Integrative Medicine, Complementary and Alternative Health and Medicine Round-up #97: November 2015
Written by John Weeks
Integrative Medicine, Complementary and Alternative Health and Medicine Round-up #97: November 2015
Policy
-Harvard Team Promotes Mind-Body
Practice as "Vaccination" after Finding 43% Reduction in Use of Healthcare
Services
-American Public Health Association Resolution Includes
Language from Chiropractors, Others, Elevating Integrative Approaches against Opioid
Overuse
-Take Action! IHPC Joins Campaign to Guarantee Quality
GMO Labeling
Endorses integrative opioid resolution
-APHA Panel Explores Sustainability and the USA Dietary
Guidelines Issue, Points to 2020 Redux Advances on Section 2706/Non-Discrimination
-National Sustainable Business Council, Holistic Chamber
and IHPC Host Webinar on2706 and the Value of Integrative Practitioners
-International Chiropractic Association Endorses IHPC's
Cover My Care Initiative (2706)
-Oregon Suit by Naturopathic Doctors on 2706 Draws
Counterpunch from Health Net Integrative Care -Hello Gabby! Boston
Group Uses "Embodied Conversational Agent" to Enhance Integrative Medicine
Group Visits
-Upper Chesapeake Health Links with Maryland University
of Integrative Health for Integrative Care -Pharmacy Times
Offers Financials Portrait of Dallas-Based Integrative Flower Mound Pharmacy
and Herbal Alternatives
-Quick Links to Integrative Medicine News in Medical
Systems and Communities: October 2015
-Is Regular Medical Delivery Creating Openness through
New "Rules for Radical Redesign"?
McGarey: honored by AIHM
Integrative Academics
-Bastyr University Begins First MPH Program in an
Integrative Health Institution Research & Evidence
-David (Katz) vs the Science-Based Medicine Goliath: Who
is the Science Denier?
-Character Assassination at Wikipedia? The Battle over
Deepak Chopra
-Update on the Council for Ayurvedic Research: Rioux in
Two Key Roles
-PERL Webinar Series Explores Important of Competency in
Evidence Informed Practice
-Parkinson's Researcher Laurie Mischley, ND, MPH, PhD(c)
with Michael J. Fox Foundation
Organizations
-First AIHM Congress Draws 800+, Fuels Interprofessional
Fellowship, Boosts Membership, Dream-Builders, and Association Leadership
Council
-Samueli Institute Reports on Chronic Pain Breakthrough
Collaborative in the IHI Model
-NCMIC Foundation's Investments in ACCAHC Initiatives
Surpasses $100,000
-Chiropractors Initiate Campaign for Medicare Equality
and Full Physician Status
Scherwitz: lifestyle health in Ecuador
International
-Former Ornish Team Members Scherwitz and Kesten Lead
Lifestyle Conference in Ecuador
-Global Integrator Round-Up from Global Advances in Health and Medicine
for October 2015 Miscellaneous
-Boston Patriots QB Tom Brady Advocates for Integrative
Model
-Is There a Role for You in Right Language to Release the
River of Health from the Medical Industry? People
-David O'Bryon, JD the new Chair of the Academic
Consortium for Complementary and Alternative Health Care
-Anne Doherty, LAc, MPH Chairs APHA Section on
Integrative and Traditional
-Gladys Mc Garey,
Jean Watson and Deborah Szekely Honored by AIHM
__________________________
Policy
Harvard Team Promotes Spread of Mind-Body Practice as Broad as
Vaccinations after Finding 43% Reduction in Use of Healthcare Services
Huge savings via mind-body intervention
The title of the open access article at PLOS from a Harvard Benson-Henry
Institute mind-body team is "Relaxation Response and Resiliency Training
and Its Effect on Healthcare Resource Utilization." The team took a
retrospective look at healthcare utilization of more than 4000 patients in the Relaxation Response
Resiliency Program (3RP) and compared them to a usual care cohort. The
finding: "At one year, total utilization for the intervention group decreased
by 43%, clinical encounters decreased by 41.9%, imaging by 50.3%, lab
encounters by 43.5%, and procedures by 21.4%. Measured by dollar,
reduction was estimated as "on the order of $2360/patient/year." The authors
note that "this reduction is on the order of that found by 3 other groups in
"other similar time-limited interventions."
Their Policy Recommendation: "The data suggests that the
intervention should be applied to all at risk populations, since the
intervention has minimal risk, minimal cost and yields substantial benefits for
patients with a wide variety of illnesses. The long-term effect of these
interventions on healthy populations is unclear, but the data suggests that
mind body interventions should perhaps be instituted as a form of preventative
care similar to vaccinations or driver education. Such interventions are likely
to be useful in population management and supported self-care, have negligible
risk and cost and may help reduce the demand curve in healthcare. While the
risk benefit ratio of this intervention is very favorable to further elucidate
the effect size a prospective evaluation is called for." The 3RP work began
with research by Herbert
Benson, MD 4 decades ago and evolved into a group-delivered intervention
developed by Benson and Eileen Stuart, RN, PhD and others starting in the
1980s.
