Integrative Medicine, Complementary Alternative Medicine and Health Round-up #52: Feb 2012
Written by John Weeks
Integrative
Medicine, Complementary Alternative Medicine and Health Round-up #52: February
2012
Policy
In which the integrative
medicine/health community, as Puer Aeternis, enters the Year of the
Dragon
Indian Health
Service includes naturopaths, acupuncturists and chiropractors in loan
repayment programs
AAAOM leads campaign to get acupuncture
listed as Essential Health Benefit
IHPC mounts
Congressional briefing on policy discrimination against CAM institutions
Alliance for
Natural Health leads campaign to protect CAM-friendly Health Savings Accounts
Institute of
Medicine's "Living with Chronic Pain" report minimizes values of
complementary and integrative approaches
Kazarian
Foundation's $36-million Health Corps proposal for integrative medicine
homecare approved via CMS Innovations program
Lessons on making a Beltway impact:
American Chiropractic Association's Congressional line-up on their grassroots
legislative day
Life University's Octagon Institute to
Sponsor Follow-up Policy Conference on the Affordable Care Act, April 12-14,
2012
Research
Report finds NIH invests over $120-million in CAM-related cancer research
Institute for Integrative Health offers
workshop on research methods, March 29-April 4, Baltimore, Maryland
Huge outpouring
of proposals for the International Research Congress on Complementary and
Integrative Medicine, May 15-18, 2012, Portland, Oregon
Integrative Centers
Jefferson-Myrna Brind begins integrative
pediatrics program
Pathways to Wellness reports
remarkable pattern of community and public health participation
True North
celebrates 10th year with "Empower Me" initiative
Professions
Update from holistic nursing leaders
Susan Luck and Barbara Dossey on the nurse coach certification process
Report finds
homebirth is making a comeback
Acupuncture
accrediting body calls for public comment on standards for new "First
Professional Doctorate"
Super Bowl: Chiropractors Help Patriots,
Giants (and 30 other teams) "Prepare for Battle"
Academic Medicine
Author-clinician Peter D'Adamo, ND and
University of Bridgeport establish Center for Generative Medicine
Brian Berman, MD
joins Tai Sophia Institute Board of
Trustees
Data points on a
decade of growth in naturopathic medical education
International
effort? Organized attacks on CAM programs in UK universities surface in
Australia
Media
Article by Sita Ananth in Hospitals
and Health Networks synopsizes latest hospital-CAM study
Niemtzow leads special issue of Medical
Acupuncture on acupuncture in the military
Kreisberg-edited
special issue of the Journal of Integral Therapy and Practice on
integral medicine
Business
Jill's List marks deal with
Massachusetts Chiropractic Society
People
AHPA's McGuffin
receives Nutrition Business Journal's
industry award
Haramati and
Harazduk: Is mindfulness positioned as bridge-builder in Middle East?
__________________________________
Policy
In which the integrative
medicine/health community, as Puer Aeternis, enters the Year of the
Dragon
Comment: Is the integrative
community aPuer
Aeternis? This is the Jungian, dreamy "eternal boy" who
refuses to grow up. The image came to mind last month while I
wrote about the policy opportunities for integrative health care as
described in the remarkable report The
Affordable Care Act and Beyond: A Stakeholder Conference on Integrated
Healthcare Reform. I juxtaposed the practical potential in this document
from the Integrated Healthcare Policy Consortium
(IHPC) and our lofty vision of transforming our healthcare system, on the
one hand, with the fact that the only multi-stakeholder lobbying entity for the
integrative health community can only support a not very well paid half-time
executive director. This community would seem to want transformation without
stepping into the messy, not very boyish, and not at all dreamy work of
lobbying to get what we want. Thus Robert Bly's story of
the puer aeternis came to mind. Can the community wake up, and step up?
I note with pleasure the efforts noted below as we enter the Chinese Year of
the Dragon that commenced January 23, 2012. One website
speaks of the dragon in remarkably integrative terms: " ... powerful
almighty king because (the dragon) was made up of different parts of animals
such as a tiger, fish, snake and an eagle. The Chinese dragon was not seen as a
threatening evil being as we do in the west - rather a symbol of power,
superiority and rule." One of my colleagues used street terms to describe
the meaning of the Year of the Dragon: "It's the year to get shit
done." Perhaps this is the time to cast off the puer aeternis and
reveal the dragon!
New openness to NDs, LAcs
Indian Health
Service includes naturopaths, acupuncturists and chiropractors in loan
repayment programs
A bit of integrative medicine history was made in January 2012 when the U.S.
Indian Health Service (IHS) quietly announced that licensed naturopathic doctors,
acupuncturists and chiropractors would be included in 2012 in the IHS' student
loan repayment programs. The announcement magnetized students and recent
graduates. Is this finally a the beginning of the end to what they view as a
long-overdue chance end discriminatory exclusion from a program to relieve
their debt burden? The inclusion was immediately celebrated by the American Association of
Naturopathic Physicians (AANP). The AANP has targeted such inclusion as its top
federal priority for the last decade. The American Chiropractic Association
followed suit with a release to their members. An article on the inclusion is here
in the Huffington Post. Actual inclusion will be a function of
relationships: one tribe selecting one practitioner. A view from inside the
naturopathic profession is
here.
Comment: These
practitioners may be an exceptional fit for tribal health. Licensed
naturopathic doctors link their primary
care scope to expertise in natural healing methods such as herbal medicine
and sweats (cleansing), lifestyle change and a belief in the importance of
spirit in health. Emerging research on naturopathic diabetes care is also hopeful in a
population in which this condition is epidemic. Naturopathic doctors would seem
uniquely useful. While the connections are not as direct, practitioners of
acupuncture and Oriental medicine (AOM) and chiropractors are similarly
disposed, philosophically, toward indigenous and natural healing methods. The
comments here include some discussion of the fit of AOM and particularly
group acupuncture in the I.H.S. environment.
Working the E.B.P.
