Integrative Medicine, Complementary and Alternative Health and Medicine Round-up #90: April 2015

Publishes paper on economic challenges in IM

Economics
-Column Available: "Perverse Incentives and the Triple Aim: Overcoming the Troubled Path to Economic Integration for Integrative Medicine and Health"
Clinical
Erik Goldman's Fascinating Portrait, for FON Consulting, of the Cleveland Clinic's Integrative Program
Quick Links to Integrative Medicine News in Medical Systems and Communities: March 2015
Research
-Briggs Blast Over-Prescribing of Opioids and Announces NCCIH Initiative to Explore "Misplaced Fear" of Drug-Botanical Interactions
-$3-million Grant to Ottawa Integrative Center for "Real World" Look at Outcomes of Advanced Integrative Oncology
-Regarding Dugald Seely, Polarization-based Medicine Bloggers, and the Integrative "Mud Smudge of Courage"
-AANP President Pournadeali's Letter to NCCIH Requesting Increased Licensed Complementary and Integrative Practitioners on Advisory Council  
-Award of $415,000 Supports Research on Via CCNM and Toronto's Brampton Hospital on Naturopathic Care for Type 2 Diabetes
Academics
-Bastyr President Dan Church, PhD: The Natural Medicine Journal's Candid Exit Interview after His 10 Years at the Helm
-Naturopathic Mothership NCNM to Add Bachelors' Programs to Expanding Graduate Offerings

Pizzorno-Murray pioneering volume: 2-million sold

Organizations
-American Medical Student Association/ACIMH Open LEAPS Program to Students from Non-MD Fields
-IAYT Takes Next Steps in Certification Program for Yoga Therapists
International 
-John Weeks' The Global Integrator Blog Round-up for March 2015 from Global Advances in Health and Medicine
-Australian Agency: "No Good Quality Evidence that Homeopathy is Effective in Treating Health Conditions"
Miscellaneous

-The 30-Year, International Reach of Pizzorno-Murray's Textbook and Their Encyclopedia of Natural Medicine
People
-Penny George Institute's Greg Plotnikoff, MD Honored as an "Inspiring Physician" by the Minnesota Medical Association
-Tieraona Low Dog, MD Granted Herbal Insight Award by the American Herbal Products Association
-Frank Nicchi, DC, MS Honored by the Association of Chiropractic Colleges
-Loren Israelsen Receives American Botanical Council's Mark Blumenthal Herbal Community Builder Award
-Terry Lemerond Honored by American Botanical Council with Inaugural Champion's Award
___________________________

Policy

FDA: hearing announced on homeopathy

Comment Period until June 22:  FDA Calls for Comments and Announces April 20-21 Hearing on Regulation of Homeopathics

The United States Food and Drug Administration (FDA) has announced plans for a "public hearing to obtain information and comments from stakeholders about the current use of human drug and biological products labeled as homeopathic, as well as the Agency's regulatory framework for such products." The April 20-21, 2015 sessions are entitled "Homeopathic Product Regulation: Evaluating FDA's Regulatory Framework after a Quarter-Century." The FDA is inviting potential presentations and seeks written testimony from the general public by June 22, 2015. The agency's Federal Register Notice details 8 specific areas of interest. Included are an exploration of other nations' regulatory frameworks, present attitudes, data sources, and the state of information for consumer decision makers. The FDA's agenda for the hearing will be published later. Sign-up for the webcast of the proceedings will be available here.

Comment: In a longer reflection on the timing of this FDA action, I note its concurrence with the recent dismissal of the entire field of homeopathy by Australia's National Health and Medical Research Council. (See international, below.) The homeopathic field is actively organizing multiple strategies. If the FDA allows the strongest voices on the science behind homeopathy to speak, this could prove to be a truly remarkable exploration of ways of seeing, and prescribing.

