Integrative Medicine, Complementary and Alternative Health and Medicine Round-up #89: March 2015
Written by John Weeks
Integrative Medicine, Complementary and Alternative Health and Medicine Round-up #89: March 2015
Policy
-Going, Going, Nearly Gone: Licensed
"CAM" Practitioners Disappearing from NCCIH Advisory Council
-NCQA
Plan Will Accredit the Healthcare Neighborhood Including Chiropractors, Others
-Chiropractic
Section Leads Effort to Promote APHA Position Statement on Non-Pharmacological
Approaches for Pain
Reports action in 6 states on non-discrimination
-Taylor
Walsh: CoverMyCare Report on State Legislative Action for Non-Discrimination in
Healthcare (Section 2706)
-Supplement
Industry Battle with NY Attorney General over DNA Testing Issue Expands Integrative Care
-Opportunity
for Additional Health Systems to Join Samueli Institute/IHI Chronic Pain
Breakthrough Collaborative
-Through the Looking Glass: Perspective of an Integrative Medicine
Newbie, Medical Student Pooja Shankar, MS -Quick Links to
Integrative Medicine News in Medical Systems and Communities: February 2015 Professions
-Physiological Birth: HRSA Grants
$100,000 for Data Project of the Midwives Alliance of North America
-HMS' Harvard Health Respects Whole Practice
of Chiropractors Organizations
-American
Board of Integrative Medicine Announces First 121 Fellows
-Yale
IM Leader Katz and American College of Lifestyle Medicine Working on "True
Health Coalition"
-Critical Mass: Samueli Institute to Join
Integrative Healthcare Policy Consortium
Anthropologist
Nurse Leader at CIIS Meg Jordan Attempts a Definition of Integrative Health Integrative
Academics
-New
MS Integrative Mental Health Marks Further Evolution of the ND "Mothership"
-University
of Western States Program Brings Chiropractors into Legacy Health Emergency
Rooms
Psylocibin: Michael Pollan's article explores re-interest in medicinal use
International
-Integrator's John Weeks Joins with GAHMJ to Produce The Global Integrator Blog
-Quick
Links to Global News in Traditional, Alternative, and Integrative Health and
Medicine for January 2015 Miscellaneous
-TEDMED
Has IHPC's Wostrel Speak on Non-Discrimination in Patient-Centered Care Webinar -Default Mode Uptake Inhibitors: Michael
Pollan's Essay on Psilocybin and LSD for Health and Medicine
-Responses
to a Blog on Connecting Integrative Health and Medicine with the Environment People
-Wayne
Jonas, MD Honored at the Integrative Healthcare Symposium
-Davis
Lamson, MS, ND Given Lifetime Achievement Award by Oncology Association of
Naturopathic physicians
-Maiers
and Lisi among Chiropractors Receiving 2015 Awards for Contributions
-American
Botanical Council Announces 2105 Awardees
-Update
on a Leader: Marc Micozzi, PhD, MD
____________________________________
Policy
Going, Going, Nearly Gone: Licensed "CAM" Practitioners Disappearing from NCCIH
Advisory Council
At
the February 2015 meeting of the National Advisory Council for
Complementary and Integrative Health, the Council's upcoming membership changes
were announced. The terms of the sole naturopathic physician and the sole
chiropractic doctor will end. (The ND has been asked to stay on until the
fall.) A new chiropractor, former agency staffer Christine Goertz, DC, PhD will
join. At that point, of the 18 members of the Council under regular terms,
(5.5%) will be licensed practitioners from the professions of chiropractic,
massage therapy, naturopathic medicine or acupuncture and Oriental medicine.
Section (b) of the 1998 mandate under which the Center was established states
that "at least half [50%] of the members of the advisory council who
are not ex officio members shall include practitioners licensed in one or more
of the major systems with which the Center is concerned."*
Did Congress mean something other than what it mandated?
Comment: What is more
dismaying: 1) NCCIH's nearly absolute refusal to abide by the mandate from
Congress; or 2) the failure of the associated professions to stand up for their
rights under U.S. law? Isn't this a good place for leadership from the Integrative
Healthcare Policy Consortium? There is some rumbling afoot of concerted action.
It's about time. Stay tuned.
*
If you are of the mind that "integrative MD" was one "major systems" under
consideration, bear in mind that at the
time of the mandate in 1998: 1) the concept of "integrative medicine" was
hardly 3-years-old in U.S. medicine; 2) there were no national standards for
such a profession; 3) there were no declared competencies; 4) there was no
national professional organization; 5) there was no Department of
Education-recognized accrediting agency; 6) there was no national board or
certification exam; and of course, 7) medical doctors with an interest in
therapies in which they were neither educated nor board-certified were not
"licensed in a system" of "integrative medicine." Most of these are still true, today. Note that
even if NCCIH met the mandate, 9 slots remain for these professionals, as long
as NCCIH continues to not have 3 consumer members also mandated. (Also in (b): "...
shall include...at least 3 individuals representing the interests of
individual consumers of complementary and alternative medicine.
