Integrative Medicine, Complementary and Alternative Medicine Round-up: October 2014
 Heather Tick, MD: on Never Only Opioids team
Policy
-"Never
Only Opioids" Policy Brief: The Imperative for Early Use of
Non-Pharmacological, Approaches and Practitioners in Pain Care
-Former
Army Surgeon General Schoomaker: The Two Reasons There is an "Imperative" for
Integrative Health and Medicine in the Civilian Care in the U.S.
-Act
Now! IHPC Urges Member to Support HR 4887, Expanding Care to Veteran's Act
-Naturopathic
Doctors Score Additional US Senate Endorsement of Naturopathic Medicine Week
-Honoring
the Immeasurable Contributions of Retiring Integrative Medicine Champion U.S.
Senator Tom Harkin
Integrative
Practices
-Cleveland
Clinic Announces Partnership with the Institute for Functional Medicine
-Richard Sarnat and the AMI Group: Update on a Trailblazing Data Producer
for the Integrative Health and Medicine Field
-Cheng-Tsui
Integrated Care Center: "Imbedded" in ACO and Emergent PCMH at Harvard
Research
-NCCAM Announces
$21.7-million Project with the VA and Their Families
-Multidisciplinary
Group Co-led by Ben Kligler, MD Secures PCORI Grant to Look at Group
Acupuncture to Address Health Disparities
 Martha Menard, PhD, LMT: led Never Only Opioids team
Publications
-Kreitzer-Saper
team to serve as co-editors for Global
Advances in Health and Medicine Journal
-Explore Commentary: Is
there a "Town and Gown" Split Related to Science and Evidence in Integrative
Medicine?
Academic Medicine
-Kreitzer's U Minnesota Center Brings in Bronfort, Evans
via $500,000 NCMIC Grant to Create Integrative Health and Wellbeing Research
Program
-Maryland University of Integrative Health Launches
First Doctorate Programs
-Snapshot: Phoenix's Southwest College Naturopathic
Medicine Boasts Record Enrollment
Professions
-Naturopathic
Doctors, Integrative Medicine Consortium and Alliance for Natural Health Weigh
in on Compounding Pharmacies
People
-Jan Schwartz, MA,
BCTMB, recognized with Distinguished Service Award by the Massage Therapy Foundation
-Integrative Health
Leader Mary Jo Kreitzer Honored among Minnesota's Most Influential Women
_____________________________
Policy
.jpg) Urging early use of non-pharma approaches
"Never Only
Opioids" Policy Brief: The Imperative for Early Use of Non-Pharmacological, Approaches
and Practitioners in Pain Care
A new Policy
Brief from a national campaign involving over three dozen pain-related
organizations, Pain Action
Alliance to Implement a National Strategy (PAINS) urges a major shift in
pain treatment in the United States. "The imperative
for incorporating non-pharmacologic, integrative approaches and practitioners
into U.S. military medicine has been accepted and
championed by former US Army Surgeon General Eric Schoomaker, and
others," states lead author Martha
Menard, PhD, CMT. Menard chairs the Task Force on Integrative Pain Care of
the Academic Consortium for Complementary and Alternative
Health Care (ACCAHC), which wrote the document. She clarified: "Our team
examined the U.S. civilian population and found overwhelming evidence that a
parallel imperative exists." The eight-page policy document is entitled Never Only
Opioids: The Imperative for Early Integration of Non-Pharmacological Approaches
and Practitioners in the Treatment of Patients with Pain.
 Sponsor of Never Only Opioids
The case in Never Only Opioids rests on two foundations. One
is the morbidity and mortality data that some have called an "opioid epidemic."
The second is the growing research supporting the effectiveness of multiple integrative
heath practices and practitioners. Co-author and ACCAHC Task Force member Heather Tick, MD, who
holds an endowed professorship in integrative pain treatment at the University
of Washington School of Medicine, states that it is "long past time that pain
treatment stop viewing these complementary and integrative approaches and
practitioners as, if anything, a last resort. The evidence is there for a
massive shift in pain treatment now." The paper came with a two-page handout
with Recommendations
for various stakeholders. The ACCAHC work on the Never Only Opioids paper was partically funded through an unrestricted grant from the NCMIC Foundation.
