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background resources in PDF |
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some CAM/IM publication links |
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Issues & 80 & #81-Sept Oct 2010 |
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Written by John Weeks
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Issue
#81
-November 3, 2010
November 3, 2010
Flurry of opposition to AMA
ownership of CPT codes amidst report of AMA's $70-million of annual
royalties ... Center for Public Integrity reports "secretive" AMA
committee that guides Medicare priorities on billions of dollars ...
AAAOM, CRN, ACCAHC, NPRI and AHMA in follow-up statements on NIH NCCAM
strategic plan ... Update on Integrated
Healthcare Policy Consortium federal action for integrated health care: PCORI and workforce issues
... "Mother of holistic medicine" Gladys McGarey, MD takes on changing
federal policy, at age 90 ... True North Center turns SmartMoney
lemons into lemonade ... Guarneri-led Bravewell team publishes pamphlet
on cost-effectiveness of integrative medicine ... Multidisciplinary
effort led by Harvard's Marilyn Moore and U Minnesota's Karen Lawson, MD
moves to set national health coaching standards ... Massage
certification group NCBTMB sets stage to offer advance practice
certification program ... ACA part of Sharecare internet play that
includes Mehmet Oz, MD, Dean Ornish, MD and nursing groups ... A call
to "put integrity into integration" from Daniel Redwood, DC ... Report
leads to reconsideration of whether some placebos were placebos ... Huffington Post
expands its integrative medicine-focused health portal ... Michael
Cohen in new law firm ... Charles DuBois honored ... Lori Knutson, RN in
expanded role ... Shelly Johnson
new interim director role at American Massage Therapy Association. More
October 28, 2010
The Integrator article
that reported the $70-million subsidy the American Medical Association
(AMA) receives via the CPT coding system stimulated a burst of reader
response. Here are notes, reflections, suggestions and responses from:
Allina integrative care director Lori Knutson, RN, BS-HN; past AHMA
president Bill Manahan, MD; former ATHM editor David Riley, MD; Alternative Medicine Integration Group president Richard Sarnat, MD; Holistic Primary Care editor Erik Goldman; CAHCIM past-chair Vic Sierpina, MD; university president Jim Winterstein, DC; AANP past-president Michael Traub, ND, DHANP; author
and educator Marc Micozzi, MD, PhD; NPRI executive director Carlo
Calabrese, ND, MPH; an unnamed federal policy-maker nurse; ACC executive
director David O'Bryon, JD; AANP president-elect Michael Cronin, ND;
past ACAM president Ronald Hoffman, MD; past APMA executive director
Candace Campbell; integrative clinic owner Chris Foley, MD; journalist
Daphne White, CHMT; and Louise Edwards, ND, LAc. More
October 26, 2010
Chris Johnson, ND writes that he is "disturbed" by the Integrator
focus on health coaching "on many levels." Johnson, who practices in
the Washington-DC area, then goes on to dissemble just why coaching is a
misfit. He responded to an article on the Harvard/U Minnesota September
2010 summit held to begin to set national standards and certification
for the field, and a follow-up report by an attendee who represented the
naturopathic profession. Johnson's view
is at great odds with the perspective that coaching people to health
should be the center of a quality integrative medical practice. He
believes physicians must create magic for patients and coaching doesn't
fill the bill. Johnson questions the science behind coaching and argues
that the economics of a physician practice don't support a key role for
the coaching modality. I offer some comments on Johnson's perspective
and hope some of you will weigh in on these philosophical-business
issues about the role of health coaching relative to a physician's
responsibility and his/her economic well-being. More
October 26, 2010
A
nice mix of themes and responses here: Michael Levin on the
Seely-Herman research on cost savings of whole practice ND care for
Canada Post employees; AHMA president David Forbes, MD on the NCCAM
priorities; short notes on the
Georgetown-Bastyr relationship promoted by Adi Haramati, PhD; Barney
Holmes on biases relative to alternative medicine in Wikipedia; Carlo
Calabrese, ND, MPH on what "CAM" fields have in common according to
Wikipedia; Community Acupuncture Network co-founder Lisa Rohleder, LAc,
and AOM educator Steven Stumpf, EdD on the
incomes of licensed acupuncturists as reported by the National
Certification Commission for Acupuncture and Oriental Medicine, plus a
brief note from an anonymous naturopathic physician who believes that
her profession has a similarly challenged economic perch. I comment on
the link between Levin/Forbes and the income discussion. More
October 20, 2010
Integrative nursing leader Mary
Jo Kreitzer, RN, PhD called my attention to a peculiar characteristic
of US health care. The guild for MDs owns the means by which members of
all the other guilds can get reimbursed by 3rd party payers. The means
are the Current Procedural Technology (CPT) codes, the royalties from which earned the American Medical Association something in the area of
$70-million of revenue in 2009. (The AMA doesn't make it easy to find
the amount.) Kreitzer's interest was provoked by the AMA's antagonism to
the independent practice of nurses as primary care providers
recommended in an October 2010 Future of Nursing report from the
Institute of Medicine. The AMA also opposes the non-discrimination
portion of the Obama healthcare law (Section 2706) and other integrative practice
advances. Should practitioners in these fields be required to offer a
tithe to a profession that is a source of their own subjugation?
