Integrative Medicine, Complementary and Alternative Health and Medicine Round-up #91: May 2015
Written by John Weeks
Integrative Medicine, Complementary and Alternative Health and Medicine Round-up #91: May 2015
Policy
-YOUR PERSPECTIVES NEEDED: Comment Periods End for NCCIH
Research Strategy (May 18) and HHS Pain Strategy (May 20)
-HHS Shuns Congressional Intent on "Non-Discrimination in
Health Care" and Refuses to Clarify Position
Congressman Ryan: nutrition in medical schools
-PETITION:
Congressman Ryan, Hyman, Promoting Measure to Force Nutrition Education in
Medical Schools
-Change from the
Inside Out: Berwick Group's Pushes New Delivery Principles "Beyond the
Triple Aim" Economics
-Health Creation
Economics: IHPC Publishes Cost-Effectiveness Booklet
-Integrator Columnist Michael Levin: How
$2.00 of Vitamin C Can Save Thousands of Dollars for Patients Following Cardiac
Surgery Research
-Bravewell Publishes Promising Results of PRIMIER
Practice Based Research Network in IM
-Where the Rubber
Meets the Road: AANMC, AANP and
ACCAHC Urge Interprofessional Make-up of NCCIH Advisory Council
-Oregon's
Interprofessional and Interdisciplinary OCIM Hosts June 2015 SPARC Conference;
Sternberg Featured
-$4.5 Million in Templeton Grants to Fund Research
Literacy for Hospital Chaplaincy Integrative Delivery
-Four Major Delivery Systems Contract with Healthways for
the Ornish Heart Program -Quick Links to Integrative
Medicine News in Medical Systems and Communities: April 2015 Integrative Academics
-Duke Leadership in Integrative Medicine Program Strikes
up Deal with Today's Practitioner
-Two Presentations from Integrative Health and Medicine
Academic Programs and Bridgeport and Arizona Featured at an IOM Forum
-Can a Naturopathic Degree Be a "Bridge" for an
International Medical Graduate?
-New England School of Acupuncture to Combine with MCPHS
University
-American College of Traditional Chinese Medicine to
Merge with CIIS
James Gordon: Gaza program on 60 minutes
-Commission on Massage Therapy Accreditation (COMTA)
Initiates "COMTA-endorsed Curriculum Status" Program Organizations
-60 Minutes Features James Gordon's Center for MindBody
Medicine's Gaza Work in "Lessons of War"
-New Website of Consortium of Academic Centers Announces
Organization as "Collective Voice"
-Sutter Health Systems Joins Academic Consortium for
Integrative Medicine and Health -AIHM Portrayal in
IMCJ Interview with Executive Director Nan Sudak, MD -GAHMJ Special
Report: Foundational Work of the National Consortium for Credentialing Health
and Wellness Coaches International -The Global Integrator Blog
Round-up for April 2015 from Global Advances in Health and
Medicine Miscellaneous
-Harmonic
Emergence? The Late 1970s Birth of
the Organized Movement for Integrative Health and Medicine People
-Meg Jordan, RN, PhD in Co-Presidency of the National
Wellness Institute
-Honoring Dan Cherkin, PhD in His (Partial) Retirement
and New Consulting
____________________________________
Policy
Public comment period ending
YOUR PERSPECTIVES
NEEDED: Comment Periods End for NCCIH Research Strategy (May 18) and HHS Pain
Strategy (May 20)
For policy ideas for the NCCIH you might consider
perspectives from the most recent strategic planning process of the organizations
reported here in the IntegratorStakeholder Organizations on
NCCAM's Strategic Plan: IHPC, ACCAHC, AHMA, AANP, IAYT, NCH, AANMC and MTFand
here in the IntegratorNCCAM Strategic Plan:
Positions of CAHCIM (MD/IM academics), CRN (supplements) and AMTA. (massage),
plus. On the positive side, the NCCIH is presently
moderately better focused on the "real world" and on pain conditions, and, for
instance, has engaged with the military. In addition director Josephine Briggs,
MD has announced interest in an excellent initiative to take on the paranoia
surrounding herb drug interactions. At the same time, NCCIH is increasingly
less interprofessional and less likely to provide any grants to any institution
that
Comment: These
are opportunities to participate in two processes under the U.S. democracy. I
come from the school that says voting - in this case making one's voice heard
through public comments - gives one the right to complain. Celebrate what you
like in these agency's work and ask for more of it. Then participate, if for no
other reason than to have no hitch in your Chakra's when you lay down a
diatribe against some policy with which you disagree in the future. Who knows,
maybe there will be ears to hear. The only thing known for sure is that if you
don't participate, you might as well be living under another kind of
governmental structure.
HHS sticks with discrimination
HHS Shuns Congressional
Intent on "Non-Discrimination in Health Care" and Refuses to Clarify Position
In an April 24, 2015 e-mail made available to the Integrator by Mike Jawer of the American Association of Naturopathic Physicians
(AANP), the US. Department of Health and Human Services effectively told those
following "non-discrimination in health care" (Section 2706) that HHS will not,
anytime soon, abide by the law. The background, captured in this
article, relates to Section
2706 Non-Discrimination in Health Care of the Affordable Care Act. More
precisely, HHS's silence is connected to a subsequently published statement by the
agency that dismissed Congress' intent in their 2013 publication of Affordable Care Act Implementation FAQs -- Set 15. More specifically, at stake is a US Senate retort
to HHS in a July 11, 2013 committee report that told the agency "to
correct the FAQ to reflect the law and congressional intent." The Senate
requested the response from HHS by no later than October 2014.