NCQA Plan Will Accredit
the Healthcare Neighborhood Including Chiropractors, Others
The payment and delivery system accreditor, the National Committee for Quality Assurance (NCQA),
appears to have cracked open a door for accreditation of offices of community
integrative health and medicine practitioners. The program responds to
how patient-centered medical homes (PCMHs) or Accountable Care Organizations
have relationships with clinical service providers who are neither employed nor
on site. The concept is of the "medical neighborhood." Under
the NCQA program, one's clinic can become an NCQA Recognized Patient-Centered
Connected CareTM Site. Some examples given are
of "non-primary care clinics that provide outpatient treatment (e.g.,
physical therapy, podiatry, optometry, dental services)." A chiropractor
has reported to the Integratorthat
dialogue with NCQA has clarified that chiropractic offices qualify.
Comment: Aficionados of
the competitive environment in which accreditors operate tend to immediately
view this program simply as a new business line and money-maker for the NCQA.
Yet for those who have been historically excluded from the playing field by the
agency's provider-centric, rather than patient-centered, accreditation practices,
this does appear to be an opening. Most distinctly licensed integrative
practices and MD-led integrative medicine centers are community-based, rather
than medical system-based, and will be for the foreseeable future. Thus those
who wish to link up with the emerging world of accountable care and health
homes, this may be the route.
The
Integrator will follow this closely,
especially because we know that when the NCQA says something, we don't know for
sure what they mean. For instance, they claim to separately accredit, through
their NCQA PCMH Recognition program, "sites delivering primary care services."
Yet the NCQA 1) focuses only on primary care "physicians" and does not include
such clinics independently run by an advance practice registered nurse; nor 2)
does the category include "physicians, naturopathic" who are licensed and
practice as primary care in at least half of their licensed jurisdictions.
Where will the NCQA draw its boundaries with this program? Any news from anyone
who begins this process will be welcome.
Urged to support non-pharma pain approaches
Chiropractic
Section Leads Effort to Promote APHA Position Statement on Non-Pharmacological
Approaches for Pain
Last fall, a team from the Academic Consortium for Complementary and
Alternative Health Care (ACCAHC) published a Never Only Opioids policy brief and recommendations
via the Pain Action Alliance to Implement a National Strategy (PAINS). Shortly
after, work began on a tactic toward the brief's core recommendation of early
intervention with non-pharmacologic approaches. Michele Maiers, DC, PhD,
who heads the Chiropractic Section
at the American Public Health Association (APHA) began exploring whether APHA
might endorse these or similar recommendations. Maiers shares news that a
formal resolution has been submitted to APHA to approve a new policy
recommendation entitled "Increased role for evidence-based
non-pharmacologic management of pain to decrease the opioid abuse
epidemic." The paper includes many of the Never Only Opioids recommendations.
Maiers: leading the campaign
Sponsoring the proposal are not only the chiropractic section but also the
section on Alcohol, Tobacco and Other Drugs. Two other sections endorsed that
proposal: Physical Activity, and the section on Integrative,
Complementary and Traditional Health Practices led by Beth
Sommers, PhD, LAc, MPH. Maiers makes clear that "this is a
submission and must go through an extensive vetting process." She credits
ACCAHC's Never Only Opioids for the inspiration.
Comment: Colleague James Whedon, DC, MS at Dartmouth's
accountable care organization group sent a brief note following an email
related to the work on Never Only Opioids:
"Never Only Statins." Suddenly one sees a long list of potential titles (Never
Only Antibiotics, Never Only Ritalin, Never Only Beta Blockers, and etc.) We've
got a regular Dummies series! In
fact, each title could directly evoke that series if for example, it read: Never Only Statins, Dummy.
Walsh: reporting state activity
Taylor Walsh: CoverMyCare Report on
State Legislative Action for Non-Discrimination in Healthcare (Section 2706)
Longtime
Integrator columnist Taylor Walsh conceived and led
development of the Integrative Healthcare Policy Consortium's consumer-focused CoverMyCare campaign. The goal is to help consumers
partner with practitioners to drive efforts to get payers to meet the intent of
the Non-Discrimination
in Healthcare provision (Section 2706) of the Affordable Care Act. While many
people are throwing their hands up in frustration with the refusal of most
payers to comply and regulators to enforce, it is clear from this recent report
in the Integrator that real work is
under way in multiple states to shift access as Section 2706 requires. Walsh
shares legislative activity in California, Hawaii, New Mexico, Rhode Island
and Minnesota. Walsh wrote a similar piece for the Altarum Blog entitled "Nondiscrimination
in Health Care"-States Stepping Up.
Comment: This campaign is
grassroots, and that means you. For instance: CoverMyCare welcomes the stories
of other patients and providers like one Walsh features in the Integrator article. Have you or anyone
you know had trouble coping with reimbursement in the context of Section 2706?
A simple form is available on the campaign's page "Share Your Story." Credit Bastyr University and the American
Massage Therapy Association for the organizational investment that has carried
CoverMyCare to this point. Who do you know who might help it next?
Note: In other
CoverMyCare news, the campaign has developed an Advocacy Tool Kit. An easy place to
start, besides having patients share a story, as noted above, is to urge
members and friends to go to CMC's Facebook page.
Scheiderman: full throttle against herb companies
Supplement
Industry Battle with NY Attorney General over DNA Testing Issue Expands
As
noted in the February 2015 Integrator Round-up, multiple
industry or industry-related organizations connected to herbal products and
dietary supplements quickly circled their wagons after an attack on product
quality from New York State Attorney General Eric Schneiderman. Their case: the
DNA test that found zero evidence of herbs in some products is an inappropriate
test. As noted in the Round-up,
credible third parties, including many who have been vigilant critics of the
industry, agree with the industry position that the AG is wrong. (See Don't Give Up On
Your Supplements Yet: Why That Damning Report Was Fatally Flawed.) A moderate
voice from the New York Botanical Gardens notes here additionally that
"it is difficult to evaluate the
test results provided by the attorney general's office due to the lack of the
study protocol."