AAAOM leads campaign to get acupuncture
listed as Essential Health Benefit
So far 5,524 emails and letters sent! So headlined the campaign
page for the late January 2012 push of the Association for Acupuncture and Oriental
Medicine to place acupuncture in the Essential
Health Benefits (EHBs) package. Under the 2010 Affordable Care Act, starting in 2014 most health
plans will be required to offer EHBs as part of a strategy to ensure access to
quality and affordable health insurance for all U.S. citizens. The AAAOM is supporting
their campaign with a 5-pageposition
statement. The core of the documents is entitled "The Medical and
Comparative Effectiveness of Acupuncture." The authors argue that evidence
supports the conclusion that: "The inclusion of acupuncture in the
Essential Health Benefits package will increase patient access to safe,
cost-effective and comparatively-effective health care, improve outcomes, and
reduce adverse events of conventional therapies, and provide an overall
increase in cost-savings for American health care." A note on January said
that, at the closure of the period, 23,000 letters e-notes had been sent.
Comment: Credit the
AAAOM for bellying-up to this bar, submitting a short white paper and mounting
this campaign. Note the American Chiropractic Association, which is
continuously on the ball in D.C. representing chiropractic interests, is dogging this issue. An
example is this testimony
to the Institute of Medicine (IOM) during the IOM's development of its
recommendations.
Congressional briefing on discrimination
IHPC mounts
Congressional briefing on policy discrimination against CAM institutions
The February 2, 2012 event was titled: "Improving
American Health Care by Leveling an Uneven Playing Field: Ending Discrimination
against Integrated Health Care." The audience(s): members of the US Senate
(or, more likely, staff) in the Dirksen Senate Office Building during the
morning then, that afternoon, to members of the House of Representatives in the
Cannon House Office Building. For each audience, the three speakers addressed
"forms of discrimination against licensed Complementary and Alternative
Medicine (CAM) professions: acupuncture, chiropractic, massage, naturopathic
medicine, and professional midwifery" including "discrimination
against federally recognized CAM educational institutions." Among the
speakers was former Washington State Insurance Commissioner Deborah
Senn, JD. Senn is credited with holding insurers' feet to the fire when
they sought to evade the 1995 Every
Category of Provider Law law in that state which required all plans to
cover all categories of licensed providers. Senn spoke to the results of its
implementation and national implications. The other speakers were former IHPC
executive director Janet
Kahn, PhD and Bastyr University dean of naturopathic medicine Jane
Guiltinan, ND. The event was sponsored by the Integrated
Healthcare Policy Consortium (IHPC).
Comment: The is the
second in 3 such briefings that IHPC is arranging through its former executive
director Janet Kahn, PhD. Discrimination against the CAM disciplines is far
more pervasive than in payment, the usual target of such concern.
Discrimination extends to numerous federal grant programs and policy-making
initiatives. Non-discriminationin that area will begin to be righted if the Section
2706 of the Affordable Care Act is not over-turned by the American Medical
Association and its allies. Good for IHPC to highlight these additional areas
where inequities prevail.
Protecting access to health savings accounts
Alliance for
Natural Health leads campaign to protect CAM-friendly Health Savings Accounts
The
January
10, 2012 Alert
from the Alliance for Natural Health for its members was entitled "New
Regulations Threaten Insurance for CAM Patients." The complicated message is that Health
Savings Accounts (HSAs) through which many individuals are accessing coverage
for otherwise non-covered complementary health services are on the line. They
share that recently issued final standards from the US Department of Health and
Human Services will harm health plans like
HSAs with higher deductibles: "Particularly hard hit will be the [HSAs] that
help so many of us pay for complementary and alternative medical (CAM)
treatments not covered by regular insurance." At issue is the treatment of
plans who do not meet requirements to limit their overhead and profit less than
20% of premiums, or 15% for large employers.
The Alliance is calling on members to contact their members of Congress
to save these HSAs. They argue:
"If
high-deductible plans are eliminated, then our only option is to combine an HSA
with a much more expensive conventional policy. That will make integrative care
completely unaffordable for many. It will also lead to less demand for HSAs.
Before long, they would probably disappear. If HSAs disappear, direct consumer
control over healthcare would suffer yet another blow. As many analysts have
suggested, the fact that consumers do not directly buy medical services
explains much of what is wrong with medicine today."
The
notice concludes with a statement that "the good news is that since HSAs are
specifically mentioned in the [Affordable Care Act], they can't legally be
killed by agency regulations, over and above the injury already received from
the statute."
Comment: Simulating a
popular movement, as the Alliance is seeking to do, that will allow insurers to
keep more of the insured's subscription for overhead and profit would seem
oxymoronic, if not utterly wrong-headed. Yet I credit the Alliance for taking
on this issue and raising awareness of it. Meantime, I would hope the Alliance
would also stimulate action amongst its members to keep the non-discrimination
clause in the Affordable Care Act - another and more broad-sweeping way to
allow more coverage of many integrative practices.
Report on living with chronic diseases dismisses use of CAM
Institute of
Medicine's "Living with Chronic Pain" report minimizes values of
complementary and integrative approaches
The name of the new Institute of Medicine (IOM) report is Living
Well with Chronic Illness: A Call for Public Health Action. The purpose of
the 307 page document, stimulated by interest from the fibromyalgia community,
is stated this way: "The overall goal of this report is to highlight the
toll of all chronic illnesses on living well from a population health
perspective, discuss the deficits in chronic disease control, and make
recommendations to improve public health efforts to help individuals live
better with chronic illness." A section on Community Based Intervention
includes a 2-page segment (157-158) entitled "Complementary and
Alternative Medicine." The conclusion of that section: "The use of
CAM approaches in the management of chronic illness raises some concerns among
health care providers because of the lack of scientific evidence supporting the
use of these products and the potential for ignoring traditional and effective
therapies but also in terms of safety and efficacy (Ventola, 2010b). The
Dietary Supplement Health and Education Act of 1994 did not mandate that
manufacturers prove that their products are safe but put the burden on the U.S.
Food and Drug Administration (FDA) to prove them unsafe (Ventola, 2010b).