 Integrative team wrote Never Only Opioids
Comment: I was part of
the team - that also included acupuncturist Arya Nielsen, PhD, Ac, chiropractor
Bill Meeker, DC, MPH, and naturopathic physician Kevin Wilson, ND - that
developed this brief. I was not certain that such a radical re-positioning of
integrative therapies and practitioners from the basement of "when all else
fails" to "early use" would go over in an initiative sponsored by an
organization, Center for
Practical Bioethics,
that has had significant pharma funding. Menard, who sits on the PAINS Steering
Committee
as an ACCAHC representative, was more certain that the evidence would speak for
itself. She was right. We hope this proves a good tool, and change agent.
Former Army
Surgeon General Schoomaker: The Two Reasons There is an "Imperative" for
Integrative Health and Medicine in the Civilian Care in the U.S.
In
a keynote presentation at a September 29, 2014 policy day at Georgetown
Conference Center to honor retiring
US Senator Tom Harkin,
former US Army Surgeon
General Eric Schoomaker, MD, PhD provided a useful response to a query.
In May, at the International Research Congress on Integrative Medicine and
Health, Schoomaker had used his keynote to address what
he called the "imperative" for integrative medicine in the U.S. military. The
question to Schoomaker: Did he believe a
similar urgency existed in bringing integrative health and medicine into all of
U.S. healthcare?
Schoomaker,
credited with a major role in the military's proactive engagement with
integrative care, answered affirmatively. He cited two reasons. First, he cited
statistics in
the civilian population to conclude that show that the trail of morbidity
and mortality from overuse and abuse of opioids and other pain killers is
similarly epidemic. Second, Schoomaker pointed to the necessity, from the perspective
of national security that the United States to begin to focus on creating a
culture of health and wellness. He cited the challenge the military has in filling
its ranks due to disqualification of overweight and obese applicants.
Schoomaker concludes that there is in fact an imperative that the values,
practices and professionals associated with non-pharmacological integrative
health and medicine be rapidly up-taken into the U.S. medical industry.
Comment: It is time for
a leader in the civilian world to step up and make a similar, courageous call,
as Schoomaker has done, for proactive exploration now! The document noted in
the article above, Never Only
Opioids,
provides a policy case. Who will it be?
 Campaign backs VA legislation
Participate! IHPC
Urges Support of HR 4887, "Expanding Care for Veteran's Act"
The
Integrative Healthcare Policy Consortium (IHPC) is going to bat for veterans.
In a late September mailing to members, IHPC urged them to message respective
congressional representatives encouraging them to support HR 4887,
"Expanding Care for Veterans Act." The bill provides for research,
education and the delivery of complementary and alternative medicine services
for veterans. According to the e-letter, HR 4887, spear-headed by
Representative Julia Brownlee (D-CA), would mandate that the Veterans
Administration (VA) conduct research while developing a plan that includes
complementary and integrative approaches over a three year period to assess the
"feasibility and advisability of integrating CAM with other health care
services" provided by VA medical centers. The IHPC provides this link for
responding.
 Mikulski: prime sponsor for NDs
Naturopathic
Doctors Score Second US Senate Endorsement of Naturopathic Medicine Week
By
US Senate
Resolution 420,
the United States Senate declared October 6th through
12th as Naturopathic Medicine Week. More valuable than the recognition of the
week for the American Association of Naturopathic Physicians (AANP), the
promoter of the initiative, is what the Senate said. The language on the
unanimous vote notes simply that the resolution "recognizes the value of naturopathic
medicine in providing safe, effective, and affordable health care." The
profession is credited with providing "noninvasive, holistic treatments that
support the inherent self-healing capacity of the human body and encourage
self-responsibility in health care." The lavished praise does not stop there:
"Naturopathic medicine focuses on patient-centered care, the prevention of
chronic illnesses, and early intervention in the treatment of chronic
illnesses." The prime sponsor of SR 420 is Barbara Mikulski (D-MD), with other
endorsement from her US Senate Appropriations Committee colleague Tom Harkin
(D-Iowa). In addition, this year the AANP picked up the support of their first Republican, in
Sen. Kelly Ayotte (NH), and also that
of Independent, Angus King (ME).
Comment: Who needs Madison Avenue
when you have the U.S. Senate sending such messages? This is a ringing
endorsement. For a small and still largely unknown profession, these comments
from this "third party" should be plastered everywhere.
