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Integrative Medicine and Integrated Health Care Round-up: August 2010 PDF Print E-mail
Written by John Weeks   

Integrative Medicine and Integrated Health Care Round-up: August 2010

Summary: The AMA's resolution in favor of discrimination against other providers as amended ... Licensed midwives take one from OB-GYNs in New York ... Legislation introduced to get DCs into US Public Health Service ... Samueli Institute links with Joint Chiefs of Staff for magazine supplement on "Total Force Fitness" ... True North shares paradigm with MGMA group ...  Cavallo Point hotel-spa and integrative center opens with Bradly Jacobs, MD, MPH in key role ... Massage therapists beat back nasty allegations from local police to protect new law in California ... New integrative dietetics practice group in the American Dietetics Association ... Author-clinician Ilene Serlin, PhD makes headway in introducing whole health practices at APA ... University of Chicago becomes 45th member of the Consortium of Academic Health Centers for Integrative Medicine ... Bastyr now home to a leading midwifery school and Simkin Center doula training ... Mail order Clayton College shuts doors, to delight of naturopathic doctors ... 6th IN-CAM Research Symposium in November 2010 ... Group Health Institute team identifies diverse positive outcomes from CAM-IM not typically captured in studies ... Research finds health in "forest bathing" ... PMG Data Services purchases Innovision ... Holistic Primary Care marks 10th year of publication ... Consumer Reports blasts "dirty dozen" of dietary supplements; Blumenthal responds ... Natural Foods Merchandiser reports modest growth in industry in 2009 ... Briggs and NCCAM in media whipsaw ... Comments on Krakow's "alternative medicine as a free market approach" ... Lewis Bazakos, DC given another significant award, this from New York Chiropractic College ... 
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The AMA SOPP approach to inter-disciplinary relations
AMA's resolution in favor of discrimination against other professions as passed in June

The Integrator posted Battle Engaged: MD Specialists Promote Repeal of Non-Discrimination Vs Integrative Practitioners, Others on May 28, 2010. The article regarded a resolution tha
t the AMA House of Delegates was to consider in their June meetings. A link to the pro-discrimination resolution as amended was provided to the Integrator by John Faladareau, vice president for government relations for the American Chiropractic Association. Language was made slightly more diplomatic, toward Congress if not toward non-MD practitioners. The House removed a requirement that the AMA "condemn" the non-discrimination Section 2706 of the reform bill. In addition, in the amended version, meetings of the  AMA's multi-year Scope of Practice Partnership campaign are not required to have updates on this anti-2706 campaign on each agenda. Instead, SOPP leaders get to choose whether or not to bring it up. The remainder of the proposed resolution was passed as originally presented. Faladareau also shared a statement from the National Association of Chiropractic Attorneys in favor of 2706.
Comment: Pleasing to see that, through the amendments, the AMA House showed great sensitivity to the freedom of choice of SOPP activists. They get to decide whether or not to put 2706 on their agendas. Perhaps this concern for member freedom of choice will mature one day into appreciation of freedoms for patients.
Victory over OB-GYN's in legislative effort
Licensed midwives in victory over the OB-Gyns in New York State

On July 30, 2010 New York Governor David Paterson signed bill A8117b-S5007a which, according to the New York Association of Licensed Midwives (NYALM) "amends the education law to remove the requirement for midwives to have a written practice agreement as a pre-requisite for practice in NY."  After "breezing" through both chambers, the bill
"hit heavy opposition from the American Congress of Obstetricians and Gynecologists," according to an account in the New York Times. The state has 800-900 practicing midwives, more than any other state. Roughly 10% have reportedly had problems getting written practice agreements from OB-GYNs. NYALM declared the signing of the Midwifery Modernization Act a "victory for New York women, families, and midwives."
Comment: The OB-GYNs are one group that is sometimes party to the AMA's Scope of Practice Partnership (see AMA SOPP-related article above) that seeks to keep more of medicine under control of medical doctors. This issue in New York, however, did not make the most recent list of areas of AMA SOPP concern. Perhaps they weren't aware until the last moment and so were stuck trying to bully in late. (Thanks to Lou Sportelli, DC for bringing the issue to my attention.)
Green: Powerful sponsor for ACA bill
Chiros have legislation introduced for inclusion in the US Public Health
Service Commissioned Corps 

