A remarkable, integrated set of 60 leaders converged in late 2010 as the Stakeholder
Conference on Integrated Healthcare Reform.
The group, organized by the Integrated Healthcare Policy Consortium
(IHPC), explored the opportunities for integrated health care in the
Affordable Care Act. Earlier this month, IHPC published the
ambitious set of strategic directions. IHPC then advertised for a new
executive director - the opportunity of a lifetime for the right
individual. The challenge is how to take the puer aeternis
that is the integrative practice community when it come to policy -
with its non-stop dreams of transforming U.S. health care and its
limited commitment to lobbying - into a responsible participant in
changing the nuts-and-bolts of U.S. policy. The table is set. The
blueprint is in the report. Time to wake up and engage the
nuts-and-bolts policy work so well laid out in this report. More
January 6, 2012
IHPC
publishes integrative care stakeholder report on Affordable Care Act
... Center for Practical Bioethics forms national group to promote
Institute of Medicine pain blueprint ... Huffington Post publishes
Top 10 lists for 2011 ... Grassroots efforts help protect National
Prevention Fund ... Certified Professional Midwives get backing from
Barney Frank ... Harkin and Hatch ask FDA to redraft guidance on New
Dietary Ingredients ... Lori Knutson steps down from Allina/Penny George
Institute position to lead The Marsh ... U Wisconsin free clinical
module for hypothyroidism ... Huge drop off in number of CAM educational
programs in Britain ... Chiropractors take battle over accreditation to
the Department of Education ... Article examines standards debate in
massage therapy ... University of Western States begins MS program in
functional medicine ... Ted Kaptchuk featured in New Yorker article on
placebo ... Chicago Tribune reporter goers after NCCAM ... Military
turns to integrative medicine ... Dieticians in Functional Medicine
established, sets standards ... After 8 years, IN-CAM begins charging
dues ... Australian CAM-public health research organization reports
exceptional year of growth ... Chiropractors call for presentations for
public health conferences ... Carla Wilson, LAc, DAOM honored by SF
Mayor Edwin Lee ... Joseph Pizzorno honored by Natural Products
Association More
2011 was a good year for integrative medicine. Many of the developments reported here grew out of the mandated inclusion
of integrative and complementary and alternative medicine practices in
the Obama-Pelosi Affordable Care Act. Here is the Top 10 for Integrative
Medicine Policy and Action for 2011. (Those interested in highlights
for the years since 2006 will find links here.) This article is posted here at the Huffington Post. Join the dialogue!
[First posted here in the Huffington Post. Be part of the larger dialogue. Click hereto read, comment, tweet, or FB from that site. Thanks.] The
forced exit
of Don Berwick, MD as administrator of the Center for Medicare and
Medicaid Services was a double whammy for the emerging field of
integrative medicine. Berwick's participation in a 2009 Institute of
Medicine Summit on Integrative Medicine gave him a depth connection with
the community. This deepened a philosophical alignment that he shared
in his Basic Principles for Integrative Medicine. Berwick's more
important contribution to the field may be his leadership in shifting
the incentive structures in the payment system toward one that will
support health. More
AMA's influence on payment
attacked in court and by McDermott in Congress ... Allina's accountable
care organization (ACO) CEO calls integrative medicine financial asset
... Trompeter and Zunin: new
economics of patient-centered medical homes (PCMH) favors integrative
teams ... Integrative medicine loses brother in the trenches as Berwick
steps down ... New York-based insurance program for unions offers integrative therapies in
patient-centered medical home ... Grand Rapids ER pilot for high-utilizers
projects $300-million in savings from "integrative medicine center" ...
