Your Comments: 3 on BI's LAc Fellowship, Wikipedia on that Quack Paracelsus, NCCAM's Agenda and Seeking the Cause

Summary:  Tom Ballard, ND shares a fascinating encounter with Wikipedia over whether Paracelsus was the original medical quack ... Acupuncturist Gary Wagman, LAc calls Beth Israel's fellowship for licensed acupuncturists a shame ... Bethany Leddy, LAc and consultant Linda Rapuano offer correction that the original inpatient fellowship for LAcs was not at Beth Israel but at St. Vincent ... Consumer Perry Chapdelaine, Sr. urges that NCCAM examine those integrative practices that seek to work with patients to find and treat the causes of disease.

Gary Wagman, LAc, MTOM

1.  Gary Wagman, LAc, MTOM: Shame on Beth Israel for making LAcs pay to work

Gary Wagman, LAc, MTOM is a clinician at Harmony Clinic outside Portland, Oregon who is also on the clinical faculty at Oregon College of Oriental Medicine. He writes in response to the Integrator article on an inpatient fellowship for licensed acupuncturists at New York Beth Israel in which the LAcs pay BI a stipend to participate in the fellowship, rather than being paid for their work. Wagman also serves the homeless as a clinician at Portland's Outside In. 

"This program is an extreme insult to the Oriental Medical profession.

"Shame on Beth Israel for making acupuncturists pay to work!!

"I am sure that a hospital as prestigious as Beth Isreal could establish even a low-ball salary for these services."

Gary Wagman, L.Ac., MTOM

Note #1:  It has come to my attention that some readers thought that an earlier version of my comment field was referencing the staff family medicine personnel and acupuncturist when I spoke of "fat wallets." My sincere apologies for any confusion there. I was referring to those specialists and administrators who are earning $200,000-$1,000,000+ per year whose patients are benefiting from the acupuncture and from whom a few alms could provide payment for the services of the acupuncture fellows.

Note #2: To be utterly clear, I have honored and continue to honor the pioneering leaders of this program and the LAcs who are delivering services throughout the BI system. They are creating change which will open road to better inpatient care for untold tens of thousands as inpatient programs begin to expand into other systems across the country. I also know that both Arya Nielsen, PhD, LAc, and Ben Kligler, MD, MPH, the fellowship directors, are doing what they can to find a way to create some payment for the fellows. What angers me is the economic injustice in which these professionals are only able to provide their services, at this point in time, by working for free while an anesthesiologist, to name just one specialty group, averages $350,000+ a year. Why not $338,000 and spin $12,000 a year off to feed the LAcs? There is plenty of fat in the system to pay the fellows. Living with the compromises of "integration" is sometimes awfully distasteful.   

Bethany Leddy, LAc

2A.  Bethany Leddy, LAc:

"In your recent integrated medicine and health care round up April 2010 you stated that the Acupuncture fellowship program at Beth Israel was the nation's first inpatient fellowship for licensed acupuncturist. 

"This statement is inaccurate. The nation's first inpatient fellowship program for licensed acupuncturist was at St. Vincent's Hospital in Manhattan. The program began in 2005 by Dr. Ning Ma, LAc, and Linda Rapuano of St Vincent's. The program ran for three years and then became a paid outpatient clinic in the outpatient rehabilitation department of St. Vincent's. 

"I was the Chief Fellow of the March 2006-2007 program. The program was fully integrated inpatient and outpatient program with didactic instruction. The Acupuncture fellows received referral orders from the physicians for both inpatient and outpatient patients, the fellows also attended Doctor, and Nurse team meetings for each department they were involved with. The program was run by the Acupuncture Research and Development corporation started by Dr. Ning Ma.  I hope you will post this information on your blog so that the inaccuracy can be corrected. 

"I am glad to see that Beth Israel has begun a program as well.  Patients will benefit greatly from the integration of Acupuncture and Western Medicine."

Bethany Leddy, L. Ac.
www.bethanyleddy.com

Linda Rapuano

2B.  Consultant Linda Rapuano: The St. Vincent program was "an incredible feat"

"That's the one; ten years of my life trying to build a model of integrative care there. Just last year I did a very large 'consumer-focused facility design' project around the new hospital they were planning to build. All the components supporting integrative care would have begun with that facility design including re-engineered administrative processes and technology interface. I am glad the laughing Buddha is entertained. The hospital itself will close in 30-40 days time.  There are some services like the HIV and Behavioral Health which I believe may still be under discussion with unnamable entities.

The Acupuncture Fellowship at BI was conceived and modeled after the Acupuncture Fellowship at St. Vincent's two years prior to BI's.

"By the way, as long as we've touched on the topic (of my work gone to dust), here's the correction on your BI piece: the Acupuncture Fellowship Program at BI was conceived and modeled after the Acupuncture Fellowship Program I launched at St. Vincent's two years prior to BI's. I spent 18 months in overdrive developing that program with Dr. Ning Ma, the then clinical director of Pacific College of Oriental Medicine, doing everything from recruitment of candidates, staffing, internal credentialing, patient charts, developing western medicine diagnostic categories, distinct acupuncture protocols that matched the diagnostics, physician and staff in-service and training, patient education, delivery logistics and yes, we even began research at the level we were able to since we began only 1 day a week. The plans for further development were very exciting but St. Vincent's internal problems made things virtually impossible. The program launched in Rehab in 2006 and we moved it into Internal Medicine in 2007. It was an incredible feat because there were even more challenges than the usual ones. By the way, if you look in your archives, you will find the blurb you wrote up.