Benson: method shows profound savings
Comment: This is a very important paper showing a huge reduction with
tremendous potential personal and socio-economic benefits. Imagine the
headlines if a pharmaceutical was found to have this impact. Given the cost
crisis in US medicine, a network of trials should immediately begin with
multiple populations in diverse social and cultural settings to see how well
these findings can be replicated. To not
do so is unconscionable for anyone who thinks we have a crisis in our medical
delivery industry and who sees how medicine's voracious appetite is devouring
the ability of the USA to deliver other basic human services. Then again, if
one is whirling in the cash of the 3-trillion industry like Slim Pickens riding
the bomb in the 1964 classic, Dr.
Strangelove, this Harvard study is one to brush aside, like a gnat.
American Public Health
Association Resolution Includes Language from Chiropractors, Others, Elevating
Integrative Approaches against Opioid Overuse
Maiers: led campaign on APHA initiative
The past chair of the Chiropractic
Health Care Section of the American Public Health Association (APHA), Michele Maiers, DC, MPH, PhD
took the lead on a campaign two years ago to get the powerful organization to
pass a resolution based on Recommendations
for Policy Makers in the Never Only
Opioids policy paper. Never Only Opioids was developed through the Academic Consortium for Complementary and Alternative
Health Care. Maiers shared with the
Integrator that when the chiropractors effort got tangled in some
challenging interprofessional politics, she and colleagues changed course and
offered amendments to a separate policy statement championed by public health nurses.
They proposed and had incorporated changes noted in bold, below:
"[APHA] Urges public health and public policy
education programs to prioritize and implement evidence based community and
provider training programs on mental health, non-pharmacological
pain treatment alternatives, substance abuse and overdose prevention...
"[APHA]
Urges pain prescription providers to be educated on identifying, and treating
pain with alternative modalities and to
coordinate pain management with complementary and integrative care providers."
The policy statement, entitled "A5: Prevention and
Intervention Strategies to Decrease Misuse of Prescription Pain Medications,"
was passed by APHA on November 3, 2015. It was championed by Cynthia Stone,
DrPh, RN from the APHA's
Public Health Nursing Section.
ACCAHC booklet stimulated effort
Comment:
Sometimes fun to recall how the sausage of policy is made. Here's a re-cap of
some of the inputs, for those counting. An interprofessional ACCAHC team lead
by Martha
Menard, PhD, LMT creates the Never Only Opioids paper. (I had the
opportunity to be on the team.) NCMIC Foundation provides a grant to support
publication. It is published through the 40-organization Pain Action Alliance to Implement a National
Strategy (PAINS) to give it more stature. A group of chiropractors begin
championing the theme and Maiers takes the lead in moving it toward an APHA
resolution through the Chiropractic Section. The APHA Section on Integrative,
Complementary and Alternative Healthcare Practices provided some support. When
the chiropractic-led initiative hit prejudice-based road-blocks, Maiers and her
team turned to the Public Health Nurses, who incorporate supporting language.
It is passed by APHA. Nice. Now, here's hoping that the chiropractors will
persevere in promoting a more powerful version. Good work!
Take Action! IHPC
Joins Campaign to Guarantee Quality GMO Labeling
Urging action on GMO issue
The Integrative Health Policy Consortium (IHPC) has issued a call to action to
derail the misleadingly titled "Safe
and Effective Food Labeling Act of 2015" (H.R. 1599). The industry
backed bill does not require mandatory labelling of GMOs and includes a clause
"that legally restricts states from passing their own labeling laws to protect
their citizens!" The bill, according to IHPC, "snuck through Congress and is on
its way to the Senate." They urge registering opposition to HR1599 and also support
of a separate bill, S. 511, sponsored by California Senator Barbara Boxer that
"supports mandatory GMO food labeling,
and can be found here."
I'll Be Baack: APHA Panel ExploresSustainability and the USA Dietary Guidelines
Issue, Points to 2020 Return
APHA panel points to 2020
The October 2015 Integrator
Round-up highlighted the battle over adoption of a whole systems view that
would put
sustainability considerations into USA Dietary Guidelines. Such inclusion, denied by industry-influenced
federal agencies (Agriculture, Health and Human Services), could, if included,
impact policies related to transportation, energy, farming, economics and
environment, to name a few. On November
2, 2015 at the American Public Health Association's annual meeting in Chicago the
following trio were part of a panel focused on the issue: Roni
Neff, PhD, MS from Johns Hopkins, Kim Robien, PhD, RD,
from George Washington University and David Wallinga, MD, MPA
with the NRDC took up the subject. Robien noted that the 2010 guideline
acknowledged sustainability as an issue but did not directly address the issue.
Wallinga discussed a billionaire-funded foundation strategy that is seeking to
move the Guidelines work to the Institute of Medicine. In comments after the
session, Wallinga shared that plans are already beginning= toward a campaign to
successfully include sustainability provisions in 2020.
Comments: The
quality of the coalition on this is extraordinary - including not only NRDC and
Hopkins but the Sierra Club, Citizens for Science in the Public Interest, and many
more. The Integrator is planning a Reader Forum on the topic. Stay tuned.
Meantime, consider this excellent
blog on Embracing Complexity in the Guidelines by Integrator reader Jamie Harvey of Commons Health. Harvie's post was
written last spring and includes excellent links, including this from Marion Nestle's Food Politics blog. Harvie states
that "the arguments that individual health is somehow isolated from the health
(or sustainability) of our food system are the frantic, specious, cries of a failing
industrial food industry."
