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Issues #74 & #75 - March-April 2010 |
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Written by John Weeks
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Issues #74 & #75 - March-April 2010
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Issue
#75
-May 5, 2010May 5, 2010
HHS Secretary Sebelius and former DNC chair Howard
Dean, MD comment on acupuncture,
homeopathy other natural healing methods ... US Congressman Tim Ryan
champions
mindfulness-based stress reduction programs in hearing; Sebelius
responds ... Josiah Macy Foundation urges lifting of obstacles
for nurse practitioners in primary care; roles of DCs, NDs, LAcs
commented upon ... Washington state data show
insurance costs for individuals using CAM for back pain, fibromyalgia,
menopause symptoms are less than those who don't use CAM ...
NCCAM references only "products" research in key message on 2011-2015
strategic plan; Briggs responds ... 1993 Seattle Post
Intelligencer letter from by Integrator publisher-editor
submitted as defense for impatience with reductive research on
integrative
practices ... White paper on research for holistic nurses articulates
critical importance of complex modeling ... Bastyr's Boutin on 8
reasons why healthcare
overhaul is good for nutritionists ... Chiropractic educator/researcher
conference draws record turnout; college presidents
group shares top 6 strategic initiatives ... Update on Georgetown Masters Degree that
links basic sciences and CAM ... Stamford Hospital begins 2-year
integrative medicine fellowship ... Bastyr to award honorary doctorates
to Mehmet Oz, MD and to Lisa OZ ... Correction on the first
regionally accredited "stand-alone" AOM school ... White paper on
regulatory issues for Yoga, Ayurvedic fields ... Naturopathic doctors
push Congress for inclusion in
loan repayment programs ... Real Simple features integrative
medicine; distinguishes this category from DOs and NDs ... Mathews to
head Yoga Alliance ... Hangee-Bauer the new AANP president ... More
April 28, 2010
The recently published "priority-setting
framework" for the 2011-2015 NIH NCCAM strategic plan left the strong
impression that the agency had merged with the Office of Dietary
Supplements.
The short statement in a April
16, 2010
"Message from the Director" by
Josephine
Briggs, MD focused on investigating "products." The term denotes the
field of integrative practice 3 times in the short guide. Adding to
this
apparent pigeon-holing are repeated highlights of basic science
questions
and efficacy trials and the absence of any allusion to outcomes
research or whole disciplines. In short, the published framework
appears
more appropriate for exploring
conventional pharmaceuticals than multi-modality, whole person
approaches. I contacted Briggs with
some pointed
questions, referencing NCCAM's Congressional mandate. Here
is Briggs' NCCAM framework, my questions, and her letter
in response. More
April 27, 2010
The 32 practitioner integrative
clinic is nearing it's 250,000 patient visit. In the economically down
year of 2009, volume and revenues expanded significantly. Findings of a
significant, integrative, team approach to chronic pain, engaged through
a contract with the state of Hawai'i's main insurer, HMSA, were
published. The positive outcomes are holding over time. A significant
consultancy with an integrative venture associated with an East Coast
academic health center is coming to a close. Meantime, the founder and
director, Ira Zunin, MD, MPH, MBA is in training with the Polynesian
Voyaging Society to participate in a 2013 world tour. Here is an Integrator
update on the Manakai O Malama clinic on the island of Oahu. More
April 24, 2010
Peter D'Adamo, ND on the
Wikipedia battle over his page and blood-type diets ... Bill Henry on
the
influence of the Bravewell Collaborative's leaders ... Tom Ballard, ND
offers strategies for the integration and reform dialogue ... Health
Freedom leader Diane Miller on her organization's role in pushing back
McCain on dietary supplements ... Energy healer Mary Klifman's words to
Congress ... Bill Manahan, MD with kudos and a suggestion for a
political-energetic use of a Beatles song ... Plus a note on paid
vigilantism in the Integrator ...
More
April 22, 2010
At the end of her talk before
the National Press Club on April 6, 2010, Health and Human Services
Secretary Kathleen Sebelius was popped a question on "acupuncture,
meditation and other alternative healing methods." Sebelius responds
positively, if perhaps with some misunderstanding, linking these
therapies to consumer choice, to comparative effectiveness research
(CER) and to potential cost-savings. Here are Sebelius' comments, plus
some additional comments on CER and alternative medicine from former
Democratic Nationla Committee chair Howard Dean, MD as reported in
Elsevier's In Vivo blog for the pharmaceutical industry. Those who want
Sebelius' whole speech, it's here. Take a look. More
April 20, 2010
The definition of "integrative
medicine" endorsed by a consortium of 44 medical schools includes the
importance of integrating not just modalities, but also of integrating
"healthcare professionals and disciplines." Accreditation standards of
the licensed integrative practice fields each require competencies in
"referral" and most in "collaboration." But are these fields adequately
educating about each other? Marketing work led by Beth Rosenthal, PhD,
MPH, is finding that interprofessional education (IPE) is yet in its
infancy. Meantime, a recent Institute of Medicine
report on continuing education strongly promotes not only IPE but
conferences with "carefully tailored
learning environments" to enhance understanding between members of
different fields. This column looks at the state of integrative practice
education in leaving the silos that limit optimally integrated team
care. More
Issue
#74
April 8, 2010April 8, 2010
What
integrative practice associations are saying about healthcare overhaul
... CMS/Medicare nominee Berwick and his principles for integrative
medicine ... Patient outcomes from Penny George Institute inpatient
integrative care ... Ground-breaking Healthpoint expands integrative
model in community health; Breed comments ... NCH's Gahles reports on
meeting of top homeopathic researchers with NCCAM team ... Anti-NCCAM
bloggers take invite from NCCAM's Briggs ... Outcomes of Medicare
chiropractic demonstration project confusing, under examination by ACA
... Ford pilot shows lowered use of drugs by acupuncture and mind-body
group ... Merrell and integrative medicine featured as cost-saving in NYT
... Update on action at Wake Forest integrative medicine ... First
inpatient acupuncture fellowship at New York's Beth Israel ... Maizes
clip highlights decade plus of changes at Arizona Center for Integrative
Medicine ... Western States Chiropractic College becomes University of
Western States ... Tri-State Acupuncture College publishes white paper
on inter-professional education ... Ornish challenges thinking in New
York Times piece ... Bravewell leaders in Vanity Fair ...
