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The Integrator Blog. News, Reports and Networking for the Business, Education, Policy and Practice of Integrative Medicine, CAM and Integrated Health Care. - Issues & 80 & #81-Sept Oct 2010
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Issues & 80 & #81-Sept Oct 2010 PDF Print E-mail
Written by John Weeks   

Issue #81 -November 3, 2010

November 3, 2010

Integrative Medicine and Integrated Health Care Round-up #37: November 2010

 Flurry of opposition to AMA ownership of CPT codes amidst report of AMA's $70-million of annual royalties ... Center for Public Integrity reports "secretive" AMA committee that guides Medicare priorities on billions of dollars ... AAAOM, CRN, ACCAHC, NPRI and AHMA in follow-up statements on NIH NCCAM strategic plan ... Update on Integrated Healthcare Policy Consortium federal action for integrated health care: PCORI and workforce issues  ... "Mother of holistic medicine" Gladys McGarey, MD takes on changing federal policy, at age 90 ... True North Center turns SmartMoney lemons into lemonade ... Guarneri-led Bravewell team publishes pamphlet on cost-effectiveness of integrative medicine ... Multidisciplinary effort led by Harvard's Marilyn Moore and U Minnesota's Karen Lawson, MD moves to set national health coaching standards ... Massage certification group NCBTMB sets stage to offer advance practice certification program ... ACA part of Sharecare internet play that includes Mehmet Oz, MD, Dean Ornish, MD and nursing groups ...  A call to "put integrity into integration" from Daniel Redwood, DC ... Report leads to reconsideration of whether some placebos were placebos ... Huffington Post expands its integrative medicine-focused health portal ... Michael Cohen in new law firm ... Charles DuBois honored ... Lori Knutson, RN in expanded role ... Shelly Johnson new interim director role at American Massage Therapy Association. More 

October 28, 2010

18 Views: Forum on the AMA's $70-Million CPT War-chest Includes Calls for Action to End the Subsidy

The Integrator article that reported the $70-million subsidy the American Medical Association (AMA) receives via the CPT coding system stimulated a burst of reader response. Here are notes, reflections, suggestions and responses from: Allina integrative care director Lori Knutson, RN, BS-HN; past AHMA president Bill Manahan, MD; former ATHM editor David Riley, MD; Alternative Medicine Integration Group president Richard Sarnat, MD; Holistic Primary Care editor Erik Goldman; CAHCIM past-chair Vic Sierpina, MD; university president Jim Winterstein, DC; AANP past-president Michael Traub, ND, DHANP; author and educator Marc Micozzi, MD, PhD; NPRI executive director Carlo Calabrese, ND, MPH; an unnamed federal policy-maker nurse; ACC executive director David O'Bryon, JD; AANP president-elect Michael Cronin, ND; past ACAM president Ronald Hoffman, MD; past APMA executive director Candace Campbell; integrative clinic owner Chris Foley, MD; journalist Daphne White, CHMT; and Louise Edwards, ND, LAc. More
October 26, 2010

Chris Johnson, ND: "Disturbed" by the Integrator Focus on Health Coaching in Integrative Medical Practice

Chris Johnson, ND writes that he is "disturbed" by the Integrator focus on health coaching "on many levels." Johnson, who practices in the Washington-DC area, then goes on to dissemble just why coaching is a misfit. He responded to an article on the Harvard/U Minnesota September 2010 summit held to begin to set national standards and certification for the field, and a follow-up report by an attendee who represented the naturopathic profession. Johnson's view is at great odds with the perspective that coaching people to health should be the center of a quality integrative medical practice. He believes physicians must create magic for patients and coaching doesn't fill the bill. Johnson questions the science behind coaching and argues that the economics of a physician practice don't support a key role for the coaching modality. I offer some comments on Johnson's perspective and hope some of you will weigh in on these philosophical-business issues about the role of health coaching relative to a physician's responsibility and his/her economic well-being. More

October 26, 2010

Reader Forum: Levin, Forbes, Rohleder, Calabrese, Stumpf and Holmes on Integrator Themes

A nice mix of themes and responses here: Michael Levin on the Seely-Herman research on cost savings of whole practice ND care for Canada Post employees; AHMA president David Forbes, MD on the NCCAM priorities; short notes on the Georgetown-Bastyr relationship promoted by Adi Haramati, PhD; Barney Holmes on biases relative to alternative medicine in Wikipedia; Carlo Calabrese, ND, MPH on what "CAM" fields have in common according to Wikipedia; Community Acupuncture Network co-founder Lisa Rohleder, LAc, and AOM educator Steven Stumpf, EdD on the incomes of licensed acupuncturists as reported by the National Certification Commission for Acupuncture and Oriental Medicine, plus a brief note from an anonymous naturopathic physician who believes that her profession has a similarly challenged economic perch. I comment on the link between Levin/Forbes and the income discussion. More

October 20, 2010

The AMA's $70-Million Taxation without Representation: Is it Time for a "CPT Party" Revolt?