Advances on Section 2706/Non-Discrimination
Business Group
Webinar Argues That "The Future of Health Care is Complementary, Integrative
and Holistic"
Business groups back Section 2706
The title of the November 17, 2015 (11:30 AM ET) webinar
captures the dreams and beliefs of many in the integrative health and medicine
movement: The
Future of Health Care is Complementary, Integrative and Holistic. The
difference is that energy behind the event includes two employer organizations: the
host, the American Sustainable Business Council, and a separate promoter, Holistic Chamber of Commerce. They
combined with the Integrative Health Policy Consortium (IHPC), a co-sponsor of the event. Speakers include
John Gamlin, Director of Human Resources at
New Belgium Brewing, Kent Bradley
the former Chief Medical Officer of Safeway, and Wayne Jonas, MD, CEO of
the Samueli Institute. One focus is Section
2706, Non-Discrimination in Health Care. To sign up, click here.
Comment: How
pleasing when someone else runs your own copy: "One of the most important
developments in American healthcare is the growing use of complementary and
integrative options like acupuncture, massage therapy, midwifery, chiropractic
and naturopathic medicine. These therapies have been increasingly shown to
deliver excellent outcomes with high levels of personal satisfaction and often
at lower costs than standard care alone. This is why corporate wellness
programs are beginning to use these complementary and integrative health
options." Looking forward to the regular Chjamber catching up with these
leading edge, whole system, business types.
International
Chiropractic Association Endorses IHPC's Cover My Care Initiative (2706)
Formally backs CoverCare
A note to the Integrator
from Alyssa Wostrel, executive director of the Integrative Health Policy Consortium
(IHPC) shares that the International Chiropractic Association has fully endorsed
via this release IHPC's CoverMyCare
campaign. ICA "encourages all organizations in the chiropractic profession
to become familiar with and engaged in its promotion and its utilization." Wostrel thanks to ICA vice president Steven Welsh, DC "for his lead
with ICA on behalf of CoverMyCare and especially for the outreach program to
the state chiropractic associations through the Congress of Chiropractic
State Associations." She adds that "this is the perfect model of engagement for IHPC and
CoverMyCare as it provides a link to the state associations so we can stay
engaged and current with those leaders about state level activities regarding
Sec 2706."
Comment: Any other national
associations ready to step up and help make these connections?
Oregon Suit by Naturopathic
Doctors on 2706 Draws Counterpunch from Health Net
ND group counter-sued on 2706
An
article in Oregon's health policy chronicler The Lund Report called Naturopaths
Face Legal Challenge from Health Net underscores the laborious nature of
the legal process the Oregon Association of Naturopathic Physicians (OANP) is
facing in taking on the insurance giant.
The report notes that "the discriminatory Health Net/ASH
practices cited in the [OANP] lawsuit allege that unlawful limitations are
imposed on naturopathic physicians as compared to other medical practitioners
who provide commensurate medical services." Health Net has moved to throw out
the suit. Laura
Farr, OANP executive director responded: "We anticipated this and are
preparing a response for the court right now; it's going to be a long process."
Farr expects a resolution no earlier than summer of 2016.
Integrative Care
Hello Gabby! Boston Group Uses "Embodied
Conversational Agent" to Enhance Integrative Medicine Group Visits
McCue: adding high tech to low tech
The low-tech, high visibility work of the Paula
Gardiner, MD, MPH-led group at Boston Medical Center in integrative
medicine group services is now being explored with a high-tech addition. The
new component, according to team member Kelly McCue, MPH in a
presentation at the American Public Health Association, is "embodied
conversational agent" known to the team as "Gabby." In a trial, Gabby -
presented via an 8" Dell tablet - received high marks from trial participants
in the safety-net setting in "reducing stress" and "talking about healthy
eating." Gabby proved useful in helping participants maintain positive habits
and extend the duration of the value of the group visit intervention.
Comment: Fascinating
tool. This is a surprising and interesting advance on the pioneering work of
the Boston University team that recently netted a quality piece in Health
Affairs. (See "Health Affairs Features Katherine
Gergen Barnett, MD on BMC's Integrative Group Visits Program" at this July
2015 Integrator Round-up link.)
Great low-tech and high-tech mix.
Upper Chesapeake
Health Links with Maryland University of Integrative Health for Integrative
Care
Firms deal with delivery organization
On November 2, 2015 Maryland University of Integrative Health (MUIH)
announced that the multidisciplinary MUIH and the University of Maryland Upper Chesapeake Health (UCH)
have signed a partnership agreement. Under the
agreement, MUIH graduate student interns will collaborate with physicians,
nurses and other health providers at UM UCH to develop and offer an integrative
medical model. Among MUIH degree programs are herbalism, acupuncture and
Oriental medicine, Yoga therapy, health couching and more.
MUIH president Frank
Vitale framed the partnership with reference to a view that "the future of
healthcare in this country depends on a model that embraces collaboration and
cooperation among providers and patients."
