background resources in PDF |
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some CAM/IM publication links |
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Integrative Medicine, Complementary and Alternative Medicine and Health Round-up #79: May 2014 |
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Written by John Weeks
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Integrative Medicine, Complementary and Alternative Medicine and Health Round-up #79: May 2014
Policy
-Three
Federal agencies announced a request for comments on Section 2706, Non-Discrimination
in Health Care-respond by June 1
-AAMC's leading workforce research
conference switches focus from "physician" to "health workforce,"
includes integrative health and medicine disciplines
-RWJF report finds limited impact of Choosing
Wisely campaign in combating the 30% of the medical industry that is waste
 Urging responses on 2706
Integrative Pain Treatment
-Samueli studies in Pain Medicine
underscore new directions in integrative pain treatment
-U.S. Senate Committee on Veteran's
Affairs examines alternatives to pain drugs
-US Health and Human Services on
combating opioid addictions: Use more drugs!
-Twitter chat on CAM and back pain
produces surprising dismissal of "CAM" from NCCAM tweeter
-Canadian firm urges multidisciplinary
approach to pain treatment, but with limited team
Surveys
-AANP survey of Medicare recipients
finds high interest in use of naturopathic doctors and in non-pharma treatment
-CDC report stimulates flurry of
news accounts on regional trends in "CAM" use
Integrative Care
-Cleveland Clinic Chinese herb program with Crane Herb makes huge waves in
media
-New School in New York City pioneers auricular acupuncture and acupressure in
university setting
Professions
-A snapshot of the size and maturation of the licensed integrative health and
medicine fields
Philanthropic Partners
-Emerson Ecologics grants funds to IHPC's
cost-effectiveness project, Foundations Project and NY NDs
-Health Partners, BCBS and Tufts make
grants to Pathways for Wellness
Academic Health
 Loeb: "hope not the same as optimism ..."
-IOM
workshop features presentations on community-based integrative health education
led by Southern California University of Health Sciences Robb Russell, DC
-Southwest College of Naturopathic Medicine opens clinic in Adelante Health
System
-George Washington University launches online integrative medicine program
-NUHS chiropractor Daniel Straus, DC
chairs Florida medical district board of directors
-Ohio State University (OSU)
integrative medicine program hosts the mindfulness Congressman, Tim Ryan
-National College of Natural Medicine announces Masters in Global Health
Miscellaneous
-Persevering in cause work: Paul Loeb's The Impossible Will Take a Little
While and how "hope is not the same thing as optimism"
__________________________________
Policy
 Respond by June 1
Three Federal agencies announced request for comments on Section 2706,
Non-Discrimination in Health Care: respond by June 1
In a document that is "a request for information regarding provider
non-discrimination," the Departments of Labor, Health and Human
Services (HHS), and the Treasury are requesting comments on all aspects of the
interpretation of section 2706,
the Non-Discrimination in Healthcare section. The request comes following
the inter-governmental disputes on interpretation in which U.S. Senator Tom Harkin (D-Iowa)
chastised HHS for violating Congressional intent. (These are captured in Beltway Battle Over Patients' Rights to
Integrative Medicine and Health.) The request states that it
"includes but is not limited to comments on access, costs, other federal
and state laws, and feasibility." The comment period began March 6, 2014
and runs for 90 days. The Integrative Healthcare Policy Consortium (IHPC) is working
on this, according to Alyssa Wostrel, MBA, executive director. The organization
is collaborating with MPA Media, publisher of Acupuncture
Today and Massage Today. Each of these publications sent out the IPHC's survey on issues regarding 2706 to its readers. These will be compiled and
reported to the three agencies.
Comment: This is a time to act! Terrific to see IHPC and MPA media
collaborating. If you have anything relevant to share, do so. The request is a
broad net: " ... includes but is not limited to comments on access, costs,
other federal and state laws, and feasibility." Get your comments and
experience in.