Comment: The report
appears to have been developed via a committee without members active in the
integrative medicine community. Clearly, none were members of the licensed
complementary and alternative medicine professions. Nor were these communities
represented in the review panel. Given the high exploration of "CAM"
by people with chronic conditions, typically in the 50%-70% range, this was a
huge oversight, and effectively a non-representative disservice by this
quasi-public agency. How can we continue, in this so-called "patient-centered"
era, to so easily dismiss what so many patients are doing? While there is much
in this report that can be instructive to the integrative health community, it
is a sign of the poor state of "integration" that the Committee was
not only non-inclusive but also comfortably dismissive. This was a missed
opportunity for healing, at many levels. (Thanks to Demie
Stathoplos of Pathways to Wellness for this link.)
Integrative project advances
Kazarian
Foundation's $36-million Health Corps proposal for integrative medicine
homecare approved via CMS Innovations program
An
integrative medicine home-care proposal developed with support of the Charles
and Agnes Kazarian Foundation has gained approval as part of the Healthcare
Innovation Challenge Proposal of the Center for Medicare and Medicaid Services.
The Foundation will provide $6-million of the funding to establish a volunteer
and internship-based Health Corps of America to deliver in-home integrative
medicine services with CMS providing an additional $30-million. According to the
February 8, 2012 release, the Foundation's is supporting creation of a
nationwide Health Corps of America. These healthcare professionals will deliver
care at home to high-cost, high-risk elderly populations. The release notes
that "the Health Corps of America is significantly based on the Foundation's propriety
research, especially on the global benchmarks and high value-add best practices
of internships and volunteerism." The Health Care Innovation Challenge,
sponsored by the United States Centers for Medicare & Medicaid Services and
funded by the Affordable Care Act, will award up to $1 billion in grants to
applicants who will implement the most compelling new ideas to deliver better
health, improved care and lower costs to high-cost, high-risk individuals.
Comment: This unusual
and intriguing announcement reached me just prior to press time. Frankly, I
haven't looked at it closely but thought I would pass the link along.
Staging its annual Washington presence
Lessons on making a Beltway impact:
American Chiropractic Association's Congressional line-up on their grassroots
legislative day
Each year, the American Chiropractic Association (ACA) has its own March on
Washington. The 2012
rendition of the National Chiropractic Legislative Conference (NCLC)
features an impressive array of Congressional and executive level personnel who
will address their assembled members. In their January 25, 2012 release, the
ACA announced that Sen. Orrin Hatch
(R-Utah) will deliver the keynote address. Hatch is the ranking Republican on
the powerful Senate Finance Committee and a member of the Senate Health,
Education, Labor and Pensions Committee. Other featured speakers include:
Rep.
Bruce Braley (D-Iowa), member of the Committee on Veterans' Affairs and the
Veterans' Subcommittee on Economic Opportunity and co-sponsor of the
Chiropractic Care Available to All Veterans Act
Rima
Cohen, counselor to the Secretary for Health Policy, Department of Health and
Human Services
Rep.
Bob Filner (D-Calif.), recipient of the NCLC Lifetime Outstanding Leadership
Award for 20 years of steadfast support for doctors of chiropractic and their
patients, and especially for his work in expanding chiropractic in the U.S.
Department of Veterans Affairs, and
Dick
Gephardt, former House Majority Leader and president and CEO of Gephardt
Government Affairs.
Comment: Imagine a day
when a multidisciplinary, multi-stakeholder movement toward a health-focused system
had such a conference and lobby day in the Beltway that attracted such federal
leadership. Behind it, of course, are years of political action leavened by
political contributions. Visualize also making those donations, strategically.
The make one, and let your member of Congress or a known leader of these fields
know why. That will wake up a Puer Aeternis
(see note above), fast.
Engages conference to advance integrative health policy
Life University's Octagon Institute to
Sponsor Follow-up Policy Conference on the Affordable Care Act, April 12-14,
2012
Gerald Clum, DC sends notice that Life
University will mount a policy-related conference through The Octagon, an affiliated institute,
which Clum directs. The conference will be held in Marietta, Georgia, April
12-14, 2012. The conference is entitled Reimagining
Health Care; Making Health the Goal. The speaker line-up is expected to
include at least 2 US Senators and numerous other policy and corporate leaders
whose decisions will impact the future of integrative care. IHPC's legislative
interim chair Nancy Gahles, DC, CCH, RSHom(NA), and Academic
Consortium for Complementary and Alternative Health Care executive director
John Weeks have been asked to present. The conference overview is:
"Health care reform is presenting
significant opportunities for redefining all aspects of health care: which
services for which conditions under which circumstances; how those services and
providers are organized; how care is delivered; and the economic organization
of the transactions that fund the system ... Great attention is being paid to
the concepts of a Patient Centered Medical Home (PCMH) and of an Accountable
Care Organization (ACO). These models may prove to be vehicles that are broadly
adopted as health care reform continues to unfold ... If they are, what are the
opportunities, perils, threats, and rewards for various professions already
engaged in health care-but rarely in a coordinated fashion? Is care integration
required? By whom, and under which circumstances? Many more questions exist
than answers ... The Octagon will bring together significant voices and
stakeholders to address these and other questions in an effort to develop
templates for health homes and ACOs that incorporate a broad spectrum of health
care options-especially as the need for wellness promotion in vitalistic terms
becomes more clearly understood-and economically important."
Research
Report finds NIH invests over $120-million in CAM-related cancer research
The article by Libin Jia, the manager of many international programs of the Office of Cancer and Complementary Medicine
(OCCAM), is entitled Cancer Complementary and
Alternative Medicine Research at the US National Cancer Institute. Jia
reports that "in recent years, NCI has spent around $120 million each year
on various CAM-related research projects on cancer prevention, treatment,
symptom/side effect management and epidemiology." Roughly 85% targets
vitamins, minerals and "pharmacological and biological treatments."
Mind-body medicine is the most significant therapy explored. The article
includes useful breakdowns by organ system as well as type of therapy. The
author's interest in Chinese medicine shapes the back end of the article.
(Note:Thanks to adviser Paolo
Roberti di Sarsina, MD for sending the link.)
