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Integrative Medicine, Complementary and Alternative Medicine and Health Round-up: February 2013 PDF Print E-mail
Written by John Weeks   

Integrative Medicine, Complementary and Alternative Medicine and Health Round-up: February 2013

-US Senator Harkin, Champion for Integrative Health and Medicine, to Retire in Two Years
-Integrative Healthcare Policy Consortium (IHPC) Announces Campaign on Section 2706, "Non-Discrimination in Health Care"
-Acupuncturists Hit 25,000 Signature Goal in Petition to White House for Inclusion in Social Security, Medicare
-Academic Integrative MD Organization (CAHCIM) Promotes Licensed Acupuncturists' Petition to the White House
-Oregon Evidence Committee Includes "CAM" and Herbs in Back Pain Guidelines
-"Health" Makes the Agenda of the National Institutes of Disease
-Back Surgery Incidence at a Fraction for Those Who First Visit Chiropractors
-Money in Medicine: "Economic Impact" of Teaching Hospitals Increases - Is This a Good Thing?
-Growth in Bucks Spent on CAM Practitioners Flattens
Integrative Practice
-"Embrace" of Yoga Therapy at Cleveland Clinic; plus Program at Swedish Hospital, Seattle
-Samueli Institute's Pledge to the Clinton Foundation: "Build the Optimal Healing Environments in the Home"
-From Google Alerts: Links to Integrative Medicine in Health Systems and Communities: February 2013
-American Journal of Nursing
Honors Coaching Book, Linda Bark's Wisdom of the Whole

-Tai Sophia Institute Become Maryland University for Integrative Health
--Have Tables, Will Travel: Palmer College of Chiropractic West's "Portable Clinics" in the South Bay Area
-Website Goes Live for Clinical Care Conference Sponsored by CAHCIM
- Bastyr University: Two Articles on the Impacts of the Affordable Care Act on the "CAM" Professions
-IBIS Database Made Available for Free  
-In Memoriam: Rick Marinelli, ND, MAcOM (1954-2013)
-To Be Honored: Larry Dossey, MD and Mehmet Oz, MD
-Clay MacDonald, DC, MBA, JD Selected as President of Logan College of Chiropractic/University


US Senator Tom Harkin
US Senator Harkin, Champion for Integrative Health and Medicine, to Retire in Two Years

U.S. Senator Tom Harkin (D-Iowa), the undisputed champion for complementary, alternative and integrative medicine for over 20 years, has announced plans to retire at the end of 2014. Harkin, who is 73 and presently is in his 29th year in the Senate, will not seek a sixth term. He serves as chairman of the Senate Health, Education, Labor and Pensions Committee as well as the Senate Appropriations subcommittee that handles the budgets for the same agencies. These include the National Institutes of Health and the National Center for Complementary and Alternative Medicine, which he created in 1998. A long-time supporter of chiropractic, in 1991 Harkin sponsored the original obscure amendment that created an exploration of unconventional therapies at teh NIH, which became the Office of Alternative Medicine and later NCCAM. His hand is on virtually all of the inclusion of complementary and alternative medicine and integrative health language in the Affordable Care Act.

Comment: Harkin has been friend, advocate and protector for the emergence of integrative health and medicine in the United States. That Harkin's close colleague and CAM/IM friend Barbara Mikulski (D-MD) has take the role of Appropriations chair that Harkin turned down a month ago takes the edge off this prospective loss. History will show that this single human being played a tremendous role in midwifing this movement and its values from the outside into the nation's dialogue over medicine and health.

