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background resources in PDF |
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some CAM/IM publication links |
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Issues #82 & #83 - Nov-Dec 2010 |
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Written by John Weeks
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Issues #82 and #83 - November-December 2010
Issue
#83 - January 11, 2011
January 7, 2011
Change in CPT codes
relative to payment for time could be major opening for integrative,
life-changing practices ... Acupuncturists credentialed for embryo
transfer unit at Colorado hospital ... 25 news items on cost,
cost-savings, and economics of integrative care in 2010 ... Draft
National Prevention Strategy needs community response to maintain law's
inclusion of integrative care, integrative practices ... Chiropractors
mount strong response on need for more inclusion in accountable care
organizations (ACOs) ... Weil Foundation support IM program for medical
students ... Bastyr's Simkin Center furthers work of doulas, other
natural childbirth support practitioners ... UCSF Osher Center for
integrative medicine moves into large new facility, receives
$2.5-million challenge grant ... Naturopathic accrediting agency gains 5
year approval ... ALLEGRA certificate programs recognized by holistic
nurses, others ... Results from Ping Ho's UCLArts & Healing drumming
program for at risk students featured in Time ... Council for
Responsible Nutrition and American Academy of Nurse Practitioners in
significant partnership on supplements, promotion of role of nurses ...
Controversy on IOM recommendations on Vitamin D ... Donna Karan reviews
Urban Zen partnerships for 2011 ... Homeopaths ring bell at NASDAQ.
That's right ... Some integrative health Top 10 lists for 2010 ... Ernst
gets bottom-feeder award .. Molly Roberts, MD is AHMA president-elect
.. Kathi Kemper, MD publishes ADD Naturally ... In Memoriam: Elizabeth "Lisa" Kimbrough Pradhan, MPH, PhD More
January 4, 2011
When
the Centers for Medicare and Medicaid Services called for comments on
guidelines for Accountable Care Organizations, the chiropractic
profession responded with strength. Over 30 DC organizations filed
responses. That of the American Chiropractic Association (ACA) is
printed in full here. The ACA's case Is one that other licensed "CAM"
and integrative practitioner groups might have made had they responded:
the circle of provider types in ACOs is too small. Notably, the ACA has
also been involved in tracking and responding to similar guidelines from
the NCQA. More
January 4, 2011
This
posting alerts you to a comment period until January 13,
2011 on the draft
"National Prevention Strategy." The law behind this process represents the most significant inclusion of "integrative health care" in federal policy. Yet
the draft Strategy only poorly reflects the health promoting or
health-focused clinical strategies of integrative practices.
Participation is critical. Perspectives of the Samueli
Institute and Association of Bodywork and Massage Professionals on the framework that birthed the strategy are included here. Each will offer you or your organization useful starting points. More organizations need to weigh in. The draft plan does not reflect the principles and value of integrative health care. Consider sending your responses to the Integrator for future community reflection. Be heard! More
December 29, 2010
A review of 2010 Integrator content
found 25 articles that directly relate to cost and economics issues.
Medicare. Duke's personalized program. Direct access to chiropractors in
Blue Cross Blue Shield of Tennessee. CAM practitioners and Washington
state insurers. Medicaid. Non-discrimination. Ornish and Pritikin in Medicare. Sebelius' views. Business viability for licensed acupuncturists. Whole practice naturopathic care for Canada
Post employees. Supplement sales. Allina's in-patient program. Massage
practice trends. Some of the 24 report research studies, others policy
action, some marketplace reports. The articles are gathered here with
links to primary sources. I follow with brief commentary. More
December 29, 2010
Making the cost case. A decade ago, now Integrator
adviser and columnist Michael Levin and I connected on this theme.
Levin's passion for the topic was, and remains, informed by experience
of conventional medical stakeholder perspectives, in part due to his own
background as executive with pharma, medical devices and more recently,
with supplement companies. Presently a consultant to the field, Levin
published his first Integrator column in January 2007 and has
fashioned 20 columns and short commentaries since. His contributions are
frequently stimulated by news items that underscore the importance of
the economic argument for integrative and wellness practices. A second
regular theme relates to issues surrounding natural products. Levin's
value to the Integrator is less visible but also considerable in
the numerous news items and studies he has sent my way through the
years. It is a pleasure to make his contributions visible. Take a look!
