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Integrative Medicine, Complementary and Alternative Medicine and Health Round-up: February 2013 |
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Written by John Weeks
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Integrative Medicine, Complementary and Alternative
Medicine and Health Round-up: February 2013
Policy
-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
 Research
-"Health"
Makes the Agenda of the National Institutes of Disease
Economics
-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
Professions
-American Journal of Nursing Honors Coaching Book, Linda Bark's Wisdom
of the Whole
Education
-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
Miscellaneous
-IBIS Database Made Available for Free
People
-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
________________________________
Policy
 US Senator Tom Harkin
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
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
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
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 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
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
Bill Walter, ND, sends notice that the 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.
Research
 National Institutes of Disease, uhh, Health
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
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.
Economics
 Savings found via chiropractic, again
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?
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
 Mathew Davis, DC, MPH: lead investigator
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
Why 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 undoing. Ultimately 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
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
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.
 From 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.
Professions
 Bark: long labor rewarded
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
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
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.
Education
 To become Maryland University of Integative 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
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
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
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
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.
Miscellaneous
 Mitchell Stargrove, ND, LAc: Makes IBIS freely available
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
MedicineWorks.com 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 IBIS.com 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."
People
 Marinelli: recently deceased integrative pain leader teaching at AAPM
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.
Comment: 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
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
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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