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Integrative Medicine, Complementary and Alternative Medicine and Health Round-up #69: July 2013 PDF Print E-mail
Written by John Weeks   

Integrative Medicine, Complementary and Alternative Medicine and Health Round-up #69: July 2013

Policy
-Advisory Group on Prevention urges Surgeon General to issue guidance to states on non-discrimination (2706)

-Georgetown University group's Affordable Care Act implementation check list notes 2706, non-discrimination

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-Integrative health academic consortium injects health and well-being into Institute of Medicine workshop
 

-Senator Harkin as pitch man for the naturopathic medical profession

-Obama administration issues rules on employment-based wellness; are employers hand-cuffed?

Research & Publications
-Iris Bell, MD leads team in JAMA Internal Medicine publication on systems outcomes in integrative medicine

-NCI calls for submissions on the role of integrative medicine in cancer survivorship
Integrative Practice

-From Google Alerts: Links to Integrative Medicine in Health Systems and Communities for July 2013
-Second major pain group creates focus on integrative pain strategies

-Update: Role of Arya  Nielsen, PhD, LAc in the Joint Commission's interest in non-pharmacological approaches

Academic Medicine
-UCLAArts and Healing to offer Social Emotional Arts Certificate Program

Professions
-Washington State massage team publishes paper on massage in Essential Health Benefits 

-Hassles of midwifery customers in getting care covered featured in New York Times

-Naturopathic doctors  move into key roles in medical homes in Oregon
-Foundation for Chiropractic Progress continues to gather strength as chiropractic visibility group

Natural Products
-Cancer Treatment Centers of America reports outcomes of quality examination of dietary supplement suppliers

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WA AMTA's Diana Thompson, LMP
Conferences

-Northwestern Feinberg School of Medicine hosts National Student Conference in Integrative Medicine, October 26-27
-Integrative Medicine for the Underserved offers 3rd annual conference in Santa Clara

-International Research Congress for Integrative Medicine and Health now accepting session proposals
Dr. -Rogers' Prize names Irving Kirsch, MD as keynote speaker for September 26, 2013 Gala Award Dinner

People
-Michael Smith, PharmD, ND joins Samueli Institute team as Senior Fellow
-Integrative medicine researcher Heather Boon, PhD appointed interim dean in Toronto pharmacy department
-Joe Stiefel, MS, EdD, DC selected a 6th president of National University of Health Sciences
________________________________

Policy


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Surgeon General Regina Benjamin, MD, MBA
Advisory Group on Prevention urges Surgeon General to issue guidance on non-discrimination, Section 2706

The Advisory Group on Prevention, Health Promotion and Integrative and Public Health, established under the Affordable Care Act, has urged Surgeon General Regina Benjamin, MD, MBA and the Department of Health and Human Services
to "issue guidance to states regarding compliance with Section 2706 ['Non-discrimination in Health Care'] of the ACA and its relationship to all plans offered through the states' health insurance exchanges." The 4-page letter, authored by Jeffrey Levi, MD, the chair of the National Prevention Council, followed a late March 2013 meeting of the Advisory Group which Levi convenes. In addition, the letter urged the "appropriate use of the healthcare workforce as defined in Section 5101 of the ACA." That section, which includes chiropractors and other "licensed complementary and alternative medicine providers, integrative health practitioners," has never been funded.

Comment
: States are in need of some affirmative guidance on 2706, as described here, and on 5101 (National Healthcare Workforce Commission). Notably, however, this push from the Advisory Group on these two sections was not the first recommendation in this 3rd year report from the Advisory Group. Rather, these were lumped and dead last, on page 4 of the letter. Still, good to see the inclusion. I am guessing advisory group member Janet Kahn, PhD had a hand in that. 