 AAMC: opening to other disciplines
Leading workforce research conference switches from "physician
worforce" to "health workforce" focus and includes integrative
health and medicine disciplines
On May 1-2, 2014, the American Association of Medical Colleges (AAMC) hosted
its annual gathering of 200 plus of the nation's top researchers on the nation's
workforce requirements. Only this year, rather than being called the
"Physician Workforce" conference the event was titled: AAMC's 10th Annual Health Workforce Research
Conference: Finding the Right Fit - The Workforce Needed to Support the
Affordable Care Act. AAMC's leader on the conference Clese Erickson,
MPAff, shared that the shift in conference's content preceded the shift in
name. Since the 2010 Future of Nursing report and the passage of the Affordable
Care Act put a focus on team care, AAMC's conferences have increasingly focused
on contributions of nurses and physicians' assistants, and more recently health
coaches, social workers and community health workers. The 2014 iteration was
the first to include a plenary segment on "Integrative Health and
Medicine," which was presented by this writer in his capacity as executive
director of the Academic Consortium for Complementary and Alternative Health Care
(ACCAHC). Slides available here: Doing
Well by Doing Good: Building the Case for Broad Workforce Partnerships Finding
the Right Fit: The Workforce Needed to Support the ACA: Integrative
Health and Medicine (May 2014). ACCAHC also presented a
poster on its Project for Integrative Health and the
Triple Aim (PIHTA), a focus of the oral presentation.
 How to contribute in the emerging system
Comment: Credit the AAMC for widening the circle and, in
general, creating such a stimulating conference. As my fellow panelist Leon Assael, DMD told the
assembled crowd: "This is not about counting noses [of types of
providers]. It's not about 'access.' It's about outcomes." Another of the
session's panelists, Lloyd Michener, MD, spoke about community
and public health interventions that can significantly disrupt overutilization
patters and create huge savings.
Michener shared how huge reductions in need for ER and other services
can come by getting out of the system and clinical care and directly building
relationships with individuals and their community support teams. These
powerful outcomes present challenges for all clinicians, and quite likely, for
the assembled workforce experts whose business has historically been MD-centric
and health system-centric.
 Campaign to end medical waste and harm
RWJF-funded report finds impact, but
limited, of Choosing Wisely campaign in combating the 30% of waste in the
medical industry
"Some experts say as much as 30 percent of the health care delivered in
the United States is duplicative or unnecessary; may not improve people's
health; and may even be harmful." So leads the e-mail boost from the
Robert Wood Johnson Foundation of a new RWJF-sponsored survey of
physicians on the successes of the Choosing Wisely campaign. The
exceptional campaign, funded by $2.5-million from RWJF, attempts to have
professions self-govern to limit waste. Each specialty is asked to select
certain of their own over-performed or over-ordered procedures and tests that
they will seek to use less. Among findings: 21% of MDs say they are
aware of the campaign. Of those, 62% are more likely to have reduced the number
of times they recommended a test or procedure because they learned it was
unnecessary, versus 45% for those who are unaware of the Choosing Wisely. In
more general findings: 73% perceive of all MD respondents believe unnecessary
tests and procedures are a "very or somewhat serious" problem, 72% believe that
an average doctors prescribes at least one unnecessary item a week, and 58%
believe they themselves are the best people to manage the problem. Said Richard
J. Baron, MD, president and CEO of the ABIM Foundation, the Choosing
Wisely sponsor: "Old habits are hard to break, but this research suggests that
America's physicians are slowly making progress in efforts to reduce
unnecessary care."
 Campaign's key funder
Comment: More urgency and outrage with the slowness of the uptake of
this campaign, fine as it is, is in order. Do the math: the 30% that is waste equals
nearly $1-trillion per year. The one procedure per week that is perceived by
slightly over 70% of MDs to be over-performed does not come even close to representing
30%. Notably, 30% of MDs don't even think they have a hand in the waste. This
waste represents a huge opportunity cost to efforts to fund
teachers, parks, schools, health care, environmental initiatives, and
more. The initiative is excellent. Yet can practitioners engage this
transformation in practice with the ferocity needed through self-policing? Notably,
only 15% thought the government should get involved in any way. Through one
means or another, more fire in the campaign is necessary.
In an interesting note, the ABIM Foundation's campaign is expanding to include non-MD
provider organizations. These include the American Dental Association, American
Physical Therapy Association and the American Academy of Nursing. These will
each release lists of medical tests and procedures which will be their
profession's targets. What might such lists be for chiropractors, or
naturopathic doctors, or massage therapists, or others in the integrative
health and medicine communities? Or, as one practitioner has suggested to me,
does an excess of "health creating" activity only lead to positive side-effects
and more health creation?