Call for public comments on pain strategy

Comment Period until May 20: HHS Publishes DRAFT National Plan for Pain Care

The US Department of Health and Human Services has released a draft of its long-awaited National Pain Strategy.  HHS was charged to develop such a document in the 2011 IOM Report: Relieving Pain in America: "The Secretary of the Department of Health and Human Services should develop a comprehensive, population health-level strategy for pain prevention, treatment, management, education, reimbursement, and research that includes specific goals, actions, time frames, and resources."  Public comment is open until May 20, 2015. The report was prepared through the NIH National Institute of Neurological Disorders and Stroke. Public comments will be accepted until May 20, 2015. The solicitation is here in the Federal Register.

Make the case for early IHM

Comment:  A cursory look for evidence on integrative medicine and health players among the individuals involved on the HHS team finds no one on the core teams. Myra Christopher, the director of the Pain Action Alliance to Implement a National Strategy is familiar with and can be friendly toward integrative strategies, though closely linked to the pharma industry. Maryland's Brian Berman, MD was on the education and training team. Some pain leaders at the integrative care-friendly Veteran's Administration are also on these teams, like Rolland (Mac) Gallagher, MD, MPH, who heads Berman's group.  It is interprofessionally unfortunate that HHS didn't deign to name anyone from the distinctly licensed complementary and alternative medicine disciplines whose nearly 400,000 licensed practitioners provide the lion's share of the non-pharmacologic pain treatment.

I have yet to engage a thorough review of the document. Here are two points to hit on, in any response. But target the effort to change the therapeutic order and have non-pharmacologic approaches upfront instead of as a last resort. One is the Never Only Opioids theme. The second is the November 2014 "clarification" from the Joint Commission that elevated non-pharmacologic approaches. Any U.S. National Plan that embraces the principal of using less invasive approaches first will be a huge step in the healing directions.

Perverse incentives

Column Available: "Perverse Incentives and the Triple Aim: Overcoming the Troubled Path to Economic Integration for Integrative Medicine and Health"

When the peer-reviewed and indexed Global Advances in Health and Medicine Journal invited me to provide a regular 1500-2000 word column I took it as an opportunity to take on a series of significant themes in the field. For the March 2015 issue I reflected on the challenges in finding business alignment since the "integrative" era began 20 years ago. The result: "Perverse Incentives and the Triple Aim: Overcoming the Troubled Path to Economic Integration for Integrative Medicine and Health."  While only the abstract is available onsite, GAHMJ has given me permission to circulate a PDF of the article. Let me know if you are interested in a copy: . I'd be curious about any responses.

Comment: The article - and indeed an important piece of my own work the last two years - have focused on the potential upside of the Triple Aim era for aligning incentives between integrative health and medicine and the economics of payment and delivery. A colleague recently sent a sobering note that underscored an emerging Accountable Care Organization practice. It appears that ACOs are once again managing to twist hopes for health creation into yet another means for profit at the expense of anything in the Triple Aim - leaving us wondering again to whom these organizations are ultimately "accountable." Despite the back-sliding, I stand with my general theme that there is gold in the new alignment in the same way that one might say, on election-day, "I voted for the lesser of two evils."

Goldman: great look at Cleveland Clinic

Erik Goldman's Fascinating Portrait, for FON Consulting, of the Cleveland Clinic's Integrative Program

Holistic Primary Care editor Erik Goldman was likely the first top-flight, mainstream medical journalist, back in the early 1990s, to take the emergence of alternative, complementary then integrative medicine seriously. So his report for FON Consulting on a visit to the Cleveland Clinic to look in on its robust integrative medicine program began and ended without rose-colored glasses. Entitled Cleveland Clinic's Center for Functional Medicine: A Test Kitchen for Healthcare's Future, Goldman concludes that he "came away with the sense that Cleveland Clinic's leaders are committed to exploring the potential of true, unfettered functional medicine." Two of Goldman's comments: "If I had just one word to describe patient care at CFM, it would be ‘thorough,' with ‘unhurried' a close second." Then:

"The space allocation is small, equipment is minimal, and there's nothing present that doesn't need to be there. In essence, the sytem is designed for maximal productivity on a minimal footprint. But it is clear that it could be scaled as the need arises."