ImageGeorgetown University group's Affordable Care Act implementation check list notes Section 2706, non-discrimination


An Affordable Care Act Implementation Checklist developed by professionals at Georgetown University references Section 2706 on page 12 of the 22 page document. The category is doubly listed as
"Providers operating within their scope of practice cannot be discriminated against" and "Issuers may not discriminate against any provider operating within their scope of practice." The Georgetown team offers this "tip": "Check to ensure that if a service/treatment is covered that there are no limitations on licensed providers who can provide that service."

Comment: The "tip" may be limiting, yet is the accepted, limited view of most regulators. One wonders why Senator Harkin could have advocated this section for his chiropractic and integrative health friends if, for instance, a chiropractic adjustment was not included. Some believe that the meaning of non-discrimination is that, if for instance treatment of back pain is covered, then non-discrimination would allow any licensed practitioner to bring what tools they have (for instance adjustment) to the task. Apparently, gaining such an interpretation, as Deborah Senn was able to do in Washington State when that jurisdiction passed its Every Category of Provider act, will need a lawsuit, or more than one lawsuit, as argued here.

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Integrative health academic consortium injects health and well-being into Institute of Medicine workshop

A comment from TEDMED 2013 by GW Bush's nephew that "exogenous factors" will be necessary to leverage change in medicine led this author to reflect on the role of integrative health and medicine leaders in bringing "health and well-being" into focus in a May 2013 Institute of Medicine workshop. The focus of the IOM meeting was on an imagined, coming era of "Transdisciplinary Professionalism."  Integrative health leader at the University of Minnesota Mary Jo Kreitzer, RN, PhD and Elizabeth Goldblatt, PhD, MPA/HA from the Academic Consortium for Complementary and Alternative Health Care (ACCAHC) carried the health and well-being content. ACCAHC, a member of the Forum while yet an "exogenous factor" relative to most mainstream healthcare dialogues, had taken the lead in introducing the health-focused content into the meeting.

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Krietzer: led key session
Comment
: I've been intimately involved with the ACCAHC work, through my consultancy with that organization. I am particularly proud of Goldblatt's success in carrying an overt focus on health outcomes into that gathering of health professions educators and leaders across all fields. We need to be overtly bringing health, healing and well-being outcomes into these debates. A full column on this IOM example in fulfilling this need for exogenous input is here, at Integrative Practitioner.


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Harkin: lauding the NDs
Senator Harkin as pitch man for the naturopathic medical profession


A transcript of the comments of US Senator Tom Harkin to members of the naturopathic medical profession strongly suggests that he will advocate for their inclusion in diverse federal programs. He states:
"No question, NDs and integrative medicine can and must play a very big role in this transformation.  We need an expanded role for NDs in order to reduce the shortage of primary care providers. Just as importantly, we need your sharp emphasis on wellness and prevention, and your (naturopathic doctor) pragmatism in taking full advantage of the very best available therapies, whether from conventional western medicine or from alternative sources and traditions." He then directly urges inclusion of NDs "in the Commissioned Corps of the US Public Health Service, and also in federal health programs generally."

Comment: The NDs better act fast. Harkin has announced that 2014 is his final year in office.

Obama administration issues rules on employment-based wellness - are employers hand-cuffed?

In a May 29, 2013 release from the US Department of Labor, final rules for employment based wellness programs were revealed. The rules are expected to "support workplace health promotion and prevention as a means to reduce the burden of chronic illness, improve health and limit growth of health care costs, while ensuring that individuals are protected from unfair underwriting practices that could otherwise reduce benefits based on health status. "Participatory wellness programs" such as discounted fitness center memberships are strongly endorsed. The rules also define the more challenging area of "non-discriminatory health-contingent programs" that reward those who meet specific health goals, such as body mass index. The final rules are here. They go into effect January 1, 2014.

Comment: I spoke with a colleague familiar with the issues who ventured: "I think they put more handcuffs on the employer. Employers have so much skin in the game. Individuals can just say 'I have what I have, and you have to treat me." My colleague thought that isn't the best philosophical approach to support. More on this topic is likely to follow.
(Thanks to Integrative Healthcare Policy Consortium chair Len Wisneski, MD for the heads-up on these rules.) 