Integrative Pain Treatment
 Integrative pain content in key journal
Samueli work in Pain Medicine underscores new directions in self-care
for integrative pain treatment
The Volume 15, S1, 2014 issue of Pain
Medicine, the official journal of the American
Academy of Pain Medicine, is devoted to sharing outcomes of the Rapid
Evidence Assessment of the Literature (REAL) self-care for pain completed by a
team lead by Cindy Crawford at the Samueli Institute. The special issue is
entitled, on the cover: Are Active Self-Care Complementary and
Integrative Therapies Effective for Management of Chronic Pain? A Rapid
Evidence Assessment of the Literature and Recommendations from the Field.
The issue opens with a column from Samueli CEO Wayne Jonas, MD then follows
with two powerful calls-to-action co-authored by former Army Surgeon General Eric Schoomaker, MD, PhD. Schoomaker is
credited with stimulating the Department of Defense's exploration of
integrative practices.
Comment: This is a coup, in a journal for some old line pain
practitioners. Side note: Under my ACCAHC hat, referenced above, I
was part of a team that chose to honor both Schoomaker and integrative pain
leader, now deceased, Rick Marinelli, LAc, ND, by
sponsoring Schoomaker's May 15, 2014 talk at the International Congress
on Integrative Medicine and Health. It will run as the ACCAHC-Rick Marinelli, ND, LAc Lectureship.
Schoomaker is a remarkable influencer. If only he'd had a chance to
talk to the Canadian team, the NCCAM tweeter, and the HHS, below!
 Sanders: urging more integrative options
U.S. Senate Committee on Veteran's Affairs promotes alternatives to pain
drugs
"With chronic pain affecting more than half of all veterans eligible for
VA health care, the Senate Committee on Veterans' Affairs today looked at
efforts by the Department of Veterans Affairs to increase access to therapies
like acupuncture and yoga as alternatives to addictive narcotics." So
opens the April 30, 2014 release from the Committee on
Veterans Affairs. The hearing highlighted recent reports that
"the department's Opioid Safety Initiative launched last fall in
Minneapolis already has begun to yield results. The facility has decreased its
use of high-dose opioids by nearly 70 percent."
Comment: Notably, especially given the item immediately below, in the release
US Senator Bernie Sanders (I-VT) "praised the National Center for
Complementary and Alternative Medicine at the National Institutes for Health
for identifying non-narcotic alternatives to treating chronic pain and mental
health conditions." They added: "The center has made groundbreaking
contributions that helped expand viable and safer treatment options."
 HHS: urging more pharmaceutical drugs
US Health and Human Services on combating opioid addictions: Use more drugs!
The U.S. Department of Health and Human Services recently published an
editorial in the New England Journal of
Medicine to "outline a
national response to the epidemic of prescription opioid overdose
deaths." The title of the press release from the agency on this
publication read like this: "HHS leaders call for expanded use of
medications to combat opioid overdose epidemic." The subhead
noted that the commentary "describes that vital medications are currently
underutilized in addiction treatment services and discusses ongoing efforts by
major public health agencies to encourage their use." The April 23, 2014 NEJM article
is entitled Medication-Assisted Therapies-Tackling the
Opioid Overuse Epidemic.
"Fortunately," the agency
heads write, "clinicians have three types of medication-assisted therapies
(MATs) for treating patients with opioid addiction: methadone, buprenorphine,
and naltrexon." The commentary is devoted to ways these drugs might be
more effectively pushed and initiatives underway to get them into people's
hands.
Comment: It is beyond my expertise to judge whether greater use of these
"MAT's" will be valuable components of an optimal solution to the nation's
opioid addiction problem. But HHS's failure to mention non-pharmacological
approaches to treatment makes one wonder how closed a tribe is running our top
non-military agencies on pain treatment. There seems to be a sort of
"better dead than red" logic that forecloses on the ability of these
leaders, amidst this crisis, to even mention the potential value in
complementary and integrative approaches. Get your heads out of the sand! When
will HHS be finally detailing a long list of agency initiatives to expand use
of non-pharmacological approaches - self-care and clinician-delivered? The
NCCAM blast, below, does not help.