Hannaway: good start for functional outcomes

The article includes reference to Goldman's prior article "Cleveland Clinic Gets ‘Functional'" in which he speaks to the depth of the commitment to an integrative and functional model of the Clinic's "visionary" leader, Toby Cosgrove, MD. Goldman quotes functional medicine icon Mark Hyman, MD stating: "For two years [Cosgrove's] been chasing me to try to get me to come to Cleveland." Hyman is now there, part-time, and so is the Institute for Functional Medicine's Patrick Hanaway, MD.

Comment:  This is quite pleasing and fascinating read. Hanaway even notes some positive PROMIS outcomes near the end. Nice to see the Cleveland Clinic's potential in fact manifesting as the tipping point that FON's Glenn Sabin and I discussed last September in Chronicles of Health Creation: Is the Cleveland Clinic/Functional Medicine Partnership a 'Tipping Point' for Integrative Medicine and Health? Favorite bit of side-learning: Cosgrove was apparently Obama's first choice to head the Veteran's Administration.

Quick Links to Integrative Medicine News in Medical Systems and Communities: March 2015

This typically monthly Integrator feature is, for March 2015, a quick capture of highlights from the stories that flow in daily from various sources relative to "integrative medicine." Michigan, Florida, Massachusetts, North Carolina, Illinois, Ohio, Iowa, Maryland, New York, Georgia, California, Connecticut, Washington, Arizona, Maine, Indiana and Texas: here, in these states, 26 selections related to hospitals and medical organizations and integrative medicine, plus 5 from alternative and integrative medicine in community, non-system practices. (Note that Global News Links are now posted at The Global Integrator Blog for Global Advances in Health and Medicine - see related notice here. Exciting development.)

Comment: In each of the named states some integrative medicine activity surfaced in the news in March 2015. While I typically don't spend time dwelling on the Polarization-Based Medicine.com people (see note below under Miscellaneous), I do enjoy thinking how these links must each be as Lilliputian ties that bind them to the awful realization that their suppressive cause is lost.  

Briggs: great new interactions initiative

Briggs Blasts Over-Prescribing of Opioids and Announces NCCIH Initiative to Explore "Misplaced Fear" of Drug-Botanical Interactions

An article in Holistic Primary Care, NIH Center to Confront Fears of Drug-Herb Interactions, has reported that Josephine Briggs, ND, director of the NIH National Center for Complementary and Integrative Health, is "launching a major initiative to re-evaluate the reality of interactions." Why? "Misplaced fear about herb-drug interactions is keeping many practitioners from recommending potentially beneficial botanical medicines." According to HPC, the initiative will include developing "rigorous standards for herb-drug interaction testing."

Briggs announced the initiative in her talk before the annual meeting of the American Herb Products Association in early March. In reference to the potential values of herbs, presently suppressed by fears of interactions, Briggs referenced that adverse consequences of overuse of antibiotics and opioids. Of the latter: "I am ashamed of the medical profession in this regard. The overuse and inappropriate use of opioids is incredibly shocking. In certain communities drug-related deaths are exceeding motor vehicle fatalities."

Stargrove: text examines positive and negative interactions

Comment:  This is an excellent and gutsy initiative, for which Briggs should be commended. It always seemed strange if not unsurprising that fear-mongering about negative interactions marked the entrance of herbs onto the medical scene. Here's hoping that NCCIH will eventually start examining situations where integrative practitioners are intentionally using herbs to wean patients off of pharma that has a more significant adverse effect profile. (The Stargrove-McKee reference text on Herb, Nutrient and Drug Interactions explores this positive angle.) It's happening today, in integrative practices all over North America. Looking forward to that research, which many of us thought, naively, would have been on the agenda in the mid-1990s when the public funding began to pour through the NIH to explore "alternative medicine."

Seely: partnered with Standish on cancer trial

$3-million Grant to Ottawa Integrative Center for "Real World" Look at Outcomes of Advanced Integrative Oncology

A grant of $3-million to the Ottawa Integrative Cancer Center and Bastyr University will allow the examination of the outcomes when 400 individuals with advanced breast, colorectal, pancreatic and ovarian cancer to receive "advanced integrative oncology" treatment. The study will be engaged at 7 clinics across North America. These study's principal investigators are Dugald Seely, ND and Leanna Standish, PhD, ND, LAc. Standish's integrative cancer work has previously been funded through the NIH. The study will also describe the integrative therapies provided by naturopathic doctors across the seven clinics.