Consortium to lead state-to-state effort
Integrative Healthcare Policy Consortium (IHPC) Announces Campaign on Section 2706, "Non-Discrimination in Health Care"

The Integrative Healthcare Policy Consortium (IHPC) announced in late January 2013 that it is launching a strategic state-by-state campaign to support what it calls the "correct" implementation of Section 2706 of the Affordable Care Act." Section 2706 is called "Non-Discrimination in Health Care." According to the IHPC, the leading multidisciplinary lobbying organization for integrative health and medicine, the language "prohibits insurance companies from discriminating against health care providers relative to their participation and coverage in health plans." IHPC argues that "correct" implementation will "encourage the full utilization of healthcare providers and [create] reduction in costs for patient care." IHPC's release highlighted the organization's retention of Deborah Senn, JD, former Washington State Insurance Commissioner, as its lead consultant. Senn was insurance commissioner following the passage of the Every Category of Provider (ECP) law that required all health plans to include all types of licensed practitioners in that state.

IHPC plans to "strategically construct a state-by-state plan of action." Elements will include creation of a national clearinghouse to share best practices, organize a community of learning, and develop white papers and a toolkit for action for leaders of individual disciplines in their own states. Funding for the launch of the campaign and for Senn's work came from the chiropractic community. IHPC, which is backed by its 18-member Partners for Health, is seeking additional funding through other sources.

Deborah Senn: terrific IHPC hire
: The known battle-lines are these: IHPC and the American Chiropractic Association lobbied the language into the 2010 healthcare law. US Senators Tom Harkin (D-Iowa) and Barbara Mikulski (D-MD) were champions. Those close to the law believe that the legislative intent was for an expansive understanding of "non-discrimination," such as Senn and IHPC advocate. On the other side of the battle is the American Medical Association. Within three months of the law's passage, the A.M.A.'s House of Delegates passed a resolution seeking repeal of Section 2706.
(See Battle On: MD Specialists Promote Repeal of Non-Discrimination Vs Integrative Practitioners, Others.)  The A.M.A.'s own state-to-state "Scope of Practice Partnership" is charged to keep the impact of 2706 limited, if they can't amend the non-discrimination out of the reform act altogether.

For advocates of increased access, hiring Senn was brilliant. She proved a warrior in Washington for consumers and thus to access to these professionals. The question is whether the integrative health community - consumers, professionals, industry and philanthropy - has enough self-respect and chutzpah to take a fire-hose to the body to end this other form of discrimination. IHPC is taking contributions via their website. My spouse and I sent them $100. Consider doing this yourself and/or getting your organization to do so.

National AOM organization pushes successful petition
Acupuncturists Hit 25,000 Signature Goal in Petition to White House for Inclusion in Social Security, Medicare

The American Association of Acupuncture and Oriental Medicine sent out a release on February 6, 2013 urging members to sign a "White House Petition to Designate 'Acupuncturist' as a Recognized Healthcare Provider under the Social Security Act."  The goal is to alert the Obama Administration "to the fact that acupuncturists are not currently recognized as healthcare providers under the Social Security Act and, therefore, cannot get reimbursement for services provided to Medicare patients." The petition was at 10,000 signatures at the sending and tipped over the 25,000 target just prior to the February 10, 2013 end-date.

Comment: I sent a push out to Integrator subscribers with a very self-interested lead in:
Would YOU like to see acupuncture in your Medicare package?  Two licensed acupuncturists wrote back chastising me for the perpetuating a fiction that the White House passes legislation. I responded that while that is Congress' job, the White House has been known to influence legislation. As I said in my push: I am not sure how much influence these petitions have but do know that getting the White House's ear on anything related to integrative health care is rare.  

Hoffman: opposed to Medicare for acpuncture
Comment from Ronald Hoffman, MD
: [Hoffman is a clinician, author and radio host who is long-time leader in holistic and integrative medicine world.]
"John, LOVE acupuncture, trained in it, want people to get it. But so DON'T want Medicare to cover it, regulate it, dictate what you can and can't do, penalize docs for not billing correctly (or allow scammers to game the system!), etc. And I sure don't want to be taxed to oblivion to create yet another entitlement as part of a creeping program of government-granted prerogatives! As it is, Medicare is unsustainable, why make it worse?  Bottom line, you can't have everything, or else you will have NOTHING. Thanks for your attention, or inattention as the case may be. Respectfully, Dr. Ron Hoffman."

