Summary: Do you see yourself as a “licensed integrative practitioner”? Do you feel kinship with those from other professions who wear that label? Would you like your professional organizations to collaborate with similar professions to advance integrative practices nationally? And what, by the way, is an “integrative practitioner”? These questions and more came to the fore when influential members of Congress chose to use “licensed integrative practitioners” as a tactical phrase to secure inclusion of various provider types in proposed health reform legislation. I tried out such questions on national policy panelists at the Integrative Healthcare Symposium on February 25 and 26, 2010. The initial reception appears to be that the “licensed integrative practitioner,” this bastard step-child of the legislative process, will not soon have a big tent to call home. I was and remain intrigued by the possibilities. Here are some reflections.
Are you a “licensed integrative practitioner?” Is the profession with which you most identify an “integrative practice” field? Do you identify with those from other professions who would also answer affirmatively? Would you recommend working with them to advance “integrative practices” in the policy arena?
I recently put similar questions to a dozen national policy leaders from disciplines associated with providing integrative practices. The professionals were participating in two panels I moderated at the Integr
ative Healthcare Symposium (IHS) in late February.
Recent Congressional action prompted my line of questioning. I noted a trend in Congressional language while preparing federal health reform-related action alerts via the
Integrator and the Integrat
Practitioner.com last month. If federal health reform passes, “licensed
integrative practitioners” may soon be enshrined for the first time in federal law. Member of Congress used the term to create inclusion in workforce planning, community medicine, medical homes and in the leadership of the nation’s comparative effectiveness research agenda.
|The term “licensed integrative
practitioner” may prove to be leverage
In short, if a reform law passes,
the person asking whether you and your
profession are in this “licensed integrative practitioner” camp may soon be
a member of Congress or a national or regional healthcare administrator or
health system or clinic official who is seeking to carry out the law’s
intent. The term may prove to be
leverage in many communities to foster inclusion of integrative
But to whom does ” licensed
integrative practitioner” refer? What does it mean?
The individuals on the IHS panels were a
diverse group. Their professions included holistic nursing, massage therapy,
integrative medicine, functional medicine, naturopathic medicine,
acupuncture and Oriental medicine, chiropractic, holistic medicine and
homeopathy. “Licensed integrative practitioner” could be considered one big
tent that includes all or most of these, and more.
I was and remain personally intrigued by the possibilities birthed by
Congressional appropriation of this term. Power can come in numbers. The nation’s licensed chiropractic
doctors, acupuncturists, naturopathic physicians, certified professional
midwives and holistic nurses total some 100,000. This is a huge base of
professionals and tremendous potential for grassroots energy. If we figure
in some 5000-15,000 holistic, functional and integrative medical doctors
then supercharge this clan with the 250,000 licensed massage therapists,
well, pretty soon it adds up to real numbers.
What if this group moved in unison in a few principled “integrative
one knows for sure who
is in or out of the
Congress would need
to clarify that.
No one appeared to be
The response from the panelists surprised me.
No one seemed particularly clear on how the language had been chosen. I
witnessed little warming to the value of this identifying denominator for
shared interests and action. Some
thought we should nip this direction in the bud and urge Congress to ditch
this umbrella approach to inclusiveness.
No one appeared to be in adoptive mode
toward this apparently bastard child
of the legislative process.
Via the panels and subsequent conversations, I gained some clarity on the
resistance. No one knows for sure who is in or out of the category. Congress
would need to clarify that. Non-MDs often assume, with past history
justifying their concern, that if the big tent includes MDs of any variety,
the system will likely meet the inclusion criterion with one of their own.
In addition, the very idea of broad collaborative federal action is yet a
rare subject for anyone in our fields. Most who have chosen to engage in
multidisciplinary activity, like those on the panels, will know that their
interest is not always reflective of the core values in their own
professions. Then again, maybe the discussion was too much too soon.
Affirmative engagement was yet a non-starter.
| What if we began to shape the
future with a
I remain intrigued. What if this term became
an excuse for us to collaborate and mold the legislative meaning of the
practices that flow from this inclusion? What if those who are selected into
new opportunities or use this federal inclusion as leverage to create new
ones view themselves as part of the inter-connected community of
“integrative practitioners” and not merely as members of their own guilds?
What if we began to shape the future with a decision to give this bastard
child a home by investing in creating and expanding this big tent?
The spirit of Pollyanna is present in all of these what ifs. Then
again, faced with $1.2-billion
spent to lobby Congress on healthcare in 2009 and the relative poverty
of virtually all the integrative practice-related interests, pooling our
numbers may be the only realistic strategy for moving the United States
toward a system that works to create health. Congress, in its wisdom, may
have given us a reason to erect the big tent.
for inclusion in a future Your Comments Forum.