Maybe it's time for a CPT party. More
October 18, 2010
In
November of 2009, diverse integrative practice organizations made
recommendations to the NIH NCCAM following a call for public input from
the agency on its 2011-2015 Strategic plan. In August 2010, the agency
again called for comments when it release of its plan that will shape
some $600-million in research investments. Some integrative practice
organizations have comments and chosen to share their follow-up
recommendations with the Integrator for this special post to the
community: American Association for Acupuncture and Oriental Medicine
(AAAOM), Academic Consortium for Complementary and Alternative Health
Care (ACCAHC), Naturopathic Physicians Research Institute (NPRI) and
Council for Responsible Nutrition (CRN). Two themes: 1st, credit to
NCCAM for some of the new directions; and 2nd, a push to elevate the
focus on real-world and health promoting outcomes. Thanks to these
organizations for responding, and sharing. More
October 14, 2010
Empowering people to
change their behaviors is the most fundamental of health reform. So when
I learned that on September 26-27, 2010, some 70 integrative-oriented
professionals were to gather to explore standards and credentialing in
the field of health coaching, my antennae went up. Don't all integrative practitioners worth their favorite self-profile have skin in the coaching game? The
professionals gathered by leaders from Harvard and University of
Minnesota represented nursing, medicine, research, psychology, academic
health care, the existing coaching field and even the rare chiropractor
and naturopathic doctor. Jennifer Johnson, ND, a clinical assistant
professor at the University of Bridgeport program in naturopathic
medicine represented her field, and the Academic Consortium for
Complementary and Alternative health Care at the Summit. Here is her
report. More
October 14, 2010
Two Israeli's leave their
country to be trained in integrative practice. One, Nimrod Sheinman, ND,
the author of this article, attends a naturopathic medical school in
the mid 1980s. A dozen years later the
other participates in a residential integrative medicine fellowship.
Each are pioneers. Each returns then to their own country where they are
presently collaborators in the Davidoff Comprehensive Cancer Center at
the Rabin Medical Center. Here is Sheinman's account of the Center, the
clinical services and the broader public responsibilities, including
keeping the practitioners who serve these cancer patients from being
ground down in their practices. Take a look. More
Issue
#80
-October 7, 2010October 7, 2010
IHPC, others convene stakeholders for policy action plan on integrative
practices in reform law ... Goertz named to influential Board of
Governors of PCORI, significant new, national comparative effectiveness
research institute ... AANP urges members to weigh in on endocrine
disruption
bill ... Australian study reports cost savings from acupuncture and 3
natural products ... Disturbing national data on incomes of licensed
AOM
practitioners stimulates soul-searching ... Two-thirds of massage
therapists note downturn in practices in lagging economy ... Supplement
sales hold steady
... Managed CAM and wellness firm American Specialty Health hits
$147-million in revenues ... Penny
George Institute/Allina publish 2010 outcomes report ... Donna Karan's
Urban Zen expands nationally with Kent State partnership in program for
nurses ... Georgetown and Bastyr initiate novel agreement between
naturopathic
and conventional academic programs ... Marino Center links with Mass
Medical Society for integrative medicine training ... True North Healing
Center's Dahlborg brings
integrative business model to Dartmouth Medical School ... Alliance for
Natural Health examines Wikipedia biases against natural health and
medical alternatives ... Foundation for Chiropractic Progress a useful
model for fund-raising a discipline's national initiative ... AAAOM
breaks pattern in naming medical doctor Niemtzow to board ... Riley and
editorial team resign from Alternative Therapies in Health and Medicine
citing differences with new owners ... Publication opportunities in new peer-reviewed
Topics in Integrative Health Care/Hawk and in special integrative health issue of Patient Education
Counseling/Rakel ... 2011 Integrative Health Care Symposium to be held
in New York, March 4-6 ... Horace Elliott, Ad Haramati and Sherman Cohn
honored More
October 5, 2010
My own dark humor about the
licensed CAM professions of acupuncture and Oriental medicine (AOM) and
naturopathic medicine (ND) is that they have gained enough
recognition for their students to go into debt, just not enough yet for
