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Integrative Medicine, Complementary and Alternative Health and Medicine Round-up: December 2014 |
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Written by John Weeks
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Integrative Medicine, Complementary and Alternative Health and Medicine Round-up: December 2014
 Arya Nielsen: led successful effort with Joint Commission
Policy
-Joint
Commission Elevates Acupuncture, Chiropractic, Massage and Relaxation in Pain
Care in Response to Integrative Team
-Herb
Industry Pleased with Pallone as New House Commerce Minority Leader
-Educating
Oregon's Medical Home Policy Leaders on Integrative Medicine and Health
-British
Agency Urges Homebirths for Uncomplicated Pregnancies
Costs
-Website on Cost Studies Offered via ACCAHC's Project for Integrative
Health and the Triple Aim (PIHTA)
Integrative Services
-Survey of AIHM Attendees Finds 67% of Integrative Practitioners Using or
Planning to Use Telemedicine
-Silver
Linings: Update on the Closure of Pathways to Wellness from Beth Sommers, LAc,
MPH, PhD
-Reiki Gets a Little Respect in U.S. News and World Reports
- From Google Alerts: Links to Integrative Medicine in
Health Systems and Communities from November 2014
Academics
-Update: The IFM-Tallahassee Memorial Family Medicine Residency Program
-Maryland University of Integrative Health and National College of
Natural Medicine Announce Partnership
-Bastyr Initiates MPH and Two Additional Public Health Degrees
 DeBusk: leading IFM-Tallahassee
Research
-Not
Exactly What We Anticipated Department: NCCAM GMOs Yeast into
Opioids
Professions & Organizations
-Breakthrough Agreement between State Massage Therapy Boards and National
Certifying Group
-Professional Self-Care:
Chiropractors Promote Bill to Improve Chiropractic Medicare
Documentation
-From Holism to Love: Marking the Transition of the 36 Year-Old AHMA into
the Emerging AIHM
-Wikipedia and Homeopathy: Ullman Makes Case for that Prejudice in Its
Whole Form is Rampant
Miscellaneous
-Say What? Average Office
Visit Lengthens Over Past 20 Years
-Consumers-Practitioners
Together: Ann Fonfa's 9th Evidence-based Complementary & Alternative Cancer
Therapies Conference
___________________________
Policy
 Non-pharmacologic approaches ascending
Joint Commission
Elevates Potential for Acupuncture, Chiropractic, Massage and Relaxation in Pain
Care in Response to Integrative Team
The
Joint Commission has issued a revised accreditation standard for pain that
significantly elevates numerous non-pharmacologic approaches. These include "acupuncture
therapy, chiropractic therapy, massage therapy, osteopathy, and relaxation
therapy." In addition, the new standard cautions clinicians to consider
negative consequences of opioids as well as positive values when making treatment
decisions. The decision followed organizing work led by acupuncture researcher Arya Nielsen, PhD,
LAc,
and Marsha Handell, MLS, each of Mount Sinai Beth Israel. Ben Kligler, MD, MPH,
the vice chair for integrative medicine at MSBI then helped organize 20 members
of the Consortium of Academic Health Centers for
Integrative Medicine
to support the petition that the Joint Commission re-open consideration of
non-pharmacologic approaches. The new standard will apply to all institutions
under the agency's guidance and review: hospitals, ambulatory care facilities,
home health and senior homes. A Huffington Post article, Chronicles of Health Creation: Joint Commission
Issues New Pain Standards in Response to Integrative Medicine Team, details the
remarkable sequence of actions that led to the change.
Comment: Credit the Joint
Commission for its responsiveness. Credit Nielsen for seeing the opportunity
and doing the major work, with Handel, to create the case as the core Mount
Sinai Beth Israel team. Credit Kligler and the Consortium of Academic Health
Centers for speaking up for the need for change. The new standards will bring
patient care a step closer to a "Never Only
Opioids" era
that can help us undo the present harm to human beings, families and
communities from unnecessary use, and overuse, of prescription pain-killers.