Integrative nursing leader Mary Jo Kreitzer, RN, PhD called my attention to a peculiar characteristic of US health care. The guild for MDs owns the means by which members of all the other guilds can get reimbursed by 3rd party payers. The means are the Current Procedural Technology (CPT) codes, the royalties from which earned the American Medical Association something in the area of $70-million of revenue in 2009. (The AMA doesn't make it easy to find the amount.) Kreitzer's interest was provoked by the AMA's antagonism to the independent practice of nurses as primary care providers recommended in an October 2010 Future of Nursing report from the Institute of Medicine. The AMA also opposes the non-discrimination portion of the Obama healthcare law (Section 2706) and other integrative practice advances. Should practitioners in these fields be required to offer a tithe to a profession that is a source of their own subjugation? Maybe it's time for a CPT party. More

October 18, 2010

Comments on NCCAM Draft Strategic Plan from AAAOM, ACCAHC, NPRI and CRN

In November of 2009, diverse integrative practice organizations made recommendations to the NIH NCCAM following a call for public input from the agency on its 2011-2015 Strategic plan. In August 2010, the agency again called for comments when it release of its plan that will shape some $600-million in research investments. Some integrative practice organizations have comments and chosen to share their follow-up recommendations with the Integrator for this special post to the community: American Association for Acupuncture and Oriental Medicine (AAAOM), Academic Consortium for Complementary and Alternative Health Care (ACCAHC), Naturopathic Physicians Research Institute (NPRI) and Council for Responsible Nutrition (CRN). Two themes: 1st, credit to NCCAM for some of the new directions; and 2nd, a push to elevate the focus on real-world and health promoting outcomes. Thanks to these organizations for responding, and sharing. More

October 14, 2010

Jennifer Johnson, ND: Report on the Summit on Standards and Credentialing of Health Coaches

Empowering people to change their behaviors is the most fundamental of health reform. So when I learned that on September 26-27, 2010, some 70 integrative-oriented professionals were to gather to explore standards and credentialing in the field of health coaching, my antennae went up. Don't all integrative practitioners worth their favorite self-profile have skin in the coaching game? The professionals gathered by leaders from Harvard and University of Minnesota represented nursing, medicine, research, psychology, academic health care, the existing coaching field and even the rare chiropractor and naturopathic doctor. Jennifer Johnson, ND, a clinical assistant professor at the University of Bridgeport program in naturopathic medicine represented her field, and the Academic Consortium for Complementary and Alternative health Care at the Summit. Here is her report. More

October 14, 2010

Integrative Care at Israel's Davidoff Comprehensive Cancer Center: Report from Nimrod Sheinman, ND

Two Israeli's leave their country to be trained in integrative practice. One, Nimrod Sheinman, ND, the author of this article, attends a naturopathic medical school in the mid 1980s. A dozen years later the other participates in a residential integrative medicine fellowship. Each are pioneers. Each returns then to their own country where they are presently collaborators in the Davidoff Comprehensive Cancer Center at the Rabin Medical Center. Here is Sheinman's account of the Center, the clinical services and the broader public responsibilities, including keeping the practitioners who serve these cancer patients from being ground down in their practices. Take a look. More

Issue #80 -October 7, 2010

October 7, 2010

Integrative Medicine and Integrated Health Care Round-up: October 2010

IHPC, others convene stakeholders for policy action plan on integrative practices in reform law ...  Goertz named to influential Board of Governors of PCORI, significant new, national comparative effectiveness research institute ... AANP urges members to weigh in on endocrine disruption bill ... Australian study reports cost savings from acupuncture and 3 natural products ... Disturbing national data on incomes of licensed AOM practitioners stimulates soul-searching ... Two-thirds of massage therapists note downturn in practices in lagging economy ... Supplement sales hold steady ... Managed CAM and wellness firm American Specialty Health hits $147-million in revenues ... Penny George Institute/Allina publish 2010 outcomes report ... Donna Karan's Urban Zen expands nationally with Kent State partnership in program for nurses ... Georgetown and Bastyr initiate novel agreement between naturopathic and conventional academic programs ... Marino Center links with Mass Medical Society for integrative medicine training ... True North Healing Center's Dahlborg brings integrative business model to Dartmouth Medical School ... Alliance for Natural Health examines Wikipedia biases against natural health and medical alternatives ... Foundation for Chiropractic Progress a useful model for fund-raising a discipline's national initiative ... AAAOM breaks pattern in naming medical doctor Niemtzow to board ... Riley and editorial team resign from Alternative Therapies in Health and Medicine citing differences with new owners ... Publication opportunities in new peer-reviewed Topics in Integrative Health Care/Hawk and in special integrative health issue of Patient Education Counseling/Rakel ... 2011 Integrative Health Care Symposium to be held in New York, March 4-6 ... Horace Elliott, Ad Haramati and Sherman Cohn honored More

October 5, 2010

Financial Challenges & Warning Labels: How Much Does a Licensed Acupuncturist Earn?

