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Issues #69,#70 & #71 - Nov-Dec 2009 |
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Written by John Weeks
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Issues #69,#70 & #71 - Nov-Dec 2009
Issue #71 January 5, 2009
January 5, 2010
Two Integrator Top 10 lists for
integrative care from 2009 ... LA Times article on licensed CAM
practices and non-discrimination provision in Harkin's Senate health
legislation ...
George DeVries' transformation of American Specialty Health into a
health and wellness firm ... Academy of Oriental Medicine of Austin
becomes first AOM school to gain regional accreditation ... Adam
Perlman, MD, MPH and Ben Kligler, MD, MPH take over as chair, vice
chair for CAHCIM ... AOM accrediting agency still seeks comments on
"First Professional Doctorate" standard for the field ... Frank
Nicchi, DC, MS honored for strengthening chiropractic-public health
ties ... Bravewell, the IOM and the AARP join to found Healthy Nation
Partnership; inputs solicited ... American Association for Health
Freedom becomes Alliance for Natural Health-USA ... New York Beth
Israel creates no-cost, online Prepare for Surgery program ...
Seattle-based Alternative Health Access Campaign seeks to meet growing
demand among the homeless ... Oregon's largest natural health clinic
opened by National College of Natural Medicine ... Chiropractors in
campaign to regain recognition as providers by Boy Scouts of America
... Integrative Healthcare Symposium sponsors major conference in New
York, February 25-27, 2010 ... North American Research Conference on
Complementary and Integrative Medicine set for May 15-18, 2012 in
Portland, Oregon ... New American Holistic Medicine Research Institute
formed with led venerable Robert Anderson, MD in lead; sets sights on
first multicenter project ... Massage accrediting agency seeks public
member ... H1N1 lifts dietary supplement
sales ... Michael Cohen re-frames his legal services More
December 31, 2009
One of the
rarely sung, significant influencers of our field is entrepreneur Jim
Strohecker. Some 18 years ago he was executive editor of the 1100 page
text, Alternative Medicine: The Definitive Guide
which involved nearly 400 practitioners and organizations. In the
mid-1990s, Strohecker co-founded HealthWorld Online, the first
aggregator of wellness and alternative medicine-oriented content,
services and professionals on the emerging web. More recently, he has
not only re-purposed that site as Healthy.net, he also brought forward
the work of wellness pioneer John Travis, MD, MPH. He promotes Travis' visionary Wellness Inventory through an
online program for integrative medicine centers, hospitals,
corporations, spas and individuals, together with a related coach
certification training. In this Integrator interview,
Strohecker's comments say much about the history of the integrative
practice movement of the last 20 years, and its relationship with the
broader wellness effort. Enjoy the learning, and for some of you, the
recollections! More
December 30, 2009
The
Healthy Nation Partnership is conceived as "a network of public and
private organizations working together to improve the health of all
Americans by transforming the way we understand, value, and practice
health and wellbeing." The potent founding partners - the Bravewell
Collaborative of philanthropists, the IOM and the AARP - envision this
as a "national movement for health and wellbeing." The first two
organizations first united to promote the role of integrative medicine
in the health of the public. This stage is larger. Here is the trio's
short concept paper. Is this the network
through which integrative ideas and practices will be promoted and
flourish? Is this a movement you and your
organization wish to support? This entity is a hopeful portent for
coming year(s). More
December 28, 2009
While reviewing recent issues of the Integrator
to
draft the Top 10 actions and event from 2009, I found myself creating a
second list. This was of names of individuals who had
been or were about to be significant contributors to the integrative
practice field. Of course there is
some overlap between key events and influential individuals. Yet a
second list seemed to be in order.
As is the Integrator custom, this Top 10 only counts 9, leaving
space for your nomination of others who have distinguished themselves,
or are about to. Who would you suggest? Who is the obvious or less
obvious omission?
Happy reflections on the year that was, and on the year to come. More
December 21, 2009
On or about the winter solstice, the Integrator
announces a Top 10 from the previous year which will support the coming
of the
light for integrative practice in the New Year. Here is the 2009 Integrator
Top
10 for integrative policy, practice, research and professional
activity. Not surprisingly in this year of healthcare reform debate,
policy dominates. Just 9 are listed. What are your suggestions
for #10? Thanks to the individuals behind the good work. Happy reading,
and reflecting, on the year that was as we look ahead. More
December 15, 2009
Implementing healthy practices seems
straightforward, not "rocket science." But
then
why are we having such difficulties? A public-private Healthy
Nation Partnership and a section of proposed federal health reform
legislation each suggest the dimensions of brilliance we must draw upon
to lay a foundation for a healthy society. The former initiative,
recently announced, is led by the Institute of Medicine (IOM), the AARP
and the Bravewell Collaborative; the latter by US Senator Tom Harkin,
the Samueli Institute and others. Wellness
entrepreneur James Strohecker, CEO of HealthWorld Online suggests the
nation needs another "Manhattan Project"
such as was created to develop the bomb.