 Pallone: point for Ds on natural products
Herb Industry
Pleased with Pallone as New House Commerce Minority Leader
The American Herbal Products Association in its December
2014 newsletter reports that the industry's "big question on the House
side" was settled with the selection of Frank
Pallone (D-NJ) as minority leader for the influential House Energy
and Commerce Committee. Pallone narrowly defeated Rep. Anna Eshoo (D-CA). AHPA
notes that "since Pallone is co-chair of the Congressional Dietary Supplement
Caucus, the industry had been pulling for him to prevail in this contest."
Pallone replaced the panel's current ranking member Henry Waxman (D-CA), who has been a vocal critic of the
supplement industry, who will retire after a 40 year career. AHPA also reports
with pleasure that Jason
Chaffetz (R-UT), who, like Pallone, is co-chair of the Congressional Dietary
Supplement Caucus, was named the next chairman of the House Oversight and
Government Affairs Committee.
Comment: Waxman's
retirement marks the end of a long hate affair. Waxman's disposition toward
more rather than less public protection and thus regulation of industry of all
kinds led him to push for more oversight than the dietary supplement industry
has typically wanted. Waxman's activism in this area given that he is the
Congressman from Hollywood was always nearly as surprising as are his looks given
Hollywood's premium on beauty and perhaps the highest supplement sucking
demographic in the U.S.
 Pioneering integrative medical homes
Educating a Oregon's
Medical Home Policy Leaders on Integrative Medicine and Health
The
Oregon Health Authority may be the only such state agency in the nation with an
Integrative Medicine Advisory Group. In July 2014, "IMAG" presented to OHA
using a slide show
available here.
The three priorities of the group, which meets monthly, are here: 1.Credentialing of Integrative Medicine providers (IM Credentialing Information Tool (almost complete); 2.Integrative
Medicine and Oregon's achievement of the triple aim - Resource guide identifies IM best practices (still in
development);
and 3. Exploring
opportunities for participation and recognition in the Patient
Centered Primary Care Home Program - Communication
plan (still in development).
Comment: The state of
Oregon is one of the very few with a long history of licensing in all five
licensed integrative health and medicine disciplines (chiropractic, acupuncture
and Oriental medicine, naturopathic medicine, massage therapy and direct-entry
midwifery). The state also has quality academic centers in each of these
fields. The relative respect and inclusion in the very existence of IMAG flows
from there. The state is become a proving ground for models for inclusion
across other jurisdictions.
 Midwifery urged in England
British Agency
Urges Homebirths for Uncomplicated Pregnancies
Women
with uncomplicated pregnancies - about 45 percent of the total - are better off
in the hands of midwives than of hospital doctors during birth. This is
according to new guidelines by the
British National Institute
for Health and Care Excellence that "reversed a generation of guidance
on childbirth" according to a December 3, 2014 New York Times article entitled "British
Regulator Urges Home Births Over Hospitals for Uncomplicated Pregnancies." The
agency has
"advised healthy women that it was safer to have their babies at home, or in a
birth center, than in a hospital." The
analysis showed that for low-risk mothers-to-be "giving birth in a traditional
maternity ward increased the chances of surgical intervention and therefore
infection." Typical costs to the system of hospital births is $2500, of birth
center births $2,200 and homebirth $1500.
The article concludes that "the findings could affect how hundreds of
thousands of British women think about one of the biggest questions facing
them." Nine in 10 of the roughly 700,000 babies born every year in England and
Wales are presently delivered in a hospital.
Comment: The leaders of
the Socialist State of Washington are the closest in the U.S. to have imagined
that the U.S. should follow a similar evidence-based path. (See Homebirth Midwives
and the Hospital Goliath: Evidence Builds for Disruptive Innovation, the most
commented upon article I have ever writing for the Huffington Post.) Nowhere is
the trumping of evidence by economics so clear as in U.S. birthing practices.
The movement to drive health care back into the outpatient world and enhance
communities misses its engine, and its heart, by allowing the huge edifices on
the hill to brand the birthing process as something that needs the machinery
and scarring of inpatient care. (Thanks to William Wulsin, ND, LAc, MPA, MPH
for the link.)