In an August 5, 2010 release, the American Chiropractic Association and the Association of Chiropractic Colleges (ACC) commended US Congressmen Gene Green (D-Texas) and Lee Terry (R-Neb.) for introducing legislation that calls for the appointment of doctors of chiropractic as officers in the U.S. Public Health Service (USPHS) Commissioned Corps.
HR 6032, according to the release, would include DCs in the Regular Corps and the Ready Reserve Corps, and would also require the appointment of "no fewer than six DCs" to the Commissioned Corps. The release notes that "although the Commissioned Corps includes representatives from many diverse health care professions, no doctors of chiropractic have ever been appointed to serve."  HR 6032 has been referred to the House Committee on Energy and Commerce on which both Green and Terry serve as senior members.

Military Medicine

Cover of Samueli-Joint Chiefs supllement
Samueli Institute, Office of the Joint Chief of Staff collaborate on special issue of Military Medicine

Admiral Michael Mullen, chairman of the Joint Chiefs of Staff of the U.S. Military has called for "a 21st century definition of fitness that balances performance and readiness with health and well-being." Materials supplied to the Integrator by the Samueli Institute describe how the Institute has collaborated with the Consortium for Human and Military Performance (CHAMP), the Institute for Alternative Futures and the office of the chairman of the Joint Chiefs to respond. The new paradigm is called "Total Force Fitness." The model envisions "an integrated approach to performance, readiness, health and well-being across the domains of military life: spiritual, psychological, behavioral, social, physical, nutritional, medical, and environmental." To highlight the work, Samueli Institute co-sponsored a special Supplement to the August 2010 issue of Military Medicine entitled "Total Force Fitness for the 21st Century: A New Paradigm." The supplement describes "the characteristics of the eight fitness domains" and discusses the challenges presented in implementing a new, multi-dimensional fitness program in the military. Samueli shares that:
" ... The goal of this issue is not to describe the many existing programs or those in development to enhance fitness in the force, as that would be beyond the scope of this effort. It does attempt to provide the foundation for how any fitness program can be evaluated and compared, along with a summary of metrics that can be used for monitoring program effectiveness, and for improving and comparing those programs already in existence."
Comment: It is one of the high ironies of the integrative medicine movement that a tree with roots in the counter-culture and its anti-war beliefs is branching vigorously into service to not only injured and returning Vets but also to the business of making soldiers. This supplement, which requires a subscription to access, will be must reading for the many integrative interests that are working in and around the armed forces.

Integrative Practice

Model enlightens MGMA group
MGMA hears from integrative center True North on a new paradigm

Attendees of the New England Medical Group Management Association (MGMA) meeting in July 2010 heard an unusual presentation.
The executive director of Maine's True North integrative health center, Tom Dahlborg, spoke about the not-for-profit's model in a conference somewhat ominously dubbed "Surviving the Changes in Health Care." Dahborg's offered his center's approach as an antidote: True North: Stepping Outside of the Powerful Healthcare Paradigm. Dahborg presented the center as "a model that brings about positive change by placing time, relationship and collaboration at the center of the therapeutic encounter and the organization's mission."

Dahlborg explained to the MGMA crowd that True Health's goal "is to create an adaptive culture - a new paradigm - that identifies the root cause of a problem in order to find creative, comprehensive solutions to both individual and global health concerns." The center's model rests on 4 pillars: collaborative leadership, an integrated approach, innovative access programs, and outcomes scrutiny. Access programs include a needs-based payment plan with a sliding scale and a collaboration with "Hour Exchange Portland" to allow users to barter for treatment. Another payment option is a fund that supports patient who, for their part, agree to engage in an outcomes survey (Dyna-36) and engage in a follow-up interview.