Coors Foundation backs integrative medicine clinical pilot partnering
Maricopa County and Weil's Arizona Center ... Donna Karan's Urban Zen
integrative therapies goes bi-coastal to UCLA medical center ... Update
on consultant-author Roger Jahnke, OMD's work in integration ... Design Principles for Healthcare Renewal
given a 2nd look 10 years after submission to White House Commission on
CAM Policy ... Why integrative disciplines should get on the
interprofessional education/care (IPE/C) bandwagon ... Pacific College
of Oriental Medicine initiates holistic nursing bachelors program with
Carla Mariano, EdD, BC-HN ... First naturopathic medical student
accepted to Weil's Arizona Center month-long integrative medicine
elective ... Grandfathering
expectations of integrative MDs for the planned board certification in
integrative medicine ... Battle over "dry needling" sees key Medicare
and court decision in Vermont and Oregon ... Gaudet's CAM booklet
re-published by OBGyns ... Army job posting for licensed acupuncturists
at Madigan sets salary at $73,000-$95,000 ... Model naturopathic ethics
and standards of practice to be in Hawai'i law ... Industry groups ask FDA to withdraw new dietary ingredient standards; chiropractic organization weighs in ... Marc Micozzi, PhD, MD co-authors Your Emotional Type, a guide to personalizing appropriate integrative therapies ... In Memoriam: Roger Hayward Rogers, MD, of the Dr. Rogers' Prize and InspireHealth More
December 6, 2011
Recently long-time
integrative health author, system-consultant and pioneer Roger Jahnke,
OMD urged me to "resurrect" a document from the early years of
integrative health called the Design Principles for Healthcare Renewal. This
is almost exactly a decade since these were well-received in October
2001 as a clarifying document by the members of the White House
Commission on Complementary and Alternative Medicine Policy. Jahnke's
request also resonated with a presentation at Bravewell Integrative Medicine in Action event November 10, 2011 in which it was suggested that we might yet see an economic
incentive structure to support a "thriving industry of health creation"
(Principle #9). Here are those 10
principles, borne out of a Task Force on Principles from the 2000
Integrative Medicine Industry Leadership Summit. Do they have useful
resonance for you?More
November 29, 2011
Best-selling
author and speaker Rick Kirschner did not know, until I told him, about
the debate over the Arizona Center for Integrative Medicine's decision
to create a formal MD specialty in integrative medicine. For 25 years
Kirschner has made his living through teaching communication and
relationship strategies. He's written such books as How to Deal with Difficult People and, most recently, How to Click with People: The Secret to Better Relationships in Business and Life.
Kirschner has skin in this game. A 1981 graduate of then National
College of Naturopathic Medicine, Kirschner is a licensed but
non-practicing doctor of naturopathic medicine. He'd heard from others
about efforts of family practice docs, in a coincident irony, to keep
naturopathic doctors from practicing at full scope. I asked Kirschner
for his perspective on "clicking" in a context like this. Here is his
column. More
When it comes to motivation, money may be the queen among
carrots and pain the king among sticks. Both financial gain and human pain may soon be promoting more rapid uptake of integrative medicine by mainstream organizations according to representatives from a major health system and the US military.
The perspectives were shared during a forum entitled Integrative
Medicine in Action sponsored by the Bravewell Collaborative of
philanthropists in integrative medicine. If true, the long-standing
struggle over misalignment of incentives between the health-oriented
approach of integrative medicine and the disease-focus that spawned the
$2.6 trillion medical industry may be finding a positive resolution. Obama's health reform and prescription pain-killers may be integrative medicine's best friends. More
Many in integrative
medicine view the payment and delivery structure of the patient-centered
medical home (PCMH) as exceptional for realizing an integrative
medicine model. A leader, if not the leader, in implementing an
integrative PCMH model is the Oahu-based Manakai O Malama Integrative
Group and Rehabilitation Center led by Ira Zunin, MD, MPH, MBA. In this Integrator
interview, Zunin describes the challenges and benefits of the new
payment and electronic medical records initiatives. His center is
engaged as PCMH with HMSA, Hawai'i's dominant insurer, and on "the same electronic footprint" with
the state's leading hospitals. Zunin, a sometimes consultant, also offers
his perspective on whether the 5-practitioner integrative clinic model
proposed by Integrator adviser Bill Manahan, MD can work in the emerging PCMH environment. More
Some integrative medicine leaders view the patient centered medical home (PCMH) as an optimal environment for expressing an integrative practice. Obama's Affordable Care Act included specific language that invited operators of PCMHs
to include chiropractors, and licensed complementary, alternative and
integrative practitioners. An exceptional resource in this area is Tom Trompeter, MHA, the CEO of Healthpoint. The 12 center network, formerly the Community Health Centers of King County, is
not only quite advanced in its development of what Trompeter prefers to
call a "patient-centered healthcare home." For 15 years, Healthpoint
has included diverse natural medicine offerings such as acupuncture,
naturopathic medicine, massage therapy and behavioral health care.
