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Integrative Medicine, Complementary Alternative Medicine and Health Round-up #61: November 2012 PDF Print E-mail
Written by John Weeks   

Integrative Medicine, Complementary Alternative Medicine and Health Round-up #61: November 2012

  • Do state-by-state Essential Health Benefits decisions violate the non-discrimination clause in the Affordable Care Act?
  • Oregon publishes useful report on navigators, wellness coaches and health workers in Coordinated Care Organizations
  • New Hampshire mandates coverage of services of naturopathic doctors
Employers, Economics and Business
  • Fortune 500 firm Parker-Hannifin CEO pumps "alternative medicine" as a solution to the health crisis
  • Glenn Sabin: Self-insured employers and integrative medicine are a "perfect marriage"
  • "Trillionaire Wellness Industry" highlighted with alternative medicine projected to reach $115-billion in 2015
  • Samueli Institute and Herman partner for book on Evaluating the Economics of Complementary and Integrative Medicine
  • Jill's List employer initiative promotes partnership with Huddleston's Prepare for Surgery as big money saver
  • Health promotion leader Michael O'Donnell chosen to head Michigan center
  • National Business Coalition on Health: chiropractic presents on the addition of DCs, LAcs and PTs to medical home
  • California Institute for Integral Studies promotes employee wellness certification
  • "To Cure Health Care, We Must Think Bigger, Much Bigger" - another CFO promotion of CAM corporate exploration
Integrative Centers
  • A profitable integrative mental health venue: A look at Scott Shannon's Wholeness Center (and a forthcoming book)
  • Mayo Clinic offers module to train massage therapists for work in hospitals
  • From Google Alerts: links to integrative medicine in hospitals and health systems in November 2012
  • NCCAM to announce new grant that "encourages partnerships" between CAM schools and medical schools for training purposes
Natural Products
  • American Botanical Council enters its 25th year, Herbalgram approaches its 100th issue
  • American Herbal Products Association efforts endorsed by consumer group
  • American Board of Integrative Medicine (ABOIM) posts eligibility requirements for MDs/DOs in integrative medicine
  • Holistic nurses in "Joining Forces" initiative for Veterans
  • Chiropractic group rescinds recognition of pediatrics certification program
  • Consumer Reports jumps on bandwagon supporting acupuncture for chronic pain
  • Goldman interviews Escape Fire director for Holistic Primary Care
  • Readers invited to participate in poll regarding shaping healthcare system from "a vitalistic frame"
  • Society for Integrative Oncology begins monthly webinar series 
  • Adi Haramati, PhD, awarded the first Bravewell Distinguished Service Award by the Consortium of Academic Health Centers for Integrative Medicine
  • Naturopathic physician Suzanna Zick, ND, MPH takes second key integrative medicine position
  • Stanford Integrative Medicine director David Spiegel, MD, elected to the Institute of Medicine


HHS' Sibelius: receiving the ACA letter
state-by-state Essential Health Benefits decisions violate the non-discrimination clause in the Affordable Care Act?

This critical question is raised by the American Chiropractic Association (ACA) in a letter October 19, 2012 to Health and Human Services Secretary Kathleen Sebelius. The ACA shares concerns "regarding the Department's implementation of a key provider non-discrimination provision of the Patient Protection and Affordable Care Act (PPACA)." The provision is Section 2706 which requires non-discrimination against licensed providers: "The law enables patients to receive care from any provider who is licensed in a state to provide a specific benefit covered through an exchange health plan." However, some states are choosing Essential Health Benefits (EHBs) in their "benchmark plan" that do not include chiropractic or other services. States Keith Overland, DC, ACA president: "We have reason to believe that several states have taken just such an action, having allowed little to no input from the chiropractic community during their deliberations." In the letter, the ACA requests that HHS "communicate to states that adherence to Section 2706 is vital and implement a process to evaluate each state's proposed benchmark plan to determine whether it is in compliance."

Chiropractic group questions on 2706 violation
: No one thought that implementing 2706 would be easy. The first shot across the bow was the AMA's House of Delegates' resolution to strike the language from the law. While the ACA's letter is framed around chiropractic, the answers will have meaning that will shape citizen access to a whole variety of integrative health services from licensed practitioners working in solo offices or in integrative medicine clinics and teams. It is unfortunate that this letter was not co-signed by a dozen organizations. The strategy here should be less legal than an organizing. A letter to Sibelius from a broader base, reaching from consumer groups to massage therapists to integrative medicine doctors and the philanthropists who support them, is what is in order. The Integrative Healthcare Policy Consortium should be partnered at the hip with the ACA here. Meantime, for some reason perhaps linked to chiropractic's Achilles heel of going it alone, the ACA remains the only significant licensed "CAM" national, organization not at that table as part of IHPC's Partners for Health. Get together you two! 