Lobby of Cavallo Point
High-end Cavallo Point rolls out integrative center led by Bradly Jacobs, MD, MPH

Homeopath and author Dana Ullman, MPH recently visited Cavallo Point as part of the spa-hotel-integrative center's roll out to the public. In an email message, Ullman spoke of "the absolutely gorgeous integrative medicine clinic and spa" run by long-time integrative medicine clinician and entrepreneur Bradly Jacobs, MD, MPH. Added Ullman: "It's a totally high class operation."  The fee schedule shows an initial 90 minute consultation at a reasonable $225 with a relaxation session set at the same rate. The site's listed rates for a 90 minute massage are similar, at $210. Integrative services include acupuncture, herbal medicine, relaxation and spa services. The site does not list an array of providers, except an intuitive healer, but promises that "services are provided by professionals in their respective fields." Jacobs is past clinical director for the UCSF-Osher Center and integrative medicine leader with Revolution Health. The list of the 5 types of services Jacobs offers is worth visiting. The investor behind Cavallo Point is Michael Freed. Freed is also the owner of Post Ranch Inn in Big Sur which was acknowledged in 2003 as one of the finest lodgings in the USA. 
Comment: The question on service rates is this: Do spa-based integrative medical doctors get tipped as well as purveyors of hot stone massages? If not, the gross cost, including tip, for 90 minutes with either a massage therapist or the integrative medical doctor runs about the same. Apparently Resource Based Relative Value Units (RBRVU) have different meaning in a spa environment. Perhaps it's Client Based Relative Value Units, a measure that catapults hot stones into a high end service.

Massage therapists, prostitution and a weird battle with cops over the California law massage statute

An article in the August 2010 issue of Massage Today, The Fight for California, includes an interesting de-brief on the legislative situation in California. The fight included the female head of the California Police Chiefs Association citing
a "random/regional sample of applicants for licensing ... conducted by the chief's association (that) found that 89 percent of these applicants were prostitutes or had questionable backgrounds." At stake was not only the image of the massage field but also the new state-wide regulation of massage therapists that replaced county-by-county registration under the previous system. The article details how a combination of some gutsy volunteer work by Ahmos Netanel, savvy political work by Mike Schroeder and a grassroots letter-writing campaign led by the state chapter of the American Massage Therapy Association showed the error of the "sample" and of the legislative direction. The attack on the law was effectively gutted. One assessment was that the chiefs simply didn't like giving up the power they held under the previous system. The American Civil Liberties Union also weighed in on behalf of the massage therapists.

Ford: Chairing integrative dietetics section
Dieticians in Integrative and Functional Medicine is a new ADA practice group

Dietitians in Integrative and Functional Medicine (DIFM) is a "dietetic practice association" of the American Dietetic Association. The group was formerly Nutrition in Complementary Care (NCC).The group's operating vision is to "optimize health and healing through integrative medical nutrition practices." The mission: "Empower members to be leaders in evidence-based practice including personalized genomics, holistic healthcare, and functional nutrition therapies." Deborah Ford, MS, RD, CCN, is the current chair. Among recent actions was the creation of an official alliance with the American Botanical Society.  The new website is integrativerd.org. Among the organization's sponsors: Lipton Institute of Tea, Pharmavite, NatureMade and Nutrilite Health Institute. The organization's next conference, a one-day event on November 6, in Boston.
Comment: Good for Ford and her colleagues for stimulating this integrative interest in their profession. The ADA has some bad karma to work off, relative to some of its recommendations to the public through the years. This practice association looks like a step in the right direction.
Organization seeks new CEO
AAAOM seeks new chief executive officer

The American Association of Acupuncture and Oriental Medicine sent its members a notice in early July that the organization has begun a search for a new chief executive officer. Former staff member Doug Newton was tapped to fill an interim role. The organization's past executive director,
Rebekah Christiansen, held the post since the AAAOM was created when a 10-year rift in the profession, expressed through two national organizations, was significantly mended via a merger. No mention was made as to reasons for the transition. 
Comment: I am among those who hoped that the creation of the AAAOM would begin to draw the nation's 26,000 licensed acupuncturists into joining their one, united national association. The potency is significant. If 40% joined (a slightly higher percentage of members than the AMA attracts) and dues were a friendly $250/year, the organization could be thriving on a $2.5-million annual operating budget. For some reasons, the attraction has not happened and membership remains somewhere in the 500-1500 range. Pretty hard to make much difference for a profession with that level of membership. Are AOM practitioners simply not joiners?
Serlin: Urging integrative psychology
Integrative Psychology: Top APA leaders in session on Whole Person Healthcare led by
Ilene Serlin

The session at the August 2010 conference of the American Psychological Association is "Whole Person Healthcare: Tool Kits." The session was arranged by Ilene Serlin, PhD and James Bray, a past president of APA. The association's president-elect will be on hand as a discussant. Toolkit subjects included guided imagery, biofeedback and the use of creativity in clinical practice.
The description developed by Serlin includes the following:
"Integrative therapies have become increasingly popular in clinical and psychotherapeutic settings, complementing traditional medical and psychotherapeutic practices. A whole person approach brings psychologists into a collaborative relationship with other health professionals, and can introduce integrative methods from a uniquely psychological perspective. While integrative psychology is a field that is ripe for clinicians, most clinicians are not trained in how to integrate these techniques into their ongoing therapeutic practices."
Serlin is a San Francisco-based therapist who is author of the 3-volume Whole Person Healthcare. Dean Ornish, MD and David Spiegel, MD introduce Serlin's books.