Comment: This is a terrific, real world study and the kind we should see more often. Notably, again, it was not funded here in the United States, but abroad, where concern is more connected to outcomes than absolutes. Great to see a U.S. player connected. Time to take a page from our northern colleagues.

The Mud Smudge of Courage

Regarding Dugald Seely, Polarization-based Medicine Bloggers, and the Integrative "Mud Smudge of Courage"

Comment: Shortly after receiving the grant noted immediately above, Dugald Seely, ND, the principal investigator and director or the Ottawa Center, was also granted the "Mud Smudge of Courage" - though not in his case for the first time. This is the name I gave the honoring of Seely by being referenced as one of the low-dog integrative scoundrels in a column one of the polarization-based medicine bloggers who operate under the April fool's title of "sciencebasedmedicine." If one doesn't feel compelled to actually read or, worse yet, respond and try to talk sense to these polarization-based operators (horrors!), one is not actually bloodied. Thus there should be no actual Red Badge of Courage. Instead, a Mud Smudge. Because as one of my mentors, Cathy Rogers, ND, taught me back in the 1980s, battling with such forces is only going to muddy you. 

Pournadaeli: letter to Briggs from AANP

AANP President Pournadeali's Letter to NCCIH Requesting Increased Licensed Complementary and Integrative Practitioners on Advisory Council  

In a letter to Josephine Briggs, MD, director of the National Center for Complementary and Integrative Medicine, Kasra Pournadeali, ND, president of the American Association of Naturopathic Physicians (AANP), expresses concern with the very low number of licensed complementary and alternative medicine practitioners on the agency's Advisory Council. (See "Going, Going, Nearly Gone" here.) In the letter, shared with the Integrator, Pournadeali writes, in part: "This is a source of concern to us. Practitioners of complementary and integrative medicine bring a strong base of clinical training as well as the understanding of patients' interests, questions, and concerns.  They are where the proverbial rubber meets the road.  AANP urges you to bear in mind Congress' mandate (in the legislation that created NCCIH) that at least half of the Council must be composed of "practitioners licensed in one or more of the major systems with which [NCCIH] is concerned." 

Comment: Excellent sign that at least one of the professions is standing up for what clearly was stated in the 1998 mandate. Here's hoping Briggs will see the merit in increasing these representatives rapidly toward the 50% mark. After all, as Briggs 2011-2015 strategic plan states, "complementary and alternative medicine practitioners are the key holders of knowledge related to the potential application of CAM intervention and disciplines." Upping these numbers from the licensed "CAM" scientists out there will be another courageous step for Briggs, like the one she is taking on drug-herb interactions (see above). Each moves away from the fear mentality that marked the first era of this mandated interprofessionalism. 

Clinical partnership becomes research partnership

Award of $415,000 Supports Research on Via CCNM and Toronto's Brampton Hospital on Naturopathic Care for Type 2 Diabetes

A clinical services connection between the Canadian College of Naturopathic Medicine (CCNM) and Brampton General Hospital has flourished into a $410,000 research exploration of naturopathic care for patients with Type 2 diabetes. According to an article on the study, the William Osler Health System will be affiliated with the study. Patients "will be offered the opportunity to participate in the clinical trial, which Osler's research team, in partnership with CCNM, will oversee." Participants from Osler's rich patient base with diabetes will be randomly selected for the active treatment group to receive naturopathic care at CCNM's Brampton Naturopathic Teaching Clinic (BNTC). The care will be delivered "in addition to their ongoing treatment." Diabetes researcher Ryan Bradley, ND, MPH is affiliated with the study.