State looks into other healthcare players
Oregon publis
hes useful report on navigators, wellness coaches and health workers in Coordinated Care Organizations

The Oregon Health Authority has published a draft report entitled The Role of Non-Traditional Health Workers in
Oregon’s Health Care System
. These are not licensed integrative healthcare practitioner, of which Oregon has a full complement. Rather, the report focuses on "DRAFT Recommendations for Core Competencies and Education and Training Requirements for Community Health Workers, Peer Wellness Specialists and Personal Health Navigators
." The report was engaged as part of the state's legislated effort to clarify what exactly is a Coordinated Care Organization, and the roles of the various professionals and others in carrying out such a mission with a focus on "Oregon Health Plan enrollees and with special attention to coordinating care and services for Medicare beneficiaries who are also on the Oregon Health Plan." The 94 page document includes a set of recommendations for competencies.

Comment: The roles of health workers, coaches, navigators, guides and connectors has been intertwined with the dialogue around the optimal integration of so called "CAM" services and providers with mainstream medicine since the work was formally engaged nearly two decades ago. Good for the state of Oregon to have taken this to a new level of recognition. (Thanks to Charles MacLean, PhD for giving me the heads up.)

New Hampshire mandates coverage of services of naturopathic doctors

In somewhat old news, the publication Seacoastonline recently featured a report that the state of New Hampshire now requires insurers to cover the services of that state's licensed naturopathic doctors (New law levels playing field for naturopathic doctors). The change came via passage of New Hampshire House Bill 351. In the state Senate the bill as narrowly approved HB 351 in a 13-11 vote in early May and Gov. John Lynch signed it into law on June 20.

Employers, Economics and Business

Washkewicz: pushing the envelope in CAM benefits
Fortune 500 firm Parker-Hannifin CEO pumps "alternative medicine" as a solution to the health crisis

On October 30, 2012, CFO Magazine published the first of a two part series entitled "A Solution to Our Country's Big Healthcare Problem?" The subhead provides the answer from Parker Hannifin's
CEO Don Washkewicz: "One Fortune 500 CEO thinks covering alternative medicine techniques and therapies is the right course for both workers' health and the bottom line." Washkewicz's wake-up to medical alternatives came via a personal positive experience from removal of mercury fillings. In a subsequent investigation, he found that 70% of his workers' caries were being filled with mercury. Said Washkewicz: "We're poisoning our workforce, paying for it up front, then paying again later for the chronic conditions that result from being poisoned." He began promoting a CAM-rich benefits plan. The article lists 23 different types of a-typical treatments Parker Hannifin covers, including chelation therapy and bio-identical hormone therapy. Says observer Ken Pelletier, PhD, MD (hc): "Parker Hannifin is a big outlier, and in fact probably unique in its breadth of coverage."

According to the article, the employer's 8-year-old CAM program has grown from 27,000 services performed in fiscal 2009 to 46,000 in 2010, 78,000 in 2011, and 102,000 in 2012.
The company has not tracked details on cost impacts but has found in the one corporate unit with the most tracking of such services that annual per-employee medical costs have sunk by more than half since 2007, from $6,500 then to $3,200 in fiscal 2012. The firm does not know what portion, if any, may be attributable to the alternative medicine benefit, but likes the trend. Says Washkewicz: "It's early days, but we're going to aggregate this and show the payoff in lower costs. And then we're going to publicize the hell out of it."
Comment: "Alternative medicine" - and for Washkewicz it clear that it is an alternative to what his employees would conventionally be receiving from their medical doctors that he is promoting - may have found its most important champion. A Fortune 500 employer may be just the right figure to lead "CAM" out of the wilderness. (Thanks to Integrator adviser Glenn Sabin, see below, for the link.)
Sabin: urging an interest alignment
Glenn Sabin: Self-insured employers and integrative medicine are a "perfect marriage"

Integrative center c
onsultant, blogger and sometimes Integrator contributor Glenn Sabin makes a case for the strange bedfellows of self-insured employers and integrative medicine centers and practitioners with his post "
Self-Insured Employers and Integrative Medicine: The Perfect Marriage."  Sabin links to initiatives on cost contributions from these services as he argues first for the case for employer attention to integrative and then turns around and makes the case for attention from integrative center operators to work directly with employers. Sabin notes that despite the apparent value, that "while growing during this transitional period for all of US healthcare, the uptake of integrative health and wellness approaches by employers and healthcare providers has been spotty." Sabin projects a change: "As a practical matter, practitioners who believe their therapeutic and clinical services belong in wellness programs are now positioned to take the initiative. Those who can articulate the health and cost benefits are likely to find a receptive audience among self-insured businesses who are taking the initiative to control their health care costs by improving the health and productivity of their employees."
Comment: Tying the knot between integrative medicine's heart-centered, soft-bellied practitioners and big business's profit-centered, hardline operators would seem to present the worst of cross-cultural challenges to an enduring marriage. Long-time readers of the Integrator will know that this  marriage of strange bedfellows has been hoped for, nee planned for, editorially, in the way that a mother might wish that a child will "marry well." (Just plug IHPM for Institute for Health and Productivity management, a former Integrator sponsor, into the Integrator search function. Here is one example. Additional links to employer content are at the bottom of this Integrator reposting of Sabin's piece. ) The reason? The spouse-apparent from next door, conventional healthcare delivery, has proved to too often be a wolf in sheep's clothing, organized as it has been around doing more of whatever that will best turn the spigots. This is not a "CAM" assertion. This is Paul Grundy, MD, MPH, from IBM, calling them "a milking machine" at a recent Institution of Medicine workshop reported here.   
Making a buck at wellness
"Trillionaire Wellness Industry" highlighted with alternative medicine projected to reach $115-billion in 2015