On behalf of the AANP, Jawer had asked a
representative of CMS to clarify current activity on the issue. A team from the
AANP had met with HHS in October of 2014 on the issue. He also asked if a CMS
representative might meet with naturopathic doctors and students at an early
May 2015 DC-FLI "lobby day" for the profession in D.C. The response came
from Jim Mayhew.
Mayhew is director, Division of Regulations and Policy,
Office of Oversight, Center for Consumer Information and Insurance
Oversight of the Centers
for Medicare & Medicaid Service. He wrote to Jawer: "Many thanks for reaching out
to us. Unfortunately, no one is available on May 4th for a meeting. Furthermore, we
have nothing new to report since October in terms of publicly available
information. We're continuing to work on issues related to section
2706 with our colleagues at Labor and Treasury and also with State regulators. Best
regards, Jim Mayhew."
What would Dr. King advise?
Comment:
Dear Dr. King. We have nothing new
to publicly report on your desire to sit in the front of the bus where I do or
to be able to get a cup of coffee where I enjoy my coffee and newspaper. We're
continuing to work with the owners of the bus lines and coffee shops. Best
regards.
Integrative
health and medicine's main advocate, former US Senator Tom Harkin, who has
pushed HHS to respect Congressional intent, is retired to Iowa. One wonders if
anything will move the agency short of a Big Honking Lawsuit. This continuing discrimination is
harmful, to individuals, and to the public health. Good for the AANP to be
remaining on this. What is the next step?
Hyman: partnered with Ryan on nutrition effort
PETITION: Congressman Ryan, Hyman,
Promoting Measure to Force Nutrition Education in Medical Schools
A note reached the
Integrator via integrative cardiologist Mimi Guarneri, MD from author and
functional medicine advocate Mark Hyman, MD. "I need your help on something,"
wrote Hyman. "I have helped Congressman Tim Ryan introduce the ENRICH
ACT into Congress to fund nutrition education in medical school! We need to get as many signatures on the
petition now to get this passed!" The petition is here. A supportive article from the Bi-partisan
Policy Center is "The
ENRICH Act will provide better tools to fight obesity" and it provides a
good overview of key points - which also include adding physical activity
content.
Comment: I
believe it was 2007 when the first report came out in the United States
suggesting increased nutrition in medical schools. This is the most recent
attempt to get medical education to be evidence based in this fundamental area.
I signed and posted via Facebook. Doesn't take much. Good luck Congressman Ryan
- who by the way is, yes, the same fellow who has been a strong advocate of meditation
and the mind-body connection. Nice work from Dr. Hyman, himself a warrior
against poor nutrition, obesity and diabetes .
Berwick: most recent initiative
Change from the Inside Out: Berwick
Group's Pushes New Delivery Principles "Beyond the Triple Aim"
The most progressive forces in U.S. medicine have signed
on and are promoting a new strategy for medicine and health in the United
States. In a recent issue of the Journal
of the American Medical Association, Institute for Health Improvement
co-founder and former Center for Medicare and Medicaid Services administrator Don
Berwick, MD published Change
from the Inside Out: Healthcare Leaders Taking the Helm. They declare a set
of eight principles including: "Cooperate and
collaborate, above all. Eliminate silos and tear down self-protective
institutional and professional boundaries that impede flow and responsiveness."
Another: "Move knowledge, not people. Exploit all helpful
capacities of the modern digital age, and continually substitute better
alternatives for visits and institutional stays. Meet people where they are,
literally."
The printed word gathers gravitas with the simultaneous
publication of a list
of a score of voluntarily participating major delivery organizations. A
Wisconsin member posts a blog
on the subject of their membership that includes: "Our efforts to
improve population health and lower cost are not aligned with how government
pays us for services - but we cannot wait for government to fix the health care
system or wait for what happens with the Affordable Care Act." Berwick is
saying that this goes well-beyond the Triple Aim - and in multiple ways focuses
on de-institutionalization.
Berwick's base for the initiative
Comment: The process of "integration" assumes there is
a "here" and a "there." The principles to shape regular medicine described in
this article are the most attractive yet to emerge when viewed through the lens
of the values set of integrative health and medicine. My reading is that this
is the action step that Berwick developed for the 30-year march he articulated
in his December
2013 speech to health system leaders.
There he dwelled deeply on the "more radical than we have imagined" concepts
of "health creation" and "salutogenesis." Berwick explained that he had become
enamored through mentorship from the likes of integrative health leaders
Herbert Benson, MD, John Kabat-Zinn, PhD and above all and Wayne Jonas,
MD. The JAMA principles are an opportunity to white board the values
alignment and points of optimal intersection, support and alignment between
"here" and "there" to create a health care system out of our medical industry.
