for decades of exclusion during which FCER carried the flag for chiropractic research.   


National Foundation for Women Legislators backs licensed acupuncturists
Licensed acupuncturists, via AAAOM, gain support for"parity" from National Foundation for Women Legislators

American Association for Acupuncture and Oriental Medicine (AAAOM) announced on September 18, 2009 that “an historic political step was achieved for Oriental medicine" over Labor Day. Participants at the 72nd National Foundation for Women Legislators (NFWL) conference passed a resolution that “declares parity for acupuncture as a health care profession.” The NFWL also passed a second, related resolution, calling for the establishment of an herbal safety database. The licensed acupuncture profession created significant visibility at the conference. National AOM organizations, including the Council of Colleges of Acupuncture and Oriental Medicine, representing the roughly 60 accredited schools, the National Certification Commission for Acupuncture and Oriental Medicine and the Accrediting Council for Acupuncture and Oriental Medicine were all present. A local AOM organization organized practitioners to give free treatments to the assembled legislators. NFWL president Robin Reed stated after the conference that “our legislators understand how important it is for acupuncturists to be included on the list of cost-saving solutions to meet the needs of their constituents."
Comment: Congratulations to the AAAOM and associated AOM organizations for the emerging unity in action, and for this result. Now, do we mark this advance up to you needle my back, I'll scratch yours.
ACA effort keeps physician status for chiropractic doctors in BCBS federal employee program
ACA notes role in protecting physician status for chiropractors in federal benefits plan

American Chiropractic Association (ACA) announced on October 2, 2009 that "after months of negotiations" with Blue Cross Blue Shield Association (BCBSA),"doctors of chiropractic are once again designated as “physicians” in the BCBSA Federal Employee Plan (FEP)." The action is particularly important as the FEP is the plan that President Obama has identified as a template for future health care reform. ACA President Rick McMichael, DC states: “Physician status under this health plan is critical, and ACA action has assured that this status is once again recognized.” BCBSA had changed the designation of doctors of chiropractic from “physicians” to “other health care providers” in January of 2009. The ACA, according to the release, "immediately recognized that the change could have a serious impact on whether DCs would be allowed to provide the physician-level services they are educated and licensed to perform—and could even influence whether chiropractic care would later be restricted or completely excluded in a national health care plan using the BCBS FEP as a model. ACA promptly contacted BCBS and requested that the designation be reversed. The ACA ticked off a list of restrictions in covered services that had already flowed from the January 2009 decision, which is now rescinded. The BCBSA FEP is the largest privately underwritten health insurance contract in the world, enrolling 4 million federal government employees, dependents and retirees. The ACA has 15,000 members.
Comment: One stakeholder's reform is another's deform. The ACA has worked hard with their allies to protect this treasured status. As noted, the "physician" language is indeed a treasure: it can open doors to payment that only goes to physician-level practitioners.
Nursing holistic certification corporation sees increase in interest
Holistic nurses draw more interest in holistic certification programs

The board certified trainings for holistic nurses, formally recognized by the American Nurses Association, and administered through the American Holistic Nurses Certification Corporation are drawing increased interest from nurses and nursing students. In an interview in the monthly e-news of the American Holistic Nurses Association, AHNCC director Margaret Erickson spoke of a "tremendous increase" in interest in certification. Erickson typically refers individuals to the list of 14 ANCC-endorsed nursing programs. Erickson reportedly says that since the holistic board, developed by the AHNA was recognized by the ANA that holistic thinking has "infiltrated" hospitals and schools more readily. Erickson also indicated that many certified nurses have found that the additional training and breadth of practice via their certification in holistic nursing has led to salary boosts for many nurses.


Employer shares how biases may limit cost savings from onsite massage
Hurdle to massage in the workplace: despite cost-savings, dismissed as "fluff"

In a conversation in the hallway at the
September 2009 one-day Seattle conference of Integrator sponsor the Institute for Health and Productivity Management, an employer acquaintance declined to publicly share information the employer's positive experience with an onsite program using deep-tissue massage, from licensed massage therapists, for musculoskeletal pain. "I'm afraid to share because I don't want to put the program at risk," explained the medical director. He noted that employees like the program "maybe too much" but at the same time the firm has seen workers' compensation costs go down since initiating the program. While he things these savings are linked and causal, he acknowledged that "it's hard to prove (return on investment)" because of confounding variables. But in these tough economic times, he said, he could imagine his operating superior "who doesn't like fluff" see a write-up on the massage-based program and "dismiss it before he read the first two paragraphs of any report." He imagined that his superior would focus on the productivity losses from workers getting massaged during paid time and use that as an excuse to gut the program. Thus, the director's strategy is to keep the program "under the radar" until workers' compensation savings are "down to a level that the program's value is undeniable."
Comment: Interesting to discover that sometimes rank prejudice is even more powerful than the almighty dollar. The road to optimal healthcare delivery is long and full of obstacles, friends. I think I will re-read the Odyssey with my 14 year old who has it in her 8th grade class this year.