An article entitled "Trillionaire wellness industry: Healthy wealthy and wise" explores the size of the emerging wellness market. The centerpiece of the posting is a recent McKinsey and Company report that calls wellness "a demographic sweet spot of enormous potential." Notably, the McKinsey version of the title inserts (maybe) before "wise". A chunk of the global growth is expected from the
Chinese economy where on average person spent about $60 on health and wellness, a 10th of what an average Canadian spent ($580). Chinese expenditures are expected to rise 13% from from 2006-2015. The author cites a report on the Global Alternative Medicine Industry that projects alternative medicine expenditures to reach $115-billion by 2015.
One factor of importance to the trend appeared to have needed no reference at all: "Life, not science, is showing that prevention, education and relaxation, which are a significant part of a holistic discipline, are actually cost effective!"
Comment: Ever since the publication of Cultural Creatives and the founding of the LOHAS movement, people have sought to quantify the dollars in health and wellness. LOHAS has estimated the market at $290-billion today. Dollars for "alternative medicine" look big but even at $115-billion in 2015 are less than 4% of the $2.8-trillion sick-care industry of 2012. We have a ways to go to create a truly thriving industry of health creation that will prove transformational.  
Herman: useful how-to text for the most impactful of research
Institute and Herman partner for book on Evaluating the Economics of Complementary and Integrative Medicine

Money may not make the world go round, but in our growing environment of fiscal restraint it is getting increasing focus by everyone." With these words Samueli Institute's president Wayne Jonas, MD kicks off a notice to the Institute's list of a new publication developed via a partnership with Patricia Herman, MS, ND, PhD. Herman, who recently had the lead
on a landmark article on cost-effectiveness in complementary and integrative medicine, has authored a book entitled Evaluating the Economics of Complementary and Integrative Medicine. The 100 page booklet is meant to instruct others in how to do these studies. Herman, a senior fellow at the Samueli Institute, is also senior behavior scientist in the health division of the RAND Corporation. The book is available at for $15.95. Adds Jonas: "We hope that this book and these initial published findings about the cost savings of integrative practices will stimulate both the quantity and quality of such research. The future of our children's health and the sustainability of our health care system may depend on finding more of these types of treatments."
Comment: First, credit Jonas and the Samueli Institute for pushing this useful tool out into the world. If NIH NCCAM began to consider this little text their guiding light, my best guess is that no one would be questioning the value of the agency, chips fall where they may, after the next decade as the agency has been challenged after its first. Herman describes the strategies for getting at what the real world wants to know, as reported in the related stories in this Round-up.
Shah: opens network to employer interest
Jill's List employer initiative promotes partnership with Huddleston's Prepare for Surgery as big money saver

In another in a series of unusual partnerships, Jill's List has announced a partnership with Peggy Huddleston and the
"doctors, nurses and other healthcare practitioners who are trained and certified in Prepare for Surgery, Heal FasterTM." Under the initiative, practitioners are listed on Jill's List for free, "making it easy for consumers, employees and referring practitioners to find a trained professional." Jill Shah, the founder of the firm, points to savings that health system research has associated with the mind-body program. In one study, those using the program had 1.6 fewer hospital stays, for a $3200 average savings.
The relationship with Huddleston is part of a new Jill's List product for  employers called JL Corporate Wellness. Says Huddleston: "Jill's List is a visionary partner who will help make many more patients aware of Prepare for Surgery, Heal FasterTM and connect them with a certified instructor."

O'Donnell: health promo leader to Michigan post
Health promotion leader Michael O'Donnell chosen to head Michigan center

The next director of the influential Health Management Resource Center at the University of Michigan School of Kinesiology will be headed by health promotion leader Michael O'Donnell, PhD, MBA, MPH according to this release. O'Donnell, an activist and organizer, is the author of the leading text on workplace health promotion, the founder and editor of the American Journal of Health Promotion and the founder of Health Promotion Advocates. The Michigan Center was founded by Dee Eddington, PhD, a independent and outspoken employer health and wellness leader.