But might not the key to establishing Harkin's "wellness society" be
nothing less than encountering the damaging dimensions of what was sown
by that earlier project?
[This article was developed as a column
for Integrative Practitioner.] More
Issue #70 December 4, 2009December 3, 2009
Examination
of Congress' mandate to NCCAM shows gross misalignment ... Synopses of
submissions on NCCAM strategic plan from 8 organizations: IHPC, AHMA,
AANP, MTF, IAFT, ACCAHC, AANMC and NCH ... New information (and rumors)
on inclusion of CAM and integrative practices in US Senate and House
versions of health reform legislation ... Nurses urge Harkin against
changing NCCAM to "National Center for Integrative Medicine" ... IOM's Summary
Report on the February Summit the perfect holiday gift for an
integrative practice wonk ... Family Medicine article
shows clarity emerging on integrative medicine in residencies ... Joint
meeting of two academic consortia celebrated as key moment ... Umbrella
specialty Board of Comprehensive Medicine under exploration jointly by
AHMA, ACAM, AANP, ICIM, ABIHM, AAEM and IFM ... National acupuncture
groups announce 5-year strategic plan ... Holistic medical group AHMA
back from the brink ... Rick Rosen, MA, LMT provides excellent overview
of the evolving massage "field" ... Nurses add 5-point acupuncture
detox to inpatient treatment at Longmont United Hospital ... IAF and
Samueli explore whole person "total fitness" for the military ...
Information on the $1-million real world
research project with Obama stimulus money
going to Marino Center and University of Arizona ... Samueli Institute
publishes white paper on cost-savings from a sampling of integrative,
wellness and public health interventions ... Kolata's New York Times integrative
cancer
article draws rejoinder from the Society for Integrative
Oncologists' Abrams ... Anti-CAM/IM crusader Novella co-founds new
institute dedicated to the same mission ... Gazella expands Community
Partners group of the Natural Medicine
Journal to 11
professional associations, 8 educational institutions and 3 industry
associations ... UCSF-Osher has opening for new fellow ... Info on
cost-effective integrative MD practices sought ... More
December 1, 2009
That
NCCAM's 2011-2015 strategic plan is critically important to the future
of the integrative practice field is clear from this set of stakeholder
responses. Together, these organizations represent over 360,000
licensed practitioners: Integrated
Healthcare Policy Consortium, Academic
Consortium for Complementary and Alternative Health Care, American Holistic Medical Association, Association
of Accredited Naturopathic Medical Colleges, International Association of Yoga Therapists, Massage Therapy Foundation, National Center for Homeopathy
and American Association of Naturopathic Physicians. (The two consortia
represent 22 separate partner or member organizations.) Notably, their
comments are almost entirely supportive of the direction Congress
mandated but in which NCCAM poorly invested under its first director.