Comment from JW on Hoffman's comment: "Hi Ron – One can opt in or out of payment. As it turns out, most professionals who have never had a chance to be involved [in insurance], would prefer they have an option. And as a general rule, incomes do go up with coverage. They certainly have in Washington State. MDs typically don’t appreciate this, having a different vantage point. Of course coverage would assist many to access. I am paying attention, perhaps to different things than you. I appreciate your feedback, though we disagree. If you are comfortable, I will post it - John."

Ben Kligler, MD,MPH: CAHCIM chair
Academic Integrative MD Organization (CAHCIM) Promotes Licensed Acupuncturists' Petition to the White House

The Consortium of Academic Health Centers for Integrative Medicine (CAHCIM) sent an e-blast on Friday, February 8, 2012 that urged their members to sign the AAAOM's
White House Petition to nudge the field of licensed acupuncturists on the many-stepped process toward becoming licensed providers under Medicare. CAHCIM is an MD-led organization the membership of which is 55 academic health centers and health systems. Acupuncture as performed by licensed acupuncturists is one among the top services most likely to be included in integrative medicine clinics in these arenas.  

Comment: The CAHCIM action note was an excellent sign of collegiality. I sent it off to a half-dozen leaders of acupuncture organizations to make sure they were aware. In this case, collegiality is spelled s-o-l-i-d-a-r-i-t-y. Nice.

Bill Walter, ND: info on Oregon pain guideline
Oregon Evidence Committee Includes "CAM" and Herbs in Back Pain Guidelines

Bill Walter, ND, sends notice that t
he Oregon Health Evidence Review Commission (HERC) has published guidelines on the management of acute, subacute, and chronic low-back pain that include, as non-pharmacological treatments, recommendations for coverage of yoga, acupuncture, spinal manipulation, cognitive therapy, and progressive muscle relaxation as non-pharm treatments. The section on pharmacological treatments recommended include devil's claw, capsicum, and willow. Walter notes that while information on the influence of these guidelines is here, there is jockeying underway regarding whether 
to give the agency more power. Concern includes who is to sit on the relevant "evidence-based" committee.
Comment: This good news follows inclusions of "CAM" in pain guidelines since the Joint Commission's May 1999 publication, and including that of the internal medicine discipline a decade later. What's missing yet is any sense of therapeutic order, or a charge to use less invasive first whenever possible; or as came up in a recent exchange with a national pain leader, an idea such as never only opioids. Now that CAM is on the bus, the effort must be to, when appropriate, move these therapies, approaches and providers to the front seats.



National Institutes of Disease, uhh, Health
"Health" Makes the Agenda of the National Institutes of Disease

The National Institutes of Health (NIH) greeted 2013 with a surprising announcement. Fifteen of the NIH's 28 institutes and centers, including the National Center for Complementary and Alternative Medicine (NCCAM) signed onto an initiative entitled "Implementation and Dissemination in Health." The NIH program urges studies that "scaffold multiple evidence-based practices within care settings, to meet the needs of complex patients, systems of care, and service integration." These may include combinations of multiple prevention strategies, treatments and the shared decision-making among teams of practitioners. The critical endpoint is "patient outcomes." Included are R01, R21 and R03 mechanisms.

Signed onto the health initiative
: The NIH's normal portfolio has led more than one observer to suggest that the powerful agency would be more appropriately named the National Institutes of Disease. This program is notable because of its rare focus on the complexities associated with creating "health." This elevation of "patient outcomes" over biomedical indicators enters a zone where integrative strategies shine. The philosophical focus of complementary, alternative and integrative providers on treating the whole person, using "all appropriate therapies, health professionals and disciplines," and forming partnership with patients measures up well in this context.

What the NIH needs to do next is to call for new research on strategies that target such health creation. Such a program must be engaged with a similar appreciation for complexities of such interventions and research methods with individualized patient outcomes as endpoints. The NIH's disease obsession enables the disease-orientation of the medical industry. We've barely begun to examine our abilities to reverse disease and create health. What roles can integrative medicine and health have in doing so? Pushing dissemination without funding new research feels a but like putting the cart before the horse. This is a good step though. In its 2011-2015 strategic plan, NCCAM noted consumer interest in health as a motive for their use of "CAM" therapies and practitioners. This program appears to be aligned with that Strategic Objective #3.