Acupuncture positively portrayed in Wall Street Journal ...
Robust SPARC/OCIM gatherings in Portland, Oregon ... Massage Therapy
Foundation receives $30,000 NCCAM conference grant ... Educators
Schwartz and Lowe team for online education business ... Caldwell heads
AHMA ... O'Connell to exec post with ACA ... Naturopathic doctor Cronin
in the cover of Phoenix Magazine "Best Doctors" issue ... Marchiori
selected as new Palmer chancellor ... Huggins elected to AHPA
presidency, plus more ... More
April 7, 2010
US President Obama's Big Tent
policy has nothing on NIH NCCAM's director Josephine Briggs, MD. Briggs
is
actively and commendably exploring the far reaches of this field for
which she is charged with creating the 2011-2015 strategic
plan for deploying some $600-million in research funds. Six weeks ago,
she and her top
staff met with an international delegation of homeopathic researchers,
organized by Nancy Gahles, DC, CCH, RS Hom (NA), president of the
National Center for Homeopathy.
Then Briggs reportedly extended an invite to a group of anti-CAM
bloggers, anchored by Yale
School of Medicine's Steven Novella, MD. These folks don't
believe there is value in anything NCCAM has done, reserves a special
vintage ire for homeopathy, and have called
for
a de-budget bombing into smithereens
of Briggs' professional home, NCCAM. Here
are reports on the two meetings. More
April 2, 2010
In 2003, the American
Chiropractic Association (ACA) took a bet
with Medicare that expanded coverage of chiropractic services would be
at least cost neutral for the agency. HHS
Secretary Sibelius has submitted her final report to Congress on the
2005-2007 demonstration project. Patients rated the pilot highly across
the board, but the cost results are conflicting from the 4 separate
sites. On the all-important question of cost neutrality, findings range
from cost saving to quite costly. Now Medicare is looking to recoup
$50-million through a lowering of reimbursement rates for chiropractors.
An ACA
team including health services expert Christine Goertz, DC, PhD and
Susan McClelland has been formed to explore the huge variances between
sites, and especially why the Chicago area showed as a costly outlier.
The lessons and process here may be of interest to any integrative
practice interests who believe all they need is a good demonstration
project to guarantee rapid adoption into the healthcare payment and
delivery system. More
April 1, 2010
The nation's first inpatient fellowship for
licensed acupuncture is into its second year in the Department of
Integrative Medicine at New York's Beth Israel Hospital. The year-long
fellowship is under the direction of Arya Nielsen, PhD, LAc and Ben
Kligler, MD, MPH. The program consists of clinical service for a wide
range of conditions and environments, plus didactic and often
grand-rounds style instruction, much of which is paired with an
integrative medicine program for the hospital's medical doctors. Here is
an overview of the program, with details on its financial model. More
March 24, 2010
Six leaders of the
Consortium of Academic Health Centers for Integrative Medicine were
hosted by the Indian government in January for a trip that was meant to
explore strategies for increasing the presence of Ayurvedic healthcare
in the United States ... A storm of activity on both sides of the
Atlantic has bellowed up following a recommendation from a committee of
the UK Parliament to end that country's recognition of homeopathy in the
Natural Health Service ... Reports are filtering back on care-giving in
Haiti as acupuncture and naturopathic organizations consider
sustainable strategies for long-term involvement. More
March 17, 2010
A decade ago US Senator Tom
Harkin told Sheila Quinn and other leaders of what would become the
Integrated Healthcare Policy Consortium (IHPC) that a unified voice
across diverse integrative
practice interests could be helpful in lobbying ideas through Congress.
Since
IHPC's incorporation in 2002, the team Quinn has chaired has worked hard
to play that role, endured periods of
low budget and no budget via the volunteerism
of board and staff alike as IHPC accrued a
growing list of accomplishments. On March 17, 2010, IHPC announced a transition at its helm. Quinn is
stepping down and long-time integrative medicine leader Len Wisneski, MD
will become IHPC's interim chair. Here is the IHPC release on the
transition, with reflections on what IHPC has accomplished in the Quinn
era, and the challenges ahead. More
March 16, 2010
"Licensed Integrative Practitioners" -
Bastard Child Up for Adoption Needs Big Tent for Home
Do you see yourself as a "licensed integrative
practitioner"? Do you feel kinship with those from other professions who
wear that label? Would you like your professional organizations to
collaborate with similar professions to advance integrative practices
nationally? And what, by the way, is an "integrative practitioner"?
These questions and more came to the fore when influential members of
Congress chose to use "licensed integrative practitioners" as a tactical
phrase to secure inclusion of various provider types in proposed health
reform legislation. I tried out such questions on national policy
panelists at the Integrative Healthcare
Symposium on February 25 and 26, 2010. The
initial reception appears to be that the "licensed integrative
practitioner," this bastard step-child of the legislative process, will
not soon have a big tent to call home. I
was and remain intrigued by the possibilities. Here are some
reflections. More
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