"Oh well, enough of that.  I went to see [Tim] Burton's Alice with my 12 year old niece and was reminded of the necessity for coming up with 6 impossible things every morning. Easy in this field."

All best,

Linda Rapuano

 

Tom Ballard, RN, ND

3.  Tom Ballard, ND: On Wikipedia's biases, quicksilver and the origins of the complimentary term "quack"

"Pertinent to your recent posting of Peter D'Adamo's challenges to Wikipedia.com, I happened to come across another example of how this site distorts truth to support the medical-industrial complex.

"An editor reading over my new book manuscript questioned my explanation of the word 'quack.' I had long ago learned that 'quack' derives from quecksilber (quick silver), a German word for mercury. The term originally referred to a doctor who prescribes mercury. In looking up 'quack' in Wikipedia I was surprised to read their claim that it is derived from "quacksalver", a Dutch word meaning 'boaster who applies salve.' Had I been wrong all these years?

"I investigated further and found that the first person labeled as a quack was Paracelsus (1493-1521), a famous Swiss physician, because he was the first doctor to use salves containing mercury to treat syphilitic ulcers. Was Paracelsus known as a boaster? No. Was he the first to prescribe salves? Not by a long shot. The only connection between Paracelsus and the word quack is his use of mercury.

The first person labeled as a quack was Paracelsus. Originally the the term was considered a compliment.

"Originally the term quack was considered a compliment. While there can be no way of knowing for sure, I believe it makes much more sense that 'quack' refers to someone who prescribes mercury.

"After Paracelsus, mercury continued to be used by medical doctors for another 500 years, both externally in salves and internally as a tonic. Natural doctors did not recommend mercury. They believe in nurturing, not poisoning the body.

"The word quack has now been appropriated by the medical-industrial-complex to mean 'charlatan' or 'pretender to medical skills." Paracelsus was not a pretender; he was a renowned medical doctor. 'Quack' is commonly used against anyone who promotes nutrition, herbs, exercise, or other lifestyle modifications to cure illness. Naturopathic doctors and chiropractors are common targets, but anyone who disagrees with the authority of the dominant medical system is likewise smeared. I'm not saying there are not people with and without degrees, even MD degrees, who overstep their education. And, there are outright frauds. However, the word quack is most commonly used to attack dissenters, those who challenge medical orthodoxy, such as the scientists that came forward to question the safety of Vioxx.

"The medical establishment claims they are 'scientific' and dissenters are 'unscientific quacks' although few of their therapies have long-term, human, independent studies.

"Sadly, we see that Wikipedia and other supposedly 'independent' media are controlled by the same powers that control major media - large corporations - and their 'independent' hacks are perfectly willing to distort history to support the pharmaceutical orientation of medicine."

Tom Ballard, RN, ND
www.PureWellnessCenters.com

Perry Chapdelaine, Sr.

4.  Perry A. Chapdelaine, Sr: NCCAM should research practices that find and treat the causes of conditions

"I'm currently located in the Philippines, and so I apologize for commenting on your article 'Why Isn't NCCAM's 10^th Year Anniversary Symposium Focusing on Real-World Outcomes?' Townsend Letters was transshipped to me a wee bit late!

"I greatly appreciated your comments regarding the National Center for Complementary and Alternative Medicine's 'signature event.' You certainly struck the proverbial nail on its big, fat head!

"I've not yet seen it clearly explained that CAM is the discovery of causation and removal of those damaging causes, not simply 'feel good programs' or relief of a cluster of symptoms."

"I would have been quite a bit stronger. There's a mind-set in those who glibly talk and write about 'alternative/complementary' medicine that - at least to me - demonstrates a total ignorance of their subject. As a lay person, and CEO of The Arthritis Trust of America (a non-profit, tax-exempt charity) since 1982, I've been responsible for telling folks how our doctors handle the multi-factored sickness condition of rheumatoid disease and related health problems. It's long been clear to successful practitioners that this cluster of symptoms is, indeed, multi-factored, and no single therapy, however double-blinded, will help more than a small proportion of folks in their search for wellness.

"Even more important is the misconception that chasing after symptom relief is any kind of measure of an effective wellness program. Pharmaceutical companies are already expert at this futile chase.

"I've not yet seen it clearly explained, as I'd prefer it to be, that 'alternative/complementary' medicine is the discovery of causation and removal of those damaging causes, not simply 'feel good programs' or relief of a cluster of symptoms.

"When a  bureaucracy hires primarily those trained to 'heal' symptoms rather than to search out causations and remove them, such a bureaucracy is bound to spin its wheels, money, and influence seeking prestige, not truth."

Perry A. Chapdelaine, Sr.
Philippine Alternative Medicine Association