Comment from Integrator
editorial adviser Glenn Sabin, of FON
Therapeutics, and board member, Society for
Integrative Oncology:
"A useful report evidently supported and vetted by OCCAM and its director,
Jeffrey White, MD, who was thanked at the end for reviewing the work.
Interesting to note that OCCAM's annual research budget to investigate cancer
specifically is close to NCCAM's $128M. White states elsewhere that
approximately $500M of NIH/NCI's total $5B is annually put toward investigating
cancer "CAM".
"Also interesting that almost 60% of this research goes toward
'prevention'. Only a mere 0.7% of this funding is used to look at 'alternative
medical systems', which, in addition to naturopathy, Ayurveda, TCM and
homeopathy, presumably includes integrative medicine and integrative oncology
whole systems. This is troubling to this staunch proponent of the rigorous
scientific inquiry into comprehensive whole systems-aligned with how true
integrated care is provided in clinic. The bioactive synergistic effects
of whole systems delivery cannot be properly examined in a reductive
manner. Perhaps under the rubric of ACA-CER, PCORI, ACOs and PCMHs-early
compelling outcomes and proven cost-effectiveness will lead to a substantive
investment that allows for proper inquiry into integrative whole systems v.
standard of care.
"Meanwhile, more useful than this helpful report would be to know how
these findings around nutrition, herbs, exercise and more have been or will be
translated RIGHT NOW to clinical application. What happens with this data
after the results are tallied and published? Who is charged with making
appropriate recommendations to practitioners? Or are clinicians always
left to their own devices while waiting for larger studies that are so hard to
get funded? Ensuring translation to clinical application-and to those
practicing disease prevention and wellness in myriad settings-is the important
ROI metric for our precious research tax dollars."
NIH NCCAM
announces 6 new members of its National Advisory Council
Just
prior to its regular February meeting, the NIH National Center for
Complementary and Alternative Medicine (NCCAM) announced 6 new members. The council serves as the principal advisory
body to NCCAM, the lead federal agency for research on complementary medicine,
and a component of the National Institutes of Health. The members are:
Catherine
Bushnell, PhD a pain expert and professor of anesthesia and professor in
dentistry and neurology at McGill University whose research focuses on brain
imaging techniques to study how pain is processed by the nervous system in
humans.
Jane
Guiltinan, ND is the dean of the school of naturopathic medicine at Bastyr
University, Seattle whose clinical practice is focused on women's health,
disease prevention, and wellness promotion.
Scott
Haldeman, DC, MD, PhD, is adjunct professor in the department of Epidemiology
at UCLA, clinical professor in the Department of Neurology at the University of
California, Irvine and chairman of the research council of the World Federation
of Chiropractic.
Frances
C. Henderson, RN, EdD, is a clinical professor in the department of medicine at
the University of Mississippi Medical Center, Jackson with a focus on for her
work in promoting health in adolescents, minority elderly, and rural
individuals.
John
Licciardone, DO, is associate dean for clinical research and executive director
of the Osteopathic Research Center at the University of North Texas Health
Science Center, Fort Worth who has served in various research and review
capacities for NCCAM projects relative to osteopathy.
Lynda
H. Powell, PhD, is a licensed clinical psychologist and professor and chairman
of the department of preventative medicine at Rush University Medical Center,
Chicago who has focused on women's psychosocial and cardiovascular health as
well as lifestyle interventions aimed at reducing the risk for developing
type-2 diabetes and cardiovascular disease.
Comment: Interesting
crop: two with health promotion expertise, two from the licensed complementary
and alternative medicine disciplines NCCAM was originally charged to explore;
one from a discipline (osteopathy) that NCCAM subsequently decided to add to
the list; and a Canadian basic scientists. The mix reflects the 2011-2015
strategic plan's new focus on health promotion.
Workshops on research methods
Institute for Integrative Health offers
workshop on research methods, March 29-April 4, Baltimore, Maryland
Brian
Berman, MD, co-founder of The
Institute for Integrative Health shares that the Institute is sponsoring a
5 day research training that includes the complementary and integrative
medicine field coordinators for the Cochrane Collaboration, Eric Manheimer and
Susan Wieland, on Systematic Reviews and Meta-Analysis. In a separate module,
whole systems and real world research experts Claudia Witt and Klaus Linde will
teach on study design and pragmatic trials. Participants can purchase
individual components of the workshop. Writes Berman:
"The course will provide participants with the skills necessary to both
critically appraise clinical research, identify gaps, and to plan and perform
their own study projects. Another important aim of the course is to foster
international networking among participants." For information click here.
Outpouring of research proposals for key conference
Huge outpouring
of proposals for the International Research Congress on Complementary and
Integrative Medicine, May 15-18, 2012, Portland, Oregon
The
already robust international research gathering sponsored by the
Consortium of Academic Health Centers
for Integrative Medicine has witnessed a huge influx of interest from
researchers. According to organizers, just one-in-three presentation proposals
was accepted. The Congress, first held in Edmonton in 2006 as the National
Research Conference in Complementary and Alternative Medicine (NARCCIM), has
continually grown with roughly 600 attendees at the first meeting, over 800 at
the second, in Minneapolis in 2009. Organizers are targeting over 1000 attendees
for the May 15-18, 2012.
Comment: For anyone
with an interest in research in these fields, this Congress is an absolute
smorgasbord of continuous abundance - in presentations, ideas and colleagues.
If you have considered going, go.
Integrative Centers
Namesake of the Myrna Brind Center
Jefferson-Myrna Brind begins integrative
pediatrics program
The
Jefferson University's Myrna Brind Center of Integrative Medicine has announced
creation of a new integrative pediatrics program. The program will be led by Christina
DiNicola,MD, FAAP. In a release
from the Center, DiNicola states: "Integrative medicine's natural and
comprehensive approach can help young people feel better, perform better and
thrive at their fullest potential. An integrative approach acts to enhance
conventional pediatric care." The "whole child approach" of the program is
presented as treating multiple medical conditions including "ADD/ADHD,
allergies, asthma, behavioral and developmental concerns, digestive
disturbances, cancer care support, emotional health, eating problems, chronic
headache, sleep problems, weight management and more."