Savings found via chiropractic, again
Back Surgery Incidence at a Fraction for Those Who First Visit Chiropractors

A press release from the Foundation for Chiropractic Progress highlights a recent study of data from the state of Washington: Early Predictors of Lumbar Spine Surgery after Occupational Back Injury: Results from a Prospective Study of Workers in Washington State. Concluded the authors: "Reduced odds of surgery were observed for those under age 35, women, Hispanics, and those whose first provider was a chiropractor." And: "42.7% of workers who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor." Finally: "There was a very strong association between surgery and first provider seen for the injury, even after adjustment for other important variables."

Comment: The cost-savings from "CAM" such as was found in the recent Medical Expenditures Panel Survey (MEPS) study is typically via foregoing expensive tests and procedures. It remains astonishing that more plans and employers do not directly establish programs that push users toward chiropractors. Culture, power dynamics and loyalties rather than evidence would seem to be shaping decision processes. The chiropractic profession would serve itself by clarifying and even certifying those chiropractors who wished to be "primary care for back pain." They will need to assure that patients would be able to appropriately access non-chiropractic practitioners of yoga, of acupuncture, of massage or other treatment, including surgery, when manual manipulation is not the most appropriate or only treatment suggested.

Association of American Medical Colleges: bragging about economic impacts, or is that high costs of treatment?
Money in Medicine: "Economic Impact" of Teaching Hospitals Increases
- Is This a Good Thing?

On January 7, 2013 the e-news of the Association of American Medical Colleges (AAMC) featured a notice entitled: "Medical Schools, Teaching Hospitals Generate Billions for Economy." The synopsis of a recently completed economic impact analysis by the consulting concluded that the nation's medical schools and teaching hospitals "infused $587 billion into the economy while supporting nearly 3.5 million jobs in 2011, reflecting a 15 percent increase over the impact institutions had on the economy the last time the analysis was conducted in 2008.

Berwick: the (un)ethical issues in medical spending
: Should medicine be bragging that it is growing as an industry? Shouldn't it only brag if it has been so successful in creating a healthy population that it needs to retrain hospital-based professionals and technicians as community workers because we are getting a handle on the growth of major conditions and limiting the waste and harm in our tertiary care environments? This release brings to mind the Congressional and community battles over closures of military bases. The debate is not about mission and need, if it ever way, but rather about protecting the industry, and jobs. Former Centers for Medicare and Medicaid administrator Don Berwick, MD has been particularly outspoken about these ethical issues. He asks medicine to consider how these "billions for the healthcare economy" are taking social investment from education, transportation and the environment. Paul Grundy, MD, MPH, IBM's global director for health, is more blunt about such boasting. He calls these economically-bloated
academic health centers "milking machines." Asks Grundy of the academics in medicine: "What happened to you guys?" The AAMC's advocacy reeks with a corruption that is all the worse for the apparent lack of consciousness. 

Mathew Davis, DC, MPH: lead investigator
Growth in Bucks Spent on CAM Practitioners Flattens

A team led by researchers out of Dartmouth and the Rand Corporation concluded in widely-covered study published in Health Affairs that services of complementary and alternative medicine providers have "plateaued" at $9-billion, or 3% of total ambulatory care. (See US Spending On Complementary And Alternative Medicine During 2002-08 Plateaued, Suggesting Role In Reformed Health System.) The authors suggest that the flattening may be connected to the increase in co-payments for services of chiropractors and others. They suggest that, given this small contribution to cost, attempts to cut expenses in medicine through targeting elimination of coverage of complementary and alternative healthcare services will have little impact on the overall economic burden of the medical system on the economy. The researchers conclude that for some conditions and disciplines, such as chiropractic management of low back pain, the system may actually save money through more coverage in delivery contexts such as accountable care organizations where the incentive structure favors keeping people healthy.