December 21, 2010
On or about the winter solstice, the Integrator publishes a Top 10of actions, events and trends from the previous year which will support the coming of the
light for integrative practice in the New Year. This column is paired with a separate Top 10 people from 2010. Here is the Integrator Top
10 for integrative policy, practice, research and professional
activity. 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 21, 2010
While reviewing recent issues of the Integrator
to
draft the Top 10 actions and events from 2010, I created a
second list of individuals who had
been, or were about to, be significant contributors to the integrative
practice field. Of course there is
overlap between key events and influential individuals. Yet this list of Top 10 People from 2010 took on a life of its own.
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
Issue
#82 December 7, 2010
December 7, 2010
IOM Committee on
Advancing Pain Research, Care and Education includes Rick Marinelli, ND,
LAc and integrative MD Lonnie Zeltzer ... Did integrative practice
organizations step up to participate in federal policy comment periods
on prevention, benefits plans and ACOs? ... Comparative cost analysis of
Blue Cross Blue Shield Tennessee low back pain data finds 20%-40% savings via using chiropractors first ... Spine
comparative effectiveness analysis also thumbs up for chiropractors ...
Primer on strategies for cost analysis of "CAM" published ... World
Health Organization publishes benchmarks for training TCM, NDs, DOs,
others ... Certified Professional Midwives push for Medicaid inclusion
... Mark McKenzie, LAc offers "progress report" for AOM field ... George
Lundberg column shows battle over independent practice by non-MDs ...
Samueli Institute in major wellness role at Big Task Weekend ...
Alliance for Massage Therapy Educators publishes results of survey on
standards ... AANP exec Karen Howard lays out federal priorities for
naturopathic doctors ... AHRQ-publishes report that finds only modest
value for CAM in back/neck pain ... Little headway in battle against
medical errors, medical deaths ... Massage researcher Tracy Walton
offers candid comment when major integrative pediatrics trials comes up
negative ... Fox Business pumps integrative medicine ... AMA board chair
Ardis Hoven, MD promotes interprofessional collaboration, with MDs in
the center ... Walgreens seeks to "own 'well'" ... Barrie Cassileth's
International Integrative Medicine conference ... Integrative Healthcare
Symposium likely to draw over 1500 in New York ... Peter D'Adamo's
Institute for Human Individuality to focus on "Generative Medicine" at
May 2011 meeting ... Vanessa Esteves takes position with Elements
Wellness. More
November 29, 2010
Readers
inform that 2 additional comment deadlines are coming up on key health
reform developments. Of most importance: What are processes in
clarifying the "Essential Health Benefits" package under the new law?
Will this reflect the non-discrimination language in Section 2706? Will
historic, discriminatory practices prevail? The IOM seeks comment for
this study requested by US Health & Human Services. Then, for those
of you who wish to get integrative practice/medicine/CAM into thinking
on Medicare "innovation" and Accountable Care Organizations (ACO),
a comment period on preliminary standards for ACOs ends December 3, 2010. Here
is summary background on each of these and information about how and
where to respond. More
November 23, 2010
Integrator readers have benefited from the research, commentary and reporting of Taylor Walsh since early mid-2007. The former software entrepreneur presently consults and writes on integrative health and digital
media. Based in Washington, DC,
Walsh combines two passions that are of immense benefit to Integrator
readers. He sees the importance of transformation of our medical system
and the value of integrative practice philosophies and model in that
process. In addition, Walsh has a good old-fashioned passion for Beltway
politics. His coverage of developments at the NIH National Center for
Complementary and Alternative Medicine and in the rapid rise of
comparative effectiveness research (CER) have proved particularly useful. Here is the assemblage of his commentary and columns. More
November 23, 2010
The
advancing comparative effectiveness research (CER) agenda of the Obama
era has been linked to complementary and alternative medicine (CAM)
since the IOM weighed in on the topic in June 2009. The health reform
law specifically included integrative practices and practitioners in CER
planning and an integrative care researcher was appointed to panel
leading what will be a multi-billion dollar national initiative. Most
recently, the NIH NCCAM cites CER interest as a prime mover toward "real
world research." The Integrator has followed the evolving story,
in part through the fine reporting Beltway-based reporter Taylor Walsh.
