Integrative Medicine, Complementary Alternative Medicine and Health Round-up #55: May 2012

Policy

• PCORI Changes Language to Include Integrative, Complementary and Alternative Medicine Providers
• Kahn: Prevention Fund under 6th attack by Republicans
• Integrative oncologist Donald Abrams, MD takes public position for legalization of marijuana

Education

• CAM educator consortium ACCAHC to represent integrative health in the 3 year IOM Global Forum on Innovation in Health Professional Education    
• Surveyed acupuncturists back educational requirements for experience in integrated environments and team-care

Employers

• National Business Coalition on Health CEO offers 10 suggestions for integrative care players approaching the employer market

Professions

• What the naturopathic doctors sought on their Washington, D.C. Lobby Day
• Transition in leadership at the American Holistic Nurses Association
• CAM/Integrative Medicine Panel At The Yale Healthcare 2012 Conference

Organizations

• Massage Therapy Foundation develops useful evidence tool-bar
• Multidisciplinary coaching group announces websites, next steps toward educational standards, credentialing

Integrative Centers

• Philanthropist-backed Casey Health Institute to feature integrative medicine in a PCMH model; medical director sought
  
• Group acupuncture at Cleveland Clinic's integrative center highlighted
• Briefly noted developments related to health system integrative medicine clinics

People

• Charlie DuBois, Standard Process' president, granted honorary Doctor of Humane Letters
• Robert Downey, Jr received award from YoSan University for advocacy of acupuncture

E-Letter in response to a past articles

• Tai Sophia Institute vice president Judy Broida, PhD on the institution's move toward university status

CAM language inserted

PCORI Changes Language to Include Integrative, Complementary and Alternative Medicine Providers

Comment: First, it's great to see PCORI acting with such conscious responsiveness. Inside the Academic Consortium for Complementary and Alternative Health Care (ACCAHC), my day job, we have the view that, at this point in time in U.S. health care, if integrative healthcare providers, complementary and alternative medicine providers are not explicitly included, as PCORI now does, they are likely yet to be excluded. This need is not ideal health care. It is realpolitik. Thanks to all who, responding to an Integrator push (Patient-Centered Outcomes Research Institute draft plan comment period ends March 15: No CAM-IM presently noted) or for other reasons, made such comments in any of PCORI's comment periods. Healthcare writer Elaine Zablocki was among these. You were heard. And I expect that Christine Goertz, DC, PhD's presence on the PCORI Board of Governors might have been the tipping point on this.

Recent news on the diabetes front underscores the wisdom of PCORI's change. When Group Health Cooperative allowed patients with non-insulin dependent diabetes to have access to "adjunctive naturopathic care" from a network of naturopathic physicians, the outcomes proved beneficial on an array of fronts. Following up on pilots such as this work, led by Ryan Bradley, ND, MPH, Dan Cherkin, PhD and others, would appear to be rich ground for PCORI funding.

Reopublicans seeking to undo prevention

Kahn: Prevention Fund under 6th attack by Republicans

Janet Kahn, PhD, a member of the Advisory Group on Prevention, Health Promotion and Integrative and Public Health to the

4/25/12 - Rep. Judy Biggert, on behalf of House Republicans, introduced the Interest Rate Reduction Act (HR 4628), which would delay the increase in federal Stafford Direct Stafford Loan rates, offset by repealing the Prevention and Public Health Fund.

4/25/12 - The House Energy & Commerce Committee advanced a budget reconciliation measure (Proposed Matters for Inclusion in Reconciliation Recommendations), which includes elimination of the Prevention and Public Health Fund. The title was approved by a committee vote of 30-22 (party line). Several Democratic members, including Capps and Matsui, offered amendments to cut the provision.

2/22/12 - The Middle Class Tax Relief and Job Creation Act (HR 3630) became law, extending the payroll tax cut, unemployment benefits, and physician payment updates ("doc fix"), offset by a $6.25 billion cut to the Prevention and Public Health Fund.

9/29/11 - The Labor-HHS FY2012 Appropriations bill offered by House LHHS Chairman Rehberg rescinded funding for the Prevention Fund for FY12.

4/13/11 - Legislation to repeal the Prevention and Public Health Fund (H.R. 1217, introduced by Rep. Joseph Pitts) passed the House on a vote of 236 - 183. The bill did not pass Senate.

1/19/11- H.R.2 - Legislation entitled "Repealing the Job-Killing Health Care Law Act" (H.R. 2, introduced by Rep. Eric Cantor) passed the House on a vote of 245 - 189. It did not pass the Senate. This bill repealed the entire Patient Protection and Affordable Care Act (including the Prevention and Public Health Fund) and the Health Care and Education Affordability Reconciliation Act, which together comprise the landmark health care reform that was signed into law by President Obama in March 2010.