Ian Coulter, PhD: RAND researcher on team
: How do we explain the flattening of investment in these services, even as costs continue to expand in other areas? Is there a natural limit to conditions or populations that may benefit from CAM? Antagonists might propose that there is a happy limit to gullibility and the placebo's impact. The unfortunate reality is that neither the mainstream delivery system nor the research establishment that enables it have much interest in exploring how, and when, these providers may actually create cost-savings compared to regular care. (Note that the
Implementation and Dissemination program above is not a call for new research.)

hy is this? If fewer procedures and surgeries are needed, the economic impacts of the academic health centers
swing into decline. (See Teaching Hospitals Generate Billions for Economy, above.) Few people or institutions willingly engage the suicidal act of funding their own undoingUltimately the responsibility for making a case for cost savings from "CAM" and integrative health will not come from those whose interests are opposed. The leadership must be from those who need the data, namely the public, payers such as employers, the elected officials who represent them, and perhaps most of all the integrative health and medicine community. To date, these have done more complaining about what the system is not doing than organized advocacy for what needs to be done. They have not spoken up, except in rare instances, to directly urge the NIH and NCCAM to do the kind of research that is needed. Leadership is needed.

Integrative Practice
International Association of Yoga Therapists
"Embrace" of Yoga Therapy at Cleveland Clinic; plus Program at Swedish Hospital, Seattle

The Winter 2012 Issue of Yoga Therapy Today, from the International Association of Yoga Therapists includes significant evidence of the successful move of yoga into leading health systems. One story is "A History and Guide" to the uptake of yoga at Cleveland Clinic. The program began in the Center for Integrative Medicine there, and expanded out as therapist (and author) Judi Bar's work became better known. Bar is now a full-time yoga therapist for the Cleveland Clinic. The same issue includes a depth look at "lessons learned" in a hospital-based yoga class at Seattle's Swedish hospital, from Cyndi Terry Kershner, RYT500. Also featured is an interview with IAYT advisory board member Loren Fishman, MD, in which Fishman focuses on yoga's relationship to MD practices. Fishman urges more yoga therapists to "acquire diagnostic knowledge." 

Jonas: optimal healing in the home
Samueli Institute's Pledge to the Clinton Foundation: "Build the Optimal Healing Environments in the Home"

Wayne Jonas, MD, the president and CEO of the Samueli Institute, sent a recent President's Message that share the Institute's promise to the exclusive Clinton Health Matters Conference. The one-day event, as Jonas explains, "brings together celebrities and decision-makers from a wide range of organizations -including national media, corporations, think tanks and non-government organizations (NGOs), to address the crisis in our health care system." The Samueli Institute has pledged to the Clinton Foundation - the event's sponsor - "to build a self-care model for creating optimal healing environments (OHE) in the home." The Institute has previously developed tools for creating optimal healing environments in health care settings. This initiative, writes Jonas, "will adapt this process for Americans in their daily lives." The product: "develop and disseminate an evidenced-based, self-care model designed to prevent disease, promote health, and maintain well-being."

Comment: Great idea! The question for every p;rovider, every educator and every discipline what is your optimal role in making sure that this primary provider of care is optimally prepared to
provide for self and family? Are you doing it? Hopefully the Samueli recommendations will include some for health professional education and for clinician roles.

ImageFrom Google Alerts: Links to Integrative Medicine in Health Systems and Communities: February 2013

This monthly report in the Integrator includes 24 short segments on integrative medicine developments in health systems and the community for January 6, 2013-February 10, 2013. These came via Google Alerts. Major players in the month's news were reports on research studies showing high use of alternative therapies by children using pediatric specialists, another that found higher use of CAM in the military than civilian populations, and a Health Affairs piece on spending on CAM services.