 Briggs: hardly the agency's view
Twitter chat on CAM and back pain produces surprising dismissal of
"CAM" from NCCAM tweeter
The NIH National Center for Complementary and Alternative Medicine (NCCAM) held
a Twitter chat (#nccamchat) on low-back pain on April 24, 2014. In the midst
of it, an unidentified NCCAM staffer tweeted: "Don't use
complementary approaches to replace conventional care or delay seeing a health
care provider about a health problem." This stimulated one of NCCAM's top
opponents to reply: "Better yet, just don't use CAM."
Comment: This must be the comment of a newbie to NCCAM. The agency's own publications strongly
rebuke this position - as the Sanders comment in the item on the US Senate
hearing, above, notes. Nor is this what we hear from Josephine Briggs, MD,
NCCAM director. Basically this says: Don't explore CAM to delay opioids!
It would be good for Briggs to spend one of her blogs correcting this and
explaining how this might have happened. The staffer was in engaging not it "groundbreaking
contributions that helped expand viable and safer treatment options" but
rather a cementing of prejudice-base policy.
Canadian firm urges multidisciplinary
approach to pain treatment, but with limited team
Meantime, across the border, Cira Medical Services has published a report
showing that Chronic Pain costing Canadian economy up to
$60 billion annually in lost productivity. They promote a
multidisciplinary approach to bettering treatment and lowering costs. The
study has the promising title of Chronic Pain: The Importance of a
Multidisciplinary Approach to Diagnosis and Treatment [the link was broken
when I sought to upload but they sent me a PDF]. The view of what might be
considered on these multidisciplinary teams reached only as far as exercise,
behavioral health and stretching. Massage is the only "CAM" that made
their consideration.
Comment: I contacted the Cira team with a link to some evidence that
might have helped in "widening the circle" of
who should be in these teams. It is a little surprising to see something out of
Canada so retro.
Surveys
 Seniors like access to NDs, conservative care
AANP survey of Medicare recipients finds high interest in potential use
of naturopathic doctors and in non-pharma treatment
The American Association of Naturopathic Physicians (AANP) has announced results of a survey of Medicare recipients. The survey found that "55% of older
Americans who live in states that license naturopathic physicians would
consider seeking care from a naturopathic physician." Medicare does not
presently cover care from naturopathic doctors. In addition, "75% of
Medicare beneficiaries prefer that their doctor use natural therapies first,
such as improved diet or supplements, before prescribing drugs or
surgery." Four-in-ten seniors are worried about adverse effects of
prescription drugs. The survey is part of the organization's plan to have
the ‘‘Medicare Naturopathic Physician Access Act" introduced in Congress.
AANP CEO Jud Richland commented: "The study is a wake-up call to policy
makers. Seniors are saying loud and clear that they want Medicare to provide
access to holistic care providers such as licensed naturopathic physicians.
Millions of Americans have paid Medicare taxes all their working lives, but
when the time comes to participate in Medicare, they find that the services
they want aren't available." Ancillary materials published
with the survey and part of the campaign to introduce the Access Act include: Naturopathic Medicine
Lowers Health Care Costs and Naturopathic Approaches
to High-Cost Diseases and A Proposal to Modernize
Medicare. The study, conducted by Infosurv, surveyed 384 individuals
65 years of age and older who live in states that license naturopathic
physicians. Details from the survey report, entitled "Older Americans
Views on Naturopathic Physicians in Medicare," are available
here.
 AANP's Richland: step #1 is useful data
Comment: This survey and the materials prepared for it are good
stepwise moves to create a base for the AANP's campaign. These follow another
step - the AANP's win last year when it was successful in pushing a resolution through the U.S. Senate
that spoke favorably about the potential value of naturopathic physicians in
combating expensive chronic diseases. That was the first time that
"naturopathic medicine" was named in a Congressional act. Curious how
the Medicare campaign will go and whether they can secure federal inclusion
with regulation in just 18 states. Notably, direct-entry midwives were
successful in
inclusion, albeit limited, in the Affordable Care Act relative to Medicaid
coverage despite regulation in just 26 states. Surely it was good news for the
AANP effort that the state of Maryland, home of US Senate Appropriations
Committee chair Barbara Mikulski (D-MD), chose a month ago to license these practitioners.
 Reports regional differences in CAM use
CDC report stimulates flurry of news of regional trends in CAM use: self-care
West vs "adjust-me" bread-basket?