Research & Publications

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Bell: pushing a whole systems research focus
Iris Bell, MD leads team in JAMA Internal Medicine publication on systems outcomes in integrative medicine


University of Arizona researcher Iris Bell, MD led a team that published
Integrative Medicine and Systemic Outcomes Research: Issues in the Emergence of a New Model for Primary Health Care in JAMA Internal Medicine. The abstract states that integrative medicine is not merely the addition of complementary and alternative medicine (CAM). Rather: "Integrative medicine represents a higher-order system of systems of care that emphasizes wellness and healing of the entire person (bio-psycho-socio-spiritual dimensions) as primary goals, drawing on both conventional and CAM approaches in the context of a supportive and effective physician-patient relationship." Bell and team focus on related research issues: "Thus, unlike biomedical research that typically examines parts of health care and parts of the individual, one at a time, but not the complete system, integrative outcomes research advocates the study of the whole ...The systemic outcomes encompass the simultaneous, interactive changes within the whole person."

Comment: This is an excellent piece of work in an area where the integrative medicine community should provide leadership. And not just for the field. More importantly, focusing on multiple agents and systemic outcomes can help us cut the umbilicus that forces health care to struggle on the thin sustenance of single agent, reductive trials. Here's hoping that the Consortium for Academic Health Centers for Integrative Medicine, with which Bell's team at the University of Arizona Center for Integrative Medicine is involved, will begin to use its 57 member organizational base to open the channels of new research methods which will allow the application of whole person care for diabetes, heart disease, cancer and every other chronic condition to thrive. 

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Cohen: guest editor in special issue
NCI calls for submissions on the role of integrative medicine in cancer survivorship


The National Cancer Institute has issued a call for submissions to a monograph to be called
The Role of Integrative Oncology in Cancer Survivorship. The NCI positions the call at "the convergence of the two exciting new fields, cancer survivorship and integrative oncology." These, the NCI notes, "create enormous opportunities to ask important research questions and to develop innovative clinical models to promote the long term health and wellbeing for cancer survivors." The monograph is sponsored by the Society for Integrative Oncology, Consortium of Academic Health Centers for Integrative Medicine, the Abramson Cancer Center at University of Pennsylvania, Allina Health, Beth Israel Medical Center, University of Hawaii, and the University of Texas MD Anderson Cancer Center. The guest editors are Lorenzo Cohen, PhD from MD Anderson Cancer Center and June J. Mao, MD, MSCE of University of Pennsylvania.

Comment: Integrative oncology center consultant and cancer survivor Glenn Sabin of FON Therapeutics forwarded news of this special report with a brief comment: "Pretty big deal for the field." I'd say so. As a person post-cancer whose career and colleagues helped him in ways that this monograph will likely help others, I urge everyone to contribute in any way possible to this publication.


Integrative Practice

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

This monthly report includes 28 segments from Google Alerts on integrative medicine developments in health systems plus 16 segments from the community for June 1, 2013-July 6, 2013. These came via requests for "integrative medicine," "integrative oncology," "alternative medicine" and "complementary and alternative medicine." A lot of negative media play this month from Paul Offit, MD's book Do You Believe in Magic? This month had the highest level of links yet from practitioners of integrative medicine in the community. Notably the IM links include naturopathic doctors and practitioners of acupuncture and Oriental medicine. In popular use, integrative medicine is not restricted to MDs/DOs. See all 44 links here.


Second major pain group creates focus on integrative pain strategies

The American Society of Regional Anesthesia and Pain Medicine has announced that it will offer a half-day Special Session Workshop: Complementary and Alternative Medicine on November 22, 2013, in Phoenix. The workshop is part of the organization's annual meeting. The objectives feature acupuncture, mind-body, Tai chi, and (explicitly) osteopathic manipulative therapy. (Italics added.) The statement of purpose includes: "Despite development of new drugs and advancement in interventional and surgical procedures for chronic pain management, non-pharmacological therapies such as acupuncture, Tai Chi/mind-body control, and osteopathic manipulative treatment have become increasingly popular due to unsatisfactory outcomes of or adverse effects and risks related to pharmacological and interventional treatments."