 Harkin: immeasurable contributions
Honoring the
Immeasurable Contributions of Retiring Integrative Medicine Champion U.S.
Senator Tom Harkin
While
policy advances for complementary and alternative medicine are famous for their
grassroots consumer advocacy, this column in
the Huffington Post
makes the case that one individual stands out above all others for his
immeasurable contributions: U.S. Senator Tom Harkin (D-Iowa). Harkin slipped
language into a 1991 appropriations bill to begin the National Institutes of
Health exploration of "unconventional medicine." He authored the 1998 mandate
giving it independence as the National Center for Complementary and Alternative
Medicine, then slowly upped its annual budget to over $125-million. Through
another deft maneuver from his position as chair of the powerful US Senate
Appropriations subcommittee that oversees, among other things, U.S. Department
of Health and Human Services, Harkin funded the 2001 White House Commission on Complementary and
Alternative Medicine Policy. Most recently, he inserted complementary and
integrative practices into numerous places in the Affordable Care Act. Included
is the powerful Section 2706, "Non-Discrimination in Health Care," for which
Harkin has gone to
battle with HHS
on that agency's failure to respect Congressional intent.
Through it all, he has used his bully pulpit to decry the limits of what he
calls our "sick care" industry and to promote his vision of us making of the
United States "a wellness society."
Comment: People more
experienced in understanding woo-woo than I are needed to explain how it is
that our grossly under-funded movement for integrative health and medicine --
and for Harkin's "wellness society" - found a champion with such political
power and appropriations clout. Imagine what the last 20 years might have been
if a buddy of one of the "polarization-based medicine" (a.k.a.
sciencebasedmedicine.com) bloggers had hunkered down into that role on the
Appropriations Committee in 1991? I am not a big adherent to the Great Man theory of history, but Harkin is
in that category for our fields his visionary promotion of system change. The
good news is that his very close colleague in advancing our movement, Barbara
Mikulski (D-Maryland), is now the U.S.' third most powerful elected official, as
chair of the U.S. Senate Appropriation Committee. And Harkin told an audience
celebrating his work at a September 29, 2014 event at Georgetown University that
his passion for wellness and integrative care will be among his core interests
from his post-Senate involvement with the Harkin Institute for Public Policy and
Citizen Engagement at Drake University.
Integrative Practices
 Another bold venture
Cleveland Clinic
Announces Partnership with the Institute for Functional Medicine
"If
we can show that we have better outcomes and it's cheaper to take a functional
approach, in the end, the doctors who adopt this model-and their patients-they
will be the ones who win." This is Institute for Functional Medicine (IFM)
president Mark Hyman, MD, in an article in the
widely read political blog The Daily
Beast
in June 2014 in which he mentioned that he was working with the Cleveland
Clinic to create a program in functional medicine. On September 15, 2014, an article in Crain's Cleveland Business propelled news of the program
nationally. The highly-regarded Cleveland Clinic is not merely dabbling in the
field but entering a full partnership with IFM, according to the release from the
Cleveland Clinic.
IFM's chief medical officer Patrick Hanaway,
MD
will be on the ground in Cleveland with author Hyman also serving in
leadership.
The
Crain's article notes a strong research focus in the partnership: "Plans for
the center include four clinical trials focusing on the treatment of asthma,
inflammatory bowel disease, type 2 diabetes and migraines." Cleveland Clinic
CEO Toby Cosgrove, MD said the new center is "not a departure for Cleveland
Clinic, but a continuation of the innovative, holistic approach that we have
embraced." The initiative is examined in this Huffington
Post piece.
Comments: Integrator editorial
Adviser Sabin and I share
extensive comments
on his FON Therapeutics site where I first posted on this topic, at Sabin's
invitation, with many captured in this
Huffington Post piece noted above that I subsequently filed. They circle
around the pricey office fees, tests and supplements of many functional
medicine practices, and question the fit in the Cleveland Clinic environment. What
will this clinical and business model look like? The Huffington
Post piece includes an excellent comment from the Institute of Functional
Medicine that speaks to this question.