ABC's Blumenthal: AG used faulty methods
American Botanical Council's Mark
Blumenthal laid out the scientific case here.
He writes: "ABC
is not attempting to defend the tested products or the companies; instead, we,
and many others, question the appropriateness of the analytical method and
scientific protocol used in this case, on which legal and regulatory
enforcement actions have been based. One of many problems is that consumers
have a misunderstanding of the relevance of DNA in herbal extracts due to some
popular media such as television crime dramas, and will presume that the NY AG's
methods and data are accurate and sufficient."
The American Herbal Products Association has set up a resource
site complete with talking points. Schneiderman
turned a deaf ear to their pleas and instead expanded his
campaign.
Comment: I was on a
conference call with a half-dozen integrative medical doctors one day amidst of
the first rush of bad press. The subject came up. All had heard of the AG's
claim. None had heard of the industry's response. Each had simply accepted that
this was just another example of poor product quality in the field. For
industry antagonists: mission accomplished.
Integrative Care
Samueli partner on integrative pain collaborative
Opportunity for
Additional Health Systems to Join Samueli Institute/IHI Chronic Pain
Breakthrough Collaborative
The
Samueli Institute Breakthrough
Series Collaborative on Chronic Pain is seeking new clinic or health system
participants. The collaborative, engaged with the influential Institute for Healthcare Improvement
(IHI),
is set to "help us shape a ground-breaking collaborative that we believe will
make a real difference in how we provide the best care for patients with
chronic pain." Collaborative work gets underway in May of 2015, with the first
face-to-face session scheduled for June 2-3, 2015. Interested
organizations have a deadline of April 20 to submit a letter of intent. A
prospectus is available through Sandi Gordon, BSc, CPC, senior program manager
(
).
Comment: Samueli
Institute's decision to link with the Institute for Healthcare Improvement IHI
was brilliant. So was its first step toward the Collaborative: a daylong
convening of 45 integrative pain experts, in January 2015. IHI, arguably the
most significant progressive force in U.S. healthcare delivery today, has not to
my knowledge yet featured integrative medicine and health in its work. One of its co-founders, former CMS
administrator Don Berwick, MD, has been engaged. This is a
terrific method, and time, to bring Joint Commission
recommendations
and a Never Only Opioids approach to
elevating non-pharmacological approaches in the treatment of individuals in chronic
pain.
Shankar: reporting her awakening
Through the Looking Glass: Perspective
of an Integrative Medicine Newbie, Medical Student Pooja Shankar, MS
Comment: It is a truism
that life is most alive when one can see with beginner's eyes. Reading
Shankar's journey will bring one back, from whatever entrenched, reified, and cataracted
place one may find oneself to wonder again at the beauty of the chaotic diversity,
challenges and possibilities that open when one leaves the rigid realm where
single agents are king.
Multiple quick links to IM activities
Quick Links to
Integrative Medicine News in Medical Systems and Communities: February 2015
This
typically monthly Integrator feature for February 2015 quickly captures
highlights from the stories that flow in daily from various sources relative to
"integrative medicine." A remarkable trend is the number of items about
new medical hires who advertise their completion of the U Arizona
Fellowship in Integrative Medicine. Here are 24 selections related to
hospitals and medical organizations and integrative medicine, plus just 2 from
alternative and integrative medicine in community non-system practices. For you
who are paying attention, January got by me without completing this article.
Apologies. When time allows, this practice continues to astound. Critical mass!
(Note that Global News Links are now posted at The Global
Integrator Blog
for Global Advances in Health and
Medicine - see related notice
here
and below.)
Professions
HRSA grant fosters data gathering for homebirth midwives
Physiological Birth:
HRSA Grants $100,000 for Data Project of the Midwives Alliance of North America
The
February 2015
issue of the e-newsletter for the Midwives Alliance of North America announced
a $100,000 HRSA grant to "explore the impact of midwifery care on women of size
and on older than average women as well as creating a predictive model to help
us better understand when intrapartum transfer is more likely." The funds will
support the merger of the organization's own data gathering on birth, MANAstats, with those from
the American
Association of Birth Centers (AABC) Perinatal Data Registry (PDR). This will to
create "the largest available set of records on physiologic birth in the US."
The
data are anticipated to be of use to both midwives and families "as they look
together at the variables that may impact transfer." An example is that based
on the outcomes from the HRSA funded work, some "may choose to have a closer
relationship with a physician because the likelihood of transfer is greater
than average."
Comment: The midwives are increasingly using this
scientific name of "physiological birth" to take the place of "natural
childbirth." The term is promoted in a strategic
initiative
of the American College of Nurse-Midwives. Like "psychoneuroimmunology" for
mind-body, and "nanotechnology" for homeopathy, these are meant to skirt the
prejudices of those in power. It will be nice when, like the Dutch, we will all
again be proud of the midwives as the
foundation of our system for delivering babies. With such respect for and
empowerment of natural process, we may even have a chance one day for a
"physiological" system for delivering health.