If this input is valued, NCCAM has significant stakeholder backing for
complying with Congress' real pragmatic research mandate. More
November 30, 2009
The issue of insurers incentivizing good
behavior, and particularly the relationship of such policies with the
growing epidemic of obesity, calls integrative practitioners to the
challenging balancing act of finances, health, behavior change and of
compassion. Here, Integrator reader Charlie Priester, a
self-employed, informed consumer of integrative, natural health
practices - particularly of the self-care variety, wades into the
debate. He offers ideas about how such policies can be good for
naturopaths, acupuncturists and Yoga therapists, and for self-employed
individuals like himself. Priester is a former colleague in publishing
the hard-copy Integrator (1998-2002) and in developing the
Integrative Medicine Industry Leadership Summits (2000, 2001, 2002). More
November 25, 2009
The Summary Report
from the Institute of Medicine on the February 2009 Summit on
Integrative Medicine and the Health of the Public is an expansive and
stimulating conversation for anyone close to the integrative practice
movement. The more than 60 sections in 164 pages are inviting in
length, style and substance. An appendix with bios let's you know
something about the sterling group of professionals who were invited to
do the talking. Here are 10 short reflections including: integrative
"medicine" versus "health"; Senator Harkin's warning about opposing
vested interests; Don Berwick's 8
principles, and his holy
grail for integrators; Ed Wagner's chronic care model and a 1989
definition of naturopathic medicine; notes
on
NCCAM's priorities, as shared; an opportunities for accessing
$75-million a year for evaluating models, such as the Penny George
Institute-Allina initiative; apparent exclusion of multiple suggestions
that licensed CAM providers can might help meet primary care needs; and
deep thanks to the Bravewell sponsors for providing the funding that
made this happen. If you are at all wonkish about this field, buy the
book. Gift yourself. It's a great little reader. More
November 23, 2009
In his
most recent book, Why Our Health Matters: A Vision of Medicine That
Can Transform Our Future, author and integrative medicine leader
Andrew Weil, MD calls for a “radical change” in US health care. Weil shifts his focus from the two passions that have
shaped his
work: transforming personal health practices and changing US medical
education. Here Weil’s ambitious eye is trained on the gold ring of
transforming healthcare itself. Weil presents his “argument that
integrative medicine is the key to solving the healthcare crisis.” He
enjoins “leaders of this new medicine to make people aware of the facts
presented (in the book) and motivate them to join us in working for
real reform." Unfortunately, Weil’s
success in engaging the leaders on whom such a
grassroots movement rests may be limited by the MD-centrism and
protectionism in the otherwise compelling vision in Why Our Health
Matters. More
November 21, 2009
This
is an auspicious moment for evaluating integrative practices. The
Obama-empowered comparative effectiveness research (CER) movement
focuses attention on practical evaluations “to
assist consumers, clinicians, purchasers, and policy makers to make
informed decisions that will improve health care at both the individual
and population levels.” Meantime, the new NCCAM strategic plan, if it
follows Congress' mandate, will march to a similar drummer. Into this
vortex steps the Institute for Integrative Health (IIH) and the Center for Medical
Technology Policy (CMTP),
led by leading NCCAM-funded researcher Brian Berman, MD and former CMS
medical director Sean Tunis, MD, respectively. They convened top
scientists in CAM/IM, CER researchers and government agencies to
explore the common ground of effectiveness. Berman calls the gathering the beginning of a process "to make
evidence much more relevant, and getting to the
essence of the clinical encounter.” The
group will create an "Effectiveness Guidance Document" to aid IM/CAM
researchers in CER study design.
Taylor Walsh, a participant, files this report
on the November 9, 2009 symposium. More
November 16, 2009
I split my professional life between the Integrator
and related writing and the organization featured here, the
Academic Consortium for Complementary and Alternative Health Care
(ACCAHC) which, as a multidisciplinary entity, lives and breaths the
integration-related issues reported here. This
article is ACCAHC's November 2009 Quarterly Report.
Featured are: ACCAHC's newly published Clinicans' and Educators' Desk
Reference on the Licensed Complementary and Alternative Healthcare
Professions;
a focal project on determining the competencies of CAM professionals
for integration in conventional delivery facilities; two collaborations
with recipients of the "reverse R-25" NIH NCCAM grants to help with
dissemination of the programs and materials they piloted (including a
conference planned for the spring of 2011); and news that NBCE and
NCCAOM have joined ACCAHC as full members. More
November 12, 2009
This
article aims to help you respond, as a stakeholder, to the next
NCCAM strategic plan. Responses are due November 30. I first analyze the
1998 Congressional mandate relative to this
most important issue that will face the integrative practice community
in the coming 5 years; namely, the prioritization of $600-million the NIH NCCAM will
spend. The mandate will surprise you:
prioritized were outcomes research, exploration of "prevention
modalities,
disciplines and systems" and evaluation of "integration ... into
delivery systems" rather than the basic research and RCTs that
dominated NCCAM under its first director. Now,
as NCCAM seeks your input, even as it is being reasonably challenged
for having created limited value to date, might NCCAM be served to
embrace what Congress originally mandated? I offer 14 trends in the
healthcare and policy worlds and inside the integrative healthcare
community that make the direction Congress' mandated 11 years ago even
more auspicious at this time. This article is background for submitting
your own stakeholder inputs on the NCCAM strategic plan. Get your
comments in by November 30! More
Issue #69 November 5, 2009November 5, 2009
Respond
now! NCCAM seeks stakeholder comments on 5 year plan ... IOM publishes
report on February 2009 Summit ... FTC/FDA cracks down on dietary
supplement sites, including DrWeil.com, for "fraudulent" H1N1 claims
such as are made in many kitchens every morning ... Update on action
relative to LAc, certified professional midwives, "non-discrimination"
and ABC Codes in federal health reform ... 2009 consumer use data on
massage (more each year for medical purposes) ... Council for
Responsible Nutrition survey info on use of dietary supplements ...