DiNicola,
a Bravewell Scholar at the University of Arizona College of Medicine in the
Arizona Center of Integrative Medicine graduates of the states that the move is
a response to consumers: "Families were growing more curious about alternative
therapies and their use as a complement to traditional medical care."
LAc-centered clinic with huge public health and community medicine impact
Pathways to Wellness reports
remarkable pattern of community and public health participation
Recently Demie Stathoplos, MBA, MSW, the director of Boston's Pathways to Wellness participated in
a recent dialogue organized by the Academic
Consortium for Complementary and Alternative Health Care, with which I am
involved. The exchange explored the present and potential future intersection
between the licensed so-called "CAM" disciplines and the public
health. More precisely: Where is there a fit with the National Prevention, Health
Promotion and and Public Health Council? Afterwards, Stathoplos tapped out
an overview of Pathways' involvement in community medicine and public health
initiatives. Pathways' clinical services features acupuncture and Oriental
medicine, bodywork and Yoga in partnership with numerous centers and agencies.
The remarkable contributions are a national model. Stathoplos granted
permission to re-publish this overview for Integrator readers.
"Participation
in research and national conversation on Public Health: Our Research
Director, Beth Sommers, PhD, LAc, serves as the co-chair on the Alternative
and Complementary Health Practices Group of the APHA. She is editor
of a forthcoming European Journal of Integrative Medicine that is focusing on "Public
Health in Integrative Medicine". She writes regularly on public
health issues in Acupuncture Today. Her research has focused on
the public health impact of acupuncture on medication adherence in people
living with HIV/AIDS, and on the reduction of cravings for addictive substances
in military veterans.
Safety &
Efficacy:
Pathways has been in the forefront of ensuring safety and efficacy of the
practice of acupuncture in Massachusetts. We were asked by the Massachusetts
Dept. of Public Health to develop standards
of care for the provision of acupuncture. We assist in training of
acupuncturists by working with the New England School
of Acupuncture to provide supervised intern clinics, that also allow us to
offer free or low cost care to people in the community. Because of our
work with clients with HIV/AIDS, our training is excellent in the areas of
confidentiality, clean needle/needle count methods, needle stick procedures and
other clinical practices. We collect baseline data and treatment data on
clients served in our main clinic, and maintain a client database that allows
us to analyze the data to determine trends in efficacy. In one example,
we were able to determine that for a specific group of clients with pain, that
gains were only seen up to 40 treatments, after which no further improvements
were found.
Consumer
Education:
Pathways clinicians provide free education on the efficacy of acupuncture
through outreach activities (talks and demonstrations) to underserved
communities, including elders, LGBTQ clients, Spanish speaking groups (i.e,
hotel workers), and AIDS Service Organizations. We provide free workshops
on topics related to Chinese medicine - i.e., Acupuncture for Allergies,
Chinese Herbal Medicine, Acupuncture for Headache, etc. Our clinicians
also speak at professional conferences locally, nationally and internationally.
We reach about 1500 lay and medical professionals each year.
10 years+ of
in-home acupuncture and massage to elders and people living with complex health
issues and/or disabilities, referred by RN Case managers to address pain,
mood/anxiety, digestive issues, quality of life issues - assisting people to
remain in their homes, and reduce use of emergency and other medical
services. Reimbursed through elder service plans or care management
groups with disability case load. We served 90+ clients last year with
about 2300 treatments, and growth this year has been about 35% over last year.
Referrals from
primary care physicians at the South
End Community Health Center for acupuncture and/or massage. We are in 5th
year of a pilot program with a local insurer which reimburses for acupuncture
with South End Community Health Center PCP referral for one of 5 diagnoses:
pain, headache, menopausal sx, menstrual sx, carpal tunnel sx. Our
clinical results show statistically significant improvement in pain symptom duration,
frequency and intensity for clients treated for pain and headache. Our
results also show statistically significant improvements in quality of life
indicators. Insurer's analysis indicated that they see minimal cost
impact on reimbursing for acupuncture vs. matched demographic set of clients
with pain and headache who do not receive acupuncture.
Infectious
Disease units of Mass. General Hospital, Tufts Medical Center and Cambridge
Zinberg Clinic
Pathways has been providing free acupuncture in our main clinic and in hospital
and community health settings for people with HIV/AIDS for 22 years. Our
satellite programs are funded through grants from the host agencies. We collect
data on adherence to anti-retroviral medication, as well as measures of t-cells
and viral load, visits to emergency rooms, use of addictive/illegal substances,
pain and other symptom levels.
Pilot program
with Spaulding Rehab hospital We recently completed a pilot where we
provided massage and/or acupuncture to inpatients recovering from surgery or
injury. We went through the pilot funding, which was meant to cover 2 years, in
about 9 months, due to demand from referring physicians. We provided 300
treatments to more than 50 inpatients. Spaulding is now trying to figure out
how to bring these services in-house rather than have an outside vendor provide
(presumably to save money, as the services were funded by a donor to the
hospital).
Reducing
disparities in care/ Access to care We provide Community style acupuncture ($25-$45/hour)
to increase economic accessibility. We have Spanish and Portuguese
speaking practitioners to improve cultural competence of care. Our
location inside the South End Community Health center, which serves a largely
Latino population, allows us to develop "word of mouth"
recommendations within the local Latino community. We participated in the
Jill's List Beta test, providing free care to 13 low income clients referred
from Boston Medical Center.
Comment: This is truly
a remarkable set of community contributions from a free-standing center
focusing on AOM services.
Interesting marketing proposal
True North
celebrates 10th year with "Empower Me" initiative
Maine's
True North health center announced
January 31, 2012 that it is marking its 10th year with a patient-focused
initiative called "Empower Me." The ingredients in the not-for-profit
Center's plans include: a means for patients to directly access 3 laboratory
tests; a Drug and Supplement Interaction Assessment; and access to the clinic's
supplement store. The release argues to readers that these supplements are of
high quality since they are pre-selected by the Center's staff.