To paraphrase that visionary Buzz Lightyear: To
the Triple Aim and Beyond.
Economics
Key cost document
Health Creation Economics: IHPC Publishes Cost-Effectiveness Booklet
The title of the long-awaited 16-page is "Integrative
Health and Medicine: Today's Answer to Affordable Healthcare." The
subhead is: "Health Creation Economics." The top-flight author trio is Erica
Oberg, ND, MPH, RAND Corporation economist Patricia Herman, ND, PhD, and former
integrative cardiologist and present president of the Academy of Integrative
Health and Medicine Mimi Guarneri, MD. The sponsor is the Integrative Health Policy Consortium (IHPC). The
author team also includes sometimes Integrator
columnist and IHPC's CoverMyCare
manager Taylor Walsh and IHPC's executive director Alyssa Wostrel, MBA. The
booklet is handsome, easily scan-able, and meant for use in policy
environments. The cover lists the following organizations for their backing of
the project: Miraglo Foundation and
the Taylor Advised Endowment Fund for Integrative and Holistic Medical
Education and Research, and Emerson Ecologics.
Oberg: lead author
Comment: This
is a great tool that, after all of the work and investment, threatens to gather
dust in the woods with no one there to use it and read it if work is not done
to raise its visibility and get it into the right hands. There does not appear
to have been a media release yet by IHPC, for instance. I know from posting it
on a couple of organization sites with which I am involved that its gets good
play when it is made visible. Here's hoping that an outreach campaign will be executed. Circulate
it!
Levin: savings via sups
Integrator Columnist Michael Levin:
How $2.00 of Vitamin C Can Save Thousands of Dollars for Patients Following
Cardiac Surgery
Integrator columnist Michael Levin has a passion for righting the
failure of regular medicine to optimally use vitamins and other natural agents
as cost savings tools. On April 23, 2015 he sent the Integrator a link to a review article entitled "Vitamin C Aids Recovery from
Cardia Surgery." Levin referenced the original research and synopsized: "The group that got the vitamin C
(as ascorbic acid) had significantly less atrial fibrillation (a-fib), less
intubation time, and less of what the authors dubbed ‘significant
complications' which included ‘death, any infection and any impairment in
the renal function.' Those who received vitamin C stayed approximately
two days less in the hospital, likely due to the lower complication rates."
Then he opined: "So, is vitamin C routinely used in
cardiac surgeries? Far from it. Of course, one study does not a standard
of care make. However, delving into the literature I found there are many other
studies that show this simple intervention consistently lowers atrial
fibrillation after cardiac surgeries and shortens hospital stays. [Note: there
review also references multiple.] One meta-analysis that included 23 studies on
various antioxidants around the time of cardiac surgery found the average
reduction in a-fib was 50% for those taking vitamin C. If a drug were invented
with such a measurable benefit, would the FDA approve its use? Seems
likely, but of course, vitamin C is not patentable so this is conjecture." He
adds: "Nothing is risk free, but vitamin C in these moderate doses comes darn
close to it. That said, why isn't it standard
of care? If the simplest answer is usually the right answer, then
it may just be that no one is really looking at the data."
Comment: This
looks a good place for a front-runner like the Cleveland Clinic, with its
functional medicine program, to work on getting engagement with their
cardiologists. This may be enough of a no-brainer to bring into any cardiology
setting. Who loses on this?
Research
Bravewell: real world outcomes
Bravewell
Publishes Promising Results of PRIMIER Practice Based Research Network in IM
On April 30, 2015 the Bravewell Collaborative of
philanthropists in integrative medicine published a report on outcomes of one
of its legacy projects. The report is entitled PRIMIER: A
National Integrative Medicine Database.
The data in the Patients
Receiving Integrative Medicine Interventions Effectiveness Registry (PRIMIER)
show that the "use of integrative medicine interventions leads to significant
improvements in patient activation and patient-reported outcomes in the
treatment of chronic pain, depression, and stress" according to a release on the project. One outcome: over six months, the
percentage of patients with low levels of patient activation decreased from 29
percent to 17 percent, while those with higher levels of activation increased
from 71 percent to 83 percent. The outcomes were created through the BraveNet practice-based
research network that is coordinated through the Albert Einstein College of
Medicine of Yeshiva University. The lead author of the report is UCSF Osher's
Donald Abrams, MD.
Comment: Whatever the hopeful expectations for the PRIMIER program were there at
its outset, this report is a good beginning on outcomes. The findings nestle in
nicely with the Patient Experience database of reports gathered through the Project for
Integrative Health and the Triple Aim (PIHTA) at the Center
for Optimal Integration: Creating Healthdirected by Jennifer Olejownik, PhD.
Briggs: urged toward interprofessional
Where the Rubber Meets the Road: AANMC, AANP and ACCAHC Urge Interprofessional
Make-up of NCCIH Advisory Council
Separate letters to Josephine Briggs, MD, from three
organizations have urged the director of the National Center for Complementary
and Integrative Health to take an interprofessional approach in her
recommendations for membership on the agency's advisory council. In a March25,
2015 letter from the American Association of
Naturopathic Physicians (AANP) and shared with the Integrator, Kasra Pournadeali, ND, noted that soon just one of the
Council's 18 members "will be affiliated with an organization representing
licensed professionals within the field of complementary and integrative
health." Pournadeali adds that practitioners from "complementary and
integrative medicine bring a strong base of clinical training as well as the
understanding of patients' interests, questions, and concerns." They are, he
added "where the proverbial rubber meets the road."