He adds: "This agreement between a university dedicated to natural
medicine and a health system dedicated to the optimum patient experience is a
small step with the potential for enormous impact." In the release, Lyle
E. Sheldon, FACHE, president and CEO of UM UCH offers this perspective:
"Treating the whole person, not just the disease or symptoms, is an
integral focus in the UM UCH Kaufman Cancer Center," said. "Our
affiliation with MUIH enhances our integrative health therapy services to
promote balance of mind, body and spirit-a cornerstone of the mission of UM
UCH." UCH, the leading medical delivery organization and largest private
employer in Harford County, consists of the Upper Chesapeake Medical Center,
the Patricia D. and M. Scot Kaufman Cancer Center in Bel Air and the Harford
Memorial Hospital in Havre de Grace.
Comment: It
will be interesting to see how deeply imbedded MUIH's students can become in
assisting UCH's requirements to cap and lower costs, under the unique system of
hospital cost controls in Maryland. Hopefully this will be a workshop from
which other can learn. (Alignment of interest note: I consult with MUIH.)
Pharmacy Times Offers Business Care Portrait
of Dallas-Based Integrative Flower Mound Pharmacy and Herbal Alternatives
Business model for integrative pharmacy
An integrative pharmacy in Dallas, Texas, Flower Mound Pharmacy and Herbal
Alternatives is reported in Pharmacy
Times to be an exemplary integrative pharmacy. The business flavors itself as "a
family-owned, innovative practice with an integrative approach to health
through medicine, supplements and nutrition."
The October
22, 2015 article notes that the
pharmacy is gathering outcomes data and has achieved "measurement of reductions
in cholesterol, A1C, and blood pressure seen with drug therapy and integration
of supplements and lifestyle changes."
The integrative component is good for the bottom line,
according to the article. The writer notes that community pharmacy revenues
from prescription fees "have been progressively shrinking." Yet at Flower Mound,
the owners take "a 3-pronged approach-comprising prescription fees, OTC and
dietary supplement sales, and clinical services and consulting fees-to ensuring
its long-term financial sustainability." While revenue from prescriptions
accounts for more than 70% of total gross revenue, these provide less than 10%
of gross profit. The larger portion of profits is in vitamin and supplement
sales and related consultations: "Scheduled private consultations paid for by
the patients provide an additional $12,000/year in revenue. In addition, these
consultations drive dietary supplement sales, which amount to more than
$250,000/year."
Comment: Nice
when "doing good" means doing well. Fifteen years ago some of us placed a line
in some Design
Principles of Healthcare Renewal that "the renewed healthcare system is a
partnership between an expanded commitment to the public health and a thriving
industry of health creation." Flower Mound looks to be a piece of such an
industry's contribution.
Quick Links to
Integrative Medicine News in Medical Systems and Communities: October 2015
This Integrator
feature captures highlights from stories on the web relative to integrative
medicine in the prior month. Here are 31 involving medical delivery systems and
13 more in communities. Included is the remarkable move in Oregon Medicaid to
cover massage, acupuncture, chiropractic and naturopathic services in pain
treatment with the intent to limit opioid addiction. Check the effective, short
interview with Penny George, the first Bravewell chair. Great post from Yale IM
leader David Katz, MD, MPH taking on the polarization-based medicine leaders.
Out in the community, naturopathic and homeopathic clinician and educator Amy
Rothenberg, ND offers a short series of videos on her own cancer process.
Is Regular Medical
Delivery Creating Openness through New "Rules for Radical Redesign"?
1. Change
the balance of power by co-producing health and well-being
in partnership with patients, families and communities.
2. Standardize what makes sense to reduce unnecessary
variation and increase the time available for individualized care.
3.
Customize to the individual's
needs, values and preferences, guided by the understanding
of what matters to the person, in addition to the typical "What's the
matter?"
4. Promote well-being and focus on outcomes that matter
the most to people, appreciating that their health and happiness may not
require health care.
5.
Create joy in workby cultivating and mobilizing the pride and happiness of the health care
workforce.
6. Make it easy, continually reducing
waste and all non-value-added requirements and activities for patients,
families and clinicians.
7. Move knowledge, not people, exploiting all helpful
capacities of modern digital care and continually substituting better
alternatives for visits and institutional stays.
8. Collaborate and cooperate, recognizing that the
health care system is embedded in a network that extends beyond traditional
walls.
9. Assume abundance by using all the assets that can
help to optimize the social, economic and physical environment, especially
those brought by patients, families and communities.
10.Return the money
from health care savings to other public and private purposes.
Comment: So much
of this reads like an invitation. Numbers 1, 3, 4, 5, and 8 each have deep
roots in the integrative health and medicine field. Yet there is no mention
anywhere that anything like integrative health and medicine exists. If there is
awareness of that field among these leaders - as has been noted
by IHI leader Don Berwick, for instance - is this a failure to acknowledge and
credit one's sources? Is this a kind of plagiarism of ideas? Why not credit the
outsiders who have been promoting these values for decades? Or is this simply
movement toward similar values from different starting places in separate
silos? Bottom line for "movement" people is that one of the rules for radicals
is not to care who gets the credit. Nice to see these values articulated. And
they are radical. Can you help with
the redesign? Here is the link
at the IHI site.
Integrative Academics
Bastyr University
Begins First MPH Program in an Integrative Health Institution
First IHM school with MPH
Bastyr University in Kenmore, Washington is now offering
a Masters
of Public Health (MPH) degree program among its roughly two dozen degree
programs. The program has a specialization in community health education.