The US Centers for Disease Control and Prevention's April edition of the
National Center for Health Statistics Data Brief describes regional trends in
the use of complementary and alternative medicine (CAM). The media picked it up
widely. Here's Health Day on April 16, 2014:
"Folks on the West Coast are faithful followers of yoga and meditation.
Midwesterners turn to chiropractors or osteopathic doctors for their aches and
pains. And nearly one in every five Americans uses herbal supplements like
ginseng, Echinacea, ginkgo biloba and St. John's Wort." How much more?
"Yoga with deep breathing or meditation is about 40% more common in the
Pacific and Mountain states than in the country overall [and] use of
chiropractic or osteopathic manipulation is nearly twice as high in the
Dakotas and Minnesota down to Kansas and Missouri than the rest of the United
States." Roughly
18% of Americans use herbal supplements, more than double that of the next most
popular complementary medicines. These are chiropractic and osteopathic
manipulation (8.5%) and yoga (8.4%). People living in southern and Mid-Atlantic
states have less use for complementary or alternative medicine.
Comment: These data suggest that the "Left Coast" is more
engaged in self-care while the center of the country relies on practitioners
for their ills. (However, massage use was found to be higher in the West.)
Meantime, it does not bode well for the support of federal policy-makers that
they are located smack in the Mid-Atlantic region where people "have less
use for complementary and alternative medicine."
Integrative Care
 Huge visibiliy via Cleveland Clinic choice
Cleveland Clinic Chinese herb program with Crane Herbs makes huge waves in
media
The Time Magazine feature "Cleveland Clinic's New
Medicine" was here. The Wall Street
Journal's "A Top Hospital Opens to Chinese Herbs as Medicines" is here. "Can Herbs Help? Dr.
Oz Explains Eastern Medicine" is here. Katie Couric's Today Show piece on it, "Why One
Hospital is Turning to Chinese Medicine" is here. Links to each of these
are in this press release from the
operation behind the story, Crane Herb Companies, the supplier
of the product. Crane sources their supplies via KPC Herbs, which requires the most rigorous testing of herbs in that
category, according to Crane officials. Couric's Today Show segment included a series of leading questions that
promoted integrative care. Cleveland Clinic lists a broad array of conditions
for which they argue that the herbs may be useful. Notably, the American
Botanical Council took on Time for its
fallacious assertion that there are no regulations for herbs.
Comment: The Couric show featured interviews with a Yale-based
integrative medical doctor, David Katz, MD, MPH, and Pina LoGiudici, ND, LAc
who fielded her lobs. Following the interview, Katz wrote an exceptional piece in Huffington Post
on how to think about evidence in the integrative dialogue. The Cleveland
Clinic move, and Crane Herbs work behind the scenes, created a huge jolt of
generally friendly integrative health media.
 Detox needling on college campus
The New School in New York City pioneers auricular acupuncture and acupressure
in university setting
A recent issue of Guidepoints, the newsletter of the National
Acupuncture Detoxification Association features the Provision of Auricular Acupuncture and Acupressure in a University
Setting, as a report in the Journal of the American College of
Health was titled. The program is at The
New School in New York City. The program focuses on auricular acupuncture's
use "as a tool to enhance harm reduction and (better) mental health
services." The Guidepoints issue features an interview with two of
the co-authors, Rachel Knopf, MPH and Tamara Oyola-Santiago, MPH. Each was were
trained at the field's mothership, the Lincoln Recovery Center in the South Bronx.
Treatment is through The New School's student health center. They reportedly
work in tandem with both medical and mental health teams. They also provide
acupressure in other settings at the University. They promote the program,
which is typically used for substance issues, as a stress management technique
and for "general wellness."
Professions
A snapshot of the size and maturation of the licensed integrative health and
medicine fields
So what was we talking about when we look at the licensed "complementary
and alternative medicine (CAM)" or integrative health and medicine
disciplines? The following chart, from page 10 of the 2013 Clinicians
and Educators Desk Reference on the Licensed Complementary and Alternative
Healthcare Professions (CEDR) provides these data.