Costs
Website on
Cost Studies Offered via ACCAHC's Project for Integrative Health and the Triple
Aim
Those seeking information on cost savings via integrative health and
medicine now have one-stop shopping. The Project
for Integrative Health and the Triple Aim (PIHTA) has
developed a website, Reduce Per
Capita Cost - a Triple Aim goal -
that houses links and abstracts to over 30 studies. These are organized via the
stakeholder setting in which the outcomes were gathered (e.g. nsurers,
employers, health systems and government agencies). PIHTA, managed by Jennifer Olejownik, PhD, MS, is
housed at the Center for
Optimal Integration: Creating Health of the
Academic Consortium for Complementary and Alternative Medicine (ACCAHC).
According to the site, PIHTA "centers on assisting participants and
decision-makers in the optimal use of the values, disciplines and practices of
integrative health and medicine in meeting the goals of the Triple Aim." The site
managers welcome additional data and studies. Development of the site was made
possible through founding grants from Visual Outcomes, an e-health integrated platform, and The
CHP Group,
an integrative health management company. (Alignment of interest note: I am
part of the team developing the site.)
 Ocker: LAc on Oregon panel
Comment: The bottom line
is the bottom line. Even though the Triple Aim is a three-legged stool, one leg
means more than the others when it comes to non-normal practices. Show me the money. One user of the site,
acupuncture leader Laura Ocker, LAc and a member of the
state of Oregon's Integrative
Medicine Advisory Group (IMAG) reported in this Round-up, recently
accessed the site as part of her research on a project with Oregon health
reform effort:
"I had a phone meeting with PIHTA
this morning, who offered to share resources to facilitate research/homework
for the third [Oregon Health Authority] Integrative Medicine Advisory Group
(IMAG) deliverable, creating a resource guide for practitioners that would
facilitate participation in Oregon's Patient
Centered Primary Care Home (PCPCH) program. I was directed to several tabs
of the Project
for Integrative Health and the Triple Aim (PIHTA). It's kind of
astounding the caliber of the resources available on this website- not just for us as practitioners but also for
our PCPCH's and for the state."
Integrative
Services
 Academy group polled on telemedicine use
Survey of AIHM
Conference Attendees Finds 67% of Integrative Practitioners Using or Planning
to Use Telemedicine
In a survey of
mainly medical doctors and osteopaths conducted at the October
conference of the Academy of Integrative
Health and Medicine (AIHM), 33% said they are using telemedicine,
another third said they planned to, but only 19% said they are being reimbursed.
Telemedicine is defined as "care via telephone, video visits, web cam visits -- or
other consultations not in person." In addition, 56% of the
respondents said they believe that technology is "ahead of medical board
guidelines." AIHM board member Nick
Jacobs, a former hospital CEO and adviser to hospital programs comments: "We need to open up
all the options for healthcare to providers and patients. It drives down costs
and improves patient outcomes."
Comment: Notably,
in a recent posting on trends
in medicines, attorney Michel Cohen, MA, JD posits that one will be "the gradual merger of integrative medicine and telehealth."
In addition, integrative health policy activist Nancy Gahles, DC, CCH is
focusing on this nexus in her blog site, Advocacy for Policy and
Legislation for Integrative Healthcare.
Silver Linings:
Update on the Closure of Pathways to Wellness from Beth Sommers, LAc,
MPH, PhD
The Integrator
reported recently on the sad closure of Pathways to
Wellness, one of the nation's most significant and enduring initiatives to
bring acupuncture and other integrative health practices to the underserved. Beth Sommers, LAc,
MPH, PhD, a co-founder, reports that there are recent "silver linings" as
the "staff have been working like crazy to restore services." For instance, the
New England School of Acupuncture took on
contracts with 3 hospitals and several home-care agencies. In addition, she
says, "a number of local community health centers are adding acupuncture (and
will be reimbursed by managed care and other insurers including Medicaid)." Sommers
notes that one managed care group "had over 200 members requesting services."