Yanez: AANP letter to Briggs
An April 3, 2015 letter from JoAnn Yanez, ND, MPH,
executive director of the Association of Accredited
Naturopathic Medical Colleges (AANMC) and also made available to the Integrator similarly urges Briggs to
widen the pool of those she recommends. "Not only do the licensed
represent the majority of practitioners prescribing the modalities and
therapeutics NCCIH is tasked to review," Yanez writes, adding: "How better to
fulfill the Congressional mandate of half of the Council being composed of
practitioners licensed of one or more of the major systems with which NCCIH is
concerned." (See Integrator Guide: NIH NCCAM's
Mandate: 1998 Congressional Enabling Act.) The Academic Consortium for
Complementary and Alternative Health Care (ACCAHC) has also submitted a letter
that included CVs of 15 candidates. ACCAHC has an observer on a task force on
the subject convened by the Integrative Health Policy
Consortium (IHPC), and headed by Erica Oberg, ND, MPH, with which this
writer is also participating.
Submitted 15 CVs
Comment: While
I'd bet my house that the NCCIH is wrong in asserting that a medical doctor who
uses herbs is "licensed in one or more of the major systems with which NCCIH (was)
concerned" when the mandate was passed in 1998, I increasingly view this
excision of whole disciplines from NCCIH process as a major interprofessional
blunder by Briggs and the agency. The documentable retraction of the membership
back to the NIH's default of MDs and PhDs from conventional academic health
centers runs contrary to the movement coursing through U.S. healthcare toward
teams, and to multidisciplinary and interprofessional activity. We are all more
richly served with more rather than less diversity in the intelligence at the
table. Sources say that Briggs may have plans to nominate at least two others from
these licensed fields this fall. These are good steps in the right direction.
To have 3/18 (17%) is better than 1/18 (6%). Why not head toward the mandated 9/18
(50%) to create a robust dialogue of ideas, perspectives and, most importantly,
clinical experience, on the NCCIH Council?
As the I Ching puts
it: It furthers one to cross the great
water.
Annual research conference
Oregon's Interprofessional and
Interdisciplinary OCIM Hosts June 2015 SPARC Conference; Sternberg Featured
One of the
great interprofessional engagements in integrative health and medicine, the
Oregon Collaborative for Integrative Medicine (OCIM - pronounced "Awesome") has
announced the 2015 SPARC Conference. A note to the Integrator from OCIM director Samantha
Simmons, MPH, shares that the keynote speaker is Esther Sternberg, MD. Her topic: "Brain Immune Interactions: The Science of the
Mind-Body Connection & Implications for Health." OCIM consists of the
University of Western States (chiropractic), Oregon College of Oriental
Medicine, National College of Natural Medicine (naturopathic base), Oregon
Health Sciences University (MD medicine, plus) and University of Pacific
(optometry and other allied health). The program includes
posters and multiple other presentation.
Comment:
Check the member page at OCIM. The initiative is an
enduring model of interprofessionalism. The OCIM mission: "Providing leadership
in advancing integrative health through collaborative education, research,
patient care and advocacy for the benefit of patients."
Exidence in chaplaincy
$4.5 Million in
Templeton Grants to Fund Research Literacy for Hospital Chaplaincy
The John Templeton
Foundation will provide two grants to Rush University and Brandeis University
totaling $4.5M over four years "to better equip hospital chaplains to use
research to guide, evaluate and advocate for the spiritual care they provide"
according to this
release. The project, entitled "Training Research-Literate Chaplains
as Ambassadors for Spirituality and Health" was developed to "close the
gap between hospital chaplains' current limited research literacy and the
importance of evidence-based care for all members of the health care team." The
grants will focus in two areas: advanced education for a cadre of leaders, and introducing
evidence concepts more deeply into recognized chaplaincy training programs.
Comment: Years ago when I did some hospital consulting
in integrative health I often found myself thinking that there was interesting
theater potential between the Sisters who frequently retained me and the (male)
medical directors who weren't always happy they did. Given the growing
scientific support for the mind-body connection - thanks in part to the National
Center for Complementary and Integrative Medicine -- this rendering unto
Caesar by these chaplains, by bowing to medicine's evidentiary priorities, will
likely empower these spirit guides in hospitals and health systems. Good timing
for the grants!
Integrative Delivery
Growing partnership with Ornish
Four Major
Delivery Systems Contract with Healthways for the Ornish Heart Program
This April
20, 2015 media release announces that Beacon Health System, South Bend,
Indiana, ‘Ekahi Health System in Honolulu, New Jersey's Hunterdon Medical
Center and Jacksonville's St. Vincent's HealthCare are the latest to partner
with Healthways to deliver Dean Ornish,
MD's Program for Reversing Heart Disease.. Healthways and Ornish
joined forces in 2013. Since then, 17 hospitals and health systems have added
the program to their "roster of treatment options for heart disease patients."