9/14/10 - The Senate defeated an amendment offered by Sen. Johanns that would offset the costs of repealing a 1099 tax reporting requirement by eliminating the Prevention Fund.

Comment: As a parent of a student with loans, and another on the way, this pitting of a national prevention strategy against prevention of ignorance and limited job potential for hundreds of thousands of young adults is Machiavellian ugly. Not investing in prevention and health promotion is akin to denying global warming. Republican readers of this blog: can you defend these actions?

Abrams: outspoken on legalization

Integrative oncologist Donald Abrams, MD takes public position for legalization of marijuana

Integrative medical oncologist

Comment: There is a worried line of political reasoning that says if you are already in one field that is not fully accepted, such as integrative medicine, you're a damn fool to attach yourself to another that is also marginalized by many, such as marijuana legalization. I love the disregard Abrams shows in standing up for what he believes, instead of kowtowing to some notion of political savvy. Go Don! Personally, I never inhaled. 

Education

Co-sponsor of IOM Global Forum

CAM educator consortium ACCAHC to represent integrative health in the 3 year IOM Global Forum on Innovation in Health Professional Education

The Academic Consortium for Complementary and Alternative Health Care (ACCAHC) announced on in an April 13, 2012 release that it has become a founding sponsor of the Institute of Medicine (IOM) Global Forum on Innovation in Health Professional Education. According to the release, IOM established the forum to:

" ... help operationalize recommendations from two significant reports produced in the centennial year of the Flexner Report that both revolutionized and polarized health professional education after its publication in 1910. The Lancet Commission's Educating Health Professionals for a New Century (2010) and the IOM/Robert Wood Johnson Report on The Future of Nursing (2010) each stressed inter-professionalism, team care and the importance of educating professionals for leadership and as change agents The Lancet Commission also focused on the globalization of healthcare and the need to better integrate health professional education with primary care, healthcare delivery and community and public health."

ACCAHC, a consortium of 16 principally education-oriented organizations centered in the 5 licensed CAM disciplines, plans to "

Comment: This is a very exciting involvement, personally of course, and for integrative health ideas as we embark on the 100 years after the Flexner century. The ACCAHC disciplines will have a lot to learn from their colleagues. We also believe we have some important content to bring to the table. In a discussion before the ACCAHC board made this huge commitment to sponsor - another $30,000 is yet needed to support costs - one member said: "Wouldn't the best innovation be to graduate professionals who focus on wellness, on getting people healthy, and helping them stay healthy." What a bodacious thought! Then again, what Flexner recommended was way outside the box of health professional education in his time. Who wants to enter the 22nd Century wondering if we ever get over being merely reactive in our healthcare treatment?

The Global Forum will develop two, 2-day forums each year from 2012-2014 on topics on innovation in health professional education. Some may be particularly of interest for the integrative community. Each will be an exceptional networking opportunity. Mark the dates for the 2012 forums (August 28-29, November 29-30) and sign-up here for the IOM for updates on content.   

Produces interesting survey

Surveyed acupuncturists back educational requirements for experience in integrated environments and team-care

The preliminary report of the 2012 Annual Survey by the American Association of Acupuncture and Oriental Medicine found 76% agreed with the statement that

Comment: Credit the AAAOM with trying to reach the entire profession. The professional association partnered with both the Council of Colleges of Acupuncture and Oriental Medicine and the National Certification Commission for Acupuncture and Oriental Medicine to mail to 18,000 licensed acupuncturists and 5,000 students. The chief focus of the survey was the profession's controversial move toward establishing a First Professional Doctorate (FPD). Findings on this topic are also available. The low response rate was likely due to AAAOM asking respondents to read two complex documents on the FPD before responding.

Meantime, the findings noted above suggest a profession whose involved leaders see their future less in silos and solo practices and increasingly in teams and multidisciplinary practices. The high percent seeking to align accreditation standards with other allied health fields suggests a recognition of the value of acquiring shared language.

Employer

Webber offers top 10 list for reaching employers

National Business Coalition on Health CEO offers 10 suggestions for integrative care players approaching the employer market

1.Prioritize the employer community as a critical customer.

2.Aim high with employer outreach (i.e. C-suite level).

3.Internalize and always relate your message to the employer community's broad goals and strategies.

4.Build partnerships and integrate chiropractic services into employer/worksite based health management strategies, e.g. onsite clinics, disease management initiatives, health promotion programs.

5.Build partnerships and integrate chiropractic services into emerging population health delivery models, particularly ACOs and patient-centered medical homes (e.g. Community Health Teams as specified in Section 3502 of ACA legislation).

6.Help design and support new provider payment models, e.g. bundled and global payments, shared risk.