Bark: long labor rewarded
American Journal of Nursing Honors Coaching Book, Linda Bark's Wisdom of the Whole

Upon receiving the news that the American Journal of Nursing has named Bark Coaching Institute's course companion, "The Wisdom of the Whole: Coaching for Joy, Health, and Success" a 2012 AJN Book of the Year in the Professional Development and Issues category, I wrote to author Linda Bark, RN, PhD, NC-BC. I shared that I would report it and noted to that the award for her long, pioneering labor must feel good. She approved me sharing her response which captures the moment of acceptance by nursing, of integrative coaching.

"Thanks John. Yes, it does and from the mother ship--AJN!  A little over a week ago, I was notified by email about the award and was very happy. That night I woke up at 3am and thought OMG I won first place in Professional Development by the AJN. I started crying remembering the times I wondered if I could continue to call myself a nurse. Sometimes I felt I was doing things sooooo differently from the main stream. I think I had been in shock earlier in the afternoon. 

"I also went through a period that night when I wondered if they really did read the book. Did they see all the things about energy and alternative healing methods? I decided they must have done so and that things are really changing. I told this story to one of my faculty and she laughed and said, 'Linda, you are still on the edge of nursing but now it is the leading edge!'

Bark's book on coaching
I had a colleague, who is a nursing leader in a very large hospital system, tell her nursing senior management about my award. This group is REALLY conservative. At various times, she has mentioned similar types of information and the group didn't even acknowledged her comment. However, because this was from the AJN, they listened, ordered books, and began thinking that I should come and present to them! Both she and I are amazed!

"I am having other experiences like this. I was asked to keynote at a nurse executive conference. I thought it somewhat odd that they wanted me and agonized over how to present to them. I finally decided to explain my model and do a very experiential presentation. I had no idea how my get off your chairs, get into your body, look at sense of purpose, move around, and collaborate with others approach would work but I already had my sizable check so if things went very poorly, I could make a run for it. To my complete surprise, they loved it. 

"I am not sharing this for publication but to you personally to let you know what I am seeing. It has been a long road for many of us all but things are changing. Hooray! Finally!"

Co-authored by Bark, Dossey, Luck, others
Bark concluded with a note that her other coaching book, which she co-authored, is now published by American Nurses Association, is entitled The Art and Science of Nurse Coaching: The Provider's Guide to Coaching Scope and Competencies. She adds:
"All good news...I feel like we are in the fun and easy part of this journey now, Do you agree?"

Comment: Bark documents a shift that is profound, from external aggravation to internal ownership. She captures how the mainstream of medicine, as it begins to dis-associate from its past in order to make change, now can look across a chasm and explore and make its own that which was profoundly other. Bark's comment on us entering the fun and easy part of this journey seemed Pollyanna to me on first reading. Then I dis-associated from my past and recalled how open many dialogues have become, and agreed, yes, it is, if not east exactly, easier, and, yes it's a word, funner.

Note: A related article
in developments in this field is The Strategic Role of the Nurse-Coach in an Integrative Care Model by Susan Luck, RN, BS, MA, HNC, CCN.


To become Maryland University of Integative Health
Tai Sophia Institute Become Maryland University for Integrative Health

It is no secret that in recent years one of the nation's most significant institutional players in educating acupuncturists has been adding multiple new programs and moving toward university status. On February 11, 2013, the Tai Sophia Institute in Howard County, Maryland announced that it has been approved for university status and will change its name to the Maryland University for Integrative Health (MUIH). Stated president Frank Vitale, MBA:
"In achieving university status, we strongly feel that Maryland University of Integrative Health is on its way to becoming the preeminent institution in this country in the area of integrative health. This designation validates our academic excellence and is a significant milestone. It also positions us as leaders in bridging ancient wisdom and contemporary science." In the last three years, MUIH has seen its enrollment jump from 400 to more than 730 graduate students and its academic programs grow from four to 18. In the release, the institution defines integrative health as "an evidence- and effectiveness-based model that considers physical, mental, spiritual, and lifestyle influences on health, is steadily becoming a desirable treatment option and career path for many people." Notably, the institution announced in January its most recent offering, a Master of Science in Health Promotion.