Ornish: expansion of his service
Comment: At a
time nearly 15 years ago time when Ornish believed he was about to gain
Medicare coverage of his program, he partnered with the Highmark Blues plans in
a venture called Lifestyle Advantage to roll the program out nationwide. His
lead there was a remarkable health promotion leader named Anita Silberman. Silberman
had gathered data at Highmark that helped make the Ornish program's case. We
were all excited: quality evidence, a major insurer partnership, cash to
support the roll-out. Then Medicare's approval was delayed - until 2011. Even more significantly, it turned out almost
no cardiologists around the country were willing to go to bat inside their
health systems to introduce the program. In those fee-for-service economics,
success with Ornish's approach would limit the need and payment for stents and
coronary artery bypass grafts. Lifestyle Advantage died. Now, under the
Affordable Care Act, and in this era of bundled payments, accountable care and
creeping capitation, it would be useful to know just how much the recent uptake
is linked to new payment incentive schemes.
Quick Links to Integrative
Medicine News in Medical Systems and Communities: April 2015
This typically monthly
Integrator feature for April 2015, a quick capture of highlights from the
stories that flow in daily from various sources relative to "integrative medicine."
A couple of themes and events that showed up significantly in April were the
controversy surrounding the efforts of Columbia medical school faculty to oust
TV celebrity Mehmet Oz, MD - and his work against them -- and the April 20-21,
2015 FDA hearings on homeopathy. Here are fifteen quick links from IM in health
systems and seven from the community.
Integrative Academics
Duke Leadership in
Integrative Medicine Program Strikes up Deal with Today's Practitioner
The Duke
Leadership Program in Integrative Medicine has announced that it has a media
partnership with Today's Practitioner
through which it will post information on business models and strategies on a leadership
site of the online publication. The web portal presently includes content
mostly from Duke's leadership program director Adam Perlman, MD, MPH. Today's Practitioner describes the
"content partnership" this way: "The Leadership Program in Integrative
Healthcare will share key aspects of Integrative Leadership, integrative business
strategies and the art of cultural transformation."
Comment: Nice
to see this town-gown collaboration between the academic center and a media
channel for a broad array of integrative content that is culturally based in
the practicing, non-academic community.
Brett: IOM talk on Bridgeport program
Two Presentations
from Integrative Health and Medicine Academic Programs and Bridgeport and
Arizona Featured at an IOM Forum
The subject of the two-day workshop at the National
Academy of Medicine (formerly Institute of Medicine) was "Envisioning
the Future of Health Professional Education." Among subjects featured were six 8-minute examples
of forward thinking academic initiatives. Two of the six came from the
integrative health and medicine community. Jennifer
Brett, ND, LAc who directs integrative clinics at the University of
Bridgeport provided a concise look at an interprofessional engagement at the UB.
The elective involves students in chiropractic, naturopathic medicine,
acupuncture and dental hygiene including some outcomes. The segment is archived
here. In addition, Elizabeth
A. Goldblatt, PhD, MPA/HA, a member of the leadership advisory team for the
Health Resources Services Administration (HRSA)-funded National Center for Integrative Primary Healthcare
(NCIPH) at the University of Arizona Center for Integrative Medicine
described core traits of this $1.7-million interprofessional collaboration. Goldblatt's
presentation is archived
here. The workshop is part of the NAM Global Forum on Innovation in Health
Professional Education that involves councils of colleges for virtually all
health professional disciplines. The Goldblatt and Brett presentations were
recruited by forum member Academic Consortium for
Complementary and Alternative Health Care.
Goldblatt: IOM talk on U Arizona progam
Comment: At
some point it will no longer seem a win for integrative health and medicine to simply
be present in such a forum. Not yet though! Each presentation is a terrific
example of representing forward thinking
in interprofessional practice. One is based
in an extended MD environment (U Arizona) and the other rooted in the non-MD intersection
(U Bridgeport) of other distinctly licensed integrative disciplines. Those who
open either link will discover a familiar face introducing the speakers. The
rest of the Forum
video content is here.
CCNM: progam for internaitonal medical doctors
Can a Naturopathic
Degree Be a "Bridge" for an International Medical Graduate?
In May 2015 Canadian College of
Naturopathic Medicine will graduate the first students of a unique program
for international medical graduates. The 24 month course allows immigrants who
arrive in North American with degrees in medicine from abroad, and who meet
critical standards, to convert their careers from regular medicine in their
home country to naturopathic medicine in North America. This article
on the program describes the standards and includes musings from this
author on what the imported MD might think of the new naturopathic medical
universe.
Comment: Most of us have the experience of
encountering an immigrant in a job as cab driver or parking attendant who, one discovers,
was a professional back home. Yet due to some regulatory hurdle he or she
cannot practice here. It will be intriguing to see how many of these international
medical graduates who become CCNM students agree with the CCNM assertion that
practicing as a naturopathic physician may in fact be a good deal more like
their practices in their native countries than to participate as an MD in the
medical industry here.