Key employer organization

7.Help design and support value based benefit design models, e.g. lowering co-pays for high value services, provider steerage.

8.Understand that employers, as their customers, can influence health plan strategies in value-based products.

9.Demonstrate chiropractic's value by more published data and research (i.e. Choundhry and Milstein study). Include productivity metrics in impact analyses - this will significantly boost potential ROI.

10. Always work with an employer-led health coalition if one exists and supports community-based health/health care initiatives.

Professions

Lobby day in DC

What the naturopathic doctors sought on their Washington, D.C. Lobby Day

Comment: Pardon the long prelude from Schoenbeck. Sometimes it is just music to hear what it is one is all about. AANP's interim executive director Terri Doerr provided some data on the event, including: 529 visits organized, 202 Members of Congress contacted from 39 state with a total of 137 participants., about 2/3 students.

Terri Roberts, JD, RN

Transition in leadership at the American Holistic Nurses Association

Comment: During Crawford's term as executive director, the AHNA took the powerful step of creating a board certification in holistic nursing that gained recognition for the field from the American Nurses Association. The number of board certified holistic nurses has grown steadily. Yet the field has largely been inward-turning, providing a newsletter and conference to support its members. It will be interesting to see, if Roberts sticks around, whether her legislative leanings might begin to move the field to have more of a voice in health affairs.

Eliot Tokar, right, with Yalek panel

CAM/Integrative Medicine Panel At The Yale Healthcare 2012 Conference

"Nurses and public health professionals have often been in the vanguard of advocating for more effective and humanistic healthcare. This tradition was once again in evidence in April at Yale University's Healthcare Conference 2012. The annual conference is a joint effort between Yale's School of Management, School of Medicine, School of Nursing, and School of Public Health.

"This year a group of students led by Christine Brubaker (Nursing) and Rebecca Ng (Public Health) produced a breakout session entitled ‘Massage or Morphine? The Role of Integrative Medicine in Modern Healthcare.' The panel leaders were Eliot Tokar, an internationally recognized doctor of traditional Tibetan medicine, writer and lecturer, and Ather Ali, a naturopathic doctor and Associate Research Scientist at the Yale School of Medicine. The panel and attendees -- which included both students and a diversity of healthcare industry professionals -- discussed topics such as the effectiveness of integrative medicine (IM) and CAM therapies in delivering quality healthcare services to patients; the significance of promoting medical pluralism in the US; IM and CAM's ability to contribute to healthcare innovation, cost containment and chronic disease management; appropriate training pathways for CAM professionals; the implications of the Patient Protection and Affordable Care Act and protocols for evaluating the applicability and effectiveness of CAM and IM approaches in disease prevention and treatment.

"Following the conference breakout session Dr. Tokar was invited to the Yale School of Nursing to conduct a workshop with students on the topic of How Can Nurses Work Effectively To Define And Achieve Progress In Expanding Medical Education And The Quality Of Clinical Practice."

Organizations

Massage organization provides exceptional tool

Massage Therapy Foundation develops useful evidence tool-bar

The Massage Therapy Foundation has developed a nifty toolbar to help massage educators, in particular, but also clinicians and students, to ready access to evidence and other resources that will help with teaching. The tool offers live literature searches from an array of databases, plus anatomical images and other teaching and clinical aids. This is another in a series of MTF projects that have sought to enrich scientific literacy in the massage field.

Comment: The MTF deserves an award for sheer functionality in the massage field. Under current president Ruth Werner as under past-president Diana Thompson, LMP, the organization has consecutively delivered tremendous value to the massage field. Credit the American Massage Therapy Association (AMTA) for substantially funding it for many years. Here's hoping the AMTA will find ways to continue to do so. 

Coaching organizing take steps forward

Multidisciplinary coaching group announces websites, next steps toward educational standards, credentialing

Comment: My view of coaching, and this work in particular, is that if you have skin in the integrative health game, then you have skin in this one. If you think your discipline "already coaches," I urge you to take a look at the modern arts and sciences of health coaching and see if you haven't something to learn. If we've lost track of prioritizing assisting people in moving toward wellness, then we've failed to keep our eye on the prize. It's a fine group, with great intentions, doing necessary work. Check them out.

David Fogel, MD and Iliana Bar-Levav, MD

Philanthropist-backed Casey Health Institute to feature integrative medicine in a PCMH model; medical director sought

In 2010, Betty Casey, a philanthropist in the nation's Beltway with an interest in integrative medicine, charged

Comment: This is exciting business. Now what medical doctor will drop everything to step into this influential, experimental medical director role? 