Comment: O'Donnell participated in the 2001 Integrative Medicine Industry Leadership Summit. While new to the field, he found himself quite taken with the health-focused energy and the preventive underpinnings of the emerging field. O'Donnell could prove an exceptional ally in supporting the "perfect marriage" Sabin (and this writer) have recommended.

Updyke: chiropractor presents on Cisco's medical home
National Business Coalition on Health: chiropractor presents on the addition of DCs, LAcs and PTs to medical home

The Cisco Systems firm in the Silicon Valley has been experimenting with chiropractors and other licensed "CAM" services in its onsite medical home clinic. At the November 12-14, 2012 conference of the National Business Coalition on Health, chiropractor William Updyke, DC, the leader for physical and complementary medicine at Cisco's
LifeConnections Health Center will be presenting, as he shared in an email, on "what happens at an onsite clinic medical home when you add acupuncture, chiropractic and physical therapy to the medical practice." He will be part of a session called "On‐Site Health Clinics: Break the Financial and Clinical Burdens." The session is listed in the agenda as sponsored via the Foundation for Chiropractic Progress.
Comment: Updyke has been  laboring quietly inside the Cisco space for some time, developing relationships, figuring out new models. This would be a great session to catch.
Jordan: coach leader promotes emplover wellness direction
California Institute for Integral Studies promotes employee wellness certification

A note from Meg Jordan, PhD, RN, CWP to her list via the California Institute for Integral Studies (CIIS), urged people to take advantage of a training from the National Wellness Institute to become a Certified Worksite Wellness Specialist (CWWS) or a Certified Worksite Wellness Program Manager (CWWPM). The programs, held in San Francisco in early November, "focus(ed) on the importance of changing the organizational culture to ensure long-term results and use the most current information and research in the field." Says Jordan, the department chair for Integative Health Studies for CIIS: "Whether you are new to worksite wellness or a seasoned professional, you will discover innovative ways to engage employees and enhance corporate wellness programs, all while earning a certification from a well respected non-profit organization."
Comment: I include this segment to underscore the point made in the previous short articles in this section: the web of connectivity between integrative health, economics and corporate health is thickening. Notably, Jordan has been intimately involved with effort to mature the health coaching field which links to the subject of the report from Oregon in the policy segment of this Round-up.   
Miller: webinar kicks off CFO's CAM exploration
"To Cure Health Care, We Must Think Bigger, Much Bigger" - another CFO promotion of corporate exploration
of CAM

Just prior to publication of this Round-up, Glenn Sabin sent an additional link to post inside a CFO Magazine which targets the Chief Financial Officers of the nation's largest organizations. The article, "To Cure Health Care, We Must Think Bigger, Much Bigger", included notice that
the Robert Wood Johnson Foundation recently "indicted the health-care system for its "failure to develop and deliver effective preventive strategies ... which continues to take a growing toll on the economy and society." The writer, CFO's deputy editor, David McCann, argues that "maybe giving CAM a fair shot isn’t so revolutionary after all." McCann quotes Wayne Miller, whose CFO Magazine webinar with Integrative Healthcare Policy Consortium chair Len Wisneski, MD was noted in the October 2012 roundup: “Because of [wasting money on regular medicine], we are crowding out the capital needed for growth, we are sustaining monopolistic behavior [by mainstream medicine], and we are causing enormous human suffering. What part of that is worth defending?” 

Comment: As I have been arguing for many years, we need to be exploring "integration from the demand side." A mentor Sean Sullivan, the first director of the National Business Coalition on Health back in the 1980s, taught me to say that phrase. The demand side is consumers and purchasers. The supply side is delivery organizations, and i would argue, researchers and insurers. Big business and the cost-saving integrative approaches may be strange bedfellows, but they belong together, experimenting, trying things, without reductive medicine as a bundling board getting in the way of their messing around toward whole person, health-focused solutions.

Integrative Centers

Shannon: holistic pediatrician's clinic turns profit
A profitable integrative mental health venue: A look at Scott Shannon's Wholeness Center (and a forthcoming book)

Integrative psychiatrist Scott Shannon, DO is a past president of the American Holistic Medical Association and of the American Board of Integrative Holistic Medicine. Shannon's clinical base is a new venture is his For Collins, Colorado-based Wholeness Center. Shannon describes it as a "fully integrative mental health clinic." The clinical mix includes 12 practitioners: 2 psychiatrists, 2 naturopathic doctors, 2 family therapists, plus onev each of: psychologist, physician assistant, nurse practitioner, MT/body worker, licensed acupuncturist, biofeedback therapist/yoga teacher and psychiatric nurse educator. Shannon notes that the Center's team "just celebrated our 2nd birthday and have been profitable this past year." The business model includes contracts from "a number of local agencies." Some of the Center's providers accept insurance. Most work in the space as independent contractors. Shannon notes that one shared characteristic is that all "are dedicated to our vision." Shannon's forthcoming book from Norton, Mental Health for the Whole Child elaborates both philosophy and model. This center appears to be the largest and most comprehensive integrative mental health program in the US.