Merging with local university
New England School
of Acupuncture to Combine with MCPHS University
The nation's oldest acupuncture school, the New England
School of Acupuncture (NESA) has "agreed
to combine" with MCPHS University, formerly known as Massachusetts College
of Pharmacy and Health Sciences. The decision, described
here, is presented by NESA
president Susan Gorman as having "great opportunities for the NESA
community as we would become part of a vibrant university, widely known for its
programs in health sciences education." The school has been seeking a strategic
partner for many months "to help us reach our strategic goals of strengthening
our academics, building enrollment, promoting research, and advocating for
our profession." MCPHS University, founded
in 1823, has 7,000 students on 4 campuses Boston-area campuses and online with
65 programs including nursing, pharmacy, optometry, physical therapy, physician
assistant, medical imaging and therapeutics, and premedical health studies.
Merging with CIIS
American College
of Traditional Chinese Medicine to Merge with CIIS
San Francisco-based American
College of Traditional Chinese Medicine (ACTCM) has merged with the
California Institute of Integral Studies (CIIS). An intent was published
June 2014. Implementation of the merger
will begin as soon as necessary approvals are granted. In a note to the
Integrator, Meg Jordan, PhD, RN, dean of integrative studies for CIIS, shared
that CIIS will then
have four schools: School of Consciousness and Transformation (women's studies,
gender studies, philosophy, anthropology, etc); School of Professional
Psychology and Health (five masters of counseling psych degrees and a PsyD in
Clinical Psych and M.A. in Integrative Health); and now a School of Traditional
Chinese Medicine. The merging allows the School of Chinese Medicine to launch a
first professional doctorate in AOM. CIIS has held regional
accreditation since 1981. The combined financials are expected to be in place
at the start of CIIS's fiscal year beginning July 1, 2015.
Comment: The
news pairs with the NESA merger above. In each case the single purpose school
is partnering with a program that has regional accreditation. The status and
the multidisciplinary environment the merging creates offer a great deal more
opportunity for research and foundation support, as well as base for interprofessional
learning and community presence. Good moves! Notably, neither partner has a
school of medicine. In an e-mail exchange, Jordan offered two examples of value
in the ACTCM-CIIS move: "I
just taught health coaching to acupuncture students for the first time, and our
non-clinical integrative health studies M.A. students are assisting the
Director of Integrative Medicine at SF General Hospital Rick McKinney, MD, in
establishing a first-time outpatient acupuncture clinic for pain relief.
"
COMTA: innovative program
Commission on
Massage Therapy Accreditation (COMTA) Initiates "COMTA-endorsed Curriculum
Status" Program
The accrediting agency for massage schools, the Commission on Massage Therapy Accreditation, has
come up with a unique program to extend its positive influence in the realm of
massage education. The COMTA-endorsed
Curriculum Status respects the financial burden of accreditation for the
typical massage school. The new status examines only the adequacy of the
curriculum and the faculty rather than the full range of standards needed for
full programmatic accreditation.
Comment: COMTA's is an agile response in a tough
environment in which over 1400 programs exist yet COMTA presently accredits
less than 100. (Some others may have status with a separate agency that has no
focused expertise in massage.) Smart move for the agency, and to give credit to
those schools who can guarantee prospective students and the public that they
meet some agreed upon educational standards.
Organizations
Features Gordon's Gaza work
60 Minutes
Features James Gordon's Center for MindBody Medicine's Gaza Work in "Lessons of
War"
On May 3, 2015 CBS 60 MINUTES featured the work in Gaza
of James Gordon, MD and Center for Mind-Body Medicine in on a 13 minute segment
entitled "Lesson of
War." Gordon, a Georgetown
University-affiliated psychiatrist, is the former chair of the White House
Commission on CAM Policy. He appears at minute 5:13 working separately with
both Palestinian and Israeli children whose psyches have been war-torn. An
estimated 20% of Palestinian children have experienced the death of a relative
and 40% some form of PTSD. Gordon and his team work with drawing and other
tools to help children visualize other futures than, for instance, the stick
figure drawn by one with a suicide bomber belt around his waist.
Comment: This
is a powerful, affecting segment with some glimmers of individual hope.
Gordon's trajectory as a professional has been fascinating, from being a very
holistic MD with an academic appointment at a prestigious school, then
influential author, and now a healing activist in Bosnia and Gaza and other
places. Wonderful how he has created ways to use his tools to help influence
the health of populations in the toughest of situations. Thanks, Jim
Consortium in new website
New Website of
Consortium of Academic Centers Announces Organization as "Collective Voice"
Open the new website of the 64-medical school Academic Consortium for
Integrative Medicine and Health (ACIMH), the former CAHCIM, a.k.a. "The
Consortium") and one is greeted with a bold welcoming statement: "The Consortium is a collective voice for
influencing and effecting change within integrative health." Below that is the
aspirational self-appellation: "Pioneering. Visionary. Integrative." A somewhat
truncated "History"
focuses largely on its origins 15 years ago - a good story for those unaware. A
Fact
Sheet provides a little more information. A closer read shows that the main
"collective" of interest is its member organizations, academic health centers.