Bradley: diabetes expert on team

Comment: One of the realities in NIH funding is that many reviewers will give lousy scores to any proposal involving naturopathic doctors because the profession is only regulated in 18 states. The logic is: How can naturopathic outcomes possibly be of national consequence? If one has no sense of the depth of the naturopathic/integrative overlap, that might be an argument one might consider that the intriguing early research of Bradley and Eric Oberg, ND, MPH and Dan Cherkin, PhD and others on "naturopathic adjunctive care" has not been advanced by funding agencies.

Great, again, to see our Canadian neighbors, and an anonymous funder, step up to explore the potential. Of course, "naturopathic adjunctive care" is likely to look a heck of a lot like "integrative medicine" and so the learning will, in fact, be very widely applicable.  Or, let's put it this way: if it shows positive, the study will be used to prove the integrative medicine model. If not, well, maybe it'll be - in that off-color Lone Ranger joke: "What do you mean we, Keemosabe?"

Church: candor in exit interview

Bastyr President Dan Church, PhD: The Natural Medicine Journal's Candid Exit Interview after His 10 Years at the Helm

"You get a couple thousand people together who are all convinced that they are changing the world and it is at once exhilarating and horrifying. The herding cats metaphor doesn't begin to touch it." This is one comment of many in a Natural Medicine Journal taped dialogue with Bastyr University president Dan Church, PhD by publisher Karolyn Gazella. On June 30, 2015, Church will leave his post after 10 years of considerable accomplishment. The interview reveals an outsider who took the job out of a desire to move back to Seattle rather than a passion for the field. He describes wrestling with "the peculiar history and ethos of the university," founded by a "passionate" group of naturopathic physicians, and how to best represent it.  He speaks to that field's "confidence and defensiveness."

In the NMJ interview, Church celebrates such milestones as the opening of Bastyr's San Diego campus and of internal, institution-shaping moments like the surprise death of co-founder Bill Mitchell, ND and the centennial of John Bastyr, ND, after whom the institutions was named.  One thought-provoking view of Church's on integration: "The MDs moved toward us more than we moved toward them." He believes the activists he represents would sometimes do better to "bite our tongues and speak collaboratively more."  A major challenge and frustration was in failing to raising the kind of philanthropic investment he would have liked. (He did see Bastyr manage to lower its tuition dependency to 72% of revenues, very good for these "CAM" institutions.) Church believes a positive legacy has been to take a somewhat "rag tag bag of people who were so passionate that they were moving forward however they could - to bring more institutional and credible trappings."

Comment:  This is a fascinating interview, at many levels. I am among the rag-tag. At times over the years I urged Church to see the institution as an agent of a movement, arguing that its graduates do not graduate into secure jobs that can readily help them shed their $200,000 of debt from their ND education. To his credit, the Bastyr that Church shepherded invested more in policy-related initiatives than perhaps any other integrative health and medicine academic institution.  Bastyr is a seven-year, ongoing Sustaining Investor in the Academic Consortium for Complementary and Alternative Healthcare and its federal policy efforts. The institution was also an early Partner in Health for the Integrative Health Policy Consortium, co-sponsoring the important 2010 Stakeholders Summit, the 2014 Harkin event, and more crucially, today, the IHPC's CoverMyCare campaign. Take a listen! Church steps down at the end of June. His successor has not been named.     

Adds new B.S. programs

Naturopathic Mothership NCNM to Add Bachelors' Programs to Expanding Graduate Offerings

The Portland, Oregon-based National College of Natural Medicine (NCNM) has announced that it will begin to offer undergraduate programs. Starting in fall of 2015, the institution - formerly the National College of Naturopathic Medicine - will offer a Bachelor of Science in Integrative Health Sciences and a Bachelor of Science in Nutrition. These add to offerings from its current schools of naturopathic medicine, classical Chinese medicine, a handful of Masters-level degree programs and the growing Helfgott Research Institute. NCNM is being guided through this growth by David Schleich, PhD, NCNM's president.