 Sarnat: bending the cost curve
Richard Sarnat
and the AMI Group: Update on a Trailblazing Data Producer for the Integrative
Health and Medicine Field
When the Samueli
Institute pieced together the cost document to support its Wellness Initiative for the
Nation (WIN), it cited the AMI Group's incredible outcomes from an integrative primary care network contracted
with BCBS's HMO Illinois. Integrative chronic pain pioneers seeking model
projects for the underserved may remember the outcomes from AMI's historic
program with Florida Medicaid. In a recent interview for this article,
co-founder Richard Sarnat, MD, an ophthalmologist turned integrative primary
care physician with a 40 year meditation and Tai Chi practice, shared that the
AMI "continues to enjoy small victories" in its work to prove that cost savings
can come with patient-centered care via well-structured integrative practices.
Sarnat offered a
quick update on the firm's business. AMI's Illinois integrative primary care
network was just one of very few independent practitioner associations selected
for expansion into the continued business options offered by Illinois Blue
Cross Shield's HMO post implementation of the Affordable Care Act. HMO Illinois
enrollment has seen a "15% to 20% uptick in volume" post ACA. Almost 3 years
ago, legislation in Rhode Island led to selection of AMI to deliver an
integrative chronic pain program for the Medicaid population there. In Rhode
Island, the firm is working closely with United Health Care, that firm's behavior
health providers, as well as Neighborhood Health Plans (NHP).
 Pre-Rhode Island AMI Medicaid project
Like the former
Florida program, the Rhode Island initiative is built around holistic nurses
with mind-body skills, tools and a model that allows them more time with each
client. They collaborate with local primary care networks, plus massage
therapists, acupuncturists, chiropractors and nutritionists. AMI also has added
newer business in Idaho, and continues with a core contract for managed
chiropractic services, forged with the Maryland Chiropractic Association, that
reaches into Washington, D.C. and Virginia. Adds Sarnat: "We're increasingly a
technology company, building our own data informatics platforms in order to
generate the variety of outcomes reports that clients are now interested in."
Speaking to the importance of generating outcomes: "We were into the idea of
big data before anyone called it "big data." Disclosure: AMI was an Integrator
sponsor from 2008-2011.
 Jim Zechman: AMI co-founder
Comment: Sarnat was upbeat about outcomes in each of
the programs. I asked him if AMI had any new data to share. He said that
independent third party analysis suggests that in the Rhode Island program,
total service utilization by the population they serve through their intensive
program appears to be down by over by 20%. Yet because AMI doesn't own the
data, hard numbers will not be officially made available for at least a few
months. Meantime, especially for those who have known Sarnat from the Integrative Medicine Industry
Leadership Summit days when he
was reporting initial outcomes of AMI's Illinois pilot, the most important new
data-point on Sarnat is that he's had a central role in creating and growing Fairfest, a Bonnaroo-type
music festival in his home town of Fairfield, Iowa (fairfestiowa.com). The
annual June free event drew some 16,000 people in its second year to see Los
Lobos and others - and also drew sponsorship from the town's Chamber of
Commerce! Old rockers never die...
Cheng-Tsui Integrated Care Center: "Imbedded"
in ACO and Emergent PCMH at Harvard
The model is
"embedded," according to Aditi Nerurkar, MD, MPH, assistant medical director with the Chen-Tsui
Integrated Care Center at Beth
Israel Deaconness Medical Center of the Harvard Medical School. In an e-correspondence, Nerurkar noted that among the
"differentiators" for the Center are that it is: within a primary care setting
within an academic medical center;
all providers are "vetted by the primary care
practice administration;" and all
Chen-Tsui practitioners "write notes within
the electronic medical record (EMR), and loop back to the referring
physician." The service includes: acupuncture, massage, nutrition services -
the most frequently offered - and also yoga, Tai chi, Mindfulness-Based Stress
Reduction, and exercise. According to data shared by Nerurkar, 73% of patients are
female with the average age of the served population 56. She notes that the primary
care practice, Health Care Associates, is "moving towards a PCMH model." In
addition, it is part of the Harvard Pioneer Accountable Care Organization and
engaged in the major initiative to redesign primary care through the Center for
Primary Care at Harvard. Kim Ariyabuddhiphongs, MD serves as Chen-Tsui's
medical director.
Comment: The service is as yet
young, with only 85 patients, for instance, seen for acupuncture since the
beginning of 2013. Yet at the same time, with the EMR, the potential for data
collection and dissemination is significant. Here's hoping this Center becomes
a learning opportunity for all of us.