Temple: Heads up U Chicago IM program
University of Chicago joins Consortium of Academic Health Centers for Integrative Medicine

The University of Chicago has become the 45th academic health center to join the Consortium of Academic Health Centers for Integrative Medicine. The director of the program is Leslie Mendoza-Temple, MD. Temple took her medical degree at the University of Santo Tomas Faculty of Medicine and Surgery in the Philippines, and subsequently completed the Fellowship in Integrative Medicine from the University of Arizona.
Mina Lee Ryu, MD, FACP, currently in the fellowship program, is another attending physican for integrative consultations at the university. The program is located at the Northshore University Health System

Myers: Founding mother of midwifery school chairs Bastyr department
Leading Midwifery School and Doula Training Merge with Bastyr University

The Seattle Midwifery School (SMS), a long-time anchor of the direct-entry midwifery field, has been approved by the Northwest Commission on Colleges and Universities as part of Bastyr University. In a release on the merger, Bastyr notes that Bastyr will also be home to the The Simkin Center for Allied Birth Vocations. The Simkin Center, named after famed childbirth educator and author Penny Simkin, offers certificate training courses for birth and postpartum doulas, lactation educators and consultants, and childbirth educators, as well as continuing education in maternity care topics." The midwifery program prepares graduates to become Certified Professional Midwives. An SMS co-founder,  Suzy Myers, LM, CPM, MPH, directs the new department. Bastyr was founded in 1978 as John Bastyr College of Naturopathic Medicine and has added numerous other health sciences degree programs and certifications since 1985.

Clayton: Offered low, low price for doctor wall diploma
Mail-order Clayton College and the Coalition for Natural Health shut their doors

On July 10, 2010, a flurry of emails arrived from colleagues in the naturopathic medical community: the Clayton College of Natural Health had shut its doors. The reason cited was economic hard times. Separate but linked news was that Clayton's lobbying partner, the Coalition for Natural Health, had moved to "inactive status." The former offered a mail-order route to becoming a "doctor of naturopathy." Clayton also provided other diplomas at various prices. The business had 3,000 students at the time of its demise. According to a staff person for Clayton at a 2008 trade show, some 25,000-35,000 individuals had become "NDs" via the program. This compares to 4,000-5,000 naturopathic physicians in all of North America who are graduates of residential, naturopathic medical programs accredited by the US Department of Education-recognized accrediting agency for the field, the Council on Naturopathic Medical Education. As graduates of the 4-year programs created legitimacy for naturopathic medicine, the cost of Clayton's diploma went up. Andrew Lange, ND, a Bastyr-educated naturopathic doctor, captured his profession's view in a Huffington Post article: The Biggest Quack School in Natural Medicine Closes.

Meantime, the
Coalition for Natural Health served as a political arm for these Clayton's graduates. The Coalition fought ardently and with some savvy to defeat efforts to expand licensing by the graduates of the 4-year ND programs. The reason for opposing licensing was simple. Any state in which a standard for practice was established, those choosing the mail-order route would no longer be able to hang up their shingles and their "Doctor of Naturopathy" wall certificates. Realizing that potential students would be interested in accreditation, Clayton advertised that the business was accredited. According to QuackWatch, such accreditation was through the American Association of Drugless Practitioners and the American Naturopathic Medical Accreditation Board. The QuackWatch brief adds that "these are not recognized by the US Secretary of Education, which means that ‘accreditation' by them is meaningless."
Comment: It is somehow appropriate that the only time I have ever cited QuackWatch as a source is this article on Clayton. As I read about the demise of these symbiotic businesses, I kept thinking about a scorpion I purposefully squashed in a motel room one evening on the Nicaraguan coast. Like some sci-fi invention, when I turned my back, the creature somehow reassembled itself and moved off under the wall. It's hard to believe these blights on natural health care may be gone. As a political colleague once stated regarding an incumbent with a health condition who we were seeking to unseat: Some guys are better off dead. Such a sentiment may disturb one, relative to a fellow human being. It shouldn't relative to these entities.