Here is Walsh's report on the "National Leadership Summit on CER Priorities, Methods and Policy: Transforming
Oncology through Comparative Effectiveness Research" led by Sean Tunis, MD, MSc.
Walsh focuses on the dialogue on the patient-involved strategies for
CER. He also reflects on CER's origins, and the recent work from Stanford's John Iioannidis, MD, DSc that
suggests flaws in 90% of the research medical research informing
medical education and clinical opinion. (Unfortunately, the integrative
practice community did not seem to be present at this summit.) More
November 22, 2010
Few practitioners of integrative medicine who use
nutritional agents have not benefited from the teachings of Yale-educated integrative clinician Alan Gaby, MD. The publication of Gaby's long-awaited 1374 page Nutritional Medicine, the product of 30 years of research and analysis, ranks as a historic moment for the field. Here is a look at the book, informed by Gaby's clinical practice with over 6,000 patients. I share comments from Integrator adviser
Bill Manahan, MD, Jonathan Wright, MD, and Joseph Pizzorno, ND, on the
power of this textbook. Gaby believes that the book has significant
public health applications. Manahan thinks comprehending Gaby's value
means recalling William Osler, MD. Wright urges a forward-thinking
conventional medical school to scoop Gaby up and honor him with a
professorship. I contacted Gaby to catch up with him on this turning point in his life and conclusion of a record-long gestation period.
What did Gaby's medical doctor father think of him embracing this
medical direction more than 3 decades ago? Pizzorno's advice to
clinicians is simple: "Buy Nutritional Medicine now. You'll use it every day." More
November 22, 2010
For
those in the integrative practice movement for over a decade, the
subject of coding cannot be considered without the thought of a new
Mexico-based business originally known as Alternative Link, and its
founder Melinna Giannini. This business declared early that
understanding the value of these therapies and fields would require a
coding set that appropriately reflected them. In a long and exacting
labor, the firm developed the ABC Codes, morphed into ABC Coding
Solutions and developing products for not just "CAM" but for nursing
(where many also chaff at the CPT) and Dubai Healthcare City. I
contacted Giannini for comment and an update. Here is the column she
co-authored with Mathias Kaesebier, the firm's executive vice president.
At risk with current CPT coding, they argue, are health reform
initiatives relative to non-discrimination and comparative effectiveness
research. More
November 15, 2011
If you care what
"integrative health care" might mean in the nation's plans for health,
wellness and prevention, the time is now for input. Three of the top 4 purposes of the National Prevention and Health Promotion Council established under the Obama-Pelosi healthcare overhaul explicitly reference "integrative health care." That Council has issued its "Draft
Framework" for a "National Prevention and Health Promotion Strategy."
December 5, 2010 is the last day for input. The framework envisions "moving the nation from a focus on sickness and disease to one based on wellness and prevention." But does the framework adequately
reflect the principles and value of "integrative health care"? What
additions or amendments to this framework are needed? Share yours with
the Surgeon General and the Council. Consider sending them here to the Integrator to share community perspectives. More
November 11, 2010
The Integrator has
closely followed the work to set standards and national certification
in health coaching led by professionals from Harvard and U Minnesota.
The coverage stimulated Chris Johnson, ND to write a column in which be
noted that he was "disturbed" by the focus. He shared his reasons:
scientific, philosophical and economic. His comments provoked these two
response columns. One is from Sheila Quinn, a 30+ year veteran of
significant educational and policy initiatives in integrative care. The
second is from Oregon chiropractor and Certified Chiropractic Wellness
Practitioner. Dyson wonders, among other things, how widespread are
Chris Johnson's views in the naturopathic community. More
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