Comment: While the
release is basically a marketing promotion for the Center, I found the
inclusion of the testing strategy and interactions reports of particular
interest.
Professions
Holistic nursing certification group tackles health coaching
Update from holistic nursing leaders
Susan Luck and Barbara Dossey on the nurse coach certification process
Holistic nursing leader Susan Luck,
RN, MS, HNC, CCN recently sent an update from her colleague Barbara Dossey, PhD,
RN, BC-HN, FAAN on the efforts to establish, via the American Holistic Nurses Certification Corporation
(AHNCC), a nurse coaching certification. Says Luck: "It captures the
work that has gone into this and the potential to greatly
impact our nation's health with over 3 million nurses in the
U.S. working in all settings within all communities." Luck notes
that the nurses leading this effort have also created the International Nurse Coach Association
"to bring nurse coaches together local to global, to network, support
one another and share our work and stories." She adds that "in the
Nightingale spirit, we are also committed to change through advocacy
and in supporting health policy initiatives that focus on health and the
environment." Here is Dossey's report:
"The
following provides the reader with a brief overview of the Nurse Coach
Certification Process offered by the American
Holistic Nurses Certification Corporation (AHNCC).
"Over the last two years the American Holistic Nurses Certification
Corporation (AHNCC) has followed the development of the health and wellness
coaching movement and the increased interest in the nurse coach role as
reported in the literature and in various healthcare areas. This also included
a series of conversations with a cohort of holistic nurse leaders, including
Linda Bark, Barbara Dossey, Darlene Hess, Susan Luck, Bonney Schaub, and Mary
Elaine Southard.
"After lengthy discussions, extensive reading, and consideration of the
implications for nursing, the topic was added to the AHNCC Board Meeting Agenda
in February 2010. The AHNCC Board decided that the role of Nurse
Coaching was important to the Profession of Nursing, and should be proactively
addressed. That is, Nursing should hold its space with this role so to ensure
that Nursing is included in the consortium of healthcare providers that are
supported in the delivery of care based on a health coach model.
"AHNCC also determined to move forward with a needs assessment to
determine if there was interest in a national certification program for nurses
who wished to carryout the Nurse Coach Role. See details at www.ahncc.org.
"AHNCC contacted the cohort of nurse leaders described above, identified
as the Professional
Nurse Coach Workgroup (PNCW). AHNCC and the PNCW discussed options for
moving forward with a Needs Assessment and a National Certification Program if
indicated by the Needs Assessment. Together, an alliance was formed with the
intent of holding and promoting the Role of Professional Nurse Coaching.
"AHNCC needs assessment was launched in March 2011. For more details see www.ahcc.org. The
findings indicated that there is an interest in a National Certification Program
in the Role of Professional Nurse Coach.
"The PNCW is in the final international review process on the draft Professional
Nurse Coach Role: Defining the Scope of Practice and Competencies (2012).This
document has identified competencies relevant to the role of Nurse Coach. The
AHNCC is now having these competencies reviewed by expert panels that will be
revised accordingly to the experts' review. Following completion of the
competencies, a Role-Delineation Study (RDS) will be undertaken, under the guidance
of the Professional Testing Corporation.
"Specifics regarding required AHNCC criteria, the certification process,
related literature, and other factors will be provided in early 2012. Helen
Erickson, AHNCC Board Chair welcomes questions and comments contact AHNCC at ."
Comment: Coaching, as
mentors have taught me, is not precisely "educating." Nor is it
"counseling." It is an art-form of its own. In an era wracked by
diseases that baffle many who have been educated and counseled to better
habits, I wonder that these new soft technologies are not front-and-center for
all integrative clinicians and healers who like to see themselves as change
agents for people's lifestyle choices. That said, a part of me wishes this
nursing group would have chosen to work within the fold of the broader,
multidisciplinary initiative to establish coaching standards kicked off in late
September 2010 and reported
here. The idea of standards that bridge disciplines has an appeal in a time
when we have increased awareness of the way guild boundaries harm patient care.
Yet creating a formal method for certification inside an army of 3-million
nurses is undeniably a great step toward health.
Homebirth use reverses, trends up
Report finds
homebirth is making a comeback
A
January 26, 2012 report from the National Center for Health Statistics led the
Certified Professional Midwives to declare in an e-message that "Homebirth is
on the Rise!" Homebirth, on a 14 year decline, increased 29% to 1-in-90
births. Roughly 90% of the increase was
among non-Hispanic white women. Differences based on race adnd ethnicity have
increased over time. Montana has the highest frequency, at 2.6% with Louisiana
and Washington, D.C. the lowest, at 0.2%. The National Association for
Certified Professional Midwives also shared a video of testimony from US Congresswoman Lucille
Roybal-Allard (D-CA) in which she heralds the outcomes of a November 2011
midwifery summit. NACPM holds its first annual meeting March 11-13, 2012 in Virginia.
Round two on First Professional Doctorate
Acupuncture
accrediting body calls for public comment on standards for new "First
Professional Doctorate"
The
Accreditation Commission for Acupuncture and Oriental Medicine is has opened a
comment period on its standards for creating a "first professional doctorate"
(FPD) for the acupuncture and Oriental medicine field. Since the creation of the ACAOM in the 1980s,
the focus of the agency has been on accreditation standards for Masters' level
education. Over the past decade, a small but growing subset of schools have
commenced clinical programs that offer a Doctorate in Acupuncture and Oriental
Medicine (DAOM). Meantime, the profession has debated the increase in standard
to bring the core education to the doctoral level. This is the second round of
public comments issue by ACAOM following a controversial first round. Comments
are urged by all members of the public. Click here for information.
Super Bowl: Chiropractors Help Patriots,
Giants (and 30 other teams) "Prepare for Battle"
The Foundation for
Chiropractic Progress (F4CP), a marketing arm of the chiropractic
profession, used the occasion of Super Bowl XLVI to tout the role of
chiropractors in keeping professional football players on the field and
playing. The February 1,
2012 release features comments from Michael Miller, DC of the Patriots and
Robert DeStefano, DC of the Giants. States Miller: "Most of our players
will get adjusted prior to games to adequately prepare their bodies for battle.