Verhoef and Boon head up organization
Canadian researchers host 6th IN-CAM Symposium, November 19-21, 2010 in Vancouver, BC

The 6th IN-CAM Research Symposium, in collaboration with two of IN-CAM's partners, HomeoNet and PedCAM, will take place at The Sutton Place Hotel in Vancouver, BC, Canada on November 19-21, 2010. IN-CAM is one of the key research meetings in Canada on CAM and integrative health care. The theme for 2010 is Complementary and Integrative Health Care: Methodological, Theoretical and Practical Issues.
Well-known Canadian integrative health researchers Heather Boon, PhD and Marja Verhoef, PhD serve IN-CAM as co-directors.
Comment: I have had an opportunity to be involved with Canadian integrative health initiatives twice. Both times have like home. The elevated focus of the Canadians on practical outcomes I attribute to the socialized healthcare mission that is deep in the Canadian system. This I take to be part of the reason that it was the Canadians not their neighbors south of the border who developed the exceptionally useful Outcomes Database. Researchers in the US would be served to be importers of this prioritization and social mission. Upping US attendance at this 6th IN-CAM conference would be a good start.
Cherkin: Part of Group Health team
Outcomes: "Unanticipated benefits of CAM therapies for back pain ..."

The research team involves the sterling Dan Cherkin and Karen Sherman dyad of back researchers from the Group Health Research Institute. The goal of the research: " ...
to provide insight into the full range of meaningful outcomes experienced by patients who participate in clinical trials of complementary and alternative medicine (CAM) therapies." The results of the study, published as "Unanticipated benefits of CAM therapies for back pain: an exploration of patient experiences" are illuminating:
"Our analysis identified a range of positive outcomes that participants in CAM trials considered important but were not captured by standard quantitative outcome measures. Positive outcome themes included increased options and hope, increased ability to relax, positive changes in emotional states, increased body awareness, changes in thinking that increased the ability to cope with back pain, increased sense of well-being, improvement in physical conditions unrelated to back pain, increased energy, increased patient activation, and dramatic improvements in health or well-being. The first five of these themes were mentioned for all of the CAM treatments, while others tended to be more treatment specific. A small fraction of these effects were considered life transforming."
The conclusion: "Our findings suggest that standard measures used to assess the outcomes of CAM treatments fail to capture the full range of outcomes that are important to patients. In order to capture the full impact of CAM therapies, future trials should include a broader range of outcomes measures."
Comment: The supposition of positive side-effects has long been part of CAM/IM thinking since many of the whole person approaches impact the person in a systemic way. Yet researchers have rarely stepped up and identified these potential benefits. Congratulations to this group, led by C Hsu. Hopefully researchers will begin to ask these questions. While their fellow researchers might diminish the import of these endpoints, employers will not. The question now: To what punishment should any CAM outcomes researcher be subjected if he/she fails to capture these benefits? Not asking is a sort of reverse negative of garbage in, garbage out.
Japanese forest: Good for your health
"Forest bathing" and the potential benefits of walking barefoot in the dewy grass ...

Author and clinician Mitch Stargrove, ND, LAc sent a fascinating link to a study in Japan. In the research, subjects walked in forested or urban environments, then received the cross-over treatment of the walk in the opposite zone. Salivary cortisol, blood pressure, pulse rate, and heart rate variability were used as indices in examining the influence of the walks.
The findings: "The results show that forest environments promote lower concentrations of cortisol, lower pulse rate, lower blood pressure, greater parasympathetic nerve activity, and lower sympathetic nerve activity than do city environments." The authors comment: "These results will contribute to the development of a research field dedicated to forest medicine, which may be used as a strategy for preventive medicine." The therapy is called Shinrin-yoku or "forest bathing.
Comment: I don't typically cover straight research outcomes, but this one merited a mention. I recall learning 30 years ago that Father Sebastian Kneipp, viewed as a founder of naturopathic medicine, recommended a therapy in which patients walked barefoot in the dewy grass. As a sometimes PR person back then, I typically refrained from leading with discussion of this therapeutic approach when trying to awaken in wary parties the potential value of natural health care. This study, had I had it then, might have swayed me to stand up for the German healer's approach. If the subjects in the Japanese study had not only been walking in forests but also been barefoot on dewy grass in those forests, I'm betting that the positive outcomes would have jacked even higher. Side-note: The study underscores again the additional challenge to health for the urban poor. Forest bathing will be a greater challenge in the concrete jungle. Meantime, this study would seem to have a supportive link with the "nature deficit disorder" about which Richard Louv writes in The Last Child in the Woods.