Graduates of the two year program are expected to find a positive job market as
"public health workers who specialize in community health education are
projected to grow at a rate that is significantly higher than average over the
next eight years."
Comment: I
believe this is the first MPH program based in an institution that specializes
in integrative health and medicine. Curious whether the program is a more or
less a cookie cutter of what one might be seen in any other MPH program, or
whether the program is infused with integrative health values. This is not
immediately clear from Bastyr's site. The program will focus on giving
graduates the ability to "apply human rights and social justice principles to
public health problem."
Research & Evidence
David (Katz) vs
the Science-Based Medicine Goliath: Who is the Science Denier?
Katz: strikes backs at the polarizers
Yale integrative medicine leader David Katz, MD, MPH recently was in the
spotlight with the publication of HRSA-funded work of the American College of
Preventive Medicine on integrative competencies in preventive medicine. The
publication stirred a
response from the bloggers at so-called "Science Based Medicine" (known in Integrator-speak as "Polarization-Based
Medicine"). Katz, who has been the backwards looking bloggers' target in the
past, decided to raise his own blogging light saber and strike back. He
published in the Huffington Post "Science
and Medicine, Fools and Fanatics: The Fluidity of ‘Woo'." Katz admirably
wades into the fluidity of evidence, and of "woo," while also suggesting that
damning him as anti-science is rather an odd pursuit given his long-time
success in securing large grants from the CDC.
Comment: If anyone wishes to offer a re-joinder to
these Polarization-Based Medicine types, this column from Katz is a good review
of how to rip them a new evidence hole. Meantime, Katz provides a link that
will be useful to anyone who has had the impulse to force feed humility onto
those claiming they are continuously operating on a secure evidence base. See,
in Science News, this 2014 piece
called Evidence-based
medicine really isn't.
Poet Graves: lessons re thoughtless passion
Alignment of interest note: I too have been a target of
the PBM types multiple times so am not a disinterested party. My own instinct,
on seeing these unbalanced tirades, is to recall mentoring from the poet Robert
Graves in his poem To Lucia at Birth:
"Outrageous company to be born into
Lunatics of a royal age long dead
So reckon time by what you say and do
Not by epochs of the war they spread
Hark how they roar but never turn your hear
Nothing can change them let them not change you."
[Apologies for botching any words - this is via memory. I
couldn't find the poem on line nor my own volume of Graves' work.]
Character Assassination at Wikipedia? In
Which Deepak Chopra is Tupac Amaru II
Chopra: drawn and quartered in Wikipedia
Colleague Rauni King, RN sent news of the battle,
captured in this
Huffington Post piece, over who is author and influencer Deepak Chopra, MD at Wikipedia. Writer
Ryan Castle notes that "Wikipedia reports that its reliability rating
approaches the Encyclopedia Britannica. While systemic bias admittedly exists
on Wikipedia, it is supposedly limited to a few minor articles." Then he
documents the gross abuses of history, practice and character the Wikipedia has
allowed regarding Chopra's profile. One highlight (lowlight): "[Chopra's] Wikipedia
biography proclaims: ‘Deepak Chopra is despised by all scientists as a
dangerous fraud who sells false hope and spouts gibberish.'"
Comment: I
wasn't surprised to see that the very first comment was from Dana Ullman, MPH,
who has seen a similar practice relative to homeopathy. I am reminded of the treatment of Tupac Amaru II,
the Inca leader who was drawn, quartered and beheaded in Cuzco, Peru in the 18th
century after trying to stimulate a revolt against colonizing ideas and
practices. Chopra's Wikipedia self is receiving roughly the same treatment.
Update on the
Council for Ayurvedic Research: Rioux in Two Key Roles
Rioux: lead roles in Ayurvedic org
The Council for
Ayurveda Research (CAR) was founded in 2012 and has been functioning
publicly since October 2014. The focus is "advancing research on Ayurvedic
medicine, as well as US-based and international collaborative research efforts."
The co-chairs of the organization's Clinical Trials Committee (CTC) are Jennifer Rioux, PhD,
CAP, RYT, formerly with the University of New Mexico, and Raja Shivamani of
UC - Davis. The CTC is "taking on the foundational work of developing
standardized assessment and outcome instruments to be used in upcoming research
initiatives so that future research outcomes will be comparable across studies."
Another goal is to develop "a reformulated case studies
framework, based on the CARE
guidelines, but made relevant for the Ayurvedic provider community, by
including standardized Ayurvedic outcomes." The CTC plans to debut these
guidelines at the National Ayurvedic Medical Association Conference in April
2016. The CAR Clinical Trials Committee is soliciting case studies for
submission and offering support for authors who would like their studies housed
in the repository. Pratibha
Shah, BAMS, Masters in Ayurveda, MPH is the founder and director of CAR.
Comment: Rioux,
who also serves on the organization's executive committee, is a long-time
advocate and promoter of whole systems research, including through case reporting.
The CAR website is not immediately clear on where it anticipates finding the resources
to power up its vision, though Shah appears to be well connected, from her bio
on the site, both in the USA and India.