Comment: This follows a May 2013 American Pain Society meeting that, for the first time, included a focus on  complementary and alternative medicine. Nice to see the direction, and the content. The day will come when these planners will realize that the focus on only osteopathic manipulative therapy, thereby excluding the practitioners from whom most patients receive manipulative therapy, is simply offensive.

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Nielsen: instigated the JCAHO exploration
Update: Role of Arya  Nielsen, PhD, LAc in the Joint Commission's interest in non-pharmacological approaches


Last month I shared the exciting news that the Joint Commission is re-opening its views on non-pharmacological approaches to pain management. (See
"Joint Commission to create expert panel to further develop non-pharmacological pain standards" at this link.) I have since learned from Ben Kligler, MD, MPH that the prime mover behind the effort is Arya Nielsen, PhD, LAc, from the Department of Integrative Medicine at Beth Israel. Nielsen engaged in a fine act of transdisciplinary work by submitting information to the Joint Commission about acupuncture while asking for a broader look at all non-pharmacological approaches. Exemplary interprofessional behavior!


Academic Medicine

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Ho: new direction for UCLA center
UCLAArts and Healing to offer Social Emotional Arts Certificate Program


UCLArts and Healing, founded by Ping Ho, A, MPH, has announced that it is launching a Social Emotional Arts (SEA) Certificate Program "to empower educators and community arts professionals in maximizing social-emotional benefits of arts experiences, and minimizing self-judgment and anxiety that can impede learning." The notice states that the program "will be interactive and experiential, and will feature the use of sound, rhythm, movement, and other creative approaches to group behavior management, verbal and nonverbal communication, managing special needs and integration with typical students, identifying and responding to trauma, strengthening personal presentation skills, and evaluating program outcomes." Trainees that complete all sessions will obtain a UCLA Certificate in Social Emotional Arts Education. Ho's organization, for which I serve on the board, is a national leader in connecting the arts and healing.

Comment: The links between the healing arts and the application of the arts in healing are rich and deep and not nearly as explored or integrated as one day they deserve to be. Credit Ho's persistence in elevating her program to this point of offering a formal certification. Check out the UCLArtsandHealing website.



Professions

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Washington massage organization provides leadreship
Washington state massage team publishes paper on massage in Essential Health Benefits

A team led by Diana Thompson, LMP and Marybeth Berney, LMP has produced a useful paper on the massage profession and essential health benefits. The PDF is available as Evidenced-Informed Massage Therapy: The Research Supporting Massage Therapy is an Integral Component in the Affordable Care Act's Essential Health Benefits. A one page summary is also on the website of the Washington State Massage Therapy Association, which funded the project. 

Comment: Massage therapists in Washington State have historically pushed the value of the field in heath care and medicine when other parts of the massage leadership have preferred that the field sit back into its role as a trade that offers "relaxation" (never mind for a moment how such stress reduction can also be a benefit to one's health outcomes). Good for Thompson, Berney and their team, including Marissa Brooks, LMP, MPH, for pushing this envelope. This is a useful document for many, across the U.S.
 
ImageHassles of midwifery customers insurance coverage featured in New York Times


The midwifery profession got a boost from the New York Times in an article called Getting Insurance to Pay for Midwives which began: "At a time when the United States is looking for ways to rein in its runaway medical spending, a surprising glitch is preventing American women from choosing the low-cost option: Many insurance plans do not have midwives in their provider networks, or do not cover midwife care at all." The article was provoked by consumer ire as expressed in comments on an earlier Times piece. Ironically, hospital rules that require midwives to be supervised by medical doctors jack up rates as they are treated as physician extenders rather than as lower cost providers who "generally order fewer tests and their patients are less likely to end up having Caesarean deliveries, studies have shown." The author links to a site on how midwife care saves money. In states with high percent of midwife attended births, such as
Oregon and New Mexico, the rate of midwifery usage is just above 15 percent while in in Britain and Denmark, more than two-thirds of all births are attended by a midwife.