Lampe: Long time leader a casualty of the purchase
PMG Data Services purchases Innovision, publisher of ATHM, Advances, IMCJ

Minnesota-based PMG Data Services has purchased one of the most significant publishing entities in integrative health care, Innovision Health Media. Innovision publishes Alternative Therapies in Health & Medicine, Advances, and Integrative Medicine: A Clinician's Journal (for which I write a column). The firm's website describes PMG as "a service bureau organization dedicated to helping specialty and trade publications cost-effectively manage their ongoing audience development activities." They add: "Today's successful publisher must rely on ancillary revenue from trades shows, web, list rental and product sales to supplement traditional revenue from advertising and subscriptions." One change: Frank Lampe, the former Innovision vice president and a highly-regarded and well-known presence in the integrative health space is no longer with the firm. Lampe was a co-founder and conceiver of the LOHAS concept.
Comment: It will be interesting to see if the firm moves Innovision toward development of conferences or tradeshows, a business direction Innovision has considered but not directly entered. 
Goldman and Sinclair publication celebrates 10th year
Holistic Primary Care marks 10th year of publication

Holistic Primary Care, a national, ad-based publication that is mailed to over 100,000 physicians nationwide, is celebrating its 10th year anniversary. According to Erik Goldman, editor, the publication will mark the accomplishment with a look back over the past 10 years. In recent years, the firm has added a conference service to its portfolio. Goldman and his partner, publisher Meg Sinclair, choose to focus their growing conference on strategies for business success. The well-received June 2010 meeting was entitled Heal Thy Practice: Transforming Primary Care

Comment: To my understanding, this long-time labor of love for Goldman and Sinclair, supplemented in its early years by Goldman's skills and reputation as a medical reporter for mainstream publications, has only recently stabilized as a going operation. That many thousands of the recipients of the publication were not self-described "holistic doctors" suggests that, over time, Goldman and Sinclair have probably quietly educated scores of medical doctors to the potential for more satisfaction in their practice, and success for their patients, from opening up their clinical visions. Congratulation on 10 years!  

Natural Products

Beating up on supplements, again
Consumer Reports features "Dangerous Supplements;" ABC's Blumenthal responds

Consumer Reports has published a special feature entitled Dangerous Supplements: What you don't know about these 12 ingredients could hurt you. The report included a list of what they called "The Dirty Dozen" (
aconite, bitter orange, chaparral, coltsfoot, comfrey, country mallow (sida), greater celandine, kava, lobelia, yohimbe, colloidal silver and germanium). The article has another  list with 11 agents "to consider" (cranberry, psyllium, pygeum, St. John's wort, calcium, fish oil, glucosamine sulfate, lactase, lactobacillus, SAM-e, and vitamin D). Mark Blumenthal with the American Botanical Council (ABC) responded with a Member Advisory on August 3, 2010 that stated, in part:
Blumenthal: Balanced assessment of the report
"Though this article is flawed and incorporates inadequate information on the safety of many of the herbs, it is in numerous ways an improvement over the cover story Consumer Reports ran in May 2004. The previous cover story contained so much erroneous information on herbs that it was readily apparent that the editors had not run the article by anyone with any real experience or expertise in herbal or dietary supplement research. This time, Consumer Reports relied heavily on the Natural Medicines Comprehensive Database as a primary source for much of its information on the safety, and to some extent, some of the potential benefits of some herbs and other dietary supplements."

In an interview with Natural Foods Merchandiser, Blumenthal commented: "There's no nuance, detail or context. They've just put everything in a list."