DCs seen for whole practice
HMS' Harvard Health Respects Whole Practice
of Chiropractors
A
recent publication from the Harvard Medical
School's Harvard Health website positions
chiropractors as far more than system tools to adjust the lower back of
patients with acute pain. The document begins by speaking of the field as "a
health care system." Then it continues: "While the mainstay of chiropractic is
spinal manipulation, chiropractic care now includes a wide variety of other
treatments, including manual or manipulative therapies, postural and exercise
education, ergonomic training (how to walk, sit, and stand to limit back
strain), nutritional consultation, and even ultrasound and laser therapies. In
addition, chiropractors today often work in conjunction with primary care
doctors, pain experts, and surgeons to treat patients with pain."
Comment: This perspective
from on high will be particularly welcome for a field that is presently in
discussion with Medicare about finally breaking with that agency's
disrespectful relationship with that field. (See Chiropractic
Doctors Hit a Trifecta in Move for "Cultural Authority.") Presently,
chiropractors are only reimbursed for their manipulation. They receive nothing
as professionals engaged in evaluation and management. Consider the potential
value to seniors and the U.S. health professions workforce planning if the
agency sought to make the most of this "chiropractic system of health" rather
than to merely boil these professionals down to extract the least. Good for the
editors of the publication. Good for Harvard Medical School. (Thanks to Lou
Sportelli, DC, for the heads-up on the article.)
Organizations
First boarded group under ABPS
American Board of
Integrative Medicine Announces First 121 Board Certified ABOIM
The
new American Board of
Integrative Medicine (ABOIM), a division of the American Board of
Physician Specialties, has announced its first class
of 121 board certified MDs/DOs. A video on the site offers a half-dozen
perspectives from integrative medicine leaders who share their beliefs that
this certification will one day become the standard that will assist patients
and also others who wish to choose quality. Speaker Roberta Lee, MD suggests
that as the field goes forward "many insurance based practices will require
some proficiency and that going forward meeting this standard is a way of
demonstrating this."
Comment: The long journey since the fall of 2011 when
leaders of the Arizona Center for Integrative Medicine switched courses and
embraced this path has finally borne fruit. (See Special
Report:
"Strategic Change in Direction" as Weil's Arizona Center Commits to
Creation of American Board of Integrative Medicine.) The next board
exam is in May. It will be interesting to see how many, for instance, of the
3,000 certified in the past as ABIHM (American Board of Integrative Holistic
Medicine) will choose to sit for what ABPS hopes will become the gold standard
for integrative MDs and DOs.
Katz: more idea than a roosting tree has birds
Yale IM Leader
Katz and American College of Lifestyle Medicine Working on "True Health
Coalition"
The
bottom of a long post at US News and World Reports from Yale
integrative medicine leader David Katz, MD, MPH, includes this note: "Dr.
Katz is working to develop a global ‘True Health Coalition' to advance the
proposition that we know enough about the fundamentals of healthy living to
eliminate 80 percent of all chronic disease, and that what we know should be
put to far better use. If you would like to join this movement, please send
your contact information to Susan Benigas, Executive Director of the American
College of Lifestyle Medicine(ACLM), at
." Katz promotes his vision in a Huffington Post
column entitled "The Case for a
True Health Coalition: Who Hears Whom?"
In a related piece onKatz' Linked-IN
site, he directly calls on
nutritionists to throw aside their differences - whether they are vegan or
Paleo, for instance. He urges them instead to focus on common ground beliefs
relative to the standard American diet: "In both cases- whether it's pure
plant foods for us to eat, or the flesh of freely ranging animals in turn
derived from the wild plants of their native diets- it's pure, minimally
processed food, direct from nature or nearly so. Multicolored marshmallows are
nowhere to be seen. Nobody is running on Dunkin."
Katz, the president of
the ACLM, launched an associated GLiMMER project (Global Lifestyle
Medicine Movement to Effect Revolution) last fall. Former pharmaceutical executive
Stephen Squinto, PhD, recently retired Alexion co-founder, is the first major backer. Says Squinto: "I've
devoted my career to the pharmaceutical industry but certainly understand the
power of lifestyle medicine in light of the fact that 80% or more of our healthcare costs are directly tied
to poor lifestyle choices."
Comment: From Katz, interesting
ideas fly like morning birds from a roosting tree. The question is whether
either of these seemingly interconnected ideas will have any legs. A first big
penance investment from a former pharmaceutical executive can help, based of
course on how much the figure was. I wonder if either might have more merit if
more time is spent lining up allies than seems to be in the present strategy.
Beltway player joins IHPC
Critical Mass:
Samueli Institute to Join Integrative Healthcare Policy Consortium
The
Samueli Institute, founded by CEO Wayne Jonas, MD
via philanthropic partnership with Susan and Henry Samueli, has chosen to join
the Integrative Healthcare Policy Consortium (IHPC). Samueli institute
has for years been, with IHPC and the American Chiropractic Association (ACA),
one of the only steady integrative health and medicine lobbying forces in the
Beltway. The Institute has produced a great deal of impactful research in
recent years, with federal and military funding, relative to integrative care. The Samueli decision follows the recent IHPC membership
of the Academy of Integrative Health and Medicine and the National
Certification Commission for Acupuncture and Oriental Medicine. This brings to
16 IHPC's Partners for Health.
Comment: Over the years,
the Integrator has referred to IHPC
as "the little engine that could" for policy in integrative health and medicine.