PERL Webinar
Series Explores Important of Competency in Evidence Informed Practice
Parkinson's
Researcher Laurie Mischley, ND, MPH, PhD(c) with Michael J. Fox Foundation
Mischley: role with MJ Fox group
Naturopathic physician Laurie
Mischley, ND, MPH, PhD(c) is blazing a new trail for her profession. Mischley, who maintains
research positions at Bastyr University and the University of Washington, is
focusing on the utility of an intranasal glutathione spray for people with Parkinson's. Mischley has two ongoing studies funded by the Michael J. Fox Foundation.” She recently presented a poster
entitled "Intranasal
Glutathione in Parkinson's Disease" at the 2015 Parkinson's Disease
Therapeutics Conference sponsored by the Foundation. Most of the Fox
Foundation partners are pharma companies.
Comment: This
is notable as a new inroad into research acceptance of a representative of a once
externalized profession. Credit the NIH NCCIH new investigator programs for
Mischley's ability to develop as an investigator in her chosen area.
Organizations
First AIHM
Congress Draws 800+, Fuels Interprofessional Fellowship, Boosts Membership, Dream-Builders,
and Association Leadership Council
Powerful 2015 conference
The Academic of Integrative Health and Medicine's (AIHM) 2015
conference, People,
Planet, Purpose: Global Practitioners United in Health and Healing" was the
first AIHM gathering fully planned as an interprofessional organization. AIHM's
president, Mimi Guarneri, MD, formerly an invasive cardiologist and AIHM's
chair, Danny Friedland, MD, formerly an AMA evidence-based medicine educator, set
an excited, movement-oriented tone of horizontal teamwork. Tieraona Low Dog, MD
and Seroya Crouch, ND, co-leads of AIHM's new interprofessional fellowship in integrative
medicine announced the program to over 300 interested attendees at a
special lunch. Conference content was led by director of education Tabatha
Parker, ND, and a volunteer team co-chaired by Wendy Warner, MD and Jennifer
Blair, LAc, and included holistic nurse Lucia Thornton, RN and chiropractic
educator and researcher Bill Meeker, DC, MPH.
This was new and different. Something seemed to work.
Over 200 new members joined AIHM during the week. Some $100,000 was committed
to AIHM's Dream Builders Society
membership. Over 70 indicated potential interest in filling the 50 slots for
the January 2016 start-date of AIHM's new fellowship. And all this began auspiciously in a
pre-conference session in which 30 organizations joined as founding members of AIHM's Associations Leadership Council (ALC).
These ranged from the American College for the Advancement of Medicine to the
Society for Oncology Massage to UCLA Healing Arts. The ALC agenda included
initial collaborative steps toward creating a broadly inclusive "Big Tent"
assembly of integrative health entities to jointly work to advance an
integrative future for health and medicine.
Guarneri: seeded the AIHM vision
Comment: At
some point in the week in San Diego I began to acknowledge a re-birthing of the
creature called ‘hope' inside me, cracking through shells of earned disbelief
and appearing thusly through my mouth: Even
this old codger is being stirred by possibility. I'm on the Board of AIHM so have been a close
observer-participant in its historic work to break down silos and create a
powerful new and inclusive engine for the field. We've had our challenges in
these first years. And this week in San Diego was remarkable evidence of what
can come when leaders from multiple fields find their ways into the same room
and learn the language and tools to explore and create new kinds of
collaboration. Congratulations to the teams that pulled this off. (My own roles
were minor.) Wonderful potential.
Samueli Institute
Reports on Chronic Pain Breakthrough Collaborative in the IHI Model
Jonas: reporting pain collaborative
An October 13, 2015 notice from Wayne Jonas,
MD, CEO of the Samueli Institute provides
an update on the organization's Chronic Pain Breakthrough
Collaborative initiative. It is modeled on an Institute for
Healthcare Improvement practice to foment rapid change, in this case in the
treatment of chronic pain: "The mission of the working group is to achieve
major improvement in person-centered, integrative care for patients with
chronic pain, resulting in optimized human performance, quality of life, and
daily function." The 8 institutions participating are listed
here. They include 3 military delivery organizations, one from the VA and
three integrative health academic institutions with programs in naturopathic
medicine.
Paul Mittman, ND, president of Southwest College of Naturopathic
Medicine, is one of 40 leaders involved. In this post
on the Collaborative's activities, Mittman honors the Samueli-IHI
connection as "a brilliant marriage" in which the Samueli Collaborative's
participants are using IHI's "Plan Do Study Act" (PDSA) strategy. Samueli will
offer a web-based seminar on the first Collaborative's outcomes on January 13,
2016. Details to follow. Samueli will initiate a second collaborative in April
of 2016. An overview
is here.
Comment:
Fascinating to see the mix of organizations attracted to the first iteration. One
imagines that the relationship building has proved a good back door for the
naturopathic doctors to make headway in their plans for gaining inclusion in
military and VA health care. That would be an additional sort of breakthrough
that may come out of this program.
NCMIC Foundation's
Investments in ACCAHC Initiatives Surpasses $100,000
Steady support of ACCAHC
With a recent 2016-2018 commitment of $10,000/year, the NCMIC Foundation will top $100,000 in
total investment in the Academic Consortium for Complementary and Alternative
Health Care (ACCAHC) since 2008. This includes a total of $60,000 to support ACCAHC's basic operations.