Profession
|
|
Estimated
Number
Licensed
|
|
Total
Accredited
Schools
|
|
Total
States
Licensed
|
|
Year
Accrediting
Agency
Established
|
|
Year
Accrediting
Agency
Recognized
by U.S.
|
|
Year
Standardized
Exam
Created
|
Acupuncture and
Oriental medicine
|
|
28,000
|
|
61
|
|
44
|
|
1982
|
|
1990
|
|
1985
|
Chiropractic
(medicine)
|
|
72,000
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|
15
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50
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|
1971
|
|
1974
|
|
1963
|
Massage
therapy
|
|
280,000
|
|
88^
|
|
44
|
|
1982
|
|
2002
|
|
1994
|
Direct-entry
midwifery
|
|
2,000
|
|
10
|
|
26
|
|
1991
|
|
2001
|
|
1994
|
Naturopathic
medicine
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|
5,500
|
|
7
|
|
18*
|
|
1978
|
|
1987
|
|
1986
|
* Current
number. The 2013 book says 16.
^ Accredited by Commission on Massage Therapy Accreditation.
Source: Academic Consortium for Complementary and Alternative Health Care
(2013)
 Great data/info on CAM disciplines
In addition, current numbers of integrative health and medicine practitioners
educated or certified to a set standard are: roughly 2,800 medical doctors and
doctors of osteopathy certified by the American
Board of Integrative Holistic Medicine; 1,100 medical doctors and doctors
of osteopathy who have completed the University
of Arizona Fellowship in Integrative Medicine; and 1,349 board certified
holistic nurses (as various levels of nurse certification and training) via the
American Holistic Nurse Credentialing Corporation.
Comment: The total here is roughly 387,500 licensed "CAM" plus
another officially board certified group of approximately 4,000 integrative
MDs/DOs and holistic nurses. For reference, there are roughly 880,000 licensed
medical doctors and some 3.3 million nurses. These are typically, whether their
preference or not, entrenched in a disease-focused industry. The numbers
suggest that it serves those in this field to work in a coordinated fashion to
advance the values, practices and disciplines associated with integrative
health and medicine. The book that includes this chart is freely available as a
PDF at this
site.
Philanthropic Partners
 Much visibility at relatively low cost
Emerson Ecologics grants funds to IHPC's cost-effectiveness project,
Foundations Project and NY NDs
Emerson Ecologics is the largest distributor of natural products to
professionals in the United States, representing over 275 brands. In 2012, to
respond to the chaos of multiple requests for financial support from the
associations and institutions linked to the professionals they serve, Emerson established an annual
$25,000 grant award program. Emerson announced the 2014 winners here:
1) The Foundations of
Naturopathic Medicine project ($7800), led by Pamela Snider, ND, to support
a residency; 2) the New York Association of
Naturopathic Physicians ($10,000) for licensing efforts; and 3) the Integrative Healthcare Policy Consortium ($7200)
for a cost effectiveness booklet. They also announced an in-kind donation to
the Patriot Project.
Comment: News of these awards strike me in multiple ways. First, I am pleased
Emerson is making awards. Many companies don't. Second, often I know the
awardees and thus am aware of the intended good work so am happy that their
projects will get a boost. Third, associated with a not-for-profit as
I am, I wonder why I didn't get a proposal submitted! Then, finally, I cannot
help but seek some perspective on the size of these grants relative to Emerson's
revenues and all the hoopla that surround the awards. How big a commitment is
$25,000 for Emerson? I could not find anything on line about the closely-held
firm's revenues or profits. I'd that this fits into the marketing budget like a
handful of full-page ads. Still, these sums all mean a great deal to the small
budgets off which these organizations work - with each dollar multiplied many
times by volunteerism. So, thanks, Emerson - and hey, consider upping your
annual amount, eh?
 Pathways: recipient of multiple area grants
Health Partners, BCBS, Tufts, etc. - payers and insurers in grants to
Pathways for Wellness
The May 2014 newsletter for Pathways to Wellness,
one of clinics for the delivery of acupuncture, massage and other integrative
services most thoroughly integrated into its local community - Boston, in
Pathways' case - announced an impressive list investment partners. These
included: 1) Tufts Health
Plan Foundation awarded $20,000 to provide home care acupuncture and
massage services to elder clients in their homes; 2) Partners Healthcare awarded $20,000 to
support operations plus $5,000 as a Gold level sponsor of our Longwood Symphony
Orchestra benefit concert (see below); 3) BCBS of Massachusetts Foundation awarded
$5,000 for the redesign of the center's website, and 4) the Boston Redevelopment
Authority awarded $20,000 to support the construction costs of Pathways'
new facility. In addition, the same newsletter noted $11,000 raised from the
Longwood Symphony benefit.