Comment: A radical shift to midwifery care will be a sign of actual health reform in the U.S. Notably, the author did not clarify whether births by direct-entry licensed midwives are included. 


Related note: This article notes that Indiana has become the 28th state to regulate direct-entry midwives. Advocates were not all happy with the scope restrictions. (Thanks to Lou Sportelli, DC for the link.)


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Milner: his center designated medical home
Naturopathic doctors move into key roles in medical homes in Oregon


Martin Milner, ND, the founder of the Center for Natural Medicine (CNM) in Portland, Oregon has received a Patient Centered Primary Care Home (PCPCH) certification as the first naturopathic group practice in that state to receive the credential according to this article in the Portland Business Journal. The article states that Milner's CNM "is the first naturopathic clinic in the U.S. to receive the credential as a Patient-Centered Primary Care Home." Milner and his team must still work out their relationship with that state's Coordinated Care Organization (CCO) movement. Meantime, Bill Walter, ND's intensive work to penetrate the CCO development in Lane County, south of Portland, has led to work as a staff provider in the Lane County Community Health Center, a county-run Federally-Qualified Health Center (and PCPCH). Walter notes that discussions continue about formal primary care status for naturopathic doctors in the Oregon CCO movement. He, however, has been "internally designated" as such by his Lane County group. Walters' work with the CCO movement was featured in the Integrator earlier this year in Integrative Medicine in Accountable Care: Report from Oregon Naturopathic Physician Bill Walter, ND.

Comment: These are intriguing steps. Milner has pioneered a series of important steps for his profession in Oregon, including establishing the CNM 20 years ago as a large, integrative cardiology center that also serves as a teaching clinic for National College of Natural Medicine. Here's looking forward to the data on the outcomes from these pilots in care delivery.

Related note: David Schleich, PhD, president of National College of Natural Medicine offers a perspective on the challenges the naturopathic doctors face in an article in the Lund Report entitled Inconsistent Oregon Healthcare Workforce Policies Undermine the triple AIM

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Continued growth and influence documented
Foundation for Chiropractic Progress continues to gather strength as chiropractic visibility group


A June newsletter for the Foundation for Chiropractic Progress (F4CP) announced a series of significant accomplishments: an additional $100,000 from Standard Process; paid distribution of the documentary Doctored to all members of Congress; the number of entities making monthly contributions surpassing 4500; completion of a white paper on chiropractic and Accountable Care Organizations; a blurb referencing the field's 30 celebrity supporters (including the likes of NFL great Jerry Rice); a notice on ad placements, frequently using these celebrities, in June 2013 (including the Wall Street Journal and USA Today); a push to contact Congress on a legislative issue for chiropractic; and an honoring of Kent Greenawalt of Foot Levelers, one of the organization's founders. The website announces the F4CP's mission
as "generating positive press for the chiropractic profession and increasing public awareness to the many benefits associated with chiropractic care."

Comment
: Good public visibility and public relations are ongoing desires of all emerging fields- both to rise
from relative obscurity with a positive story and to combat negative perceptions. The F4CP organization models behavior in unity. Every other integrative practice field would be served to go to school on their structure and game plan.