Comment:  A problem with a single purpose professional institution is that, short of a gazillionaire benefactor, the institution will always be resource-pressed to even hire much full-time faculty.  Forget about sustaining research, policy or community engagement. Over the past couple decades, a half dozen such schools have formally left their single purpose roots to become universities of integrative health and medicine: one other ND-based, 4 from chiropractic schools, one acupuncture and Oriental medicine. NCNM appears to be the next in the process of becoming a broad-based university of natural health sciences.

It is interesting, in the context of the Church interview, above, to consider the messianic fire for naturopathic care and natural medicine that Schleich brings to his work. Will this fire be doused by the necessary increase of bureaucracy that comes with size? I'll never forgot the awakening I had at age 37 when, facing a regional accreditor, I learned that the joke educators like to tell on themselves is that "no educator likes to do anything for the first time." Dashed my naiveté! Church, above, speaks to the challenge of including activist entrepreneurialism while also acting with academic credibility. How will the NCNM model mature as this growth continues?

Inviting non-MD students to IM intensive

American Medical Student Association/ACIMH Open LEAPS Program to Students from Non-MD Fields

A program that has been quietly stoking medical student interest in integrative medicine for a dozen years is the Leadership and Education Program in Integrative Medicine Tremendous (LEAPS). The program offers 30 students each year an opportunity to deeply access faculty mentors such as holistic medicine leader Bill Manahan, MD during an intensive, week-long immersion. In 2015 for the first time LEAPS will go interprofessional. Students from other disciplines are invited to apply for the June 14-19, 2015 program in Oceanside, California. Applications are due April 15, 2015. The program is offered through the Academic Consortium for Integrative Medicine and Health.

Comment: This is a terrific opening. Some take the position that it is best for MD doctors or students awakening to integrative interests to do so first among their own kind. One can see the argument. But why not lay down the first identity for "integrative" as being, well, "integrative" of all "health professionals and disciplines as the ACIMH definition puts it? Here's hoping some quality candidates sign up.

Stepwise process to certification

IAYT Takes Next Steps in Certification Program for Yoga Therapists

On March 26, 2015, the International Association of Yoga Therapists (IAYT) posted a note to members of new developments in its initiative to create a quality method for certification in the emerging field of Yoga therapy.  The notice from IAYT executive director John Kepner notes that "this continues be a work in process and our goal is to post more details about the grand-parenting avenues well before our annual membership conference." The IAYT Certification Committee will be reporting out to interested parties at the meeting of schools at its June 2015 conference. The IAYT's Certification Committee site lists 16 reasons why the certification process is moving at a pace that is slower than some would like.

Comment:  As "news," this IAYT e-blast was not much. I report it as a step in an intricate and wise roll-out process. The plodding, tortoise-like method respects that there is suspicion that lands heavy if anyone is believed to have any private agenda in such a profoundly important public and professional purpose. Transparency and process are key. It is a truism that spoon-feeding is in order when it come to the precarious, head-bumping baby-steps of profession building.   

John Weeks' The Global Integrator Blog Round-up for March 2015 from Global Advances in Health and Medicine 

In January 2015, Integrator publisher-editor John Weeks (this writer) began producing "The Global Integrator Blog" for the web portal of the exceptional Global Advances in Health and Medicine Journal. Each month, Weeks produces 7-10 posts that are gathered into a monthly Round-up with headlines succinctly delivered. For the March 2015 Round-up, included among 7 posts were: a Chinese traditional medicine group obtained WHO status; a new web resource from Norway on "CAM" regulation in Europe; a review of developments in the medicinal trade in animal (and Albino human) parts; the new Global Wellness evidence base; and 50 hot links to other developments. For February's Round-up, click here. 

Comment: Take a look if you have any global, travel or international passion. For those of you who are interested and choose to peruse this activity, or are otherwise involved globally, I invite your news items and perspectives on areas where the international movement in integrative health and medicine might become more linked and engaged. I am involved with a team at the Academy of Integrative Health and Medicine working on this. Comments and suggestions are welcome.