The organization has contributed a great deal since it was founded as a part of
the now defunct Collaboration for
Healthcare Renewal Foundation in 2001despite an annual budget that has
typically been below $50,000. For many of its years, years, revenues have been far
south of that. With these new members, IHPC has, under the direction of Len
Wisneski, MD, chair, and Alyssa Wostrel, MPH, executive director, nearly shed
the Little Engine handle. What it needs next is for the new leaders of the ACA,
Tony Hamm, DC and Richard Miller, to finally bring the ACA into long-overdue
membership. Though still "little" by the standards of mainstream medical
lobbying, IHPC is now clearly the guiding light for the field. Let's see what
this newly energized consortium can do.
Anthropologist
Nurse Leader at CIIS Meg Jordan Attempts a Definition of Integrative Health
The
term "integrative health" is defined in this page-long
perspective
from Meg Jordan, PhD,
RN, CWP,
the director of the Masters in Integrative Health
Studies
program for the California Institute for Integral Studies. Jordan positions the
term as arising out of the complementary and alternative and integrative medicine
movements. She speaks to the variety of professionals involved, offers 6
principles and this one sentence version: "Integrative health is an
individualized, client-centered model of promoting optimal health and wellness,
combining a whole person approach with evidence-based strategies to reduce
disease risk by turning around lifestyle behaviors."
Comment: Anyone following
the evolution of integrative health and medicine in the United States will know
that there is a glaring definitional gap since the U.S. Congress chose to
include "integrative health" and "integrative health practitioners" in the
Affordable Care Act. That is: what do we mean by "integrative health"? The ascendancy
of this term began in earnest with the
2009 Institute of Medicine Summit on Integrative Medicine and the Health of the
Public, the report from which captured the consensus that the multidisciplinary
movement is for "health" rather than medicine. (See IOM's Inviting Report on the February 2009
Summit on Integrative Medicine, uh, I mean "Integrative Health Care.")
The
accent on health rather than medicine has been the preference since 2004 with
the Academic Consortium for Complementary and
Alternative Health Care. It has now been embraced, with a twist, by the Academic Consortium for Integrative
Medicine and Health
(formerly the Consortium of Academic Health Centers for Integrative
Medicine). I recall a time in 2007 or so
when Lori Knutson, RN, BC-HN, the founding director of the nation's most
significant inpatient-outpatient clinic, began referring to what they were
doing as "integrative health" rather than "integrative medicine."
So
what is a sweet, short and sublime definition? One place where Jordan's start
falls down is in confounding language regarding "therapies" and entire systems.
While one of Jordan's principles rightfully calls out the "importance of
collaboration among multiple disciplines," she writes: "The burgeoning field of
integrative health draws fresh thinking and solutions from a world of healing
options, including a broad understanding of complementary therapies such as naturopathic medicine, chiropractic, nutrition,
diet and targeted supplementation, fitness and exercise, stress management, and
yoga therapy, along with diverse, global healing approaches, such as Ayurveda, Traditional Chinese Medicine,
indigenous healing arts and folk medicine." [italics added] Interprofessional
respect, which Jordan's work with "healing circles" exemplifies, must begin
with clarity that separate systems are neither "therapies" nor "approaches." Still,
good food for thought for language wonks, here.
Integrative Academics
ND-based school in integrative mental health Masters
New MS Integrative
Mental Health Marks Further Evolution of the ND "Mothership," NCNM
In
the late 1950s, the National College of Naturopathic Medicine (NCNM) was
founded by a handful of committed naturopathic doctors from throughout the Northwest.
The last naturopathic program had been
discontinued. They sought to preserve a dying profession. Presently, NCNM, now
the National College of Natural Medicine, is expanding its
offerings significantly beyond its Classical Acupuncture program.
Recently
growth is most prominent through its School of Research
& Graduate Studies. The dean of the school is Heather Zwickey, PhD, who
also heads up NCNM's Helgott
Research Institute.
The rapid growth is evident in this sequence: 2012, Master of Science in Integrative
Medicine Research; 2014, Master of Science in Nutrition; 2014, Master of Science
in Global Health; and for September 2015, Master of Science in Integrative
Mental Health. A communications official at the college, Marilyn Considine,
notes that several other programs for the School of Research & Graduate
Studies are under consideration and in various stages of development.
Zwickey: overseeing the group of programs
Comment: The movement toward multidisciplinary,
university status of former single purpose academic institutions is profound altering
the landscape of integrative health and medicine. More programs allow more for
more full-time faculty. Thus, potentially, the institution can increase organizational
support for research, policy and community initiatives. The contributions of
the following such institutions (with original lead profession in parenthesis)
have been huge: Bastyr University (ND), National University of Health Sciences
(DC), Southern California University (DC), Northwestern Health Sciences
University (DC), Maryland University of Integrative Health (AOM) and University
of Western States (DC).
NCNM
is, with New York Chiropractic College/Finger Lakes School of Acupuncture and
Oriental Medicine, also multi-program and multidisciplinary. Challenging laws
in New York reportedly hold NYCC back from university status. With these
graduate programs, NCNM is already behaving like a university-level institution
with its breadth of academic and community service. Personally, as the sibling
of two mental health counselors, I am particularly pleased to see the September
2015 Integrative Mental Health program shaping up. That field is in desperate
need of more connection to nature, exercise, food, supplements, and
physicality.