In addition, an agreement "is in the works" under which two departments at Boston
Medical Center (Integrative Medicine and Infectious Disease) that will "partner
to offer acupuncture to clients with HIV/AIDS via a contract from Mass.
Department of Public Health. Sommers concludes: "Acupuncture services will be
significantly integrated into comprehensive clinics/hospitals where clients
routinely get their care," adding: "Sounds like a major win to me. Stay tuned."
Comment: This is
a fascinating turn of events. One wonders how this outsourcing will shake down
from a patient perspective. And what agency will take up the community
visibility and advocacy that was always a part of Pathways? Regardless, the
community's response attests to the respect Pathways earned.
.jpg) Jain: positive commentary for Reiki
Reiki Gets A Little
Respect in U.S. News and World Reports
A
November 10, 2014 issue of U.S. News and World Reports gave Reiki what
one close observer and activist in the field, Pamela Miles, calls the most balanced article ever on
Reiki in a mainstream medium. Giving value to the field is researcher Shamani
Jain, PhD: "Reiki is one of several therapies based on the biofield, or a type
of energy field that ‘regulates everything from our cellular function to our
nervous system,' says Shamini Jain, assistant
professor of psychiatry at the University of California-San Diego. While
the biofield itself is generally accepted - it ‘consists of things that we
can measure like electromagnetic energy that actually emanates from us,' Jain
says - biofield therapies such as reiki and therapeutic touch are more
controversial because they're based on the idea of a ‘subtle' aspect of
the biofield, which is harder to measure." Jain
is then quoted again: "It's difficult for our Western science to wrap
its mind around" because, as the writer paraphrases, "it's not about popping pills, injecting needles
or otherwise altering the body's chemical composition, says Jain, a clinical
psychologist who studies integrative medicine."
Comment: For Miles, an indefatigable
activist for "Reiki in Medicine," this good press is a particularly long time
coming. One might guess that the Wikipedia site for Reiki is as unfriendly as
that for homeopathic medicine, as detailed by Dana Ullman,MPH,CCH, elsewhere in
this Round-up. If so, you are right.
The Reiki page begins with boilerplate antagonism: "Reiki is a spiritual
practice, now considered to be a form of pseudoscience ..."
From Google Alerts:
Links to Integrative Medicine in Health Systems and Communities from November
2014
This
typically monthly Integrator
feature
is a quick capture of highlights from the multitude of links that flow in daily
via Google Alerts for "integrative medicine," "complementary and alternative medicine" and "alternative medicine." Recently the
field's cup seems to be running over. Tremendous level of news and developments.
This is in part due to my use of a broader inclusion net for what I am
selecting. At the same time, the activity level suggests that those who believe
the movement is headed toward a "tipping point" may have something.
Here are 15 selections related to hospitals and medical organizations and
integrative medicine, 10 from alternative and integrative medicine in community
non-system practices and media, and 21 developments from around the world for November 2014.
Academics
 IFM: report on Florida project
Update: The
IFM-Tallahassee Memorial Family Medicine Residency Program
The Integrator recently
contacted the Institute
for Functional Medicine for an update on a collaboration between the
Institute for Functional Medicine and the Tallahassee
Memorial Family Medicine Residency Program. Uniquely, the project, designed
and implemented by Cathy Snapp, PhD and Ruth DeBusk, PhD,
RD, was
funded first by the U.S. Health Resources Services Administration (HRSA)
and now by the State of Florida. The collaborative
initiative seeks to
integrate the principles of functional nutrition "with mind/body/spirit
approaches to prevention and self-care as the basis of treatment" in both
patient care and education. An early clinical focus was on treatment of repeat
emergency room users.The educational component trained medical doctors "in chronic
disease prevention using all the basic areas of the functional medicine matrix"
and a component on "physician well-being." IFM provided faculty, materials, and
consultation.