Comment: This
consortium has a powerful opportunity to lead as its members did in helping
change the Joint Commission pain standard. (See Joint
Commission Issues New Pain Standards in Response to Integrative Medicine Team.) And this sort of initiative is clearly not
only for "effecting change within
integrative health." These Consortium member as doing so within U.S. health
care, period. At the same time, the organization walks an interesting line. By
membership requirements, only regular academic health centers can join. So the
"collective" it represents is a narrow band of all of those professions,
stakeholders and interests in "integrative health." So, here's to more of the
ACIMH's exciting recent commitment to collaboration and partnership such as it
is showing through its partner base in the International
Congress for Integrative Medicine and Health. Finally, an editorial suggestion. Why not
"The Consortium is a collective voice for influencing and effecting change through [vs. "within"] integrative
health."
Sutter Health
Systems Joins Academic Consortium for Integrative Medicine and Health
Comment: The move by ACMIH a few years back to include health systems as well
as academic health centers as members clearly has been valuable for revenue
generation as Bravewell's founding financial backing was pulled back. However,
the two types of membership allow ACIMH to move to the front of the class in an
area of major interest in all of health professional education; that is, better
connecting the academy and the real world of healthcare delivery in the community.
For instance, how does integrative care dovetail with accountable care? How
does it fit best with patient centered medical homes? The Clinical Working Group page notes
a focus on creating "information and strategies regarding clinic
administrative structures, credentialing, privileging, operational issues,
billing, and insurance" - a step in the right direction. It is not clear from the ACIMH website
whether any targeted programs meant to cross the academic-delivery divide are
in the works.
Sudak: AIHM's vision and early action
AIHM Portrayal in IMCJ Interview with Executive Director
Nan Sudak, MD
Integrative
Medicine: A Clinician's Journal chose to devote significant space to a
portrait of the new kid on the block, the Academy of
Integrative Health and Medicine (AIHM). The vehicle is an interview with
AIHM executive director Nan Sudak, MD entitled "On
Unifying the Voices of Integrative Practices." The piece documents AIHM's
origins as a re-unification of two holistic and integrative mainly MD groups,
and also speaks to AIHM's direct efforts to expand its circle. Partnerships
with the Integrative Health Policy Consortium and the Academic Consortium for
Complementary and Alternative Health Care are described. Sudak notes that AIHM's reach and influence
is intended to be international. The membership ranges from individuals to
organizations to consumers.
Comment: AIHM's is an incredibly ambitious agenda. As
noted above, I serve on the AIHM Board. I can only say that any ride that
promises to go as wide as global and as deep as forming full, trusting
partnerships between professions that have mistrusted and misunderstood each
other for decades if not centuries, well, there are no dull moments!
Key resource on health coaching
GAHMJ Special Report: Foundational Work of the National Consortium for
Credentialing Health and Wellness Coaches
The Special
Report in Global Advances in Health and
Medicine Journal is entitled National Training and Education
Standards for Health and Wellness Coaching: The Path to National Certification. The work documents the foundational efforts of
an ad hoc group that formed within months after the passage of the Affordable
Care Act suggested an important place for health coaching in the new system.
The report, written by coaching pioneers at California Institute of Integral
Studies, Duke, Harvard and U Minnesota, documents the emergence of the National
Consortium for Credentialing Health and Wellness Coaches (NCCHWC) and two principal activities: "(1)
to announce the findings of the job task analysis [for health coaches] as well
as national training and education standards for health and wellness coaching
(HWC) that have been developed by the large-scale, collaborative efforts of the
National Consortium for Credentialing Health and Wellness Coaches (NCCHWC) and
(2) to invite commentary from the public." A grant from Aetna supported the
report development.
Comment: In so much of the transformative
work in U.S. medicine I am reminded of a Biblical phrase taught me via the
social gospel Protestantism (United Church of Christ version) in which I was
raised: the first shall be last and the last first.
A medical industry targeting acute conditions, disease reactivity and ectomies pedestals the specialist and leaves
health coaches utterly off their totem pole. Why didn't we have these team members or these competencies ingrained in
multiple other professional groups all these years? Build a system of health
creation, however, and these coaches and community health workers are the foundation.
Good to see this labor mainly of love, reach this stage.
International
The Global Integrator Blog
Round-up for April 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 Global Advances in Health and Medicine
Journal. Each month, I
produce 6-10 posts that are gathered into a monthly Round-up. For the April
2015 Round-up, the 6 posts are: Acupuncturists
without Borders Responds to Nepal Earthquake; Traditional Medicine in Universal
Health Care: The Powerful Perspective in the WHO Strategic Plan; India Report:
Announcement of Department of AYUSH Promotes Flurry of Activity; British Official Acts against Public, WHO, Prior
Recommendations, and Will Not Regulate Herbalists; Quick Links to Global News
in Traditional, Alternative, and Integrative Health and Medicine for March 2015;
and The Remarkable International Reach of Pizzorno-Murray's Textbook and
Their Encyclopedia of Natural Medicine. Click in here for the March 2015 Global
Integrator Round-up.
Comment: If
any of you have not poked into the WHO Traditional Medicine Strategy 2014-2023
take a look
at this short summary piece. Fascinating document. Comments and suggestions
are welcome.