Trompeter offers his reflections on the nature of the PCMH paradigm and
what it asks of both practitioners, and those who would educate them for
participation in this emerging model. More
Integrative
community dialogue on board certified integrative MDs and the direction
of "integrative medicine" ... Congressional Wellness Caucus established
with bipartisan backing ... Obama names Kahn and Ornish to Advisory
Group for National Prevention Council ... IHPC's Parters for Health
group expands ... Integrative medicine not featured at TEDMED 2011, moves to the Beltway in 2012 ...
Knutson urges response to US Preventive Medicine Task Force ...
Dartmouth researcher Davis breaks down $$$ in CAM market ... Bastyr
reports $136-million of economic impact ... CHP Group offers case
statement for CAM integration ... Steiner Leisure purchases Cortiva
Group ... Sabin on role of philanthropy in integrative medicine ...
Chesney in line to chair conventional academic consortium ...
Acupuncturist Beau Anderson gains faculty appointment at Albert Einstein
... Taylor Walsh adds perspective on debate over whether alternative
medicine killed Steve Jobs ... IAYT's John Kepner addresses the Group
Health findings relative to "sham yoga" ... Report on naturopathic
profession's Science & Policy Summit ... Chiropractors push
inclusion in loan repayment ... New Hampshire Republicans cross party
line to support mandate to cover naturopathic doctors ... Acupuncture
Without Borders in tough financial position ... American Medical Student
Association leader is a naturopathic medical student, SCNM's Rebecca
Snowden ... Zunin's Manakai
O Malama, Hawai'i's most significant integrative
center, seeks additional integrative MD/DO ... Christina Jackson named
the 2011 Holistic Nurse of the Year ... Rita Bettenburg takes position
at CHP Group. More
October 29, 2011
The
discussion of the origins, intentions and ramifications of the move to
create a formal integrative medicine specialty through the American
Board of Integrative Medicine (ABIM) produced 5 additional, especially
thoughtful responses. These had a chance to first read the forum of 20
voices. These five are: former Integrated
Healthcare Policy Consortium chair Sheila Quinn; Daniel Redwood, DC, Cleveland College of Chiropractic faculty member and writer on policy issues; past American Holistic Medical Association (AHMA) board member Kjersten Gmeiner, MD; AHMA founder and past American
Board of Integrative Holistic Medicine (ABIHM) executive director
Robert Anderson, MD; and ABIHM co-founder Bill Manahan, MD.
These provide balanced, watchful, mainly supportive comments and advice
to the founding ABIM board members. Can the ABIM demonstrate that they
are not like all the others?More
The Vancouver, B.C.-based
organizers of the 2011 Dr. Rogers' Prize asked me to help kick off the
afternoon Colloquium that preceded the black-tie event. Their theme was
integrative clinic models. They wanted a look at trends in integrative medicine
internationally, though focusing principally on the United States. I'd
have 10 minutes and would be followed by Steven Carter speaking at
similar length on Canadian trends. After Carter gave me an okay to
publish his comments, I thought why not publish mine. I am curious about
any major blind spots. What did I miss or should have included to give
that audience a better picture of the world integrative that is
emerging. (Congratulations to Marja Verhoef, PhD on winning the $250,000
prize!). More
Steven Carter, the long-time editor of the Journal of Orthomolecular Medicine.