Opens ER observation for DCs
University of
Western States Program Brings Chiropractors into Legacy Health Emergency Rooms
The
University
of Western States
has announced an agreement with Legacy Health, the largest not-for-profit
system in the Portland, Oregon area, through which chiropractic students in the
UWS program will have the opportunity to "experience observational clinical
rotations in various emergency room settings in the Legacy system." The design
of the agreement is particularly
for "sports medicine fellows who have recently completed the UWS Master of
Science sports medicine degree and Doctor of Chiropractic programs." The
program is led by Sara Mathov, DC, director of the
exercise and sports science department at UWS. She states: "This opportunity is
incredibly important for a variety of reasons. It allows the fellows to see
medical situations beyond what is typically seen in a chiropractic office or
training room. It also allows them to see what happens when patients are
referred to the emergency room."
Comment: This opening
into the emergency care environment is significant, even if only for
observations. It will be interesting to see how this toe under the tent grows
and flourishes under the expansive UWS leadership of President Joe Brimhall, DC. In other recent
news, UWS announced an
articulation agreementwith
National University of Health Sciences to "enable UWS students
and graduates of the doctor of chiropractic (DC) program to complete a doctor
naturopathic medicine (ND) degree at NUHS in as few as four additional
trimesters, saving both time and expense for students seeking both degrees."
International
Invites Weeks to blog, column
Integrator's
John Weeks Joins with GAHMJ to
Produce The Global Integrator Blog
An
article here in
the Integrator Blog News and Reportsdescribes the decision of Integrator publisher-editor John Weeks
to works with a team at the peer-reviewed and indexed Global Advances in Health and Medicine Journal (GAHMJ). Weeks will
contribute articles 8-10 times a month as The Global Integrator Blog on an open access
site attached to the GAHMJ. Weeks was
invited by GAHMJ co-founder and CEO Michele Mittelman, RN, MPH to work with editors
Mary Jo Kreitzer, PhD, RN, FAAN and Robert Saper, MD, MPH and the rest of the
GAHMJ team. Weeks will also produce a regular column for the GAHMJ.
Some
features will be known to Integrator
readers. He'll use a report-comment format. A monthly Global
Integrator Round-up will capture each month's activity. A Quick
Links feature will offer very short notices - for instance here are 32 from January - on global
developments in integrative, traditional, complementary and alternative
practices. Readers can sign up the GAHMJ RSS feed and for
GAHMJ
E-Alerts.
Weeks' first post shares his long-time and growing interest in the global
scene: Global Integrator: Blogging Globally to Support
Local Action in Integrative Health and Medicine. States Weeks: "I
received a wonderful offer that met with a rising personal area of interest:
the global movement for integrative health and medicine."
Weeks: new Global Integrator Blog
Comment: Writing in the 3rd
person about myself would have been more troubling 4 decades ago when I was fascinated
and frightened by R.D. Laing and his The Divided Self and Knots.
That aside, this note from my known selves in shocking unison is to let
you who wish to know that this is a happy-making, intriguing and I hope useful engagement.
I hope some at least of the content can prove as stimulating for you as it is
proving to be for me. Zanzibar. India. UAE. Gambia. Canada. China. USA. Turkey.
Thailand. Ghana. Philippines. And more. All engaged in integrating traditional
practices in some fashion with regulatory efforts and Western medicine. The
"them" is us.
Multiple short links from GAHMJ
Quick Links to
Global News in Traditional, Alternative, and Integrative Health and Medicine for
January 2015
This
monthly Global
Integrator Blog
feature highlights developments in traditional medicine and alternative and
integrative health during a 1-month period. Here are 32
selections
from India, Gambia, Vietnam, indigenous Canada, South Africa, Nigeria,
Ethiopia, and elsewhere for the month of January 2015. Samples: In late-January
meetings with Nguyen Hoang Son, deputy director of the Traditional Medicine
Administration in Vietnam, traditional healers
signed an oath
to not use rhino horn medicinally. In South Africa, the Herbal
Drugs Research Unit at Tshwane University of Technology will begin
looking into the healing properties of the country's indigenous plants. They
estimate that there are 200,000 traditional healers in the country. Much, much
more.
Miscellaneous
Wostrel: representing choice at TEDMED
TEDMED Has IHPC's
Wostrel Speak on Non-Discrimination in Patient-Centered Care Webinar
Integrative
Healthcare Policy Consortium (IHPC) executive director Alyssa Wostrel, MPH,
took part in a national TEDMED webinar on patient
experience/patient-centered care. The panel included Joe Selby, MD, MPH,CEO of
the Patient-Centered Outcomes Research Initiative and Stephen Horowitz, MD, an
integrative cardiologist with the founding force in the patient-centered care
movement, Planetree. Wostrel informed TEDMED's influential national audience
about the importance of Section 2706,
Non-Discrimination in Health Care to patient choice. She also noted the
evidence available on enhancing patient experience and cost-savings via
integrative health and medicine that is available via the Project for
Integrative Health and the Triple Aim portal.
Comment: I congratulated Wostrel for IHPC's good work
in getting on the panel and asked what led to the invite. She gave the best answer
possible: the invite came out of the blue, merely via IHPC's
work and presence. Notably, panelist Nadine Burke
Harris,
founder and CEO of a program for at-risk children called the Center for Youth
Wellness actively supported the importance of having acupuncture, specifically,
available as an option. Nice job, Alyssa!