Miscellaneous
What he said
Harmonic Emergence? The Late 1970s Birth of the Organized
Movement for Integrative Health and Medicine
Comment: I recently had a call from a colleague who
was recently asked to deliver a course on the history of integrative health and
medicine. I shared one of my favorite discoveries as a chronicler of numerous
streams of activity in the movement documented in the Integrator. That is: the late 1970s witnessed a remarkable
surfacing of the new values in U.S. medicine. The National Wellness Institute
was founded in 1977. The year 1978 birthed the Planetree movement that awakened
the idea of "patient-centered care" in the United States. That same year the
American Holistic Medical Association was founded as were the first new modern
era naturopathic medical schools, Canadian College of Naturopathic Medicine and
the then John Bastyr College of Naturopathic Medicine. Then in 1979, nurses founded
the American Holistic Nurses Association.
Meantime, within
a couple of years, national organizations to funnel the advance of acupuncture
and Oriental medicine, the maturation of the herb industry, and the elevation
of the therapeutic value of massage therapy were created or re-purposed. Clearly,
something was in the air. The advent of the wild ideas from the 1960s of
holism, globalism, back-to-the-land, East-meets-West, respect for nature, and
environmentalism needed a decade to congeal into vehicles for change. I see it
as huge, cultural amniotic soup out of which we all emerged. It has not always
been harmonic among these groups. And it is wonderful that in the last decade
through multiple means and re-directed intention we are seeing these family
lines re-connecting. I am pleased to have a chance to speak to this at a
plenary session at the October 2015 conference of the Academy of Integrative
Health and Medicine, People, Planet, Purpose: Global Practitioners
United in Health & Healing.
People
Jordan: co-guideing the National Wellness Institute
Meg Jordan, RN,
PhD in Co-Presidency of the National Wellness Institute
The co-president of the National Wellness Institute
is Meg Jordan, PhD, RN. Jordan, an
anthropologist, is dean of integrative studies at the California Institute for
Integral Studies. NWI, founded in 1977, "was formed to realize the mission of
providing health promotion and wellness professionals unparalleled resources
and services that fuel professional and personal growth." Jordan is also a
leader in the health coaching movement for which she developed one of the
initial academic programs. She was the chief author on the recent publication
of results of a job Task Analysis and recommended coaching standards.
Comment:
Jordan continues to pop up as a leader in multiple places that are critical to
the advance of integrative health and medicine. Discovering that she has made
herself a significant force as connective tissue between integrative health and
medicine and the sometimes surprisingly separate "wellness" movement was a
pleasant surprise.
Cherkin: semi-retirement
Honoring Dan
Cherkin, PhD in His (Partial) Retirement and New Consulting
On April 7, 2015 a set of advisers to his "BACK Choices"
PCORI grant to Group Health Research Institute's Dan
Cherkin, PhD received an email from Cherkin in which he announced that, for
a variety of reasons, he will not be re-submitting a follow-up PCORI proposal
that already received excellent reviews.
In fact, he shared that he will no longer be submitting more grant
proposals and will "at least partially retire" early next year after his 30
years at Group Health. Cherkin noted that he might be "seeking other ways to use my continued
passion for improving care for back pain, possibly as a consultant to health
care systems and others committed to this goal." But meantime: "I am
looking forward to spending more time with my growing family (including 4
grandchildren in Seattle), reading, traveling, hiking, puttering, and
re-discovering many of the joys of life that have gotten lost in the shuffle of
life."
Comment:
Cherkin's decades of research in the integrative health and medicine field and
at one of the most prestigious real world research centers has spanned across
chiropractic, massage therapy, acupuncture, and mind-body (yoga). He built a
team that included his frequent partner Karen Sherman, PhD and mentored leading
researchers in the naturopathic field, Ryan Bradley, ND, MPH and Erica Oberg,
ND, MPH. For a brief period Cherkin remarkably held a joint position as
director of Bastyr's research effort, with which Bradley and Oberg were then affiliated.
Cherkin chaired the program committee for the 2012 International Congress for
Research in Integrative Medicine for the Academic Consortium for Integrative
Medicine and Health (then CAHCIM) and served for a period on the Research
Working Group of the parallel consortium representing all the councils of
colleges in the distinctly licensed integrative health fields. His results did
not always please. In fact, he had a run of studies that raised the paradoxical
issues of the intervention showing better than regular care but not better than
the placebo he selected. He's been a major influencer.
My personal favorite piece of Cherkin's work is a secondary,
qualitative study of the patients in his "CAM" trials. He and his team wanted to
understand better what the experience with these "CAM" practitioners was like.
The result was a paper entitled Unanticipated Benefits of CAM therapies for
back pain. In this
remarkable exploration of patient experiences, he and his team concluded: "Positive
outcome themes included increased options and hope, increased ability to relax,
positive changes in emotional states, increased body awareness, changes in
thinking that increased the ability to cope with back pain, increased sense of
well-being, improvement in physical conditions unrelated to back pain,
increased energy, increased patient activation, and dramatic improvements in
health or well-being. The first five of these themes were mentioned for all of
the CAM treatments, while others tended to be more treatment specific. A small
fraction of these effects were considered life transforming." Thanks
for the work, Dan. Enjoy the re-discovery of self (including of consulting) and
the grandkids.