Economics of CAM

Article locates cost savings from acupuncture
Paper on economics of AOM published
, includes details on 18 studies

The Fall 2009 issue of the American Acupuncturist includes a 7-page article entitled "Economic Evaluation in Acupuncture: Past and Future." The author team, led by New York acupuncturist Michael Jabbour, LAc, MS, searched the literature for all studies of acupuncture that examined costs.
A wide range of studies of various types of outcomes were included. A key focus is on monetizing "quality of life years" gained. Table 2 in the paper includes a handy list of 18 cost studies and their findings, 14 of them since 2000 and none older than 1995. The authors recommend the inclusion of simple health-related quality of life type measurement (such as SF-36) in future clinical trials of AOM. They also note the importance of including "indirect costs and intangible costs" in economic studies. The authors ultimately conclude with a note that "acupuncture has the capacity to offer cost-effective treatment, even when compared to conventional medicine." Then they add the caveat: "However, a common language must be adopted, one the decision makers can understand."

Economist-researcher Patricia Herman, ND, MS, PhD
Herman offers clarification on her review of areas of cost savings from CAM

An Integrator reader contacted economist and researcher Patricia Herman, ND, MS, PhD following publication of the recent Integrator article (Herman's Systematic Review Yields Top 9 Therapies/21 Conditions with High Quality Evidence of Cost Savings from CAM
, August 27, 2009) with a query about inclusion criterion for the articles she is selecting. Particularly, he asked, why were the studies led by Richard Sarnat, MD which showed significant cost benefits from integrative practitioners as primary care providers not included? Herman shares that the Sarnat work "is an important and valuable study" but, because it did not include randomization, it didn't meet the criteria of "high quality' she used in the review. Herman further notes that the most intriguing take home from the studies she has been able to evaluate to date is that "over 50% show cost savings." She underscores that "this is beyond cost-effectiveness to cost-savings," adding that "this is not likely just an artifact of publication bias because there is no disincentive for publishing something as cost-effective vs cost saving." Herman notes that this is particularly interesting given "the typical conventional point of view that CAM increases cost." 


Changes in list of philanthropists backing Bravewell
Changes in philanthropic backing of the Bravewell Collaborative 

The promotional materials for the "Distinguished Evening" that will kick off the publication of the report from the Institute of Medicine on the National Summit on Integrative Medicine and the Health of the Public provide some insight into the backing of the sponsor organization, the Bravewell Collaborative. The event, to be held at the Mandarin Oriental in Washington, DC on November 4, 2009 is pricey, with individual tickets at $750 and table sponsorship running $10,000 to $50,000. Then again, this is the organization that spent $445,000 to back the Summit and that has made a series of significant strategic investments that have propelled the launch of "integrative medicine" in the public mind and in medical schools. A September 2007 article on the last major Bravewell event analyzed changes from 2003-2007 in the organization's member philanthropists. The list for the 2009 event includes 16 individuals, representing 12 philanthropic families/organizations. New in 2009 are philanthropists Blythe Brendon, Ruth Westreich and Barry and Janet Lang. There is one new foundation, The Karan-Weiss Foundation, associated with fashion maven Donna Karan and her Urban Zen initiative. Absent in 2009 after having played a role in 2007 are the Marsh and Wood-Rill Foundation and the Globe Foundation.
CommentThe heart of the Bravewell funding collaborative has stayed entact for this l;ast decade of the organization's activities. Still, I find myself wondering what will be up next for the Bravewell Collaborative. Is this Summit with the IOM the pinnacle toward which these philanthropists, led by co-founders Penny George and Christy Mack, have been striving through through their distinguished set of accomplishments? Has the Bravewell done what it was created to accomplish? Certainly, healthcare is not yet transformed, their stated goal, and nor is medical education. But will this impatient, leading edge organization hang in there for the less glamorous, nuts and bolts hanging-in-there that now must follow the more visionary successes? Or alternatively, where might the Bravewell make its next, high visibility mark?  
Winners Ricki (L) and Gunn (R) on either side of son of Dr. Rogers, presenting the award
Dr. Rogers Prize of $250,000 goes to
Hal Gunn, MD and Badri (Bud) Rickhi, MD