Pollan: exceptional New Yorker piece
Default Mode Uptake Inhibitors: Michael Pollan's Essay on Psilocybin and LSD for
Health and Medicine
In
a solid February 9, 2015 New Yorker piece
entitled The Trip Treatment, best-selling author
Michael Pollan explores the revitalization of research, banned in the late
1960s, on the use of psilocybin and LSD as medicinal agents. Pollan reports
research at Hopkins, New York University, and in England in which volunteers
participate in facilitated, placebo controlled (with active placebos) "trips." Roland
Griffiths, the lead researcher at Hopkins, states: "I don't want to use the
word ‘mind-blowing' but as a scientific phenomenon, if you can create
conditions in which 70% of people will say they have had one of the 5 most
meaningful experiences of their lives? To a scientist, that's just incredible."
Griffiths references the governmental taboo on research: "Can you think of
another area of science regarded as so dangerous and taboo that all research
gets shut down for decades."
Modern
neuroscience research Pollan document is discovering that one means by which
the psilocybin seems to work is to "substantially reduce cognitive activity in
the brain's ‘default mode network.'" This part of the brain is considered the
"orchestra conductor," the corporate executive" or the "capital city" - a.k.a.
the ego. If one inhibits the ‘default-mode' power of the constructed ego, other
areas of the brain have a chance to appear, connect, and create different kinds
of meaning. One observation from the NYU team: "The fact that a drug given once
can have such an effect for so long is an unprecedented finding."
Comment: One dates
oneself if several family members or friends immediately alert one to this
exceptional article. A first note for those of you who are experienced: the controlled environment appears to limit "bad
trips." Pollan offers the researcher's safety rules for the road. Beyond the
personal, one is struck by the policy consonance faced by these natural agents
and those facing the multiple more mundane natural healthcare practices that are
at the core of integrative health. For instance, perverse economics: a single
pill that does so much is certainly and absolutely unfair competitor to a
pharmaceutical firm's take-daily-and-forever depression drug. (I think I might
support a ban on exploration too, if the die had cast me as a pharma player.) Second,
the article notes the tension between those scientists who are comfortable with
documented positive human outcomes and others who wish to sit on results until they
somehow conforms to their idea of an understood intervention. This is familiar
ground.
The
increasingly well-researched, extraordinary power of these mushrooms urges a reminder
of the obvious: how can much of Western medicine continue to denigrate natural
agents as placebos when coffee beans, John Barleycorn, tobacco leaves, tea, coca,
opium poppies, marijuana buds, and psilocybin mushrooms are each mere herbs? Gosh,
might there be substantial physiological power in scores upon scores of other botanical
agents for myriad human conditions? What a prejudice in favor of human made and
patentable versus natural agents and our self interest in our healthcare
commons! What a shame that for decades the right to research that created the
value found here was suppressed, even as active engagement of the licensed
integrative health and medicine fields in researching their own value appears
to being suppressed today. (See top article under "Policy" in this Round-up.) Where else is our collective
brain being blockaded by a too domineering "corporate executive" who upholds
the status quo. Perhaps, to invoke a sentiment from back in the day, someone needs
to put a dose of "default mode uptake inhibitors" in the NIH's water supply.
Re-published look at environment/IHM connection
Responses to a
Blog on Connecting Integrative Health and Medicine with the Environment
Shortly
after some particularly powerful presentations at the 2015 Integrative Health Symposium (IHS) on environmental
issues from Robert Rountree, MD, Walter Crinnion, ND, the IHS re-posted a 2010 column
I wrote on its Integrative Practitioner
website. The column was Forging Links between
Holism, Integrative Health and the Environmental Movement: Is This the Time?I referenced activities of integrative pediatrics
leaderLarry Rosen, MDwho runs a Whole Child Center and integrative psychiatristScott Shannon, MD, whose multidisciplinary clinic is call Wholeness
Center. While drawing out the common ground, I ultimately expressed the view
that the integrative health and medicine field should focus on firming its core
coalition prior to extending into the environmental movement. This led to the following
reader response fromHenderson J. Smith, Jr, IIQTC, NQA
Certified and Holistic Wellness Consultant.
Henderson Smith: "Related to your
closing comment - Humanity must focus on the big picture and the effect of our
actions on all things both now and in the future. Nature is the great example.
Billions of single cells make up our bodies; even they realize that
survival is more certain when working collaboratively to support the
"whole" host. A city cannot thrive if the infrastructure was not
envisioned to support its growth. Why should the well-being of its citizens be
governed by a different principle? The traditional medical establishment
is conflicted between the ethical focus on human health and the socioeconomic
profitability of treating symptoms. Humanities leadership is mired in the
minutia of perception, finger pointing, separatism, politics, financial influence
and institutional survival. Disruptive Innovation says that real change
does not come from the same thinking that originated the problem. Silos of
solutions will never solve the ‘whole' problem. In this work, survival of
the host and its inhabitants is at stake on a global scale. Holistic Health and
Integrative Practitioners were so named for a reason. If you don't
consider the big picture and all parts of the ‘whole', who will?"
Weeks: I told Smith
that, today, I agree, both because the field has done a better job of firming
up its connectivity in the intervening 5 years and the issues in the
environment are pressing ever more forcefully into all corners of human and
global health. Smith was pleased that
I'd come around. I subsequently re-contacted Rosen and Shannon. Each responded.