Comment: The Wholeness Center has two key elements of profitability and success in a center like this. One is using a contract model to keep the incentive for bringing business with the individual practitioner. The second is shared vision, which keep re-knitting the centripetal tendencies back into a whole.

Mayo Clinic offers module to train massage therapists for work in hospitals

A feature in Massage Today entitled "Hospitals Embracing Massage" reports that Mayo Clinic in Minnesota has developed
a course for massage therapists to train them for participation on hospital teams. The article describes the Mayo program as divided into three modules and requiring two months to complete. Those admitted to the training must have previously completed a 500-hour minimum massage therapy education program.
The Mayo program is offered twice a year with just 12 students in each. According to the article, the limit on participants is in place "to ensure that therapists receive close one-on-one instruction and a more comprehensive experience.Among content areas are: self-care exploration, a team-based approach to integrative health care and scope of practice, navigation and documentation in a medical record, establishing therapeutic relationships and treatment planning. To date, placement for therapists completing the instruction has reportedly been very good.
Comment: Mayo joins MD Anderson and Allina among major healthcare centers that have sought to fill a training gap through developing formal training programs for massage therapists in hospital-based treatment. It would be interesting to see the extent to which the competencies on which the program focuses are aligned with the Competencies for Optimal Practice in Integrated Environments developed in part through leaders of the massage field

Tracking integrative medicine developments
From Google Alerts: links to integrative medicine in hospitals and health systems in November 2012

This monthly report includes 20 short segments, with links, on developments in integrative medicine in hospitals, academic health centers and health systems from mid-October through November 6, 2012. These were selected from scores of Google Alerts postings during that time period. They are meant to serve as a quick scan of developments in the rapidly evolving medical doctor-focused areas of integrative medicine in hospitals, health systems and academic health centers.


New program to foster collaborations
NCCAM to announce new grant that "encourages partnerships" between CAM schools and medical schools for training purposes

new announcement from the NIH National Center for Complementary and Alternative Medicine (NCCAM) shared that NCCAM will launch a new program that "encourages partnerships between institutions with demonstrated expertise in training complementary medicine practitioners and institutions with demonstrated expertise and capacity in conducting clinical and translational research." NCCAM views the initiative as "aimed at improving the capacity of the integrative health field to carry out rigorous research." The new partnerships "must be committed to create a comprehensive interdisciplinary complementary and integrative health clinical research training program that builds on the existing strengths, expertise and infrastructure of both institutions." The goal: " ... generate a cadre of research clinicians who are able to participate fully in multi-disciplinary teams engaged in complementary and integrative health research."
Comment: Good for NCCAM. Some of the most influential, culture-shifting grants that the agency has promoted in the past are the so-called R-25 and "reverse R-25" education grants that either prompted or required such multi-institutional collaboration across institutional, guild and organizational chasms. Many influential relationships were build, and careers commenced, under programs of the awarded recipients.

Partnerships can strip CAM schools of their best and brightest
A trick in this environment is the nature of the connection that "CAM" researcher will have with the dominant academic medical center. The gravitational pull is first toward the kinds of reductive questions that are the bread and butter of conventional academic medical centers but are not the highest shared priorities of researcher in the licensed CAM disciplines. The second question is long-term. As the best-and-the-brightest of the "CAM" researchers are drawn into these useful and important relationships, many jump to the better-funded conventional schools. Thus there is, as leading chiropractic researcher William Meeker, DC, MPH has named it, a "brain drain."
These programs from NCCAM are terrific. Here's hoping that long-term outcomes will be infused with whole systems thinking that are infused with interest in developing the research culture in the "CAM" schools.

Natural Products

Blumenthal: great success with his organization and publication
American Botanical Council enters its 25th year, Herbalgram approaches its 100th issue

In early 1980, a very thin publication developed as Herbalgram to link consumers, producers and retailers in the herb industry, was founded by herbalist and entrepreneur Mark Blumenthal. A few years later, this morphed into an organization, the American Botanical Council, which boasted ethnobotanist James Duke, PhD, and pharmacognosist Professor Norman R. Farnsworth, PhD (now deceased) as its additional board members. Roping these two in was a coup for Blumenthal. That they made a good bet is evidenced by the transformation of the newsletter into a quarterly, peer-reviewed journal that boasts amongst its trustees and advisers a who's who of the botanical field. Meantime, ABC and its numerous other publications have served as a platform for Blumenthal's incessant travels to speak at scientific, professional and consumer conferences, while also engaging the media and government agencies in many of the key scientific, evidence and claims issues that have marked the field's maturation. The organization sent a release noting that it is entering its 25th year in which it notes that 100th issue of Herbalgram is slated for publication in late 2013, just as the organization's Silver Jubilee ends. A piece of good news accompanying the announcement is the election of Tom Newmark to the organization's Board of Trustees.
Comment: A point of professional pride is a term I served on the ABC's Board of Trustees. (I continue to serve on their editorial advisory group.) Blumenthal is a one-of-a-kind, street-smart, self-and-friend-taught character with an aesthetic appreciation that grounds botanical science in the beauty of the herbs themselves, and the traditional peoples who have used them, that predates the analysis. ABC's is a remarkable story. If you haven't seen the publication, treat yourself. Issue after issue takes one into the richness of culture and place that breath life into what most of us know mainly in capsule or pressed-pill form.
Website draws consumer organization's support
American Herbal Products Association efforts endorsed by consumer group