As such, he has been a fixture, organizer, writer and observer of the
development on complementary, alternative and integrative medicine in
Canada for over 2 decades. Carter was asked by the organizers of the
2011 Dr. Rogers Prize to delivery a 10 minute overview on the state of
these developments in his country. He touches on recent controversies
with complementary medicine and Ontario physicians, the IN-CAM national
network, the coverage plan in British Columbia and what he sees as a
threat to access to natural products. I thought Carter's review might be
of interest to Integrator readers and asked him if I might publish it. He agreed. More
The Integrator Special
Report on the decision of the Arizona Center for Integrative Medicine
to promote a board specialty in integrative medicine has proved the most
widely read Integrator piece in 2 years. Opinions vary. Mostly they are
strongly held. None doubt the significance of the moment. Here are Bill
Manahan, MD, NCMIC, Lou Sportelli, DC, Marc Micozzi, MD, PhD, Pamela
Weeks, MA, Taylor Walsh, Jim Winterstein, DC, Kevin Wilson, ND, Richard
"Buz" Cooper, MD, DSc, Bill Reddy, LAc, DiplAc, Chris Foley, MD, Nancy
Gahles, DC, CCH, RSHom, Patrick Massey, MD, PhD, Andrew Rubman, ND,
Stephen Marini, MS, PhD, DC, actuary Heather McLeod, plus an
anonymous MD, anonymous chiropractor academic, anonymous journalist,
anonymous integrative medicine academic; plus, special bonus, a couple
of the prominent anti-quackademic bloggers. I hope this exchange will be constructively utilized. Most of these comments beg this question: What
relationship should the guild of Board Certified Integrative Medical
Doctors strike with other practitioners if their interest is, in fact, the positive transformation of our system? I splice my own musings and perspectives throughout. Thank you each for contributing. More
Patient Centered Outcomes Research Institute (PCORI) hears from complementary
and alternative medicine (CAM) group, pushes research culture change ...
IHPC's Kahn appointed to Advisory Group to National Prevention Council
... Canadian survey suggests cost effectiveness of naturopathic services
... Weil's Arizona Center announces move to formally develop
integrative medicine and medical specialty ... American Academic of
Family Physicians pass resolution against naturopathic physicians in
primary care ... Chiropractors pass resolutions against AMA activity
that fosters discrimination ... Family doctors fighting against doctors
of nursing ... Massage summit identifies needs in education and
licensing standards ... National acupuncture group announces strategic
planning ... National College of Natural Medicine begins naturopathic
medicine for chiropractors programs .. Tai Sophia Institute in new
medical herbalism offering ... New York Chiropractic adds sports
medicine certification ... PBS "Curious George" engages curiosity about
acupuncture and naturopathic medicine ... Growth in employment in
MD-academic medicine ... Columbia pediatric oncology group publishes
book ... Marja Verhoef wins $250,000 Dr. Rogers Prize ... Mimi Guarneri,
MD to be honored with Bravewell's leadership award ... Berkley Bedell
and Gladys McGarey, MD highlighted at Samueli Institute 10th anniversary
event ... Tabatha Parker, ND with Natural Doctors International one of
25 leaders featured by Utne Reader ... In Memoriam: Lee
Lipsenthal, MD ... Pharmacognocist and medicinal plant researcher and
long-time American Botanical Council trustee Norman Farnsworth, PhD dies
at 81 ... Keith Overland, DC elected president of the American
Chiropractic Association ... Linda Bark, RN, PhD, MCC publishes whole
person coaching book More
Hospital and health system environments have
proved challenging for sustainable integrative business models. Talk of philanthropy is never far from the table. In this article, Integrator
adviser Glenn Sabin offers a view of philanthropy's role, including his
perspective on where donated support is appropriate and where
non-sustainable. I follow Sabin's take with some additional perspective:
first, on a "glass ceiling" relative to philanthropy and some
integrative practice, and second, on the hydroponics of the seemingly
symbiotic integrative MD-philanthropic relationship. Most
philanthropists grow weary at some point. How long will integrative
medicine's philanthropic partnership last? More
Lee Lipsenthal, MD died on September 20, 2011. He
played key roles in promoting a more humane, integrative health care
and a model of "health creation" as one of his friends and colleagues in
this series of notes and remembrances. Lipsenthal served with such
leading entities as the Preventive Medicine Research Institute, the
American Board of Integrative Holistic Medicine and his own Finding
Balance in a Medical Life program to help physicians re-connect with
healing. Here are comments on Lipsenthal from Scott Shannon, Victoria
Maizes, Dean Ornish, Wendy Warner, Vic Sierpina, Karen Lawson and Dave
Rakel. More
Consider the irony in
establishing a research institute to prioritize patient-centered interests and
outcomes. Shouldn't this be the focus of all healthcare research? The Board of Governors of
the new quasi-governmental Patient Centered Outcomes Research
Institute (PCORI) is taking the patient-centered charge seriously.