Comment: The Pathways to Wellness operation has been enmeshed in care
delivery in Boston for a quarter of a century. Great to see these grants and,
in the interest of recognizing full value, maybe one or more might consider adding
a zero to their next contribution!
Academic Health
 Russell: SCUHS educator at IOM
IOM workshop features presentations
on community-based integrative health education led by Southern California
University of Health Sciences Robb Russell, DC
The two day workshop on May 1-2,
2014 at the Institute of Medicine (IOM) Global Forum on Innovation in Health
Professional Education was entitled Scaling-up Best Practices in Community-Based
Health Professional Education. Among the presenters in a poster
session on May 1, 2014 and in a May 2, 2014 webinar from the workshop was Robb Russell, DC, the
director of the Centers of Excellence at Southern
California University of Health Sciences (SCUHS). Russell presented on two community-based
models of integrative care delivery. One was at Venice Family Clinic, directed
by Myles Spar, MD, a 2013
Bravewell Collaborative award winner, and the second a Canadian College of Naturopathic Medicine (CCNM)
project with Brampton Community Hospital. The Venice clinic's pain-focused
services include a collaboration that involves students and faculty from UCLA,
SCUHS, and two acupuncture and Oriental medicine schools: Emperor's College and
Yosan College. The Toronto-based CCNM project is brings naturopathic medical
students into a hospital environment. Spar, and CCNM's Nick De Groot, ND
were part of a team with Russell that developed the poster and presentation as
part of their participation organized through the Academic
Consortium for Complementary and Alternative Health Care (ACCAHC). ACCAHC
is a member of the IOM Global Forum. The poster and presentation are available
at this link. A separate, longer
presentation on the CCNM-Brampton collaboration is here.
 Spar: part of ACCAHC team on poster, presentation
Comment: The odd irony is that while the Affordable Care Act is pushing
care and health professional education out into communities - thus the focus of
this workshop - many institutions in the licensed integrative health space,
like SCUHS and CCNM, are already in the community yet better meet new
populations by forming such partnerships, even in hospitals. It was a pleasure,
as a member of Russell's team, to see this integrative health and medicine
content featured at the IOM. The two articles immediately below are additional
examples of community integration of integrative health and medicine
educational programs.
 New clinic in Adelante system
Southwest College of Naturopathic Medicine opens clinic in Adelante Health
System
Tempe, Arizonza-based Southwest
College of Naturopathic Medicine (SCNM) reports a new relationship
with Adelante
Healthcare Mesa in its Spring 2014 magazine, SCNM Now. The Adelante
system was developed in 1979 by community members to serve underserved
populations. It now operates in seven communities, including Mesa. Notes fourth-year
naturopathic medical student Tracey Cook: "We've seeing people who have
never health of naturopathic medicine. It's exciting to educate people and show
them what we are capable of." The most common condition seen by student
clinicians at the Adelante facility is diabetes. This is the most recently
established of the multiple SCNM Community Medicine
initiatives.
 Chiropractor-educator on medical district board
NUHS chiropractor Daniel Straus, DC chairs
Florida medical district board of directors
Volume 50, No. 1 of the newsletter for alumni of the National University of Health Sciences (NUHS)
and this release share that Daniel Strauss,
DC, dean of the College of Professional Studies of the university's Florida
campus has been elected to chair the board of directors of the Pinellas Park Medical District (PPMD).
The medical district is comprised of health care providers, hospital
administrators, educators, and health care support services in the Pinellas
Park area. The sponsors of the PPMD include Northside Hospital, St. Petersburg
College, and the Pinellas Park Chamber of Commerce. The note mentions this
appointment as "a great example of National's commitment to integrative
medicine." NUHS has programs in chiropractic medicine, naturopathic
medicine, acupuncture and Oriental medicine and massage therapy.
Comment: Always good to see this level of community participation of
integrative health and medicine practitioners, especially as awareness
heightens of the critical importance of integration in community and public health
of clinicians of all types. NUHS's commitment to integration has also been
evidence in its Gold Level sponsorship of the Center for Optimal Integration: Creating
Health.