Citizens for Health (CFH), a consumer advocacy group associated with the natural products industry, has urged its members to use the website as an educational resource to help them avoid consuming tainted products being sold as dietary supplements. The website was opened in August 2012 by the American Herbal Products Association (AHPA), an industry organization. A release from AHPA notes that this was the first endorsement by a consumer group. The AHPA release explained that the site was created by AHPA to support heightened efforts by the Food and Drug Administration (FDA) and the dietary supplements industry to address significant public health problems posed by products that are illegally marketed as dietary supplements but contain ingredients that do not qualify as dietary ingredients. The website offers "information on illegal tainted products and identifies the product categories that are most susceptible to adulteration, such as weight loss, sexual enhancement and body building, categories in which consumers may be looking for immediate or dramatic results." Citizens for Health dubs itself "the voice of the natural health consumer."
Additional AHPA note: The organization also announced last month that it received the Patient Partnership Award from Americans for Safe Access (ASA) "in recognition of AHPA's work during the past year in developing recommendations to state regulators in states where medical cannabis is legal under state law." The announcement is here.


ABPS: requirements for IM board certification posted
American Board of Integrative Medicine (ABOIM) posts eligibility requirements for MDs/DOs in integrative medicine

The American Board of Integrative Medicine (ABOIM), a new entity taking shape under the umbrella of the American Board of Physician Specialties, has declared its eligibility requirements. Medical doctors or osteopaths or British MDs who have finished normal residencies can be accepted to sit for the exam. Their training in integrative medicine can be either completion of a fellowship in integrative medicine or, as an option, a full, a four year residential program in naturopathic medicine, a National Certification Commission for Acupuncture and Oriental Medicine-recognized acupuncture and Oriental medicine program, or a chiropractic program accredited through the Council on Chiropractic Education. In addition, applicants "must currently hold, or previously have held, board certification granted by an American Board of Physician Specialties (ABPS), American Board of Medical Specialties (ABMS), American Osteopathic Association (AOA) or a Royal College of Physicians and Surgeons of Canada (RCPSC) Board."
Comment: This is the first significant news from ABOIM (as it will be known) since September 2011 when the initiative was announced. (See the Integrator Special Report on the initiative to create the Board and the 20 voices of an Integrator Forum on the subject.) The focus on MDs/DOs will disappoint some. Once the University of Arizona and their colleagues entered the ABPS zone, they were committed to this direction. Credit them for formally honoring the depth and breadth of the ND, AOM and DC programs as providing the requisite training . That was a giant step out of the guild box. In an email give-and-take with a group of non-MDs/DOs about the ABOIM requirements, one naturopathic physician remarked: "What is most important here is that in the struggle for existence against the traditional US Medical System, integrative medicine has created a very strong foothold. Our allies and friends have reached a new position of strength and recognition that can only benefit us all." Well said.
AHNA: joins Veterans effort
Holistic nurses in "Joining Forces" initiative for Veterans

The American Holistic Nurses Association (AHNA) last spring signed on to the Joining Forces campaign led by
First Lady Michelle Obama, Dr. Jill Biden, and the White House "to bring mainstream awareness to Veteran issues." These include post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) according to an October AHNA notice to members. As part of their commitment to veterans, the AHNA dedicated the October 2012 Beginnings magazine to "Holistic Nurses Caring for Veterans." Explains Glenda Christaens Ph.D, RN, AHN-BC, AHNA president: "The expectation is to educate and bring greater awareness to holistic nurses across the country with the goal of providing improved person-centered care to Veterans and their families." The six-part feature describes various roles holistic nurses are playing in treating veterans.
Comment: Pleasing to see the typically insular AHNA reach out and connect to an external initiative. I hope that one day soon they will see the value in joining their colleagues in additional change agency initiatives, such as membership in the Partners for Health of the Integrative Healthcare Policy Consortium.
Requirements for membership limit value
Chiropractic group rescinds recognition of
pediatrics certification program