Research
 Briggs: teed up the VA/DoD collaboration
NCCAM Announces $21.7-million Project with the
VA and Their Families
The National Center
for Complementary and Alternative Medicine (NCCAM) announced on September 25, 2014 that it has engaged a $21.7-million program to "address pain and related conditions in U.S. military
personnel, veterans, and their families." The 5-year program includes 13
research projects. According to the release, the "research will focus on
nondrug approaches." Other funding came from the National Institute on
Drug Abuse (NIDA) and the U.S. Department of Veterans Affairs (VA) Health
Services Research and Development Division provided funding for this
initiative. The release leans on a commentary, Pain and
Opioids in the Military: We Must Do Better in JAMA Internal Medicine last June by
former US Army Surgeon General Eric Schoomaker, MD, PhD and Samueli Institute
CEO Wayne Jonas, MD. The 13 grants are all described in the release. One grantee for $718,000 is the Palmer Center for Chiropractic Research, led
by Christine Goertz, DC, PhD. The study will look at how chiropractic care
might be integrated with Veterans' clinical practice guidelines for
veterans with a combination of musculoskeletal pain and mental health
conditions.
Comment: A person
might have seen this coming. NCCAM director Josie Briggs, MD has stacked the
National Advisory Council for Complementary Medicine with the likes of
Schoomaker and Tracy Gaudet, MD, of the VA's office of Patient Centered Care
and Cultural Transformation. Exciting work - that meshes well with the new
policy brief noted above, Never Only
Opioids: The Imperative for Early Integration of Non-Pharmacological Approaches
and Practitioners in the Treatment of Patients with Pain.
 Kligler: team earns PCORI grant
Multi-disciplinary Group Co-led by Ben Kligler,
MD Secures PCORI Grant to Look at Group Acupuncture to Address Health Disparities
Arya Nielsen, PhD, Ac
sent news that a team from the Albert Einstein College of Medicine scored. a
$1.94-million, 3-year grant from the Patient Centered Outcomes Research
Institute (PCORI) The project is called Acupuncture
Approaches to Decrease Disparities in Outcomes of Pain Treatment- A Two Arm
Comparative Effectiveness Trial (AADDOPT-2). The co-PIs are Ben Kligler, MD,
MPH and Diane McKee, MD and their team includes Nielsen and Belinda Anderson,
PhD, LAc. In their proposal they note
reimbursement challenges for acupuncture that limit access and state: "Because group acupuncture can be offered
at a lower cost, demonstrating that individual and group delivery are both
effective could reduce barriers to use of this effective pain management
approach. The research team
will conduct a randomized comparative effectiveness study to assess outcomes of
individual and group acupuncture for treatment of chronic pain."
 Funds to explore group acupuncture for underserved populations
Comment: Kudos, first, for successfully being awarded the grant. Despite PCORI's
specific charge to explore complementary and alternative medicine, only 4 prior
awards focus in this area. (One issue may be a lack of submissions.) Kudos #2
for this great study idea. Alignment of interest bias: I have found group
acupuncture to be immensely useful, personally, and in fact prefer it to
one-and-one. Is there something of value to being in a group, rather than solo,
especially with a health issue as subjective as pain? That would be a different
research question. Great team! Looking forward already to the results.
Publications
 Mittelman: guiding GAHM to new team
Kreitzer-Saper
team to serve as co-editors for Global
Advances in Health and Medicine Journal
Michele Mittelman, RN, MPH, the cofounder and power behind the scene of the
most intriguing journal to emerge in the integrative health and medicine space
recently, Global Advances in Health and Medicine (GAHM), has announced the hiring of a
new editorial and leadership team with whom she will be working in setting
the magazine's direction. It's a powerful nurse/medical doctor duo: Mary Jo
Kreitzer, RN, PhD, FAAN,
the founding and longtime director of the Center for Spirituality and Healing
at the University of Minnesota; and Robert Saper, MD, MPH, director of The Program for
Integrative Medicine and Health Care Disparities at Boston Medical Center and
associate professor of Family Medicine at Boston University School of Medicine.
Additionally, Avery Stirratt has joined the team as president and
publisher.