their graduates to get out of it. The
2008 Job Task Assessment by the National Certification Commission for
Acupuncture and Oriental Medicine (NCCAOM) included a set of questions
on income, education debt and practice settings to enhance the
profession's self-knowledge. Publication of the findings has kicked off a
round of sometimes
acrimonious soul-searching over how licentiates are
doing economically. One leader concludes that the profession
should have a warning sign that entry into the field can be hazardous
to
one's financial health. Here are some data and commentary. More
September 29, 2010
Karla Karapetian: Report on the Penny George Institute Conference on Hospital Based Integrative Care
Imagine this: A hospital
system has delivered 61,000 inpatient visits. It is committed to
serving as a model for the nation, so offers a conference on
hospital-based integrative care. Would that be a smart place to be if
one wishes to learn the ins-and-outs from experts? Or if you couldn't go, have a
proxy attend? The Penny George Institute, part of Minnesota's Allina
Hospitals & Clinics, and led by Lori Knutson, RN, BS-HN, happens to
have offered such an educational opportunity for 4 days in late July 2010.
For those of us who didn't or couldn't attend, here is a report from our
collective proxy, Karla Karapetian. Karapetian, a manager with the
American Massage Therapy Association, is a communications professional.
Here is her useful and thorough report. A similar conference is anticipated for 2011. More
September 22, 2010
The
concept of coaching patients toward healthy behavior is deeply embedded
in many integrative disciplines and practices. The healthcoach.com
website, for instance, was claimed at the dawn of the worldwide web by a
naturopathic doctor. The use of a health coach as a distinctive
practice, however, evolved separately and more recently in the employee
health and managed care industries. Now federal health reform legislation
has highlighted the potential in health coaching. Nursing and
integrative medicine leaders associated with Harvard University,
University of Minnesota and the The
Institute for Integrative Health have begun a defining process toward
setting national standards and certification for the field. The official kick-off is a
Health and Wellness Coaching Invitational Summit this month.
Representatives of the chiropractic and naturopathic disciplines have
been invited. In reductive political terms, health coaching is broadly
shared turf. All integrative practice fields that claim to be health
creating have skin in this game of figuring out what is, certifiably, a
health coach. More
September 17, 2010
A model inter-institutional relationship may help bridge the chasm
that separates health professions education in conventional academic
health centers from institutions educating students for the distinctly
licensed integrative practice ("CAM") professions. Says one leader: "I
believe we are poised to make an important advance in how the future
training of health professionals may evolve." The speaker is Adi
Haramati, PhD, integrative medicine leader at Georgetown University,
describing a new relationship between Georgetown and Bastyr University
relative to Bastyr's naturopathic medical program and Georgetown's MS
CAM program. Haramati and his co-director Hakima Amri, PhD are exploring
similar relationships with chiropractic schools and other health
professions institutions. The developers "would like nothing more" than
to see this bridge-building relationship be used as a model for other
academic health centers and CAM institutions. More
September 16, 2010
Credit the current NCCAM
administration for fostering a spirit of open dialogue and give-and-take
in its National Advisory Council. Washington DC-based writer Taylor
Walsh captures some of the bandying of ideas and differences of opinion
exceptionally well in this report on the September 3, 2010 meeting of
the NIH National Advisory Council on Complementary and Alternative
Medicine. The subject could not be more
important: the proposed Strategic Plan that is to guide some
$650-million of NCCAM spending. Walsh focuses on the segment of the
meeting in which Strategic Objective #3 ("real world research" and
health-enhancing outcomes) was discussed. What will we have an opportunity to learn about the potential contributions of integrative practices? Walsh, a regular Integrator
contributor, captures perspectives of advisers Steve DeKosky, Tim
Birdsall, Adam Burke, Janet Kahn, Gary Curhan and Gert Bronfort, as well
as those of NCCAM staff, in this well-written report on a critically
important meeting. More
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