Several times during the playoffs, incidents occurred that required
chiropractic care and, subsequent to sideline treatment, players were able to
return to action the following play. We expect to have the same efficiency
going into and during the Super Bowl." The article stresses the
multidisciplinary manner in which the chiropractors work. The Professional Football Chiropractic
Society links these clinicians from the 32 teams.
Comment: My fantasy is
this: one of the academic
bloggers who spends his free moments railing against chiropractic, CAM and
integrative medicine bellies up to one of these inside linebackers freshly off
the adjusting table and girded for battle. The anti-CAM blogger shows the
courage of his or her (usually his) convictions and says: What you just did
is a waste. It's all in your head. It's of no real use. Why waste your time on
it? I think I just heard the sound of a body slammed against a
locker.
Academic Medicine and Health
D'Adamo firms up U Bridgeport relationship with new Center
Author-clinician Peter D'Adamo, ND and
University of Bridgeport establish Center for Generative Medicine
On January 26, 2012, the University of
Bridgeport and Peter
J. D'Adamo, ND announced the "collaborative launch of the Center for Excellent in
Generative Medicine. According to the release, the COE "will continue to train
naturopathic doctors while broadening the College of
Naturopathic Medicine's curriculum." David Brady, ND, Bridgeport's
vice provost for health sciences called D'Adamo "a giant in the field of
naturopathic and integrative medicine (who) has made transformational changes
in the way thousands of doctors treat their patients." D'Adamo, the author
of the 1996 international best-seller Eat Right 4 Your Type, which
promoted the ideas of blood
type, diet and personalized nutrition, has published over 20 books. The
most recent is the Textbook
of Generative Medicine. States D'Adamo: "I believe that today we
embark on a project that holds great promise for humankind and I am especially
proud that this initiative has found a partner in the University of
Bridgeport, a recognized educational world leader in the field of
integrative medical education." According to the release, the Center also
will sponsor research in the fields of nutrigenomics and epigenetics. D'Adamo's
speech at the January 24, 2012 ceremony is here.
Comment: I have been
intrigued to see D'Adamo move toward this affiliation in recent years. Since an
important stint for his profession's national organization as the founding
editor of ahead-of-its-time Journal of Naturopathic Medicine in the late
1980s and early 1990s, he has mostly practiced and written as a solo-operator.
As the release notes, the Center was 2 years in discussion and planning. The
concept of a generative medicine is an attractive one. It nestles nicely with a
favored phrase for the work of the integrative practice community: health
creation.
Berman: Joins Tai Sophia board
Brian Berman, MD
joins Tai Sophia Institute Board ofTrustees
Comment: Pleasing
always to see these interlocking directorates established between the complementary
and alternative education and practice community and the integrative medicine
community. Another excellent example is the role of Ben Kligler, MD, MPH, the
current CAHCIM chair, on the board of the Pacific College of Oriental
Medicine.
Data points on a
decade of growth in naturopathic medical education
Coquina Deger, MBA, the editor of the newsletter of the Association of Accredited Naturopathic Medical
Colleges (AANMC), offered interesting data on the evolution of naturopathic
medical education in a recent
reflection on her 10 years in the job. Since 2002, the pool of students
applying to the 7 accredited programs has grown from 617 to 1,119. New
enrollments increased from 265-606 in 2011. The number of accredited schools in
North America was at 5 in 2002 and is anticipated to be at 8 total campuses
when Bastyr University adds it San Diego campus in late 2012. (The other new
programs are the British Columbia-based Boucher Institute and the ND program at
National University of Health Sciences in Chicago.) Deger's note lists additional
markers of growth.
Comment: Some of you
will know that I began my work in the integrative health field in the 1983
working for a little educational entity called the John Bastyr College of
Naturopathic Medicine. JBCNM was the second of two schools, then housed in a
former Seattle elementary school. At the time, that profession that was
fighting with itself about whether it could sustain two schools or if all
resources should go to the mother ship, then called the National College of Naturopathic Medicine. At the
time, the total number of licensed NDs in the United States was fewer by half
than the number of students today
Actuary Heather McLeod
International
effort? Organized attacks on CAM programs in UK universities surface in
Australia
Heather McLeod, a New Zealand educator and leader in integrative medicine
writes that "the concerted effort against CAM at UK universities that you
reported on in January 2012 is now making its way to Australia." McLeod
sends as example this
link. McLeod's upcoming report in her next New Zealand Center for
Evidence-Based Research in CAM (ENZCAM) newsletter notes that
"more than 400 doctors, medical researchers and scientists have formed a
powerful lobby group to pressure universities to close down alternative
medicine degrees. According to McLeod, the new group, entitled Friends
of Science in Medicine, "wrote to vice-chancellors this week, warning
that by giving 'undeserved credibility to what in many cases would be better
described as quackery' and by 'failing to champion evidence-based science and
medicine', the universities are trashing their reputation as bastions of
scientific rigour." The group is also campaigning against insurance
coverage. Chiropractic is a favorite target.
The
story has jumped the ocean and was reported here
in the New York Times. McLeod reports that presently in three
Australian universities offer courses in some form of alternative therapy or
complementary medicine, including traditional Chinese herbal medicine,
chiropractics, homeopathy, naturopathy, reflexology and aromatherapy. An
international connection is noted. David Colquhoun, a professor of pharmacology
at University College London who has called for ending of alternative-medicine
programs in Britain, is also a member of the Australian group.
Comment: The passion of
these antagonists deserves a DSM code. Perhaps the starting place of an
international counter-insurgency is to begin defining the nature of CAM-phobia.
Is it linked to Nature
Deficit Disorder? Unfortunately, phobias continue to shape themselves into
public policy in many arenas and nations. Phobias presenting themselves as
rational are particularly dangerous.