.jpg) New publisher, new editorsa, same mission
Krietzer, a former vice chair of the Consortium of Academic Health Centers for Integrative
Medicine (CAHCIM), as well as a Council of
Advisers member of the Academic Consortium for Complementary and Alternative
Health Care, is the most significant nurse leader in integrative health and
medicine. She has a passion for community and public health, health creation,
and coaching. Saper is viewed as one of the standout emerging leaders of
CAHCIM. He will chair the organizing of the 2016 iteration of the International
Research Congress on Integrative Medicine and Health. Stirratt is a senior media
executive with 25 years' management experience with a wide range of companies,
from iconic brands (Forbes, Newsweek)
to foundations and new business ventures. Mittelman shared with the Integrator that she is excited to see the
journal's interprofessional mission reflected at the top. She envisions the
journal as a comprehensive communication platform that will advance health and
well-being around the globe. The new editorial team replaces David Riley, MD,
who resigned last spring.
Comment: Many assumed that when Riley, GAHM's
founding editor, left the journal that it would collapse. They underestimated
Mittelman and the power of her vision and partnership in creating GAHM as it is today. I am a big fan of GAHM's three ongoing priorities, set in Riley's term: global
convergences in health and medicine, whole systems approaches in
healthcare, and high-quality case reports. What's not to love in that? Riley
led some fine work, particularly in the remarkable case reports area, and in
turning out some exceptional, focused issues. I am very curious to see where
the Kreitzer-Saper-Stirrat team, working with Mittelman, will take the journal
next.
 Commentary on role(s) of evidence
Explore
Commentary: Is there a "Town and Gown" Split Related to Science and Evidence in
Integrative Medicine?
"Evidence
based medicine...evidence-informed practice...patient-centered care...the art of
medicine...These terms fly around the landscape of integrative health and
medicine with the potential to ultimately generate a meaningful consensus and a
shared language for how we discuss clinical decision-making and clinical
practice. But more often than not the discussion around evidence and knowing
degenerates into a Tower of Babel." This is the opening of a commentary in Explore co-authored by Ben Kligler, MD,
MPH,
a past chair of the Consortium of Academic Health Centers for Integrative
Medicine, and this writer, entitled Finding a Common
Language: Resolving the Town and Gown Tension in Moving Toward
Evidence-Informed Practice. The
perspective explores the mixed views of research and evidence as cited in
"gown" (academic medicine) and "town" (practice-driven functional, naturopathic
and integrative conferences and texts). How do we explain decrees that there is
"none or limited evidence" from the National Institutes of Health about
something on which one has just received a hand-out with 150 scientific
references?
The
authors explore the cultural-economic-scientific rift that has led to differing
uses of evidence. For instance, "town" dwellers may speak about in vitro studies as though they prove
something in vivo. Meanwhile, "gown"
oriented academics, who may be over-critical about such an infraction in
application of science, may have little appreciation that they are daily reimbursed
for treatments for which only a small fraction have quality evidence. The
authors make the following recommendations. First, embrace mixed methods
research to better capture whole person outcomes. Second: promote case reports "as
a legitimate means to accumulate new clinical knowledge." The final
recommendation is, according to the authors, recognized as a challenge for
those who "hide behind the
notion that every question can ultimately be answered with randomized clinical
trials." In fact, "there will always be many answers only available to us
through intuition, experience, and patient-centered communication." The kicker:
"... as of this moment we hide this from our students and residents." All parties
"need to be open and honest about how much of even our own type of practice is
based on not knowing what evidence has to say."
 Bradley: comment on commentators
Comment from Ryan Bradley, ND, MPH: "My
overall response to your editorial is positive. I think you two do a good job
of being humble and bring needed light to the issue of evidence limitations in
all categories of practice. Ironically in all settings ego and ‘status quo'
practices, based on history and not evidence, often win out over the art of
individualized practice, based on a balance between patient preferences, the
available evidence and rational thought.
"My friendly fire would be, the first several paragraphs
appear to be very ‘stream of consciousness' and casually written. Also it takes
over a page (of a two page editorial) to make your recommendations. I think
your recommendations could be developed more, including how/where your
suggestions apply in diverse practice settings, how they may specifically
encourage integrative practices/cooperation between providers, and how to
specifically encourage doctors/policy makers to accept broader perspectives on
the evidence hierarchy.