They view themselves as leaders of a significant culture change in
research. The 4 questions they
urge researchers to answer will resonate with those whose practices,
and outcomes, are whole-person and integrative. In a recent Seattle
meeting, the Board strategized how to
meet its considerable challenges, including the strangling of innovation
from the pharma mind that dominates research. Among those presenting in Seattle was a panel on complementary and alternative medicine. CAM is a mandated PCORI interest. Here
is a look at PCORI's recent Board of Governor's meeting and a few of the directions urged by that panel. More
September 21, 2011
In a major strategic
shift, the University of Arizona Center for Integrative Medicine (ACIM)
has announced that it will lead the creation of a formal specialty for medical doctors in integrative medicine. ACIM, founded by Andrew Weil, MD and directed by Victoria Maizes, MD, is in dialogue with the American Board of Physician Specialties toward establishing an American Board of Integrative Medicine. They
are collaborating with leaders of the American Board of Integrative and
Holistic Medicine (ABIHM). Here is the ACIM announcement, a statement
from two ABIHM leaders, a brief interview with Maizes and the list of 18
founding Board members. Is this the right strategic choice? What impact
will this have on integrative medicine and the broader integrative
healthcare movement? More
American
Hospital Association/Samueli Institute find growth in hospital CAM use
... Allina group shows health workers use CAM more than typical
consumers ... Consumer Reports finds high use of CAM, high value for
chiropractic, massage, yoga ... Dr. Rogers' Prize symposium September 23
focuses on integrative centers ... Blog strategy for business
enhancement explored by Glenn Sabin via FON Therapeutics ... Significant
integrative center activity noted via Google Alerts ... Naparastek on
getting coverage for mind-body interventions ... Inc. 5000 fastest
growing includes Standard Process, American Specialty Health, GNC,
Massage Envy, others ... Alternative Medicine re-launched ...
"Distinction Track" in integrative medicine approved at U Arizona ...
Tai Sophia find quick uptake of Masters in Nutrition program ... Bastyr
University's California campus to be near Scripps in San Diego ...
Chiropractors produce white paper on their role in patient centered
medical homes (PCMH) ... Work to set standards for health coaches
advances ... International Association of Yoga Therapists completes "hat
trick" with $30,000 NCCAM grant ... Team led by Steven Stumpf, EdD
collates report on acupuncturist income and debt ... International
Research Congress on Integrative Medicine and Health opens website,
online program applications ... Association of Chiropractic Colleges
announces March 2011 meeting ... Tracy Gaudet, MD's's view featured in
Modern Healthcare video ... Guru Sandesh Khalsa, ND selected as Boucher
Institute president ... Oldest university in the West to offer CAM course with Paolo Roberti di Sarsina, MD ... Society for Integrative Oncology seeks first
executive director ... Palmer Colleges seeks 2 research faculty... More
September 7, 2011
Two reports this summer have given "alternative treatments" and "CAM" their most significant media attention in years. Consumer Reports surveyed 45,000 and examined use for 11 common conditions. This Integrator culls
data relative to which treatments for which conditions "helped a lot"
relative to prescription drugs and OTCs. Just after the Consumer Reports
wave of coverage, a team linked from Allina Hospitals & Clinics,
the Penny George Institute and U Minnesota reported findings of
complementary and alternative medicine (CAM) use by healthcare workers.