The biannually-awarded $250,000 Dr. Rogers Prize for contributions in complementary and integrative medicine in Canada was granted to Hal Gunn, MD of Vancouver and Badri (Bud) Rickhi, MD of Calgary. Gunn runs InspireHealth, an integrated oncology program, and Ricki established the Canadian Institute for Natural and Integrative Medicine (CINIM) and played a key role in establishing the Integrative Health Institute at Mount Royal College. Gunn's work carries forward ground-breaking integrative oncology work of Roger Hayward Rogers, MD a pioneering integrative physician in Canada after whom the award was named. Nancy Baxter, the Dr. Rogers' Prize coordinator, shared with the Integrator that the 2009 Dr. Rogers Prize events on September 25th, which included afternoon seminars with integrative practice luminaries, drew attendees from across Canada and from the United States. Says Baxter: "The first Dr. Rogers Prize Colloquium filled the 174-seat Wosk Centre for Dialogue with overflow attendees taking in the proceedings via 'live' closed circuit projection as [invited integrative health leaders] discussed the topics of evidence and integration."


Taylor Walsh - organizing the integrative medicine Twitter community
Twitter comes to the integrative medicine, CAM and integrative practice worlds

NIH NCCAM announced on September 9, 2009 that NCCAM is Twittering. This inspired Integrator reader Taylor Walsh to explore the Twitter world for recognizable integrative medicine and CAM players who are expressing themselves to the universe in 140 characters or less. Here's Walsh's quick list:
NCCAM, DrWeil (Andrew Weil, MD), BrianBermanMD, 2YrHealth (Berman's Institute for Integrative Health), DrOz (Mehmet Oz, MD), NaturalStandard (the information business), UCSFosher (UCSF Osher Center), markhymanmd, adiharamati (Adi Haramati, PhD), stephenbolles (chiropractor and sometimes Integrator columnist), FMJournal (Functional Medicine Journal), handstoheart (Integrator columnist Daphne White), azcim (Arizona Center for Integrative Medicine). Walsh also located a few who aren't quite as identifiable. Then there is Walsh at taylorw. Two of Walsh's most recent:

  • "Recovery Act NIH research $$: @NCCAM share of $5 Bn announced today by Obama: $17.9 Mn or 0.36% | Americans spend $35 Bn/yr on alt health."

Comment: Since Twittering began, I've had a handful of people suggest I participate. I made the sign of the cross - which in this case looked like the top of an old-technology telephone pole - refusing to engage another form of the new, life-speeding tools. As I just discovered, Walsh has created a "share group" for integrative medicine. It's at the address in his September 24, 2009 Tweet, and here.Walsh has begun a blog called Getting to Integrative Health and Medicine.
Editorial stance: The use of "chiropractor," "doctor of chiropractic" and "chiropractic physician"

Following the last issue, a chiropractor reader who sees himself as a physician and doctor of chiropractic medicine took me to task for using "naturopathic physician" for members of that profession while typically using "chiropractors" to designate members of his own. He referenced my September 3, 2009 article on the AMA Scope of Practice Campaign. He wondered if this "elevation" of NDs was favoritism, based on my prior work in the 1980s with that profession. I responded that the members of that discipline and the profession itself are unanimous in seeking the "physician" word to describe themselves. Witness the name of the professional association: American Association of Naturopathic Physicians. All of the state ND associations follow suit except the one, California, in which the state medical association prevailed in an effort to keep them from using "physician" during a licensing battle.