The
team has published some outcomes here showing moderate
betterment in a population with diabetes. As part of the charge from the state
of Florida as a funding agency, Snapp and DeBusk "have already provided
training at a number of other academic medical centers in Florida and beyond,
and have adapted the program to make it suitable for export to other kinds of
organizations as well." According to the report to the Integrator from IFM, DeBusk considers that "the umbrella for our
longer-term focus is the MBTLC initiative (Mindfulness-based Therapeutic
Lifestyle Change)." Such programs are presently in place and include patient
wellness, employee wellness and physician wellness with the former two running
12 weeks and the latter 6 weeks. The team is currently working on a program for
medical students. A previous report on
the collaboration is here.
Comment: The original Integrator short article on this
initiative noted the $1.2-million grant from Florida Agency for Health Care
Administration and the founding media
release. Snapp, DeBusk and IFM are truly toiling in the vineyards here. While
they speak of the importance of developing a laboratory of clinical practice, a
lesson here is clearly that clinical energy will not move unless there are
medical doctors grounded in self-care and training in mindfulness-based
practices. This work brings to mind that of Elizabeth
Goldblatt, PhD, MPA/HA of the Academic Consortium for Complementary
Health Care and Mary Jo Kreitzer, RN, PhD to elevate health and well-being at
the Institute
of Medicine (IOM) Global Forum on Innovation in Health Professional Education. When and
if the IOM should focus on this critical topic, the IFM-Tallahassee story
should be fodder for discussion. This is the kind of innovation in health
professional education we need.
 NCNM's Schleich (L) and MUIH's Vitale
Maryland
University of Integrative Health and National College of Natural Medicine
Announce Partnership
A bicoastal relationship was announced between
two of the most dynamic multidisciplinary academic institutions for integrative
health and medicine. On November10, 2014, Maryland University of Integrative Health (MUIH) reported a partnership with Portland, Oregon-based National College of Natural
Medicine (NCNM). The release on the
relationship, which featured MUIH president Frank Vitale and NCNM president
David Schleich, PhD, notes that the schools are "kindred spirits" in philosophy.
Areas of prospective collaboration are broad and include faculty and curriculum
development, research, and distance learning.
Comment: This is
quite a combo. NCNM is the "mother ship" for the modern naturopathic medical
profession. From the late 1950s until 1978 it was the only legitimate ND
program in North America. Meantime, the taproot of MUIH is one of the first
acupuncture programs in the United States, the policy active Tai Sophia
Institute. Not directly mentioned in the release is an area of likely
collaboration: a naturopathic medical program for MUIH. MUIH sent a team to the
August 2014 meeting of the American Association of Naturopathic Physicians to
meet with that profession's academic leaders. Notably, the same MUIH
publication that noted the partnership also rolled out a plan for a massive
MUIH campus expansion.
 Three public health degrees for systemic change
Bastyr
Initiates MPH and Two Additional Public Health Degrees
Bastyr University has announced that starting in the fall of 2015 it will
offer the first Master of Public Health degree program in a naturopathic-based
university of natural medicine. The program
announcement from Bastyr linked this offering to two additional programs
in public health that are presented as "preparing students to create systemic
change." The two others are a Master of Arts in Maternal-Child Health and, at Bastyr's San
Diego campus, a Master of Science in Nutrition for
Wellness.
The three new programs are part of the institution's "growing focus on serving
the health of communities."
Comment: The conscious
focus on preparing students as change agents and on the health of communities
reflects a theme that was repeatedly present at the September 2014 policy day
to honor retiring U.S. Senator Tom Harkin. A wholistic perspective necessarily
brings one out of the clinic to engage community health dimensions. These are
legacy pieces for retiring Bastyr president Dan Church, PhD.
Research
Not Exactly What We Anticipated Department: NCCAM
GMOs Yeast into Opioids
In a November18,
2014 newsletter, the NIH National Center for Complementary and Alternative Medicine
(NCCAM) announced that Stanford researchers funded in part by NCCAM discovered
that yeast, genetically modified, can "brew
opioids and other opioid drugs." The researchers argue that
"turning microbes into mini-factories" may remove dependencies on uncertain
farming and political cycles.