Frank Vitale, MBA: leads Institute to university status
: Kudos to Vitale, his executive vice president and provost Judi Broida, PhD, and their team. They set the goal of recognition as a university, and via a stepwise process, achieved it. The name change surprised me. I like the poetry of Tai Sophia. At the same time, to letting the institution's name directly say what it is and market, as happens with
Maryland University for Integrative Health, makes sense.

Choosing to tie the institution to
"integrative health" is intriguing. This is a relatively new concept in the culture. The term has elevated during the Institute of Medicine Summit on Integrative Medicine and the Health of the Public. There it became clear that most of those assembled favored the more unifying and value-laden "integrative health" to "integrative medicine" as a descriptor of the movement. The following year the concept appeared in federal policy, in some sections of the Affordable Care Act. I personally find the term the most comfortable way to speak of these fields, as in advancing the values of integrative health. The landscape has shifted with this institution declaring in its name for an integrative health future. My personal hope would be that MUIH will take full advantage of its position in the Nation's beltway to direct its leadership in integrative health to policy leadership.  

Palmer West, San Jose, California
Have Tables, Will Travel: Palmer College of Chiropractic West's "Portable Clinics" in the South Bay Area

Greg Snow, DC is the dean of clinics at Palmer West in San Jose, California. I recently became aware of the institution's clinical programs that both provide educational opportunities and service to the under-served and asked Snow for some information. He provided this brief synopsis of the school's "outreach clinic program." 

Greg Snow, DC: director of clinics for Palmer West
Snow reported: "
For more than 20 years, Palmer College's West Campus has developed and operated outreach clinics in the South Bay area serving those whose health care resources are limited or non-existent, including the homeless, individuals battling substance-abuse addictions, and low income seniors. The West Campus outreach clinics are an integral part of the student doctor's educational experience, and "community health" is part of the College's ongoing mission. West Campus outreach clinics are based at off-site facilities managed by social service agencies: the Salvation Army, Emergency Housing Consortium, and Ecumenical Association of Housing. The outreach clinics are staffed by clinicians and interns from the campus-based Palmer Chiropractic Clinic in San Jose. These clinics provide care that is well in excess of $100,000 annually."

He explained that with the exception of the Salvation Army clinic, the clinics are each located in common areas at the respective sites. Each clinic is set-up for operations each shift, portable tables and transported files that are typically in secured storage on site between clinic days. These are taken down at the end of the day.

Comment: A useful research project would be to estimate the total contribution to the under-served, in visits and in dollars, of all of the outreach clinics of all of the schools that educate professionals for the licensed "CAM" disciplines. The finding would be significant.

Melinda Ring, MD: co-chairing the conference
Website Goes Live for Clinical Care Conference Sponso
red by CAHCIM

The website for the first International Congress for Clinicians in Complementary and Integrative Medicine (ICCCIM) which will be held October 29-31, 2013 in Chicago is live. Call for papers will be sent out February 28, 2013 with the close on April 26, 2013.

Comment: The content of this conference, organized by academic integrative medicine leaders, will be an interesting comparator to, for instance, an Institute for Functional Medicine conference, or the Integrative Healthcare Symposium. The latter two represent the "town" side of the gown/town split between integrative medicine's ivory tower and its streets. Either could reasonably be sub-headed as a conference "for clinicians in complementary and integrative medicine." How will ICCCIM content differ?
What portion will include forms of researched outcomes? Will exploration of clinical care in integrative clinic structures suggest more content on work by teams? Interestingly, CAHCIM did not choose to partner with the Academic Consortium for Complementary and Alternative Health Care on this Congress as they did for a recent congress for educators. Consider submitting!

Bastyr University: Two Articles on the Impacts of the Affordable Care Act on the "CAM" Professions

Bastyr University has had Jon Hiskes research two articles that explore the role that the Affordable Care Act is having or may have on the "CAM" community and on naturopathic medicine in particular. The first is
Health Care Law Creates Openings for CAM Fields and the second is entitled Health Care Reform Extends Reach of Naturopathic Medicine. The former includes some specific information relative to acupuncture, midwifery, mental health, physical therapy and nutrition. 