Growth not bad for a hurting economy
Upbeat release from the 2010 Market Overview from the
Natural Foods Merchandiser

"Despite the doom and gloom, naturals retailers are profitable." So reads the subhead on the June 2010 Market Overview on 2009 business from the natural products industry publication Natural Foods Merchandiser. Surveyed
independent products retailers reported that, on average:

  • Net profit margins fell to 5 percent in 2009, from 8 percent in 2008.
  • Net sales grew 8.9 percent in 2009, but when corrected for store closings and weighted based on the number of stores per category, sales grew only 3.4 percent.
  • Total natural products store sales were $33.9 billion in 2009, compared to $32.7 billion in 2008.

Food sales were up 3.9% over 2008 and supplements up 4%. The report is an interesting scan. One must sign up prior to access.


Briggs: Whipsawed from all directions
The media whip-sawing of Briggs and NCCAM: Bloggers, Prevention, MSNBC and a response

Comment: Colleagues sometimes urge restraint in my critical perspectives on the direction and priorities of the NIH National Center for Complementary and Alternative Medicine and NCCAM's director, Josephine Briggs, MD. Such urging is usually accompanied by noting how NCCAM is under attack from others. Two items this past month underscore just what a hot-seat Briggs inhabits. First, a polarizing medical doctor blogger who loves to hate everything "CAM" and who has a particular antagonism toward naturopathic medicine took the NCCAM on with an Open Letter to Dr. Briggs. The reason: Briggs planned to attend the 25th annual conference of the American Association of Naturopathic Physicians. Never mind that the NDs are one of the licensed disciplines that NCCAM is charged by Congress to explore.

Next, Prevention magazine included comments from Briggs in an article in which Briggs appeared to be endorsing certain CAM approaches. Given the scrutiny under which she operates, the presentation of her views must have felt particularly damaging. A shovel full of salt hit the wound when the Prevention piece was picked up and broadcast by MSNBC. The title: 9 cures you can trust. Briggs chose to use her NCCAM mailing list to counter
with an August 4, 2010 Director's Message. She noted her disappointment with Prevention and MSNBC: "Simply put, the article does not accurately portray the state of the science nor the perspective of NIH." I am pleased that this is not a month in which I have expressed what might be considered an unkind word.
Addendum: I can't resist a comment on the anti-NCCAM blogger's perspective on limiting the stakeholders with whom Briggs should be meeting. How threatening the NDs must feel to them to put Briggs' decision in the same grave category of action as if Obama were to sit down with leaders of the Al-Qaeda.  

Cohn recommends Krakow's "Alternative Medicine: A Free Market Approach to Health Care"

Georgetown University professor of law Sherman Cohn, JD, a long-time leader in the maturation of the AOM field, recommends a guest editorial from the June-July 2010 issue of Integrative Medicine: A Clinician's Journal. The perspective is from integrative practitioner Barry Krakow, MD and is entitled
Alternative Medicine: A Free Market Example of Health Care. Cohn, a sometimes Integrator contributor, shared this view of Krakow's piece: "The article is quite provocative -- it raises the question of whether those of us who believe in the efficacy of what is often termed CAM really want to join the established medical system with all of its problems."
Comment: While Cohn's question is an interesting one, the choices being made are clear. First, very few integrative organizations and doctors who can have coverage are choosing to forgo participation in insurance coverage. Second, virtually all licensed CAM fields want the option to be bought in, not only to insurance but also federal programs such as loan-repayment that are linked to insurance. Finally, while one hears talk of how the IM/CAM fields should be defining and shaping new relationships, little of this is actually done. So the question, while interesting, rarely gains much traction.


Bazakos: Honored by New York Chiropractic College
Lewis Bazakos, DC adds NYCC award to long list of distinguished honors

Lewis J. Bazakos, DC, a 1978 graduate of New York Chiropractic College (NYCC) was chosen as the multidisciplinary college's 2010 Distinguished Alumnus.  NYCC president Frank J. Nicchi, MS, DC acknowledged Bazakos for his work in developing and chairing of the
Chiropractic Summit, a "think-tank" made up of leadership from some 40 chiropractic organizations. Bazakos was NYCC board chair from 2004-2007 when the school inaugurated the NYCC's Finger Lakes School of Acupuncture & Oriental Medicine and School of Applied Clinical Nutrition.  He has been a member of the board of the American Chiropractic Association (ACA), past president of the New York State Chiropractic Association (NYSCA) and has been named chiropractor of the year by both his state and his national professional associations.

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