Comment: A person wise to NIH predilections might
assume that the funding of research
on the "modalities, systems and disciplines" associated with
complementary and alternative therapies would come to this; still, I mean
really, is drug development the highest and best use for those precious few
NCCAM dollars? That being said, since self-activation is one pathway for a
person in pain to begin to find means to reduce dependence on painkillers, this
project may have an unexpected positive outcome as patients with pain rise up to
demand "No GMO Opioids!"
Professions
& Organizations
 Guptha: leading for unity
Breakthrough
Agreement between State Massage Therapy Boards and National Certifying Group
A major obstacle to coherent advancement of the massage therapy field was
overcome recently in an
agreement between the Federation of State Massage Therapy Boards and the National
Certification Board for Therapeutic Massage and Bodywork (NCBTMB).
Under the agreement, the NCBTMB "will no longer provide examinations for licensure purposes and will
now focus exclusively on delivering quality certification programs." Leena Guptha, DO,
MBA, BCTMB,
the chair of the NCBTMB states: "This landmark demonstration of collaboration
between these two premier organizations exemplifies ambassadorship by leaders
shaping the future of the profession. I am very proud to lead the NCBTMB
through this transformation and evolution." Meantime, Karen Armstrong, FSMTB
vice president, adds: "This represents a monumental shift for the profession in
a positive direction and benefits all therapists. The regulatory community
will also benefit from this simplification and standardization of the licensing
process." Guptha explains the move in this Massage Today article.
 Focusing on certification
Comment: The move is
indeed another good one toward unity in a field that has suffered from serious
internal dysfunction for years. The rapprochement
follows, for instance, an announcement that virtually all of leading
national organizations associated with the field will join the Commission on
Massage Therapy Accreditation and the Alliance for Massage Therapy Educators in
a joint conference
in July 2015.
Credit Guptha's leadership for moving the NCBTMB in the right direction: tough
for any organization to limit its principle revenue stream. Now to focus on the
places where specialty massage certification may be useful to all concerned.
 Hamm: program addresses justified concern
Professional
Self-Care: Chiropractors Promote Bill to
Improve Chiropractic Medicare Documentation
"We can
no longer make the assertion that we are being discriminated against,"
said American Chiropractic Association president Anthony Hamm, DC in an announcement to ACA
members of the introduction of Protecting the
Integrity of Medicare Act (PIMA), H.R. 5780. The bill urges that Secretary of
Health and Human Services to develop an education program to help improve
documentation in chiropractic Medicare claims. Hamm underscores his point: "While
this legislation may appear to be an indictment against the chiropractic
profession, comparative data from 2011 shows [chiropractic] at the top of the
error rate list at 44.1 percent." Thus, Hamm argues, the additional concern is
warranted. The bill stipulates that the program would be created in
consultation with the American Chiropractic Association (ACA) and
representatives of Medicare administrative contractors.
Comment:
Hamm, who
happens to be the most influential of any integrative health and medicine
practitioner on the American Medical Association's powerful coding committees, sees a very positive silver
lining if this program is enacted: "It will also
potentially offer us the opportunity to interact with CMS and the individual
Medicare Administrative Contractors to provide a better understanding of our
unique model of patient care."
 Holistic org in last newsletter
From Holism
to Love: Marking the Transition of the 36 Year-Old AHMA into the Emerging AIHM
On November 26, 2014, the 36-year-old American Holistic Medical
Association (AHMA) issued its final
newsletter. The e-newsletter begins with an AHMA banner at the top and ends with a
logo for the Academy of Integrative
Health and Medicine (AIHM) at the bottom: all AHMA members are now charter
members of the new "Academy" as it is increasingly known. In his final words as
AHMA executive director, Steve Cadwell - now the AIHM co-executive director - honors a
critical consideration of the AHMA during the year-long transition:
"You
insisted that AHMA keep its DNA, maintain its treasured holistic-medicine
principles and hold the Academy to its promise to center its work on the
healing power of love." AHMA modeled interprofessionalism in recent years for
an association, with members who were MDs, DOs, NDs, DCs, LAcs, RNs, PAs,
nutritionists and others.