Mitchell Stargrove, ND, LAc: Makes IBIS freely available
IBIS Database Made Available for Free  

One of the earliest clinician-oriented electronic databases, IBIS (Integrative BodyMind Information System) has been made available free to all interested parties. The program has been updated from its founding 20 years ago in the dark ages of the internet by a visionary team at led by Mitchell Stargrove, ND, LAc, co-author of Herb, Nutrient and Drug Interactions. A multidisciplinary team of 74 contributors, weighted toward naturopathic doctors, participated in content development. Go to site and request the IBIS installer.

Comment: Stargrove was given the Vis Medicatrix Naturae award by his national professional association in 2012, signifying his contributions to enhancing respect for the healing power of nature, the core precept in naturopathic philosophy. Stargrove and his clinician wife and partner Lori Beth Stargrove, ND, LAc, have been remarkable in the database world for their clinician-centric and patient-centric approaches. They were among the first, for instance, to shape content around the clinical experience that many "interactions" are not, in fact, negative. Making IBIS freely available is, as jazz musician Rahsaan Roland Kirk might have put it, "a duty free gift for the traveler."  


Marinelli: recently deceased integrative pain leader teaching at AAPM
In Memoriam: Rick Marinelli, ND, MAcOM (1954-2013)

National integrative pain leader Rick Marinelli, ND, MAcOM (1954-2013) died recently from recurrence of a throat cancer. Marinelli is credited with key roles in focusing the American Academy on Pain Management toward an integrative medicine approach and for helping formulate the Institute of Medicine's 2010 declaration for a culture change in pain treatment toward an integrated, team-care model. Marinelli had a huge influence in naturopathic care in the state of Oregon and in pain treatment in the naturopathic profession. An interview with Marinelli on his appointment to the Institute of Medicine Committee on Advancing Pain, Care and Research is here.

Rick touched many, including me, and my family. In Memoriam: Rick Marinelli, ND, LAc (1954-2013) includes perspectives on his life and contributions from Laura Farr/Oregon Association of Naturopathic Physicians, Institute of Medicine pain committee colleagues (Phil Pizzo, MD, Myra Christopher, Adrienne Stith, MD, Charles Inturrisi, PhD), his American Academy of Pain Management colleagues (Robert Bonakdar, MD, Lennie Duensing), Joanna Forwell, ND, Michael Traub, ND, DHANP, Pamela Snider, ND, Elizabeth Goldblatt, PhD, MPA/HA, and John Weeks. His life will be celebrated in Portland on February 16, 2013. See you, Rick.

Dossey: to be honored
To Be Honored: Larry Dossey, MD and Mehmet Oz, MD

The Integrative Healthcare Symposium has announced that it will honor Larry Dossey, MD with its Visionary Award and Mehmet Oz, MD with its Leadership Award at the upcoming in conference in New York City, February 27-March 2, 2013. Dossey is an influential author and best-seller who has shaped dialogues on mind-body and energy medicine nationally and internationally. Oz's television show is far and away the most significant platform in the U.S. from which the merits of integrative medicine and health are trumpeted. Forgotten by many now was the cardiothoracic surgeon's early partnership with Jerry Whitworth in creating the complementary and alternative medicine program at Columbia-Presbyterian hospital in the late 1990s.

Clay McDonald, DC, MBA, JD
Clay MacDonald, DC, MBA, JD Selected as President of Logan College of Chiropractic/University

Educator-clinician Clay McDonald, DC, MBA, JD, has been chosen as the new president of Logan College of Chiropractic/University Programs in Chesterfield, Missouri. McDonald has previously served as provost of Texas Chiropractic College and
vice president and provost for New York Chiropractic College, as well as in various leadership positions with Palmer College of Chiropractic. McDonald ran a clinic in Montana for a decade before devoting him self to health professional education. He replaces George Goodman, DC who retired after 20 years and after building a $25-million endowment for the school. McDonald is a Logan alumnus.

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