Finds no support for homeopathy

Australian Agency: "No Good Quality Evidence that Homeopathy is Effective in Treating Health Conditions"

The National Health and Medical Research Council (NHMRC) of Australia has published a report blandly entitled: Evidence of the Effectiveness of Homeopathy for Treating Health Conditions. The agency's release on the study is blunt: there is no "good quality evidence that homeopathy is effective in treating health conditions." The finding was based on 225 papers that met the NHMRC's controversial inclusion criterion out of a total of 1800 papers assessed. The report was picked up internationally. Some examples: ABC News ("Homeopathy Doesn't Work"), The Guardian ("Homeopathy Not Effective for Any Condition") and Al Jazeera ("Ineffective for any health condition").

In response, the U.S. National Center for Homeopathy guides its readers to a critique of the NHMRC report by the Homeopathy Research Institute (HRI). HRI notes that while they participated in the report's preparation, their questions about the study's methods were not included in the report. Was this bogus process? They question parameters of what NHMRC considered useful evidence. Their core concern is methodological: "The inaccuracy of the NHMRCs conclusions stem primarily from one fundamental flaw at the heart of this report-the NHMRC reviewers considered the results of all trials for one condition together as a whole, even though the individual trials were assessing very different types of homeopathic treatment."

Ullman:challenges inclusion criteria

Comment: These media accounts are hardly palm fronds to welcome the homeopaths to the April 20-21 public hearings by the US FDA. (See Policy, above.) According to author and homeopath Dana Ullman, MPH, CHC, acceding to the MHMRC inclusion criterion could set a nasty pattern for other natural health fields. In an e-exchange with The Global Integrator, Ullman shared that one such criterion was that studies must have "three clinical trials of 150+ subjects, each randomized, double-blind, placebo-controlled, with three separate groups of researchers." Such criteria would, Ullman opines, likely bring such flagellated by headline to acupuncture, herbal medicine, and virtually every other non-pharmacologic approach or treatment.

The historic, loose-leaf, Textbook

The 30-Year, International Reach of Pizzorno-Murray's Textbook and Their Encyclopedia of Natural Medicine

In 1985, science-based natural medicine pioneer Joseph Pizzorno, ND, and his coauthor, Michael Murray, ND, first published the Textbook of Natural Medicine. It was the first of its kind to link natural medicine as thoroughly as possible to existing scientific evidence for specific agents, therapies and conditions. The original loose-leaf binder format eventually encompassed two volumes in its 14 year run. It was meant to be responsive to the changing and already growing international evidence base. Pizzorno recently recalled for The Integrator that the Textbook in this format for 14 years "was updated 30 times with new/revised content."

Now, following 3 subsequent hardbound editions, 100,000 copies have been sold. Pizzorno credits Murray, his former student: "Most of the chapters in the Textbook were written by Murray, starting with the first edition in 1985."  Multiply those sales times 20 and one has the reaches the 2,000,000 copies sold of a consumer version the two subsequently created entitled The Encyclopedia of Natural Medicine. It's been translated into Greek, Hebrew, Italian, Russian, Spanish, and Yugoslavian. The Textbook found translators into Japanese, Italian, and Cyrillic.

Comment: It is difficult to overstate the impact of these two volumes on the growth of integrative health and medicine. The very phrase "science-based natural medicine" that Pizzorno and Murray brought forward was a striking announcement of a nascent cultural blossoming. With the twin eruptions of globalization and the internet in the 1980s, new sources of evidence were increasingly available. Today, we see many similar heavily referenced volumes and web portals. The Textbook marked a paradigm shift in thinking about herbs and other natural health approach. Science was not an enemy but an ally. (A longer version of this article was first published here.)

Plotnikoff: an inspiration

Penny George Institute's Greg Plotnikoff, MD Honored as an "Inspiring Physician" by the Minnesota Medical Association

The Minnesota Medical Association (MMA) has named Greg Plotnikoff, MD as an "Inspiring Physician." The award page notes that 25 years ago Plotnikoff was challenged by a patient to explore non-pharmacologic practices. Since then "he's been an integral part of several highly acclaimed integrative medicine programs, including the Minneapolis-based Penny George Institute for Health and Healing." The evidence of "inspiring" the MMA reported about Plotnikoff relate to his use of Vitamin D and of other functional medicine.