Natural Products

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Product study reveals challenges
Cancer Treatment Centers of America reports outcomes of quality examination of dietary supplement suppliers


The multi-center pioneer in integrative cancer treatment, Cancer Treatment Centers for America, will have the abstract of its examination of supplier quality published in association with the upcoming American Society for Clinical Oncology meeting. Entitled Assuring dietary supplement quality for cancer patients: An integrated formulary systems approach, the study reports an examination of products of 12 manufacturers "with a reasonable reputation among providers for quality." The abstract states:
"All 12 companies claimed to be operating in full compliance with FDA regulations. However, 3 had received Warning Letters from FDA for GMP violations; 2 performed a product recall within the last 5 years; 4 reported products that failed Consumerlab.com for potency or purity; 1 did not have product specifications; 1 was found by FDA to have inadequate testing; 1 was found to have a lack of sufficient controls throughout the supply chain to guard against microbiological contamination; and 2 had confirmed melamine contamination or lack of melamine testing on protein powders." One firm, not mentioned, "met all quality standards."

Comment: Remarkable here is that the firms chosen were those believed to have top quality. Perhaps I am jaded, but this outcome does not appear to be that negative. The FDA can be picky. A product recall can be a good thing. Was it just 4 products of the 12 firms that failed ConsumerLab's analysis and was this over a 5 year period?


Conferences

Northwestern's Feinberg School of Medicine hosts National Student Conference in Integrative Medicine, October 26-27

The lead up to the International Congress for Clinicians in Complementary and Integrative Medicine (ICCCIM) will be the second National Student Conference in Integrative Medicine. The conference, organized by medical students, was first held in 2011 at UCLA via medical student organizers. The 2013 organizing team is here. Melinda Ring, MD, the co-chair of the ICCCIM program committee, is on the student conference team. The conference's mission includes to "unite students across medical fields."

Comment: This conference might benefit from networking into the student groups for other disciplines to mount a more spirited, "co-owned" interprofessional session on integrative medicine and health. Perhaps in 2015! Meantime, anyone who wants to see what program items made the cut, and didn't, for ICCCIM, can open this page.  The updated agenda is here.

Integrative Medicine for the Underserved offers 3rd annual conference in Santa Clara in August

Integrative Medicine for the Underserved (IM4US) announces its mission with the blunt statement that while integrative medicine is often associated with the purchasing habits of the well-to-do, "the reality is that many integrative treatments are not only more effective but also more cost-efficient, and many community clinics and other practices are already using these strategies with underserved populations." The objectives of the August 9-10, 2013 gathering in Santa Clara, California include: to provide practical information to increase the capacity of working clinicians of diverse disciplines and backgrounds; to provide integrative medicine and lifestyle counseling to underserved communities; and, to "connect and foster community among clinicians across disciplines with an interest in integrative medicine for the underserv"ed" while highlighting existing sustainable models and structures of practice in integrative medicine for the underserved." The founders see their work as developing a movement as well as shifting medicine's paradigm toward one focused on health and wellness. 

ImageInternational Research Congress for Integrative Medicine and Health now accepting session proposals

The
International Research Congress for Integrative Medicine and health (IRCIMH), to be held in Miami May 13-16, 2014,
is now accepting scientific research abstracts and proposals for workshop sessions. IRCIMH, sponsored by the Consortium of Academic Health Centers for Integrative Medicine in association with the International Society for Complementary Medicine Research (ISCMR) anticipates 1200 attendees from over 30 countries. Accepted submissions will have the opportunity to present at the 2014 Congress. Click here to learn more about the submission process.

Comment: I have a connection with this CAHCIM Congress since the first, in 2006, as a member of the marketing and outreach committee and then as a sometimes contributor of a post-Congress Summary Report. The report for the 2012 meeting, in Portland, Oregon, is here for those who have not experienced this remarkable gathering.