The American Chiropractic Association (ACA) announced November 1, 2012 that it has rescinded its recognition of a pediatrics
certification program administered by the International College of Chiropractic Pediatrics (ICCP). The ACA made the move on learning "that certain requirements of the ICCP Board violate industry standards and could potentially affect public safety." At issue was a requirement that those sitting for the board must also be members of Council on Chiropractic Pediatrics of the International Chiropractic Association (ICA). ICA is a separate national organization for chiropractors. The ACA views the membership requirement as giving a professional organization "undue influence on examination writers and testers or graders, potentially compromising the validity of the certification process." The president of the ACA's own Council on Chiropractic Pediatrics, Elise Hewitt, DC, DICCP, explains: "After ACA had lengthy discussions with both ICA and ICCP leaders, these organizations decided to continue their membership requirement. In rescinding our recognition of the ICCP Board, we have acted to prioritize public safety."  The release concludes with a note that "aside from this issue, the ACA Council on Chiropractic Pediatrics and the ICA Pediatrics Council have had a successful five-year alliance, including collaboration on joint conferences." More detail on the decision is here.
Comment: Seem a pretty simply thing to clean up. But given the depth of the fighting between the two organizations on various fronts, the present outcome is not surprising. I contacted Hewitt for further comment. She responded via email:
"You're so right in your comment about this being an easy thing to clean up! It's really just an issue of professional evolution for the pediatrics board. The ICCP started out as a small board for one organization and has since grown into a profession-wide certification board. Now the ICCP simply has to allow its policies to evolve as well in order to be able to retain autonomy in the certification process. Limiting certification solely to members of the ICA Pediatrics Council unnecessarily limits those who can attain certification. Ideally, the ICCP certification should be available to all chiropractors who wish to specialize in chiropractic pediatrics."

Catching up to consumer use of acupuncture
Consumer Reports jumps on
bandwagon supporting acupuncture for chronic pain

The influential magazine Consumer Reports has taken the publication of a recent individual patient-data meta-analysis  on acupuncture for chronic claim to declare that "the results provide the best evidence to date that acupuncture is a reasonable option for people with chronic pain." The Consumer Reports article, published September 26, 2012, is entitled Acupuncture is more than a placebo for chronic pain. The writer add this guidance: "If you decide to try acupuncture, talk with your physician first to set realistic expectations for improvement." Then: "Our recent survey of subscribers to Consumer Reports found that many derived benefit from acupuncture and other alternative therapies for 12 common health problems."
Comment: Fascinating that the consumer's physician, who is likely to know and have experienced something close to zero about acupuncture, is to be leaned on by the consumer for best evidence of what is likely to happen with his or her use of acupuncture. Clearly it will take Consumer Reports awhile to trust what consumers in fact report.
Goldman: interviews Escape Fire filmmaker
Goldman interviews Escape Fire director for Holistic Primary Care

On November 1, 2012 Integrative Practitioner Online featured an interview with Escape Fire! filmmakers Mathew Heineman and Susan Froemke written by Erik Goldman, editor of Holistic Primary Care. The highly-regarded documentary cross-fertilizes inputs from conventional luminary Donald Berwick, MD and integrative medicine leader Andrew Weil, MD. States Heineman: "The frustration we saw (among doctors) at Andy Weil's fellowship, the frustration we saw with [another MD interviewed] showed us that nobody's happy. It requires change at all levels. We definitely became much more sympathetic to physicians, and aware of the handcuffs that they are shackled by." Heineman closes the interviews optimistically: "I think we really are at a tipping point in America right now. Everyone recognizes that the situation is unsustainable and that it needs to be fixed."
Comment: When I was 18 I wrote a poem that went something like this: "There is a clarity in this fog/from the center one can see/as well each way ... " It must have been a harbinger of my still distant professional choices. It certainly describes Heineman's basis for optimism.
Octagon institute looks at Millennials
Readers invited to participate in poll regarding shaping healthcare system from "a vitalistic frame"

The Octagon Institute of Life University is working to elevate the importance of vitalism in healthcare policy and practice. Stephen Bolles, DC, a sometime Integrator contributor who works as an organizer and developer of Octagon events notes that the Institute's 2013 conference will "focus on the health of Millennials" and that as a lead-up, they have created a survey "to try to create a better understanding of the unique design elements this cohort is going to require for engagement, participation and change agency." Bolles' invite reads: "We've created a survey site at There are some introductory videos, a simple survey with five areas of questions [source of health (extrinsic/intrinsic), sources of information, sources of guidance, sources of economic support, sources of emotional/relational support], and the ability to see one's answers in the context of the group that's taken the survey." The former consumer engagement leader for United Healthcare adds that there is "normal social media stuff too." The Octagon Institute was conceived as "a forum for global conversation that connects health care philosophy, vitalism and integrated cultural and biological change."