Comment:  Nice to see a functional, integrative medicine doctor celebrated by a state medical association and to have the organization focus on the nature of his non-regular approach to medicine in explanation of why he is inspiring.

Low Dog: herbal insight award

Tieraona Low Dog, MD Granted Herbal Insight Award by the American Herbal Products Association

In recognition of "her efforts to significantly increase and further knowledge and understanding of botanicals and their uses," the American Herbal Products Association has awarded Tieraona Low Dog, MD the AHPA Herbal Insight Award.  Low Dog is internationally-recognized for her expertise related to dietary supplements, herbal medicine and women's health. The AHPA statement notes that Low Dog has "spoken at more than 550 scientific/medical conferences, published 40 peer-reviewed articles, and written 20 chapters for medical textbooks." In granting the award, Roy Upton, founder and executive director of the American Herbal Pharmacopoeia, called Low Dog a "moving force of change."

Comment: Rare is the integrative medical doctor whose career as a healthcare professional began as an herbalist and midwife and included a long period in leadership, then directing, a program as influential as the University of Arizona's fellowship in integrative medicine program. N of 1, Dr. Low Dog.

Nicchi: honored by chiropractic colleges group

Frank Nicchi, DC, MS Honored by the Association of Chiropractic Colleges

The president of the New York College of Chiropractic, Frank Nicchi, DC, MS, has been honored by the Association of Chiropractic Colleges following 15 years of service in the organization's leadership. He has held virtually every officer role, including the presidency, overseen a strategic planning process and brought "a disciplined ‘no nonsense' style to the position," according to current president Brian McAulay, PhD. Said McAulay: "Dr. Nicchi's leadership within the ACC over the past decade has been exemplary; he provided clear direction and a strong strategic approach to the organization, moving the ACC's agenda forward in a most inclusive and productive manner."

Comment: I had the opportunity to work closely with Nicchi when he chaired the first stages of the Primary Care Project of the Academic Consortium for Complementary and Alternative Health Care. He held the space beautifully for some strong-willed leaders from four disciplines to find their way toward consensus on the outlines of a passionately engaged project.  

Israelsen: community builder

Loren Israelsen Receives American Botanical Council's Mark Blumenthal Herbal Community Builder Award

The American Botanical Council (ABC) has selected Loren Israelsen as the recipient of its 2014 Mark Blumenthal Herbal Community Builder Award. Israelsen, an attorney and policy leader since taking a position at Nature's Way in the late 1980s, is founder and president of the United Natural Products Alliance (UNPA - formerly Utah Natural Products Alliance). A release on the award notes that "Loren is one of those rare jewels that this industry is highly fortunate to have in its midst. His measured, thoughtful, and insightful approaches to the issues and challenges we face on a daily basis reinforce not only his value - but also his values - to the greater community."

Comment:  I can recall encountering Israelsen for the first time at a trade show in Atlantic City in 1986 when I was introducing around, and trying to solicit industry investment in, what is now Bastyr University. Israelsen was one of the few who immediately understood the potency of there being, for the first time, an accredited academic institution, recognized by the federal government, in which botanical medicine was part of the curriculum, closely linked to the industry for which he was already an emerging leader. He has shown such valued-based vision for the industry many times since. 

Lemerond: inaugural champion

Terry Lemerond Honored by American Botanical Council with Inaugural Champion's Award

Terry Lemerond, founder and president of EuroPharma, is the recipient of the American Botanical Council's (ABC) inaugural Champion Award.  The award was created to recognize an individual or who has been an outstanding supporters in the achievement of ABC's nonprofit educational mission. Lemerond founded and owned Enzymatic Therapy and PhytoPharmica which he sold in 2000 before founding EuroPharma, and its sister company for professionals, EuroMedica.  Blumenthal spoke of Lemerond's extraordinary and ongoing support of ABC's mission.

Comment: An interesting coincidence is news of this award and the note related to Michael Murray, ND above. Murray worked closely with Lemerond to popularize standardized extracts. Lemerond was also an early financial investor in the growth of Bastyr.