ImageDr. Rogers' Prize names Irving Kirsch, MD as keynote speaker for September 26, 2013 Gala Award Dinner

The build up to the most significant financial award in complementary and integrative health and medicine, the Dr. Rogers' $250,000 prize, will be provided by Irving Kirsch, MD. His work on the placebo effect has influenced National Health Services guidelines for the treatment of depression in the United Kingdom. According to
the announcement, Kirsch "originated the concept of response expectancy" and his meta‐analyses on the efficacy of antidepressants were covered extensively in the international media and his book, The Emperor's New Drugs: Exploding the Antidepressant Myth. The book was also the topic of a 60 Minutes segment on CBS and a 5-page cover story in Newsweek. The Gala Award Dinner will be held September 26, 2013, at Vancouver's Fairmont Waterfront Hotel. The event will be preceded by a colloquium, “Exploring the Mind‐Body Continuum.”


People

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Smith: key role with the Samueli Institute
Michael Smith, PharmD, ND joins Samueli Institute team as Senior Fellow


The Samueli Institute announced on June 17, 2013 that it has engaged Michael Smith, BPharm, ND, as a Senior Fellow for Integrative Medicine. Smith, a global leader in natural product regulation,
will focus his work for Samueli Institute on international projects as well as research dealing with the regulation, use and policy development of dietary supplements and natural health products. Smith's training as both pharmacist and a naturopathic doctor has led to top regulatory positions for natural products in both Canada and Australia. He has been closely associated with World Health Organization efforts relative to traditional and complementary medicines since 2008, He is currently one of three retained advisers to the W.H.O.s updated Global Strategy for Traditional and Complementary Medicines expected in 2014. Smith will work from his office in Toronto, Canada and is expected to collaborate closely with the Institute's CEO Wayne Jonas, MD and David Eisenberg, MD, Samueli Institute Executive Vice President for Health, Research and Education.

Comment: Smith has carved a remarkable niche
via a refined combination of skills in network building, comfort in the language of conventional and integrative health care, plus a proficiency around governmental regulation and policy development, especially related to dietary supplements. He's also been a unique bridge-builder and breaker of glass ceilings for the naturopathic profession. I've had a chance to observe him closely though work I have been honored to participate in with the W.H.O. Smith is a smart hire for the Samueli Institute. Curious to see the work product that will come from this relationship.

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Boon: position in Toronto pharmacy department
Integrative medicine researcher Heather Boon, PhD appointed interim dean in Toronto pharmacy department


Canadian integrative health researcher Heather Boon (BScPhm, PhD) has been named Interim Dean of the Leslie Dan Faculty of Pharmacy, University of Toronto according to a newsletter from the Canadian research organization IN-CAM for which Boon serves as co-director and co-founder. Boon has led some of the most significant explorations of what we mean by integrative and integrated practices. She is health services researcher whose interests also include why and how patients use complementary and alternative medicine, natural health products issues, and policy and regulatory matters related to complementary and integrative medicine products and practitioners. Boon has published more than 100 peer-reviewed articles and book chapters on complementary/alternative medicine and is co-author of the textbook, A Complete Natural Medicine Guide to the 55 Most Common Herbs (2nd Edition).

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Stiefel: new president at NUHS
Joe Stiefel, MS, EdD, DC selected as 6th president of National University of Health Sciences


On June 22, 2013, National University of Health Sciences welcomed its sixth president, Joseph Stiefel, MS, EdD, DC.  Stiefel, a graduate of NUHS, has held an array of leadership positions at the university over the past decade. Stiefel's background includes work in engineering at General Motors, a position in a biotech firm, and study of classic cultures, all prior to entering the chiropractic medicine field in 2001. He most recently headed up NUHS' Florida campus. NUHS is the only institution in the U.S. that educates chiropractors, naturopathic doctors, practitioners of acupuncture and Oriental medicine and massage therapists. Stiefel succeeds Jim Winterstein, DC, under whose direction NUHS expanded from it 100 year-old leadership in chiropractic education to a multidisciplinary institution dedicated to fostering better integration of diverse disciplines in patient care.

Comment
: Integrator readers will know Winterstein for his direct and sometimes biting commentary published here from time to time. Here's hoping that in retirement he'll hammer the keyboard from time to time in response to something here. Meantime, congratulations Dr. Stiefel.





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