 Heyman: heads up GWU program
George Washington University launches online integrative medicine program
In a partnership with the Metabolic Medicine Institute, George Washington
University is launching an online integrative medicine program according to this April 24, 2014 release. The
release suggests that graduates will
have the "requisite skills to oversee a
practice in integrative medicine, as well as balance the business, regulatory,
and legal aspects of clinical care." In addition, they will learn to
gather outcomes data. The later is presented as a "distinguishing
feature" of the program. Andrew Heyman, MD, MHSA is the leader of the program. The Metabolic
Medical Institute describes itself as "a medical organization
dedicated to promoting health and prevention of disease by educating health
professionals, researchers and the public." Those who complete the 18
credit hours of the program will earn a certificate. The programs is open to
those with "a degree in a health related field and a GPA of 3.0 or
higher."
Comment: While the release notes the existence of a new American Board
of Integrative Medicine, the program does not appear to be tracking students to
that end. It is interesting to
see the business model of broad inclusiveness of all licensed
professions as potential students.
 Ryan: passion for mind-body
Ohio State University (OSU) integrative medicine program hosts mindfulness
Congressman Ryan
The April 2014 newsletter from the OSU
integrative medicine program featured the visit of Congressman Tim Ryan (D-OH).
The ex-football player and military man is author of A Mindful Nation: How a Simple Practice Can
Help is Reduce Stress, Reduce Performance and Recapture the American Spirit.
He champions mindfulness and wellbeing. The focus of the OSU event, which
included a "World Cafe"
interactive segment, was on how OSU can foster a "culture of
mindfulness" at the university.
 Parker: co-chairs new global health department
National College of Natural Medicine announces Masters in Global Health
Portland, Oregon-based National College of Natural
Medicine (NCNM) will soon offer a Global Health Masters' Degree, according
to this April 30, 2014 release from the
institution. NCNM's provost and vice president for academics, Andrea C. Smith,
EdD, states that a global health degree is "a natural fit for NCNM."
The reasons: "The college's core naturopathic and Chinese medicine
programs have global origins. In the less developed areas of the world,
integrative therapies, such as plant medicine, mind-body medicine, nutrition
and physical medicine are both available and cost-effective. Natural medicine
is ideal for countries with low economic resources and limited access to
Western medicine." Tabatha Parker, ND, the co-founder
and director of Natural Doctors International
will serve as a co-director of the program. Parker has been the leading force
for global services learning in her profession, mainly through a clinic on the
island of Ometepe, Nicaragua. She has worked with W.H.O. and was recognized in
2011 by Utne Reader as a Global Visionary.
Comment: This is a terrific move for NCNM. How reasonable to have a
workforce abroad of practitioners who respect and are knowledgeable about
global healing traditions and, in the case of naturopathic doctors at least,
are deeply versed in Western medical sciences and have a scope that allows
prescriptions for basic public health needs. The potential employment for
these graduates should be a no-brainer, if only lower-chakra prejudices could
be dissolved.
Miscellaneous
 Loeb's book: "Hope is not the same ..."
Persevering in the cause: Paul Loeb's The Impossible Will Take a Little
While and how hope is not the same thing as optimism
Author and expert on citizen action issues Paul Loeb has sold 170,000 copies of his Soul of a Citizen: Living with
Conviction in Challenging Times. Paul is a good friend of this writer. In
fact, that book includes a short couple of pages on me and my own
"cause" work in integrative health and medicine. His newest book, the
collection of short essays beautifully titled The Impossible Will Take a Little While (from the Billie
Holiday line) gave me the credo for everything I do professionally. People
wonder sometimes how I stay active and hopeful given the power of the US
medical industry's continuous feeding on the increase of disease. In the book, Czech
artist-dissident-president Vaclav Havel has this
to say about the distinction between "hope" and "optimism."
Havel writes: "Hope is definitely not the same thing as optimism. It is
not the conviction that something will turn out well, but the certainty that
something makes sense, regardless of how it turns out." Hope, in Havel's
framing, is a verb. Engagement allows hope. The reverse, in my experience is
also true: disengagement creates pessimism. This collection of essays and
anecdotes from scores of inspirational, progressive leaders is food for the
soul. These short pieces are, as Loeb aptly named an earlier book, hope in hard times.
If you are practicing hope, you will find much to aid and abet you here. If you
are not, buy it to refine your scoffing
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