MSNBC stirs antagonism to integrative medicine programs in medical and
nursing schools ... School yoga champion creates new not-for-profit
organization to support advance of programs ... AMTA responds to Integrator
comments
the termination of its Council of Schools ... International CAM: Brief
reports on recent developments in Switzerland, Italy, England and South
Africa ... Harvard professor, key employer leader find chiropractic
cost effective for low back and neck pain in new review study ...
Congressional amendment stimulates debate over financial incentives for
healthy behaviors ... November is a time for giving of thanks to the Integrator
sponsors
... Kokolulu Farm and Cancer Retreat shifts to donations-based business
model ... Integrative Medicine Alliance announces new website ... JACM
in deal with Natural Standard more
October 27, 2009
[From John
Weeks' October 2009 IntegrativePractitioner.com
column] There was a time not long
ago that licensed medical doctors, a.k.a. the kings
(and queens) of the hill in U.S. medicine owned the term "physician."
Much common and professional usage of the term still connotes MDs. Yet
legal
realities are shifting. Recently promulgated US Department of Labor
definitions note that naturopathic doctors and chiropractors may use
this term. In Florida, licensed practitioners of acupuncture and
Oriental medicine can legally call themselves Acupuncture Physicians.
The legislature in New Mexico just set up a category of "certified
advanced practice chiropractic physicians." The AMA is warring against
the perceived erosion of authority. But trends suggest that one endpoint
of
the movement toward integrative medicine is that “physician” will
increasingly umbrella a rainbow of disciplines. This column reviews
these trends and how they reflect jockeying for economic as well as
cultural authority. More
October 26, 2009
Passage of a bipartisan amendment from US
Senators John Ensign (R-NV) and Tom Carper (D-DE) has elevated a debate Integrator
columnist Michael Levin has repeated brought to these pages. To change
behavior, in Levin's view, "education rarely works, economics usually
does." The Ensign-Carper amendment allow health plan costs to be cut by
as much as 50% for those who engage healthy behaviors. Some unions and
major disease-based organizations are opposed. Employers tend to
support the direction, as Kenneth R. Pelletier, PhD, MD(hc) and Sean
Sullivan, JD, each share. A tremendous discussion has been kindled on
the Washington Post site. Levin lays out what he believes are
significant opportunities for the integrative medicine community. Where
are you on this issue of patient engagement, habit change, healthcare
economics and public policy? More
October 23, 2009
Harvard's
Niteesh Choudhry, MD, PhD and Pacific Business Group on Health medical
director Arnold Milstein, MD, MPH take on the most hard-fought "CAM"
versus conventional question: Are the covered services of
chiropractic physicians (as they are called by these researchers) in
health plans for effective and cost-effective than those of medical
physicians? The answers are mixed but with a very strong tilt in
the direction of chiropractic, especially if the cost of drugs are
factored in. There are implications here for how we belly up to the
cost-effectiveness bar in other integrative practices. A leading
researcher offers a blunt comment
that suggests comparative cost-effectiveness research should be at the
top of our research agenda. More
October 18, 2009
This is a
catch-up on some comments sent recently from Drisko, Quinn, Foley,
Korn, Sportelli, Whedon, Zabik, Hoagland, Clay, Matteson, Bark,
Pannozzi and Patel. The themes are the IOM coverage, NCCAM on use,
research focus and NCCAM defensiveness, advance of certified
homeopaths, Gawande's influential New Yorker article on how
economic structure's create use patterns, the practitioner-industry
relationship in integrative medicine, the value of a DC lobby-day
experience, and more. Enjoy these voices of 2 researchers, 3 DCs, 2
RNs, a community LAc, 2 MDs, 3 organization leaders, a student and a
lobbyist. More
October 15, 2009
Welcome to this Integrator
travelogue, linking you to international policy developments in
traditional medicine and complementary and alternative medicine
practices ... A citizen's referendum in Switzerland forces inclusion of
CAM practices in healthcare planning ... In England, a report from the
King's Fund concludes that we need both new methodologies and new
attitudes, thank you, to optimally research complementary medicine and
health ... A report on non-conventional medicine (the preferred term)
in Italy calls for an end to 20 years of procrastination, and shares
what's already covered in Tuscany and parts north ... Actuary Heather
McLeod, a CAM leader in the International Association of Actuaries, is
setting up a similar group in a new African health economics
organization ... More
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