Rosen: comments on the connection
Larry Rosen: I continue my relationship with Center for Health and the Environment
(CHE) and I know both Scott and I consider
the widest parameters of environmental health strong threads in our work. Of
course, I'm speaking freely for both of us! That
2010 CHE conference was one of the most powerful and enjoyable with which I've
been involved. To see the mix of speakers/participants from all
disciplines including education, ecology, health, philanthropy - we had Rich
Louv, Fritjof Capra- just terrific out of the box thinkers. Might have to think
about something like that again!
Scott Shannon: This theme remains front and center for me. I continue to
push the ecological teaching metaphor more and more. It is crucial that we get
the message. With the epigenetic implications of the ENCODE data
in 2012 this model becomes even more
crucial as the primary model for biological health. [He then adds that the 2010
column referenced 1300 certified ABIHM MDs/DOs and that number is 3,000 today.]
People
Jonas: honored at IHS
Wayne Jonas, MD
Honored at the Integrative Healthcare Symposium
The
former U.S. Army military doctor, son of a minister, influential director of
the former Office of Alternative Medicine and co-founder and president of the
Samueli Institute Wayne Jonas, MD was honored with the 2015 Visionary
Award
by the Integrative Healthcare Symposium. Jonas. In his keynote on receiving the
award, Jonas, a scientist who likes both basic and translational questions,
teased his audience with multiple stories of the power of suggestion, of
placebo, of intention, and of integrative health.
Comment: Jonas path took
a fascinating twist when a meeting 15 years ago with Susan Samueli led not to
his direction of an academic health center integrative medicine clinic and
program at UC Irvine but instead to the founding of the Samueli Institute. Some
of my favorites of his work have been: the Institute's frequently frustrated
but well-intended Optimal Health Environments initiative; the Wellness
Initiative for the Nation (WIN) that shaped the National Prevention, Health
Promotion and Public Health Council; and, alignment of interest note, the early
link of the NIH OAM to real-world outcomes through which Jonas took a risk with
a college drop-out and launched me into national work in integrative care via a
paper he contracted which began ‘Match-maker,
match-maker, make me a match.". Thank you, Wayne. Richly-merited award.
Lamson: honored by ND oncology group
Davis Lamson, MS,
ND Given Lifetime Achievement Award by Oncology Association of Naturopathic
physicians
Former
research chemist and naturopathic physician Davis Lamson, MS, ND was granted a
lifetime achievement award at the 4th annual conference of the Oncology
Association of Naturopathic Physicians. Lamson has been a staff physician at
Jonathan Wright, MD's Tahoma Clinic in Washington since 1988. Lamson was reportedly given
the award
"for a slew of reasons including his oncology teaching to generations of
students at Bastyr University, his research contributions, his devotion to
patient care, and most importantly his long-time support and persistence in pushing
the profession forward."
Comment: Good to see
Lamson awarded. There was a time in the early days of the re-awakening of the
naturopathic profession in which to have a former research chemist as an
incoming student was a sign that the field just might have enough attractant to
go somewhere. .He's been a significant contributor to his field ever since.
Lisi: honored by chiropractic leadership
Maiers and Lisi
among Chiropractors Receiving 2015 Awards for Contributions
The
awardees for at the late February 2015
National Chiropractic Leadership Conference included: as Researcher of the
Year, Northwestern Health Sciences University's Michele Maiers, DC, PhD. Maiers
work includes heading up the campaign to have the American Public Health
Association adopt a position statement on non-pharmacologic approaches to pain,
noted under policy, above. For Educator of the Year, director of chiropractic
services at the Veteran's Administration Anthony Lisi, DC and University of
Bridgeport faculty member.
Comment: These two have
each been remarkable contributors in multiple ways: Lisi principally, lately, in
his daunting task of shaping the US Veterans Administration's inclusion of
chiropractors, and Maiers via multiple channels inside research and policy.
Announces 2015 awards
American Botanical
Council Announces 2105 Awardees
The
pioneering work of anthropologist and author Marc Micozzi, PhD, MD in integrative
health in medicine was substantial, and diverse. In the early 1990s, he
convening a federally-sanctioned program on complementary and alternative
medicine via the National Museum of Health and Medicine. He published the field's
first textbook, Fundamentals of Complementary
and Alternative Medicine in 1995 and subsequently directed the integrative
medicine program at Thomas Jefferson University. I was in touch with him
recently and asked for an update.
Fundamentals into 5th edition
Micozzi
offered that the "main thing" is the 5th edition of the textbook,
which has continuously been in print for 20 years. The edition, he wrote, will
make the case that "contemporary naturopathic medicine represents authentic and
self-conscious "integrative medicine." Never one to shy from
controversy, Micozzi states that in a new chapter he will offer his opinion
that "what is formally called ‘integrative medicine' does not in my opinion
achieve meaningful integration." The book will have forwards from former
Surgeon General C. Everett Koop, MD, George Lundberg, MD, former editor,
Journal of the American Medical Association, and Adi Haramati, MD, from
Georgetown, where Micozzi maintains an adjunct professor position. Micozzi is also working on a "concept about
offering residential Nature Cure programs at Resort and Spas." Along that line,
he will keynote speaker a 4-day educational conference at Bedford Springs
Resort, September 10-14, 2015.