Comment: Among the very first, organized signs in the
emergence of a new health and medicine in the United States was the founding in
1978 of the AHMA. Mainly the organization has served as a sanctuary, providing a
periodical and a conference, while generally eschewing politics in favor of the
heal thyself work in nurturing a new community. Meantime, AHMA has served as a pioneering
zone for AIHM's own interprofessionalism. As a close observer of this migration
(I serve on AIHM's board), I am particularly impressed with how leading with
the heart - a practice scorned and derided by hardened professionals of all
stripes, inside and outside of medicine - has infused the emerging AIHM with both
a deep resonance with inclusion and the skillsets to populate it.
 Ullman: taking on Wikipedia
Wikipedia
Guts Homeopathy: Ullman Makes Case for Prejudice in the Whole Form
Homeopathy, author and promoter Dana
Ullman, MPH, CCH, sent a note to the Integrator
that simply read: "I
have presented a very strong case for extreme bias at Wikipedia and I'm sure
that many CAM therapies have similar problems." The article, with over 2300
"likes" as of December 8, 2014, is Dysfunction at
Wikipedia on Homeopathic Medicine. Ullman frames his take-down as on open
letter to Jimmy Wales following a chance encounter Ullman had with the Wikipedia
co-founder. Ullman focuses on presenting evidence that the charges in Wikipedia's homeopathy page of
"pseudoscience" and "implausibility" are incorrect, citing multiple
meta-analyses that conclude otherwise. He suggests that in a case like this
where antagonists are "squatting on a subject," Wikipedia should consider
simply allowing two stories. Ullman's letter is co-signed by an international
group of scientists.
Comment: The medicine may be in infinitesimal doses
but the controversy is huge. In fact, on Wikipedia, as Ullman shares, "homeopathic
medicine" ranks #2 behind "Jesus Christ" as most controversial. Religion
figures heavily in each. I particularly like the contortions of this logic
relative to the sub-controversy of whether water - such as that in which homeopathic
remedies are succussed - can have memory. Ullman quotes former Nobel Prize
winner Brian Josephson,
PhD: "The
idea that water can have a memory can be readily refuted by any one of a number
of easily understood, invalid arguments."
Miscellaneous
Say What?
Average Office Visit Lengthens Over Past 20 Years
A
new retrospective analysis of data from the National Ambulatory Medical Care Survey of the
National Center for Health Statistics has found that from 1993 through 2010
reported visit duration increased from 17.9 minutes to 20.3 minutes for primary
care visits and from 19.0 minutes to 21.0 minutes for specialized visits. The
increase was "consistent across different age ranges, for different numbers of
diagnoses, and for patients who did and did not have a procedure performed
during the visit." Co-author Stephen Feldman, MD, PhD
is integrative medicine faculty at Wake Forest.
Comment: The authors
begin the conclusion portion of their abstract with: "Contrary to expectations and beliefs ..." Their guess is that
the increase is connected to more discussion time forced by patients with
access to the internet. Connection to better team work and coordinated
ancillary services was also postulated as being associated with the increased visit
duration. The big question to many of us is: whatever happened to the "7-minute
average visit" that many have rolled out as a fact of medicine in recent years?
Did it never exist? Bottom line, these data do not agree with perception of
most. (Thanks to Carlo Calabrese, ND, MPH, for the link.)
 Fonfa: next conference coming up
Consumers-Practitioners Together: Ann Fonfa's 9th
Evidence-based Complementary & Alternative Cancer Therapies Conference
The 9th Evidence-based Complementary & Alternative Cancer
Therapies conference will be held Feb 26-28, 2015 in West Palm Beach. The conference is promoted through the Annie Appleseed Project run
by cancer survivor Ann Fonfa. The project has distinguished itself from other
integrative cancer conferences by attendance of both patients and
practitioners. The project is in its 15th year. This conference includes "speakers from 3
continents and a patient panel where people present patient-centered evidence."
Comment:
Fonfa is a pioneer in promoting integrative oncology, especially from a
patient-centered perspective. This labor of love is a rare event in a nominally
"patient-centered" era that seeks to bring patients, practitioners and vendors
into one room.
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