Jamie Starkey, LAc

Group acupuncture at Cleveland Clinic's integrative center highlighted

The community acupuncture movement that grew out of a working class neighborhood in Northeast Portland, Oregon is making its way into academic medicine. An article in the Cleveland Plain Dealer features a program begun last October by acupuncturist Jamie Starkey, LAc at the

Comment: Notably, to me, the reporter focused on a patient who was finding success with acupuncture for a number suffer from xerostomia. I can vouch for the value, in the group acupuncture format. I receiving treatment via Jordan VanVoast, LAc at the Communichi community acupuncture clinic in Seattle.

• Northwestern Integrative Medicine re-posted information about its philanthropy program here. The page describes a series of funds to net diverse donor interests.
• Integrative medicine doctors at the University of Wisconsin will have a new home in a small part of  $241-million facility expansion.
• The Simms-Mann UCLA Center for Integrative Oncology at UCLA's Jonsson Comprehensive Cancer Center was among the beneficiaries of a $400,000 Lance Armstrong Foundation grant via Aspen's Pillars4Life.
• A Baltimore Examiner article declared the University of Maryland integrative medicine's first health conference a success. Some 500 turned out for an event featuring Andy Weil, MD.
  
• Weil and another principal at University of Arizona Center for Integrative Medicine Tieraona Lowdog, MD have engaged a relationship with product manufacturer Innate Response for what they call the "first seasonal therapeutic program."
  
• Kentucky-based St. Elizabeth's Healthcare has opened a new integrative oncology program in Crestview Hills offering an array of integrative services.
• Family Practice News published a piece on research carried out at the Women's Heart Center at Cedars Sinai Hospital that found acupuncture to improve heart rate variability in CHD.
• The University of Wisconsin Program in Integrative Medicine has updated their publicly available GERD module.
  
• New Jersey's Raritan Bay Medical Center had an open house for its integrative medicine center.
  
• A CNN Money article notes that Susan and Henry Samueli, backers of the Susan Samueli Center at UC irvine, are among 12 more billionaires that have signed onto the Gate-Buffet pledge to give away at least 50% of their wealth in their lifetimes.
• Cincinnati's TriHealth Integrative Health & Medicine has added acupuncturist Diane Kloecker LAc, MSOM, Dipl.OM to their team.
  

People

Charles DuBois: honorary doctorate from NYCC

Charlie DuBois, Standard Process' president, granted honorary Doctor of Humane Letters

New York Chiropractic College granted Standard Process' president Charles DuBois a Doctor of Humane Letters at its April 2012 graduation ceremony. It was only the second such degree granted by NYCC in its 90-year history. The release from the school noted that the American Chiropractic Association earlier named DuBois Humanitarian of the Year. In an address to students, DuBois urged then to

Comment: Cynics may note that Standard Process is a huge donor to the chiropractic field, including NYCC. Insider cynics will raise an eyebrow with the knowledge that my own professional work, including the Integrator itself, have benefited from Standard Process' donations. Yet I report this because the quote from DuBois is not empty. His firm has more than once been honored as a top place to work in Wisconsin. The employee health promotion program has likewise been honored. The firm has also been recognized as an contributor to its community of Palmyra. And for whatever self-interested reasons, the dollars that Standard Process has given to NYCC and other institutions and initiatives in the field of chiropractic have created tremendous opportunities to enhance practices for thousands of chiropractors and the treatment received by tens of thousands of patients. Few executives make such commitments to any field. This honorary degree was earned. Congratulations, Dr. DuBois.

Robert Downey, Jr and YoSan founders

Robert Downey, Jr received award from YoSan University for advocacy of acupuncture

In a March 2012 ceremony in Malibu, California, actor Robert Downey Jr

Judith Broida, PhD

Tai Sophia Institute vice president Judy Broida, PhD on the institution's move toward university status

In the April 2012 Integrator Round-up I reported steps take at Tai Sophia Institute toward becoming a university then wondered about whether the Institute could keep its distinctive focus on wellness. Tai Sophia vice president Judy Broida, PhD, vice president, responded:

"After reading your blog comment about Tai Sophia's proposed move to a university, I wanted to respond. Having worked at many universities, private and public, small and large, highly prestigious and some not so, I can assure you that as long as I and the new leadership are here, Tai Sophia will not 'regress to the mean' of universities and will always retain its roots.  It is what makes us special and all of us here commit to a future for Tai Sophia that is based on its values-driven foundation, its self-care, and transformational philosophy. 

"We are all deeply passionate about birthing and growing a health care model that uses the best of the allopathic approaches integrated with the 'alternative' or 'complementary,' both ancient and contemporary approaches for the benefit of delivering a personalized, natural, and optimal approach for the patient. We believe that it is possible to unite our 'healing presence' approach with both innovative approaches to higher education, research, scholarship, and service to create a unique university that is poised to develop future leaders who will be at the forefront of reforming the delivery of health care."