My own dark humor about the licensed CAM professions of acupuncture and Oriental medicine (AOM) and naturopathic medicine (ND) is that they have gained enough recognition for their students to go into debt, just not enough yet for their graduates to get out of it. The 2008 Job Task Assessment by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) included a set of questions on income, education debt and practice settings to enhance the profession's self-knowledge. Publication of the findings has kicked off a round of sometimes acrimonious soul-searching over how licentiates are doing economically. One leader concludes that the profession should have a warning sign that entry into the field can be hazardous to one's financial health. Here are some data and commentary. More

September 29, 2010

Karla Karapetian: Report on the Penny George Institute Conference on Hospital Based Integrative Care

Imagine this: A hospital system has delivered 61,000 inpatient visits. It is committed to serving as a model for the nation, so offers a conference on hospital-based integrative care. Would that be a smart place to be if one wishes to learn the ins-and-outs from experts? Or if you couldn't go, have a proxy attend? The Penny George Institute, part of Minnesota's Allina Hospitals & Clinics, and led by Lori Knutson, RN, BS-HN, happens to have offered such an educational opportunity for 4 days in late July 2010. For those of us who didn't or couldn't attend, here is a report from our collective proxy, Karla Karapetian. Karapetian, a manager with the American Massage Therapy Association, is a communications professional. Here is her useful and thorough report. A similar conference is anticipated for 2011. More

September 22, 2010

With National Standards in the Works, Is it Time to Claim, and Certify, the Health Coach Within?

The concept of coaching patients toward healthy behavior is deeply embedded in many integrative disciplines and practices. The healthcoach.com website, for instance, was claimed at the dawn of the worldwide web by a naturopathic doctor. The use of a health coach as a distinctive practice, however, evolved separately and more recently in the employee health and managed care industries. Now federal health reform legislation has highlighted the potential in health coaching. Nursing and integrative medicine leaders associated with Harvard University, University of Minnesota and the The Institute for Integrative Health have begun a defining process toward setting national standards and certification for the field. The official kick-off is a Health and Wellness Coaching Invitational Summit this month. Representatives of the chiropractic and naturopathic disciplines have been invited. In reductive political terms, health coaching is broadly shared turf. All integrative practice fields that claim to be health creating have skin in this game of figuring out what is, certifiably, a health coach. More
September 17, 2010

Pause and Appreciate: New Academic Integration Modeled by Georgetown with Bastyr and Others

A model inter-institutional relationship may help bridge the chasm that separates health professions education in conventional academic health centers from institutions educating students for the distinctly licensed integrative practice ("CAM") professions. Says one leader: "I believe we are poised to make an important advance in how the future training of health professionals may evolve." The speaker is Adi Haramati, PhD, integrative medicine leader at Georgetown University, describing a new relationship between Georgetown and Bastyr University relative to Bastyr's naturopathic medical program and Georgetown's MS CAM program. Haramati and his co-director Hakima Amri, PhD are exploring similar relationships with chiropractic schools and other health professions institutions. The developers "would like nothing more" than to see this bridge-building relationship be used as a model for other academic health centers and CAM institutions. More
September 16, 2010

Who Are We? Taylor Walsh Reports Give-and-Take as NCCAM Advisers Discuss Proposed Strategic Plan

Credit the current NCCAM administration for fostering a spirit of open dialogue and give-and-take in its National Advisory Council. Washington DC-based writer Taylor Walsh captures some of the bandying of ideas and differences of opinion exceptionally well in this report on the September 3, 2010 meeting of the NIH National Advisory Council on Complementary and Alternative Medicine. The subject could not be more important: the proposed Strategic Plan that is to guide some $650-million of NCCAM spending. Walsh focuses on the segment of the meeting in which Strategic Objective #3 ("real world research" and health-enhancing outcomes) was discussed. What will we have an opportunity to learn about the potential contributions of integrative practices? Walsh, a regular Integrator contributor, captures perspectives of advisers Steve DeKosky, Tim Birdsall, Adam Burke, Janet Kahn, Gary Curhan and Gert Bronfort, as well as those of NCCAM staff, in this well-written report on a critically important meeting. More   
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