Meantime, the chiropractic or chiropractic medical field is mixed. The leading national association is called the American Chiropractic Association, not the American Association of Chiropractic Physicians. The academic organization is the Association of Chiropractic Colleges, while that in the naturopathic field asserts its medical focus as the Association of Accredited Naturopathic Medical Colleges. Yet clearly the DC profession is split. The Council on Chiropractic Education (no "medical" there) specifically states that it accredits programs that may be educating "chiropractic physicians." The recent U.S. Department of Labor definition of the field notes that "chiropractors [are] also known s doctors of chiropractic and chiropractic physicians." As noted in the Professions section of this round-up, the American Chiropractic Association recently celebrated its victory in keeping the word "physician" in the Blue Cross Blue Shield Federal Employee Plan. A lobbyist for chiropractic in Washington, D.C. shared with me that recent federal legislative issues have often a component in which assertion of the role of doctors of chiropractic as physicians is frequently important. Meantime, subsets of doctors of chiropractic in various states are promoting broader scopes of practice which present the field as a field of medicine and chiropractic education as chiropractic medical education.
Editorial line: On reflection, I will plan to use the range of these terms more often, going forward, especially when I know that the individual about whom I am  reporting has preferences. Integrator readers will henceforth be more likely to see "chiropractic" in one sentence, "chiropractic medicine" in another and "chiropractic physician" elsewhere, perhaps in the same article.


Rachel Wong, MPH, to lead Hawaii Consortium
Hawaii Consortium for Integrative Healthcare names Wong as executive director

Rachael Wong, MPH was recently appointed as the new executive director of the Hawaii Consortium for Integrative Healthcare, a non-profit organization committed to promoting wellness and advancing the practice of integrative, holistic care throughout the state. Wong was previously the executive director of Kokua Mau, the state hospice and palliative care organization. She is a doctoral candidate in the University of North Carolina at Chapel Hill's Executive Doctorate in Health Leadership Program.  Her dissertation research will focus on U.S. solid organ transplant recipients' CAM use and integrative healthcare needs. The Consortium is unique nationally in the array of stakeholders, from practitioner groups to hospitals, goivernmental agencies and payers, that are member organizations.

Dana Ullman, MPH now blogging at HuffPo
Ullman now a HuffPo blogger

Dana Ullmnan, MPH has joined the ranks of integrative medicine-oriented bloggers on the pages of the Huffington Post. Ullman's first post was September 24, 2009, and is entitled the Wisdom of the Body. His name on the site lists his expertise in homeopathic medicine. His Epidemic of Fever Phobia: The facts on Why Fever is Your Friend generated a lively discussion with over 130 responses as of October 6, 2009. The last Integrator Round-up noted that Dean Ornish, MD is serving as medical editor for HuffPo. (By the way, Ullman's article on the IOM Summit was published here in E-CAM.)

Pathways seeks new executive director for expanding operation
Pathways to Wellness seeks new executive director as Porter stays on but re-focuses

Pathways to Wellness
, one of the largest providers of complementary medicine in the U.S., is seeking a "highly experienced, strategic thinking, entrepreneurial, and visionary leader who will guide Pathways into its next level of development." In a note to the Integrator, Kristin Porter, LAc, the present executive director writes:
"We are restructuring Pathways to provide optimum infrastructure for growth and expansion, which includes hiring an executive director so that I may narrow my focus on the development and growth of Pathway’s clinical capabilities, research and integration strategy (yes, that means I am not leaving Pathways…heck, I'm heading into my 20th year!)." Pathways provides a variety of complementary services, with acupuncture and Oriental medicine lead approaches and modalities. Potential applicants are invited to explore the site and apply online. At least 10 years of senior nonprofit management is "preferred." Inquires and nominations should be directed to Judy Freiwirth, the clinic's "transition consultant," at

John Scaringe, DC, new president at SCUHS
Scaringe named president at Southern California University of Health Sciences

John Scaringe, DC has taken over as president of Southern California University of Health Sciences. The multidisciplinary institution has programs in chiropractic medicine, acupuncture and Oriental medicine and massage therapy. A release from the University notes that Scaringe previously served as vice president for academic affairs and chief academic officer at SCUHS since 2006. He began his career at Los Angeles College of Chiropractic (LACC), which later expanded to become SCUHS, as faculty in 1991. Former SCUHS president Ronald Kraft, PhD stepped down to pursue other professional opportunities.

CTCA's Tim Birdsall, ND, FABNO chosen AANP Physician of the Year
Tim Birdsall, ND, FABNO selected as AANP physician of the year by naturopathic doctors

Timothy Birdsall, ND, FABNO, vice president of integrative medicine for Cancer Treatment Centers of America (CTCA) was honored as 2009 Physician of the Year by the American Association of Naturopathic Physicians (AANP) at their August meeting. Birdsall’s leadership within the profession has included legislative, policy and research initiatives as well as a visionary integration of naturopathic medicine into health care. In the past decade, Birdsall has been particularly important in developing the field of naturopathic oncology. Birdsall currently serves as a member of the NCCAM advisory council. A CTCA release on Birdsall's honor is here.

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