"For example, is a couplet of a prospective,
quasi-experimental (1) and qualitative (2) studies evaluating patients'
experiences with naturopathic care for diabetes, including evidence of improved
blood glucose, improved self-management, increased medication adherence,
increased self-efficacy, improved mood and overall complementarity to usual
care, enough to incorporate naturopathy into conventional practice settings, or
leverage the need for demonstration projects of integrative care teams for
diabetes? It hasn't been enough yet, and I'd sure to know why not! ;)"
1. Bradley R, Sherman KJ,
Catz S, Calabrese C, Oberg EB, Jordan L, Grothaus L, Cherkin DC. Adjunctive
naturopathic care for type 2 diabetes: Patient-reported and clinical outcomes
after one year. BMC Complementary and Alternative Medicine. 2012.
12:44. doi:10.1186/1472-6882-12-44
2. Oberg EB, Bradley R,
Sherman K, Calabrese C, Hsu C, Catz S, Cherkin DC. Patient-Reported
Experiences with First-Time Naturopathic Care for Type 2 Diabetes. PLoS ONE.
2012. 7(11): e48549. doi:10.1371/journal.pone.0048549
Comment: Bradley's
final point is good: having the mixed methods research is not necessarily
enough to get the ball of coverage and inclusion rolling. One his other commentary:
far be it for me to argue that Bradley, or anyone else, has wrongly stated that
I have ever been involved in using
too many words or not being succinct enough.
Academic Medicine
 New Center team: Johnson, Evans and Bronfort
Kreitzer's U Minnesota
Center Brings in Bronfort, Evans via $500,000 NCMIC Grant to Create Integrative
Health and Wellbeing Research Program
On September 10, 2014 the University of
Minnesota's Center for Spirituality & Healing announced the launch of a
unique Integrative Health &
Wellbeing Research Program. Among the core faculty are two of the top researchers
from institutions associated with the licensed integrative health and medicine
fields, Gert Bronfort, DC, PhD and Roni Evans, DC, MS, PhD. Each were formerly
with Northwestern Health Sciences University, from which they will transfer
their current grants. They will be part of the first research core at the
long-standing Center, headed by founder and director, Mary Jo Kreitzer, PhD,
RN, FAAN. Kreitzer anticipates that "the team will investigate the biological,
psychological, social, environmental, and other dimensions of mind-body and
integrative therapies." the new program will use various modes of inquiry to
explore the science of wellbeing from holistic, interdisciplinary, and
collaborative perspectives. Pamela Jo Johnson, MPH, PhD fills out the research team.
The
program is partially funded by a $500,000 grant from the NCMIC Foundation. Lou
Sportelli, DC, president of NCMIC Mutual Holding Company, explains that they
found this venture "a fantastic opportunity to collaborate with a University
whose innovative thinking is already eliminating the ‘barriers' to health and
wellbeing through interdisciplinary cooperation in clinical and research
programs. This is truly a 21st century innovative application to health and
wellbeing, and so consistent with the chiropractic approach that the decision
was really an easy one to make."
 Major grant funds transition
Comment: This is a fascinating development. Among Kreitzer's
distinguishing traits as a leader in the integrative health and medicine field is
the linkage of a powerful and abiding, and respectful interprofessionalism with
a constant eye on the prize of creating health and wellbeing. Powering that up
with a core research team is terrific and the NCMIC Foundation's grant has
brought her two of chiropractic's best researchers. Together these two attracted
over $22-million of research funding to Northwestern. Yet excitement over the
good that will come of the new Minnesota center is coupled with a shadow: a drain
of some fine brains from the institutions that directly education the licensed
integrative health practitioners, and the concurrent depletion of one of the
top research programs in any institution associated with chiropractic and the
other licensed integrative health disciplines. Is this part of a general trend toward
giving up on developing research capacity inside such universities? If so, what
happens to the research and evidence dialogue in institutions that aren't in
the game?
 Into the doctoral business
Maryland University of Integrative Health Launches First Doctorate Programs
The ambitious Maryland University of Integrative
Health is adding to a score of bachelors, Masters and certificate programs by
offering not one, but a set of 3 doctoral level programs according to this release. These include First
Professional Doctorate in Acupuncture (D.Ac.), First
Professional Doctorate in Oriental Medicine (D.O.M.), and Doctor of Clinical
Nutrition (D.C.N.). Judith Broida, PhD, MUIH's provost and
executive VP of academic affairs explains: "Approval to offer terminal degrees
in our unique disciplines has long been a dream of Maryland University of
Integrative Health. This tremendous achievement is a testament to the vision of
our leaders and the steadfast work of our faculty. These programs meet a
growing market demand for scientific and compassionate healers in integrative
health and MUIH is proud to be a national leader in offering them."