SIO: new webinar program for members
Society for Integrative Oncology begins monthly webinar series

Members of the Society for Integrative Oncology have a new benefit: a monthly webinar series which will feature some of the guiding lights and a number of past presidents of the influential organization. The first, from founding president Barrie Cassileth, PhD, was held November 6, 2012. The others are:
December 6, 2012 6:00 PM, Opportunities and Controversies in Integrative Oncology (Donald Abrams, MD); January 30, 2013 6:00 PM, Metabolic Effects of Exercise Relevant to Cancer Survival (Dawn Lemanne, MD, MPH); February 20, 2013 6:00, PM, Herb-drug Interactions in Cancer Care (K. Simon Yeung, PharmD, LAc); March 6, 2013 6:00 PM, Mind-body Research: Improving Outcomes in Cancer Care (Lorenzo Cohen, PhD); and April 10, 2013 6:00 PM, Acupuncture in Integrative Oncology (Gary Deng, MD). 


Haramati: distinguished service award
Adi Haramati, PhD, awarded the first Bravewell Distinguished Service Award by the Consortium of Academic Health Centers for Integrative Medicine

Aviad (Adi) Haramati, PhD, integrative medicine leader at Georgetown University has been selected by his colleagues in the Consortium of Academic Health Centers for Integrative Medicine as the first recipient of the Bravewell Distinguished Service Award. Haramati was honored for demonstrating exemplary efforts for the Consortium during 2012, particularly in respect to two Congresses, the May International Research Congress on Complementary and Integrative Medicine in Portland and the October International Congress for Educators in Complementary and Integrative Medicine. The award was announced October 22, 2012 at a dinner in which the Consortium honored the Bravewell Collaborative of philanthropists for integrative medicine for their dozen years of work in co-birthing and supporting the Consortium's growth. Haramati was CAHCIM's founding vice chair. The recently concluded ICECIM, co-sponsored by CAHCIM, the Academic Consortium for Complementary and Alternative health Care and Georgetown University, while born out of a history of collaborations, was largely Haramati's brainchild.

Comment: The Consortium's first Distinguished Service award couldn't have gone to a more deserving person.
In the story I tell about the founding of the Consortium, it is Haramati, as vice chair, who was the principal organizer. The founding chair, the exceptional integrative medicine leader at Maryland Brian Berman, MD, provided the necessary MD at the top of the bill. But it was Haramati, working closely with Berman as he was, in the trenches, doing much of the people work, organizing, pulling all of those (mainly) academic MDs into form. Nice choice for CAHCIM!
Side note: An article from Georgetown Medical Center on the ICECIM conference is here.

Zick: ND in leadership of MD-led orgs
Naturopathic physician Suzanna Zick, ND, MPH takes second key integrative medicine position

Naturopathic physicians and researcher Suzanna Zick, ND, MPH recently completed a term on one key board of an organization led by integrative medical doctors and has assumed a position on another. Zick served a three year term as co-chair of the Research Working Group of the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM), the organization of 51 medical schools. Now, according a recent notice from the Society for Integrative Oncology, Zick was elected to that organization's executive board. Notably, Zick does this work from her position as associate research professor at the University of Michigan Health System in a state that has no license for naturopathic physicians.
Comment: Zick and her fellow member of the SIO executive board, Heather Greenlee, ND, PhD, an assistant professor of epidemiology at Columbia University, is among a handful of non-MDs who have risen into the ranks of leadership of MD-led integrative medicine organizations. A third is Ather Ali, ND, MPH, an associate research scientist at Yale School of Medicine Integrative and formerly Zick's co-chair of the CAHCIM Research Working Group. Ali was recently selected to serve on CAHCIM's executive committee. This evidence of openness at the top end of these organizations speaks well of the evolving interprofessional nature of the integrative medicine movement.
Spiegel: integrative medicine leader elected to IOM
Stanford Integrative Medicine director David Spiegel, MD, elected to the Institute of Medicine

The Institute of Medicine (IOM) of the National Academies of Sciences has announced that David Spiegel, MD, the medical director for integrative medicine a Stanford University, has been elected to the IOM. Spiegel, who is a member of the Stanford Cancer Institute, is known for his research work with stress and with complementary approaches for cancer treatment. Among the trials he currently has underway or in development are two regarding mindfulness and another for acupuncture for patients with sleep disruption.
Comment: This short piece was going to begin with a note that no one associated with integrative medicine appears to have been selected to receive a Young Leader Awards: Recognizing Leaders for a Healthier America from the Robert Wood Johnson Foundation. I was then going to follow with a similar note about the IOM elections, having briefly scanned the new IOM list. On re-checking my scan, I spotted Spiegel and changed the headline. Congratulations Dr. Spiegel! Has anyone else with such a professional title associated with integrative medicine been elected to the IOM before? Now, how many young leaders in integrative medicine submitted, or had submitted, their experience for consideration by RWJF? Notably, the organization that administers the award, the Institute for Alternative Futures, has a long history of connection with complementary and integrative medicine initiatives. Be good for the community to be submitting names in the coming years.

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