The authors anticipate what they discovered will have significant,
positive implications for the integrative care movement. More
I spent a better part of the
week of August 15, 2011 with the naturopathic profession at their annual
conference and related meetings. This report includes 11 short selections
including: Jeffrey Smith's anti-GMO talk; Rick Kirschner's ideas from
Dr. Oz on the profession's branding strategy; perspectives from Ian
Coulter and nurse anesthetist Lorraine Jordan at the Science and Policy
Summit; concerns relative to perceived boundaries between the profession
and the products industry; outcomes of an exemplary whole practice
research project on Group Health members with Type 2 diabetes;
resignation of executive director Karen Howard, the voice of the
profession for a decade; Bruce Milliman and the lack of position papers
from the AANP House of Delegates; winners of annual awards; Letitia
Watrous and applying the therapeutic order to pharmacy hours; and a coda
for naturopathic students on what the profession may bring to the
nation's integrative medicine movement. More
August 31, 2011
Toss a switch at Google
Alerts and you you can witness the proliferation of integrative medicine
and alternative medicine initiatives and coverage. Since August 3,
2011, Google has sent me updates for "Integrative medicine" and
"alternative medicine." The results are astonishing. I include a
selection of 40 links - 20 from as many hospital-based integrative
clinics. The level of activity got me thinking about the optimal role
for the Integrator. I include some thoughts. Thanks to adviser Glenn Sabin for teaching this troglodyte about this exceptional service. More
The Samueli Institute
hosts an open reception on October 4, 2011 to mark its first productive
decade. The Institute, funded by Susan and Henry Samueli and led by
Wayne Jonas, is the integrative medicine leader in 3 significant areas. From
time-to-time I have had a chance to serve the Institute as an unpaid
outside adviser. Here is a reflection, especially on the tension between
exploring mechanistic science and moving real world practice.
Originally named the Samueli Institute for Information Biology, the
Institute played a key role on Obama's top wellness initiative. Included
are the Institute's 20 Success Measures for 2021. What do you think of
these measures? More
The
stories of patients arriving at doors of
integrative practitioner offices with avoidance of prescriptions as
their
motivation are legion. In an earlier column, Stephen Bolles, DC
challenged the move of credit rating firm FICO into drug adherence
monitoring in part for its failure to appreciate what may be called
positive non-adherence. In this exchange, Integrator columnist
Michael Levin notes the substantial estimates of harm from
non-adherence. His take is friendlier toward FICO's intent. Bolles
responds, and Levin replies. It's a complicated exchange in which
paradigms collide. I add a couple comments. More
The Susan Samueli Center
at UC Irvine is the lesser known, alongside the Samueli Institute, of
the 2 major projects in integrative medicine that philanthropists Susan
and Henry Samueli have backed. The Center, at UC Irvine, includes a
world-leading acupuncture-cardiology research operation, education
initiatives and, since 2008, an off campus integrative medicine clinic.
This report on the Center is based on interviews with director John
Longhurst, MD, PhD, medical director Wadie Najm, MD, MEd and associate
director Laurie Macauley. The center is a microcosm of the
research-centered or patient-centered duality that, for better and for
worse, is at the heart of the evolution of integrative medicine. Here is
a report, plus some reflection on the duality. More
Lessons from a Flooded Inbox: August 2011 Google Alerts for "Alternative Medicine" and "Integrative Medicine" 