Comment: It is no
secret that MUIH is also looking at a fourth doctoral program. At the August
2014 conference of the American Association of Naturopathic Physicians, MUIH's top
staff showed up to meet with academic leaders in naturopathic medicine from
across the country. MUIH is examining of potential offering an additional
doctorate in naturopathic medicine. Recent licensing of naturopathic doctors in
Maryland opened the door.
 Highest new enrollment
Snapshot: Phoenix's Southwest College Naturopathic Medicine Boasts Record Enrollment
In an October 2, 2014 release, the Southwest
College of Naturopathic Medicine (SCNM) pegged their record-setting influx of
new students to the rising primary care crisis in the United States. A total of
97 students enrolled, from 26 states, British Columbia, Nova Scotia and Puerto
Rico. Roughly 42% of the enrollees are from Arizona. SCNM, which opened its
doors in 1993, graduates 82 students in July, also an SCNM record, bringing the
total number of graduates to 1,171 since SCNM opened in 1993. SCNM
president Paul Mittman, ND, EdD, notes that the school received over 8,000
inquiries last year. He notes that this level of interest "coincides with the
growing interest in incorporating complementary and alternative medicine in
overall healthcare and wellness programs."
Professions
 New regs for compounding pharmacies
Naturopathic Doctors, Integrative Medicine
Consortium and Alliance for Natural Health Weigh in on Compounding Pharmacies
Mike Jawer, the director of government relations
with the American Association of Naturopathic Physicians (AANP) shares that the AANP along with the Integrative Medicine Consortium and the Alliance for Natural Health have each submitted comments to the FDA States Jawer: "It's a
complicated issue but the stakes are high - namely, the continued availability
of compounded drugs - especially as dispensed for patients in the office." In a
notice to members, the AANP stated that via "a collaboration with McGuff, a well-respected compounding
firm that has been very active on this issue, our ND volunteers documented the
clinical need for 43 ingredients that are essential in the compounded drugs
that naturopathic patients are treated with." The AANP asked for
additional time to fulfill on the burdensome application requirements to
document the clinical need for another large group of ingredients.
People
 Schwartz: honored as educator
Jan Schwartz, MA, BCTMB, recognized with Distinguished Service Award by the Massage Therapy Foundation
Education and
Training Solutions co-founder Jan Schwartz, MA, BCTMB, was honored by the Massage Therapy Foundation with a Distinguished Service Award. Schwartz' roles for the massage field have been
many. She was chair of the Commission on Massage Therapy Accreditation during a
period of robust activity. She served as vice president for education with
Cortiva Institute when they were consolidating massage schools. As an
interprofessional leader, Schwartz became a founding member and the core massage
presence on the Academic Consortium for Complementary and Alternative Health
Care (ACCAHC) where for 5 years she co-chaired the Education Working Group. She was a leader in the program committee in
the breakthrough International Congress for Educators in Complementary and Integrative
Medicine. She teaches business
at a Tucson acupuncture school. Her service includes a stint on the MTF board
of directors and an ongoing role in providing online education with the
gigantic Massage Envy, and others, through her Education and Training
Solutions.
Comment: What a well-deserved award! For a decade I have leaned on Schwartz to
educate me with her balanced perspectives on the sometimes turbulent
ins-and-outs of the massage field, and to draw quality individuals to our work
together in ACCAHC. My vote was in a long time ago on this one.
 Kreitzer: a top woman leader in the Twin Cities
Integrative Health Leader Mary Jo Kreitzer
Honored among Minnesota's Most Influential Women
A "Twin Cities Women
Leaders" event on September 16, 2014 honored 84 of the most powerful and
influential leaders in the Twin Cities area. One was Mary Jo Kreitzer, RN, PhD,
FAAN, the founder and director of the Center for Spirituality and Healing at
the University of Minnesota. The event was sponsored by the George Family
Foundation. In a press release on the event, Penny George, president of the foundation, states: "We are
pleased to honor Dr. Mary Jo Kreitzer for her leadership and contributions to
our community. I find it immensely gratifying the number of talented women who
have led the Twin Cities in building institutions and solving significant
social problems." The full list and a
photo of those honored is here, with Kreitzer third from the right, first row, next to the Georges.
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