The Foundation, guided by Lou Sportelli, DC, has also made investments in the
organization's Center
for Optimal Integration: Creating Health.
In addition, NCMIC Foundation sponsored presence of ACCAHC and the potential primary care
contributions of chiropractors, naturopathic doctors, acupuncture and
Oriental medicine professionals and direct entry midwives at the Association of
American Medical College's 2010 workforce meeting. The Foundation also provided
capital needed to print and distribute ACCAHC's influential Never Only Opioids policy paper. (See
related story on an APHA resolution under Policy,
above.)
Comment:
Anyone who grew up on the "CAM" side of the integrative health street will know
how rare a total of $100,000 in philanthropic investment is, from any source,
over any time period, to those often seemingly red-lined philanthropic areas.
NCMIC Foundation has moved a good deal of energy with this strategic investment
- helping launch ACCAHC, backing critical initiatives, then supporting the
present leadership transition. Nice!
Chiropractors
Initiate Campaign for Medicare Equality and Full Physician Status
Going after Medicare
The American
Chiropractic Association (ACA) announced
on October 29, 2015 that it is taking on "a blatantly anti-competitive
provision of Medicare law that arbitrarily limits reimbursement for medically
necessary services delivered by doctors of chiropractic (DCs)." In what the ACA
calls a "grassroots campaign," DCs would gain definition as
"physicians" under Section 1861 of the Social Security Act. The
target is "generating a robust level of patient grassroots support aimed at
Congress that seeks to ensure that Medicare beneficiaries have full access to a
broader range of covered services provided by chiropractic physicians than
current law permits." The tool is a National Medicare Equality Petition.
Since 1972, Medicare has covered chiropractic adjustment for back pain but does
not respect the profession as professionals who evaluate and manage patients,
and can provide an array of services. ACA's House of Delegates passed a
resolution in February 2015 making Medicare parity a top legislative and
regulatory priority.
Comment: Perhaps the most
significant complaint one hears about chiropractors is that some are merely rack'em and crack ‘em, taking little
time with patients. This type of chiropractic practice is a consequence of
insurance that defines them essentially as machines to do just that, rather
than as physicians who can evaluate and manage and provide multiple services to
positively impact quality of like - and who have a great deal of evidence
saying there should be top of the line for back pain care. It's long past time
to right this injustice and, more importantly, help the profession return to a
strengthened whole person manifestation. Side note: Interesting timing that
this kicked off just after the RAND
Corporation's new report Complementary and
Alternative Medicine: Professions or Modalities?
International
Former Ornish Team
Members Scherwitz and Kesten Lead Lifestyle Conference in Ecuador
Kesten: lifestyle education to Ecuador
The town of Cuenca, Ecuador, will host a 3-day Congreso
Internacional Estilo de Vida Saludable through its Casa de la Diabetes November 11-13,
2015. The leadership of the gathering, reportedly the first of its kind in
Ecuador, is through recent ex-pats in Ecuador Larry Scherwitz,
PhD and Deborah
Kesten, MPH. Authors and educators, Scherwitz and Kesten were the lead
scientist and nutrition expert, respectively, on the first research on Dean
Ornish, MD's program to reverse atherosclerosis through an integrative
lifestyle program. Another lead presenter at the event is Oregon-and-California-based
Ryan Bradley, ND, MPH.
Comment: In an
e-dialogue with the Integrator
regarding the conference, Scherwitz shared this blog
post that tells the story of the origins of the groundbreaking Ornish program.
(Anyone else out there think that Ornish
deserves a Nobel in Medicine for shocking the medical establishment with the
power of natural health care in reversing atherosclerosis and later, extending telomeres?)
It appears that Scherwitz and Kesten are hardly dropping out of their life's
work in their new Andean community
Global Integrator Round-Up from Global Advances
in Health and Medicine for October 2015
Global news in traditional medicine
The October
Global Integrator Round-up from Global
Advances in Health and Medicine Journal includes 8 short pieces including:
a review of activities in multiple nations on Africa Traditional Medicine Day;
a notice on the need to fund research by, and about, the clinicians who provide
the most Western care in Africa, namely nurses; an unusual Canadian
naturopathic college collaboration with Rwanda researchers shows promise for
supplemental selenium; the Dr. Roger's Prize of $250,000 that went to the
immensely deserving Heather Boon, PhD, at the University of Toronto; an
ambitious initiative to galvanize integrative initiatives in Scandinavia via
the new Nordic Integrative Medicine; and theQuick
Links to Global News in Traditional, Alternative, and Integrative Health and
Medicine for August 2015 with 75 one-liners on myriad global activities in
traditional medicine.
Miscellaneous
Boston Patriots QB
Tom Brady Advocates an Integrative Model
Brady: aligned with integrative values
A recent media alert from Bastyr University began with a
statement that the institution "and 4-time Super Bowl champion Tom Brady have
something in common: we know about the benefits of natural medicine." The
message links to this
radio interview in which, among other topics, Brady opines on how his view of medicine differs from the
mainstream: "That's kind of [the conventional] approach to medicine --
let's wait until you get sick, let's wait until you get hurt, oh, and then
we'll treat you. Well, how about finding ways to try to prevent yourself from
that even happening? I think that's a much better approach to medicine. When
you say, 'This sounds like quackery', well, there's a lot of things I see on a
daily basis in Western medicine that I think, 'Wow, why would they ever do
that? That's crazy. It doesn't work.' But that's just the way life is; I think
a lot of things that are the norm, that are very systematic, don't work."