Media
Sita Ananth: Writes up her own report
Article by Sita Ananth in Hospitals
and Health Networks synopsizes latest hospital-CAM study
A January 26, 2012 article by Sita Ananth, MHA in the electronic Hospitals and
Health Networks provides a good synopsis of a large survey based report led by
Ananth for the Samueli Institute. The reportwas
published in August 2011. The article is entitled More
Hospitals Offering CAM. Ananth splices in a few comments from David
Eisenberg, MD. Mayo's Brent Bauer, MD
and hospital trend expert and futurist Ian
Morrison. Ananth finishes with a statement that many hospitals "include
'whole person health' in their mission statements, making CAM a natural
fit." She tags on a quote from Nancy Foster, vice president for quality
and patient safety at the American Hospital Association: "The rise of
complementary and alternative medicine reflects the continued effort on the
part of hospitals and caregivers to broaden the vital services they provide to
patients and communities ... Hospitals have long known that what they do to
treat and heal involves more than just medications and procedures. It is about
using all of the art and science of medicine to restore the patient as fully as
possible."
Niemtzow: Edits special issue
Niemtzow leads special issue of Medical
Acupuncture on acupuncture in the military
Comment: Growing up in
Seattle with Boeing as a near neighbor and many Boeing engineers and machinists
as literal neighbors provided my original context for understanding the meaning
of "defense contractors." Little did I know that in getting involved
in natural healing modalities in 1983 I would once again be surrounded by them
in 2012. This issue of the journal is certainly an excellent resource for anyone
working in or around the military's exploration of integrative therapies in the
care, treatment and resilience of its troops. (Thanks to Stacy
Gomes, EdD at the Pacific College of Oriental Medicine for alerting me to
the issue.)
Kreisberg: Edits special issue
Kreisberg-edited
special issue of the Journal of Integral Therapy and Practice on
integral medicine
Comment: The journal's
attractive subheading is: A postdisciplinary discourse for global action. Both
ends of that phrase are nice. None of the author's names on the title page have
degrees or disciplines attached. I was first introduced to Ken Wilbur's
integral thinking via Dossey and her colleague in holistic nursing
standard-setting, Carla
Mariano, RN, PhD, BC-HN, FAAN, an Integrator adviser. The most
significant take-home in that 2006-2007 inter-professional exploration was how
much we abuse "integration" when we approach it only from right
quadrants. And we have. How is it that Dr. Spock became the arbiter of
optimal health?
Business
Inks deal with chiropractic group
Jill's List marks deal with
Massachusetts Chiropractic Society
A January
24, 2012 release has announced that Jill's List has inked a deal with the
Massachusetts Chiropractic Society through which the Society will urge its 700
members to become participating providers on Jill's List. Scott Darragh,
DC, a vice president with the Massachusetts Chiropractic Society calls it
"a wonderful partnership." He adds: "We are aiming to have all
our 700 plus members of the MCS on Jill's List
and it's a great way for us to collaborate with other practitioners, help
patients get the right information about their overall health and even work
with other doctors to complement our patients overall well being." Jill's
List calls "all about sharing the health - the resources, information,
practitioners - so consumers can have one place to go to evaluate and construct
their overall comprehensive health and wellness plan." Jill Shah, CEO and
founder, calls the relationship "our first of many partnerships to come
with organizations who represent professionals in the Integrative Healthcare
community."
Comment: I recently had
the opportunity to participate in an evening event that Jill's List founder and
CEO Jill Shah facilitated in which the integrative medical leadership of all of
Boston's health systems gathered together for the first time. Shah was a lead
organizer of the meeting and the group met at her offices as does Boston's
integrative health community, monthly. The firm thus far appears to have nested
in its business model a far deeper integration of health consumers and
practitioners than other similar inter-net based operations that have popped
up. This firm bears watching.
People
Honored for years of service
AHPA's McGuffin
receives Nutrition Business Journal's
industry award
Long-time
executive director of the American Herbal Products Association executive
director Michael McGuffin has been selected as the winner of the Efforts on
Behalf of the Industry Award by the Nutrition Business Journal (NBJ). McGuffin was chosen from more than 215 nominations
submitted by the general public, as well as nominations from NBJ's
editorial advisory board and the content team at New Hope Natural Media, which
publishes NBJ. The vetting process included review by NBJ
staff, New Hope's advisory board, and the New Hope standards team. Nutrition
Business Journal is the publication of record for the nutrition, natural,
organic, dietary supplement, and integrative medicine industries.
Comment: McGuffin was
an executive with McZand Herbals in the late 1980s when AHPA and the industry
just began to mature. Under his passionate and insightful leadership, the
organization has become an able and active trade association. This is a
well-deserved accolade.
Haramati: Role for mindfulness in connecting humans in the Middle East
Haramati and
Harazduk: Is mindfulness positioned as bridge-builder in Middle East?
In
a special Common
Group News Service on December 13, 2011, Georgetown integrative medicine
leaders Aviad Haramati, PhD and Nancy Harazduk, MSW ask if mindfulness can help bridge
divisions in the Middle East? The two spoke at the Middle East
Cancer Consortium (MECC), an initiative begun during the Clinton
administration. The MECC was formed with the support of the Health Ministries
of Israel and the Palestinian Authority and joined by Egypt, Jordan, Cyprus and
Turkey. It brings together 40-50 cancer care-givers (physicians, nurses and
social workers) for three days to share aspects of their oncology practice and
to learn about best practices. One feature of the gathering: participants spend two hours each day
together "experiencing meditation, guided imagery and even expressive movement
to reduce stress and foster self-awareness." The outcomes: "Individuals who
would likely never interact with each other, much less share personal stories
or feelings - come to genuinely care about each other and explicitly express
such sentiments."
Comment: Haramati has
been a principal go-between for the sometimes thick cultural wars between conservative
academic health center leaders and more exploratory integrative medical doctors,
and between conservative academic MDs and the licensed integrative
practitioners from non-MD disciplines. I have joked with him that he ought to
have a hand in Mideast negotiations. This is fun to see his work and that of
Harazduk directly involved in bringing those parties together in this community.
My guess is that something like such mindfulness personal work with be a
necessary, if not sufficient, part of the peace process if we are to ever find
our way there.