Comment: As a Seattle Seahawks guy, hard to give it up to Mr. Deflategate on
anything. But hey, politics makes for strange bedfellows.
Is There a Role for
You in Right Language to Release the River of Health from the Medical Industry?
Confucious: get your language right!
Confucius said: "The beginning of wisdom is to call
things by their proper name." Mark Twain said: "The difference between the right word and almost the
right word is the difference between lightning and a lightning bug."
These quotes were shared with me by colleagues Suzanne Snyder and Greg Busch,
MPH, respectively, when I shared with them the gist of a column I recently had
published in Global Advances in Health
and Medicine Journal. The title: Right Language to
Release the River of Health from the Medical Industry.
In the column, I take off with the unveiling and
empowering that came with President Obama's renaming of Mt. McKinley as Denali
to cast light on how the concept of "health" has been bruised and buried by misappropriation.
Should we use "health" when we are referring to the practices of a medical
industry that is focused more on production of procedures or, at best, sick
care, than on health care, or on, as Don Berwick, MD has called it, "health
creation."
Twain: get your language right!
The column concludes with this recommendation: "To foster
the liberation of the health creation enterprise, consider committing to these
everyday language changes. In the place of routine use of healthcare system'
speak of the ‘medical delivery organization.' Use ‘disease treatment' or
‘symptom suppression' when these describe the boundaries of the intervention.
If motives in a given context are substantially focused on production of
procedures, call that ‘medical industry.' If a clinical or community strategy
takes on the holistic view of engaging the causes, then consider ‘healthcare.' The
exercise is not punitive. Each type of intervention can be useful. Clarity of
purpose is the goal. Call salt salt and pepper pepper. Call sick care what it
is. And call the unsolved puzzle of health creation honey. Each right use will
help release the river of health."
Comment: The
quotes sent by my colleagues convince me further that this conscious use of
language is critically important. Listen to yourself and others. See if you
don't get a wee bit offended when "health" is abused. Let's liberate it from
false patterns of expression. (If you cannot access the column and would like
to read it, send me a request to
)
People
David O'Bryon the
new Chair of the Academic Consortium for Complementary and Alternative Health
Care
O'Bryon: new ACCAHC chair
In a October 12, 2015 newsletter, the Academic Consortium
for Complementary and Alternative Health Care (ACCAHC) announced that David O'Bryon, JD, CAE was elected
ACCAHC chair. O'Bryon is the long-time president of ACCAHC core member organization,
the Association
of Chiropractic Colleges. He also currently serves as the
co-chair of the Advisory Council of the National Association of Advisors to the
Health Professions. O'Bryon states: "ACCAHC continues to be a guiding force
in integrated health care and I hope it continues to provide its member
organizations leadership opportunities to enhance the health care system."
One of the founders of ACCAHC, he previously served as the board's vice chair. He
replaces Elizabeth Goldblatt, PhD, MPA/HA who was selected by the board as a
new co-executive director of ACCAHC with Martha Menard, PhD, LMT.
Comment:
O'Bryon was an early visionary in the chiropractic community who saw the value
in the interprofessional engagement ACCAHC represents. His leadership extends
to key roles with the Integrative Health Policy Consortium particularly in the
area of policy where his background in successful lobbying for chiropractors has
been particularly valuable.
Anne Doherty, LAc,
MPH Chairs APHA Section on Integrative and Traditional Practices
The former director and organizer of the pioneering
integrative cancer program at Dana Farber Anne
Doherty-Gilman, MPH has stepped up to chair the Integrative,
Complementary and Traditional Health Practices Section of the American
Public Health Association. She takes over from her close Boston colleague Beth
Sommers, LAc, MPH, PhD whose term has seen what was a CAM special interest
group successfully gain elevation as a full Section as its membership doubled
to nearly 500 members.
Comment: The Sommers-Doherty duo has brought powerful
advances to this work inside the huge APHA machine. Here's looking forward to
the new advances under Doherty's leadership.
Gladys Mc Garey,
Jean Watson and Deborah Szekely Honored by AIHM
Szekely: honored by AIHM
In its first award ceremony, the Academy of Integrative
Health and Medicine chose to honor three powerful pioneers. Two are
novogenarians. Gladys Mc Garey, MD of
the Foundation for Living Medicine was honored with the Lifetime Achievement Award. San Diego
local, Deborah Szekely,
known as the Godmother of the Wellness Movement, received the Change Maker Award for work as activist,
philanthropist and writer. Jean
Watson, PhD, RN of the Watson Caring Science Institute, was awarded the Visionary Award for caring science leadership. The award
descriptions are here.
Comment: Of
the three, Mc Garey is the one with whom I have had the opportunity to connect
with over the years, going back to the early 1980s. Most recently her close
aide and CEO of her Foundation for Living Medicine Rose
Winters contacted me for a brainstorm when Mc Garey decided to take on
Congress a few years back at the youthful age of 90. Wow! All I felt was: Bow down! Three lives well-lived.